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Smokers may feel it in their bones.

WASHINGTON, D.C. Female smokers who are concerned about developing osteoporosis have another good reason to kick the habit, based on findings of a U.S. Department of Agriculture (USDA) study.

The two-year study of 320 women past menopause produced the first evidence that smoking accelerates the loss of bone mineral - at least in some bones, said principal investigator Elizabeth Krall, an epidemiologist at the Human Nutrition Research Center on Aging at Tufts University, Boston.

"The effect of smoking on bone mineral may not be nearly as great as the effect of estrogen loss, a low calcium intake or the lack of physical activity," she said. "Smoking is a small influence, but it's an influence."

Krall and colleagues measured the women's bone density at four body locations - the forearm, hip, spine and heel - at the beginning, middle and end of the study. All 320 women began with abut the same bone density.

But the 35 smokers lost bone mineral in their forearms at an average of nearly 1% per year, whereas the 285 nonsmokers experienced no loss, Krall reported in the Journal of Bone and Mineral Research (4-91).

Differences between the two groups in the hip, spine, and heel were not statistically significant, she said, but the trend was similar.

The smokers also retained substantially less calcium from a supplement, she said, and this could account for their greater bone loss. It appears they absorbed less of the mineral to begin with, she added, noting that an earlier study concluded that smoking reduces calcium absorption.

Krall said two previous studies that followed the rate of bone loss in smokers and nonsmokers over several years found no difference between the two groups. But the number of women may have been too small to see a difference, she said, or the women were in the early stages of menopause.

"During the first few years after menopause, women are losing bone rapidly due to the loss of estrogen, so it might be difficult to see a difference due to smoking," she explained. "Our women were older - averaging 58 and 59 years of age."

Other studies that made a one-time comparison of bone density between smokers and nonsmokers in all age groups produced mixed results. Some reported less dense bones in smokers, whereas others found no difference, she said.

In the studies that found a difference in women before and during menopause, she said, researchers speculated that smoking reduces the peak bone mass attained in early adulthood.
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Title Annotation:loss of bone mineral
Publication:Nutrition Health Review
Date:Mar 22, 1992
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