No Bones About It

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ew years ago, my mother went for her annual checkup and added a new word to her vocabulary — osteopenia. She was well aware of osteoporosis, the bone thinning that occurs with age, but had never heard of its precursor. Having osteopenia meant she had low bone mass and was at greater risk of developing osteoporosis and perhaps breaking a hip or other bones in the years ahead.

Like my mom, some 34 million Americans have osteopenia, according to Surgeon General Richard Carmona, who released a survey of the state of America's skeletal system last week. It was the first Surgeon General's report on bone health, and the news wasn't good. According to Carmona, 10 million Americans age 50 or older already have osteoporosis, and 1.5 million each year suffer osteoporosis-related fractures — typically in the hip, spine or wrist. Treating these fractures cost between $12 billion and $18 billion in 2002, the most recent year for which figures are available. And the situation will get only worse as the population ages. If doctors and patients don't do something to protect their bones, 1 out of every 2 Americans will have — or be at high risk of developing — osteoporosis by 2020.

"There is a gap between what we know and what we do for bone health," says Carmona.

His report is a call to arms — and legs, hips and backbones — for doctors and patients to start putting into practice prevention and treatment strategies already proven to strengthen bone. These include building up bone mass beginning in childhood by exercising regularly--30 minutes of moderate activity every day — and getting plenty of calcium and vitamin D in the diet. Reducing caffeine and sodium intake can also keep calcium from leaching out of bone. And it's important to be aware that some drugs, such as corticosteroids, speed up bone loss by interfering with calcium absorption.

If you're over 65, it's a good idea to take a bone-mineral-density test every few years. It measures how "full" your bones are. If you have osteoporosis or advanced osteopenia, your doctor may prescribe drugs such as bisphosphonates or estrogen substitutes as well as a weight-training program. If you've already suffered a fracture, injections of parathyroid hormone can actually rebuild bone.

In my mother's case, calcium supplements and weight-bearing exercises brought her bone mass back to normal within a year — proof that, as the Surgeon General says, you can do something about your bone health.

For more information on the report, go to surgeongeneral.com