BREAKING NEWS CARE FOR YOUR BONES TODAY WILL PAY DIVIDENDS WHEN IT COMES TO AVOIDING OSTEOPOROSIS.

Byline: Mariko Thompson Staff Writer

Dr. Suzanne Hecht likes to say that Americans need to invest in their bones in the same way that they save for retirement. Fragile bones, like paltry retirement accounts, can be devastating in the senior years.

``You have to save bone,'' says Hecht, a staff physician at the UCLA Osteoporosis Center. ``The time you can do that the most is as a teen and young adult. We call it acquiring peak bone mass. If you didn't save enough, you can run into problems faster than someone who had a lot in the bank to start.''

Of course, most Americans aren't particularly good at saving, which is why the risk of life-threatening or crippling fractures from osteoporosis remain such a concern. It's not just women who have to worry about hip and spine fractures as a result of lost bone mass. One in two women over the age of 50 will suffer from a fracture as a result of osteoporosis in their lifetime. So will one in four men, according to the National Osteoporosis Foundation.

``Your grandfather who fell and broke his hip probably has osteoporosis,'' Hecht says. ``Doctors will say men don't get it, but that's just not true. It's under-recognized.''

Experts tend to be of one mind when talking about osteoporosis prevention, stressing a nutritious diet that includes enough calcium and vitamin D as well as weight-bearing exercise. But there's less consensus around routine screening guidelines. The National Osteoporosis Foundation recommends that women get a bone density test at age 65, or earlier if she has other risk factors at menopause. At Kaiser Permanente in Woodland Hills, women undergo a bone density test no later than age 60.

``We're looking even more aggressively,'' says Dr. Carol Kurz, chairwoman of the women's health committee at Kaiser.

A woman with normal results on her bone density scan probably won't be screened again for five to 10 years. If her score falls in the borderline range, she might have a second screening in two to five years, Kurz says.

A borderline score - a state dubbed ``osteopenia'' - doesn't mean the patient has osteoporosis but is at greater risk for the disease.

For men, no guidelines for a routine screening exist at all. The National Osteoporosis Foundation hopes to produce guidelines for men in the next two to three years, says Dr. Felicia Cosman, clinical director of the National Osteoporosis Foundation.

Osteoporosis is responsible for about 1.5 million fractures each year. By age 20, most women have achieved nearly all of their bone mass, which puts the onus on the childhood and teen years. In the five to seven years following menopause, women can lose up to 20 percent of their bone mass. The bones continue to weaken as elderly women and men age.

This is why Hecht stresses the importance of savings in the bone-mass account.

On the prevention front, calcium is critical to building and maintaining healthy bones. Most people should aim to consume 1,000 milligrams a day. Dairy products are a leading source of calcium. These days, a number of products come fortified with calcium, including orange juice and oatmeal. Vitamin D helps the body use calcium. A minimal exposure to sunlight and fortified foods such as milk are considered enough to meet that need.

Two recent studies published in the New England Journal of Medicine suggest that high levels of an amino acid called homocysteine may increase the risk of osteoporosis. Should that prove to be the cause of porous bones, homocysteine levels could be lowered through increased intake of folate, B6 and B12 vitamins, researchers said.

Exercise is another boost to bone health. Hecht says there is ample evidence that weight training and impact exercises like jogging stimulate the bones. Though swimming and biking are great forms of exercise, they don't stress the bones and should be interspersed with weight-bearing activities, she says.

``The best thing about exercise is it allows you to put on new bone,'' Hecht says. ``It's never too late to start.''

For patients diagnosed with osteoporosis, medication is an option. The most common medications slow bone-mass loss. One medication, called Forteo, forms new bone but so far has been reserved for patients who failed other treatments or sustained multiple fractures, Cosman says.

More research is needed to determine exact guidelines for routine screenings and to pinpoint how long to prescribe medications for osteoporosis. But overall the outlook is bright.

``Osteoporosis is a disease that's preventable and treatable,'' Cosman says. ``This is true at all stages. There is reason to be hopeful about the outcome now that we have so many different therapies available.''

Mariko Thompson, [phone]

mariko.thompson(at)dailynews.com

Boning up on osteoporosis facts

--An estimated 10 million Americans have osteoporosis and another 34 million suffer from low bone mass.

--About 80 percent of patients with osteoporosis are women. In the seven years following menopause, women can lose up to 20 percent of their bone mass, which makes them more susceptible to osteoporosis.

--Osteoporosis leads to 1.5 million fractures each year. The most common fractures are to the hip, spine and wrist.

--Nearly one in four patients over the age of 50 who sustain a hip fracture die within a year. Among patients who could walk before suffering a hip fracture, 25 percent require long-term care afterward.

--Fractures related to osteoporosis resulted in $17 billion in hospital and nursing home costs in 2001.

Source: National Osteoporosis Foundation. Visit www.nof.org for more information.

CAPTION(S):

4 photos, box

Photo:

(1 -- cover -- color) NO BONES ABOUT IT

Prevent osteoporosis with good nutrition and exercise

(2) no caption (skeleton hand)

Photo illustration by David Sprague/Staff Photographer

(3) Lydia Dadon, 46, of Hidden Hills, has her bone density scanned at Kaiser Permanente in Woodland Hills. The National Osteoporosis Foundation recommends that women get a bone density test at age 65, or earlier if risk factors are present at menopause.

(4) X-ray technician Robin Zecher watches a bone scan of a patient at Kaiser. Preventive measures for osteoporosis include a diet rich in calcium and vitamin D as well as weight-bearing exercise.

Tina Burch/Staff Photographer

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Boning up on osteoporosis facts (see text)