December 18, 2006
Many people have heard
Osteoporosis: "a disorder
in which the bones become increasingly porous, brittle, and subject
to fracture, owing to loss of calcium and other mineral components,
sometimes resulting in pain, decreased height, and skeletal deformities:
common in older persons, primarily postmenopausal women, but also
associated with long-term steroid therapy and certain endocrine
When most people think
of osteoporosis, they usually think of older women. Teens (especially
girls) may have heard from parents or doctors that they need to
care for their bodies now in order to avoid the disease in the future...
"Here are several
reasons why teens should be concerned about osteoporosis:
*During the teen years, almost one-half of the adult skeleton is
*Less than half of all teens get enough calcium every day. For teenage
girls, the statistics are even worse-only 15 percent of them get
* If you build your bones when you're in your teens, you will
be less likely to fracture your bones when you're older."
While children and teens
are often not concerned about something that will not have consequences
until later in life, doctors stress that it is something all people
need to be careful about -- even when they are young.
"Osteoporosis is a
silent disease that can often be prevented. However, if undetected,
it can progress for many years without symptoms until a fracture
occurs. It has been called 'a pediatric disease with geriatric consequences,'
because building healthy bones in ones youth will help prevent
osteoporosis and fractures later in life."
For some teens and young
adults, the consequences will be come earlier. Those who are on
extreme diets -- or are suffering from an eating disorder -- are
contributing to more significant losses in bone density for both
females and males.
has significant physical consequences. Affected individuals can
experience nutritional and hormonal problems that negatively impact
bone density. Low body weight in females causes the body to stop
producing estrogen, resulting in a condition known as amenorrhea,
or absent menstrual periods. Low estrogen levels contribute to significant
losses in bone density. In addition, individuals with anorexia often
produce excessive amounts of the adrenal hormone cortisol, which
is known to trigger bone loss. Other problems -- such as a decrease
in the production of growth hormone and other growth factors, low
body weight (apart from the estrogen loss it causes), calcium deficiency,
and malnutrition -- contribute to bone loss in girls and women with
anorexia. Weight loss, restricted dietary intake, and testosterone
deficiency may be responsible for the low bone density found in
males with the disorder."
Children and teens often
think that their bodies are strong enough to handle almost anything.
While some cases of
juvenile osteoporosis are unexplained or brought on by disease,
others can be brought on by medication or lifestyle choices.
"Osteoporosis in children
(juvenile osteoporosis) is rare. When it does occur, it is usually
due to a medication or underlying medical condition. Doctors refer
to this as secondary osteoporosis. ... The most common sign or symptom
of juvenile osteoporosis is a fracture that occurs with minimal
trauma. A doctor can diagnose a fracture by X-rays of the affected
bone. Treatment of secondary osteoporosis is directed at the underlying
cause. In rare cases, the cause of juvenile osteoporosis can't be
determined. Doctors refer to this as idiopathic juvenile osteoporosis.
This rare form of osteoporosis typically occurs in previously healthy
children between the ages of 4 and 16. Signs and symptoms include
pain in the lower back, hips and feet, and difficulty walking."
Idiopathic juvenile osteoporosis
is rare. Many people with osteoporosis will not have symptoms until
they have broken a bone.
"Persons with osteoporosis
may not develop any symptoms and the disease, therefore, is often
called silent. ... Diagnosis of juvenile osteoporosis is often not
made until the child has a broken bone. In addition to a complete
medical history and physical examination, diagnostic procedures
for juvenile osteoporosis may include:
*family medical history
*skeletal x-rays - a diagnostic test which uses invisible electromagnetic
energy beams to produce images of internal tissues, bones, and organs
*bone density test - a diagnostic procedure to determine bone mineral
content and skeletal changes, such as bone loss.
*blood tests (to measure serum calcium and potassium
Since osteoporosis is rare
in healthy children, these test are not routinely done for children
"What causes my risk
*Not getting enough calcium.
* Females are four times more likely than males to develop osteoporosis.
* Drinking too many soft drinks-teens who drink lots of soda often
drink less milk.
* Too little physical activity-regular physical activity that puts
weight on your bones, like walking, running, playing basketball
or dancing, helps prevent osteoporosis.
* Race plays a role-African Americans have a lower risk because
their bones are usually stronger and more dense than Caucasians
* Family history-other people in the family with osteoporosis.
* Smoking causes bone loss."
Healthy teens still need
to do all they can to reduce their risk factors and prevent osteoporosis.
"What can I do to
*Eat lots of calcium-rich foods like milk, yogurt and cheese; calcium-fortified
orange juice and bread; green leafy vegetables like collards and
kale; canned salmon and sardines or tofu.
* If you don't eat dairy products, it may be necessary for you to
take a calcium supplement to meet your high calcium needs as a teen.
Talk to your doctor or a registered dietitian before taking any
type of supplement.
* Get some type of weight-bearing physical activity every day.
* Limit soft drink consumption to one or less a day."
Even those with fewer risk
factors still need to do all they can to prevent the disease. While
women and girls are often reminded by doctors and parents to get
enough calcium, "being female" is just one factor that
increases the risk of developing the disease.
"[R]emember that 20
percent of the osteoporotic population is male. We tend to assume
that what we learn about women
will apply to men, but this is not necessarily the case. Is lifelong
low-calcium intake bad for men, as it is for women? A woman whose
mother or grandmother had osteoporosis is at greater risk. We assume
the same familial disposition for a man, but we don't know. By asking
what the differences are between the genders, we hope to glean information
that will apply to prevention and treatment in men. ... One interesting
piece of information is that some men who have sustained an unlikely
fracture in childhood are at greater risk of developing osteoporosis
later in life."
Questions of the Week:
What do your friends, siblings, and parents need to know about osteoporosis?
How might the information they need vary based upon their age, gender,
and stage of life? What can children, teens, and adults do to reduce
their risk factors and increase their chances of preventing the
disease? What would be the best way to reach them with this information
so they would see the need and make the lifestyle changes that may
Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.
I look forward to reading
what you have to say.
Health Community Coordinator
Access Excellence @ the National Health Museum