Osteoporosis

OSTEOPOROSIS AND BLACK WOMEN

Osteoporosis is a bone disease characterized by low bone mass, which makes bones fragile and easy to fracture. There are no symptoms or pain until fracture occurs. While Black women tend to have higher bone mineral density (BMD) than white women throughout life, they are still at significant risk of developing osteoporosis. As Black women age, their risk of developing osteoporosis more closely resembles the risk of White women. As the number of older Black women increases, there will be an increasing number of Black women with osteoporosis.

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Risk Factors

The risk factors for osteoporosis include:

	Being female;
	Having a thin and/or small frame;
	Advanced age;
	A family history of osteoporosis;
	Being postmenopausal, including early or surgically induced menopause (hysterectomy);
	Abnormal absence of menstrual periods (amenorrhea);
	Anorexia nervosa;
	A diet low in calcium;
	Use of certain medications, such as corticosteroids and anticonvulsants;
	An inactive lifestyle;
	Cigarette smoking;
	Excessive use of alcohol.

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Nutrition and Osteoporosis

Adequate intake of calcium plays a crucial role in building bone mass and preventing bone loss. Studies indicate that Black women consume 50 percent less calcium than the Recommended Dietary Allowance. The National Academy of Sciences suggests the following calcium intake levels for women:

Recommended Calcium Intakes
Age	Amount
9-18 19-50 (premenopausal) 51 and older	1300 mg/day 1000 mg/day 1200 mg/day

Lactose intolerance can hinder calcium intake. As many as 75% of all Black women are lactose intolerant. A recent study found that many people who are lactose intolerant can digest as much as two cups of milk per day, if divided into small servings, without symptoms. Although milk and other dairy products such as cheese and yogurt are the best calcium sources, there are many non-dairy foods that also contain calcium. Turnip greens, mustard greens and kale are good sources of calcium among green vegetables; however, large quantities must be consumed to equal the amount of calcium supplied by dairy products. Sardines and salmon with edible bones and calcium-fortified orange juice are also good sources of calcium.

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Prevention of Osteoporosis

The prevention of osteoporosis begins in childhood. The recommendations listed below should be followed throughout life to lower your risk of osteoporosis:

	Eat a balanced diet adequate in calcium and vitamin D.
	Exercise regularly, especially weight-bearing activities such as walking, jogging, dancing and weight-lifting.
	Avoid smoking and excessive alcohol intake.

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Treatment of Osteoporosis

Although there is no cure for osteoporosis, there are drugs available to help stop further bone loss and may lower the risk for fracture. Talk to your doctor about these medications:

	Estrogens (Premarin, Ogen, Estrace, Estraderm, Estratab, Prempro)
	Alendronate (Fosamax)
	Calcitonin (Miacalcin)
	Raloxifene (Selective Estrogen Receptor Modulator) (Evista)
	Risedronate (Actonel)

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Caring for Elderly with Osteoporosis

Preventing falls is essential to decrease the risk of fracture. Some basic preventive measures include: getting regular exercise to increase balance and muscle strength; having regular physical examinations including vision and hearing tests; learning the proper way to use walkers and canes; reviewing with your doctor the medications you are taking; and, removing through rugs from the house, installing grab bars, stair rails and applying non-skid tape on the outer edges of stairs are tips that will help avoid potentially dangerous situations in the home. Be sure to consult a doctor before beginning an exercise program or participating in other physical activities.

References:

National Institutes of Health: Osteoporosis and Related Bone Diseases-National Resource Center