Oh dem bones! Time to cut your losses.

Posted by Liz on Nov 19, 2012 in osteoporosis | 2 comments

Remember the ‘Capture the Fracture’ post from a few weeks back? In it, I reported that the International Osteoporosis Foundation is urging women and men alike to receive screening for bone loss, especially if they had some sort of fracture in their early years. Ironically, over the weekend, a close friend shared that she had been told that she has osteopenia, i.e. low bone mineral density, and it started me wondering how many of my readers have actually gone to their practitioners for a baseline? Me? I am guilty as charged; in fact, because of an absolutely crazy work schedule for most of this year, I’m very much behind on all my health visits.

So, back to osteoporosis, osteopenia and fragility fractures. I imagine that many of you are growing tired of reading about these topics on Flashfree but I can’t help myself; they’re vitally important.

According to the National Osteoporosis Foundation, by 2020 — a mere seven years from now — more than half of Americans over the age of 50 are expected to have low bone density or develop osteoporosis. Data also suggest that the risk of hip fracture in women is greater than the risk of all female cancers combined. What’s more, women who experience a hip fracture in their later years have almost a 3-fold risk of dying in the three months that follow.

Are you paying attention yet? You should be, because as I’ve written time and again,within the first 10 years of the onset of menopause, women  lose up to 50% of their spongy, or trabecular bone (the network that makes up most of bone structure) and up to 30% of their cortical bone (the outer shell).

However, it’s not just hormones at play. In the latest issue of the International Journal of Medical Engineering and Informatics, Portugese researchers are reporting that several factors appear to be associated with an increased fracture risk in menopausal women with and without a history of fracture, including age over 65, lower bone mineral density (BMD), a sedentary lifestyle, and eating or drinking caffeine-containing foods. In population of 127 women, almost 41% had osteopenia and roughly 20%, osteoporosis. Less than 40% had normal bone mineral density values.

However, these factors are not the only variables that you should be thinking about. Research shows that many medications can contribute to bone loss. They include:

• Aluminum-containing antacids
• Antidepressants (SSRIs), such as Lexapro®, Prozac® and Zoloft®
• Gonadotropin releasing hormone (GnRH) such as Lupron® and Zoladex®
• Heparin
• Lithium
• Depo-Provera®
• Methotrexate
• Proton pump inhibitors (PPIs) such as Nexium®, Prevacid® and Prilosec®
• Steroids such as cortisone and prednisone
• Tamoxifen® (premenopausal use)
• Type 2 diabetes medications (Actos® and Avandia®)
• Thyroid hormones in excess

And, a small case study analysis has shown that if you are a woman who has had estrogen receptor positive breast cancer and previously treated with aromatase inhibitors (e.g. Arimidex, Femura), you have a 27% increase for the risk of bone loss and a 21% risk for   a hip fracture at an earlier age. Additionally, these events can occur at a higher bone mineral density level than postmenopausal women who have not had chemotherapy.

Short of starting medical therapy with bisphosphonates (which have a rash of problems associated with their use), what can you do? Clearly, a great place to start is with regular weight-bearing exercise and insuring that your diet contains adequate amounts of calcium and vitamin D, although we know that some of amount of bone loss is inevitable as we age. However, before you become frustrated, there are a few lesser known steps that have clinical evidence behind them:

• Eat prunes. Researchers say that as little as 6 to 10 a day can help boost BMD and reduce rates of bone resorption.
• Incorporate onions into your diet. Onions are another type of functional foods that have been shown to improve bone density.
• Eat more sea fish. Data have shown that who make sea fish (not shellfish or freshwater fish) at least 16% of their daily protein intake have greater BMD.
• Talk to your practitioner about taking the lowest effective dose of the medications listed above.
• Drink moderately. One or two alcoholic drinks a day may be protective. More?  Not only does your liver hate you but your bones are at risk too.

There’s bad to the bone. And then, bad to the bone. Time to cut your losses, literally…