UC HEALTH LINE: Osteoporosis?Not Just a Woman's Disease

CINCINNATI—More than two million American men have osteoporosis, or weakening of the bones, but very few of them are aware of this major health problem.

"Although osteoporosis is less common in men than women, no one is immune to the disease," says Nelson Watts, MD, director of the University of Cincinnati Bone and Osteoporosis Center. "At least 20 percent of people with osteoporosis are men."

Bone is a complex living tissue that constantly renews itself. The body builds and stores bone tissue efficiently until about age 30. With aging, bones begin to break down faster than new bone is formed. This breakdown of bone, osteoporosis, affects 10 million Americans, and 34 million more are estimated to have low bone mass (osteopenia), which places them at increased risk for osteoporosis.

"Osteoporosis is a silent disease," says Watts. "You can't tell from the way you feel that your bones are losing density. You often don't realize it until you fracture a bone."

There are several reasons that women are more likely to develop osteoporosis than men, says Watts. Men have about 5 percent higher bone density after their growing period than women. Men also tend to have bigger bones, and it's generally harder to break bigger bones. In addition, men often have larger muscles than women and may be less likely to fall.

"Even though men are less likely to have osteoporosis than women, the average age of men who experience hip fractures has actually been younger than women in several recent studies," says Watts. "Fractures are a sign of possible bone loss, and men or women who experience fractures should have their bone density checked, regardless of age."

Several factors increase the risk of osteoporosis in men:

·         Age: Bones become weaker and less dense as you age.

·         Race: Caucasians and Asians are at highest risk; however, men from all ethnic groups develop osteoporosis.

·         Bone structure and body weight: Small-boned and thin men are most vulnerable.

·         Low testosterone levels

·         Medications: Long-term use of certain medications has been linked to bone loss. These include glucocorticoids, used as an immunosuppressant and to suppress various allergic, inflammatory and autoimmune disorders, aluminum-containing antacids, anti-epilepsy drugs and the anti-clotting agent heparin.

·         Chronic diseases: Diseases that affect the kidneys, lungs, stomach, intestines or alter hormone levels put men at a higher risk. These diseases include cystic fibrosis, rheumatoid arthritis, eating disorders and inflammatory bowel disease, among others.

Whether you're male or female, Watts recommends the following steps to reduce bone loss and the risk of developing osteoporosis:

• Have a bone mineral density (BMD) test: This is recommended for healthy women 65 and older, men 70 and older and those at increased risk. Talk to your doctor about your risk factors for developing osteoporosis.
  
  "Unfortunately, it can be difficult to get Medicare to cover bone density tests for men younger than 70, even when they have certain risk factors," says Watts. "However, it's still important to consider testing, even if insurance doesn't cover it."
   
• Get enough calcium and vitamin D: The recommended daily allowance of calcium is 1,300 milligrams (mg) per day for ages 9–18, 1,000 mg for ages 19–50 and 1,200 mg for those aged 51 and older. Calcium-rich foods include low or nonfat dairy products, kale, broccoli and oranges.
  
  From birth to age 50, people should get 200 IU of vitamin D a day. Adults 51–69 require 400 IU daily, and those over 70 require 600 IU. Watts recommends patients with osteoporosis get at least 800–1,000 IU of vitamin D a day.
  
  Multivitamins usually contain only 400 IU of vitamin D, says Watts, so most people need an additional supplement.
   
• Build and protect strong bones: Weight-bearing exercises stimulate bones, especially the hips and spine, and help make them stronger. Watts cautions that weight-bearing exercises that involve high impact can be hard on joints or weak bones.
   
• Live healthily: Don't smoke or abuse alcohol. Excessive alcohol consumption and smoking rob the bones of hard-earned calcium and mineral content, making them weak and fragile.

Watts chairs the FDA's Advisory Committee for Endocrine and Metabolic Drugs and is on the editorial boards of Osteoporosis International and the Journal of Clinical Densitometry. He is past president of the International Society of Clinical Densitometry and past president of the American College of Endocrinology (ACE).

For more information on osteoporosis, visit www.netwellness.org, a collaborative health-information Web site staffed by Ohio physicians, nurses and allied health professionals.