BE
Healthy ™
Sponsored by
Boston Public Health Commission
VOL. 4 • NO. 9
© May 2010
Osteoporosis:
run in families. Osteoporosis, or porous bones, is characterized by a decrease in bone density that leaves those affected more vulnerable to lifethreatening fractures. Bone density refers to the amount of calcium, other minerals and protein packed in bone. According to Dr. Sherri-Ann M. Burnett-Bowie, an endocrinologist at Massachusetts General Hospital, on average, black women have a higher bone density than white women, but that does not offer complete immunity. The National Osteoporosis Foundation (NOF) has determined that 5 percent of black women aged 50 and older as compared to 20 percent of white and Asian women aged 50 and older are estimated to have osteoporosis. But Burnett-Bowie cautioned that some experts estimate the prevalence among black women is closer to 11 percent. The frequency in men is smaller — 4 percent and 7 percent in black and white men, respectively.
Aging bones need youthful attention
On average, black women have a higher bone density than white women, but that does not offer complete immunity.
Dr. Sherri-Ann M. Burnett-Bowie
As side effects go, this one flew below the radar. Hope White, 45, knew she needed strong doses of steroids to wage her battle against a particularly virulent case of lupus. But she didn’t give much thought to the fact that those treatments to combat her auto-immune disease would make her susceptible to weakened bones. In fact, when her doctor suggested that she — a young black woman — could acquire osteoporosis — a condition that hits mostly aging, white women — she was almost amused. “I’m too young,” White remembers saying after her doctor recommended a bone density test to check for the disease. “I’m not white, and I’m not frail.” Fortunately, her doctor insisted and ordered the first of three bone tests. Sure enough, White was diagnosed with osteoporosis. Like most people, White didn’t pay much attention to the
Hope White, shown above and with her son, Narai (left) was diagnosed with osteoporosis after longterm treatment with steroids for lupus. (Ernesto Arroyo photos) health of her bones. Fortunately, the Surgeon General did and in 2004 delivered a sobering report that more than 10 million people across the country had osteoporosis and another 34 million were at risk. And the costs were — and remain — significant. Treatment for fractures resulting from osteoporosis amounts to about $18 billion a year, and fractures are just the beginning of the medical problems. Twenty percent of older people who sustain osteoporosis-related hip fractures die within a year, and those who survive can experience a downward spiral in their health. Most at risk are thin, older white and Asian women, but men and black women are not exempt. Although more prevalent in people over the age of 50, osteoporosis can strike at any age. The disease also tends to
The threat of osteoporosis is greater in blacks than expected, White learned, largely because of the long-term use of medications, such as steroids, to treat illnesses prevalent among African Americans. Asthma, arthritis, lupus and some cancers are examples of diseases where some of the treatments increase the risk of developing osteoporosis. Indeed, there’s not much amusing about osteoporosis at all. Studies have indicated that death rates following osteoporosis-related hip fractures are higher in blacks than in whites. Complications of pneumonia, blood clots and poor circulation take a hefty toll. Misperceptions are part of the problem. Because many blacks believe that osteoporosis is not a threat, they are not looking for it, and worse, some doctors aren’t looking for it either. In one study, doctors from the Johns Hopkins School of Medicine found that significantly fewer African American women were tested for osteoporosis than their white counterparts, a surprising statistic given that both groups evaluated shared similar risks. Another group of researchers found more bad news. Many blacks treated at Howard University Hospital were not tested for the disease — even in the presence of bone fractures commonly associated with osteoporosis. Bone is composed of collagen — a type of protein — and calcium, which combine to give bones strength and flexibility. White, continued to page 4
More calcium, vitamin D key to healthy bones in their health at an early age and consume foods high in calcium and vitamin D to maintain healthy bones throughout their lives. That’s because one of the biggest culprits in bone deterioration — and one of the most modifiable — is the lack of calcium and vitamin D. National nutrition surveys indicate that most people consume less than half of the minimum recommendations. “Both men and women should consume enough calcium and vitamin D throughout life,” Burnett-Bowie said. “Not just when you get older. Additionally, while osteoporosis affects women predominantly, roughly one-third of broken bones due to osteoporosis occur in men.” Calcium is the most common mineral Bones, continued to page 4
Active Growth
Children and teens
Slow Loss Mid-30s
Rapid Loss
After menopause
Less Rapid Loss Seniors
After about age 30, you begin to slowly lose bone mass. This loss accelerates the first few years following menopause, and continues at a slower pace in older men and women.
Bone Growth/Loss
Dr. Sherri-Ann M. Burnett-Bowie, an endocrinologist at Massachusetts General Hospital, readily admits aging bones come with the territory. “If we live long enough,” BurnettBowie said, “chances are we will eventually suffer some bone loss.” And that means trouble for those who choose to ignore the risks and fail to take preventive measures to combat osteoporosis, or low bone density, and other bone diseases. The key is to start early in life when bones are developing in strength and size. To further that goal, the federal Office on Women’s Health, for instance, has developed a program called “Best Bones Forever!” that encourages girls to get active