Boning Up on Osteoporosis.

It affects more women than men, and it can lead to crippling injuries. But there are ways to lower your risk of osteoporosis.

Osteoporosis is reaching epidemic proportions in this country. Today 28 million people have it, 80 percent of whom are women. And 18 million more are at risk because of low bone mass, according to the National Osteoporosis Foundation.

A woman's risk of developing fractures from osteoporosis is equal to her risk of breast, uterine, and ovarian cancer combined. As for men, more of them will suffer an osteoporosis fracture than will develop prostate cancer.

Osteoporosis literally means "porous bones." It's called the hidden disease because it can sneak up on you. There are no early symptoms, but it can result in crippling, lasting disability and permanent disfigurement.

Sneezing, lifting a suitcase, or bending down to tie a shoe can cause a fracture of the hip, spine, or waist. Fragile vertebrae that have crumbled cause crush fractures of the spine.

"Doctors are only beginning to learn how to deal with osteoporosis in the same way that they now deal with heart disease," explains Dr. Robert Lindsey, past president of the National Osteoporosis Foundation.

Debbie Reynolds was shocked when a bone density test found that she had osteoporosis, although her grandmother suffered from it. Reynolds became a spokesperson for a national educational campaign called "Stay Strong! Test Your Bone Strength." She says that if a bone density test is given early enough, you need not get osteoporosis in the first place.

The National Osteoporosis Foundation reports that Medicare now covers bone density tests for people over age 65 considered to be at risk. Many private insurance companies also cover the tests.

A Gallup poll of women from age 45 to 75 found that three out of four women never even asked their physicians about the disease.

How It Happens

Slowly over the years osteoporosis causes bones to lose calcium and other minerals. Starting at age 35 you lose up to 1 percent each year. A woman can lose up to 20 percent of her bone mass in the first five to seven years after menopause. The decrease in estrogen production, along with generally lighter, thinner bones, is the primary reason that osteoporosis affects more women than mere.

Dr. Isadore Rosenfeld wrote, "After a female turns 50, there's a one in two chance she'll have osteoporosis-related fractures at some time in her life." The risk comes a little later for men. After 65, male risk begins to approach that of women.

Both the public and the medical profession are learning more about the disease all the time. Osteoporosis is preventable and treatable.

New Developments

The Lancet medical journal recently published new research that shows there's a drug that may protect women from having osteoporosis-related bone fractures. It's a cholesterol-lowering drug taken by millions to prevent heart attacks. The study suggests it could provide an alternative to hormone therapy.

In the realm of devices, researchers are exploring the use of ultrasound to assess bone health.

How to Prevent Osteoporosis

The good news is that your risk of suffering osteoporosis can be dramatically reduced with proper exercise and nutrition. A healthy diet can reduce your risk 30 to 40 percent.

If your body doesn't get enough calcium, it will steal from your bones, according to Michael Holick, M.D., Ph.D., at Boston University Medical Center. Many women consume less, than half of the daily recommended amount of calcium.

Milk is the first thing that comes to mind when it comes to calcium. Your mother saw to it that you always drank your milk. But as adults, many give up milk in favor of coffee.

Researchers at the University of California at San Diego studied 980 women from ages 50 to 98. Those who drank more than two cups of coffee a day without regularly drinking milk had weaker spinal and hip bones than the average woman. (One cup a day had no increased risk.) The same is true for tea and caffeine-containing soda.

A flood of recent studies shows that calcium also protects more than bones for both men and women. Eating lots of calcium-rich foods or taking calcium pills appears to control blood pressure, reduce colon cancer in men, and ease women's premenstrual syndrome.

Many dairy foods are rich in calcium. Choose the low-fat or fat-free versions if you use dairy in your diet. Soybeans, navy beans, and pinto beans are good sources too--among others. Leafy green vegetables are modest sources. Almonds and filberts are good sources, but they are also high in fats and calories.

It's a good idea to get in the habit of reading labels. Look for foods that have added calcium, such as orange juice, cereal, and bread.

The National Academy of Sciences recently set a goal of 1,000 milligrams of calcium a day for women before age 50; 1,200 milligrams for women aged 51 and above; and 1,300 milligrams for pregnant women and nursing mothers. Men under 65 need 1,000 milligrams of calcium, but 1,500 milligrams after 65.

If you can't get enough calcium from food, you can get the rest from supplements. They need to be easily absorbed by the body. To test, drop a tablet in a small glass of white vinegar. It should dissolve almost entirely in 30 minutes.

Importance of Vitamin D 

Many people don't realize that vitamin D is just as important as calcium for strong bones. In order for calcium to enter the bloodstream, it needs the help of vitamin D.

The relationship of calcium and vitamin D has been compared to a locked door and a key. Vitamin D is the key that unlocks and opens the door that lets the calcium leave the intestine and go into the bloodstream.

In 1957 an American Medical Association Committee recommended that milk be fortified with 400 IUs (international units) of vitamin D per quart. That federal requirement still holds today. The National Osteoporosis Foundation recommends 400 to 800 IUs of vitamin D per day.

Even 30 to 60 minutes a day of sunshine stimulates your skin to make vitamin D. Just remember to apply sunscreen with an SPF of at least 15 to avoid skin cancer.

Other recommendations for osteoporosis prevention:

* Avoid too many foods with lots of protein or salt.

* Get plenty of exercise.

* Avoid alcohol and quit smoking.

* If you're a menopausal woman, check with your doctor about estrogen and any medications that you're already taking.

While the effects of osteoporosis are most often seen later in life, everyone should be concerned about the disease. Proper nutrition and exercise' throughout life can dramatically decrease a person's risk of suffering from osteoporosis.

Aileen Mallory writes from Topeka, Kansas.