Men and osteoporosis

By Kyle Roderick
Third Age News Service

A silent disease that results from a loss of bone mass, osteoporosis can progress, sometimes for decades, without any outward signs, until a sufferer has a fracture. This crippling disease thins and weakens bones throughout the body, including the spine, and can lead to fractures in the bones of the spinal column. Collapsed vertebrae cause debilitating pain while also producing a consequent loss of height with age. The most common skeletal disorder in the United States, osteoporosis is a major health problem for many women -- and men.
While osteoporosis afflicts some 8 million American women, researchers increasingly are finding that it is an equal opportunity illness. It affects as many as 5 million older American men, according to researchers at Johns Hopkins University
in Baltimore. And if you still don't believe that men are vulnerable to osteoporosis, consider that up to a quarter of all hip fractures in the United States happen to men.
Just as women, men lose bone mass as they age. In some men, the process can be accelerated by alcohol intake along with poor dietary, exercise and other habits. The risk factors for osteoporosis are the same in men as in women. Men who have the greatest risk of brittle bones and fractures include those who:
-- are smokers
-- are Caucasian or Asian
-- drink excessive amounts of alcohol
-- have a family history of osteoporosis
-- are sedentary
-- have too much protein and too little calcium in their diets
-- are vitamin D deficient. Vitamin D helps the body absorb calcium.
-- are aging
-- have low testosterone levels
-- have prematurely gray hair. Balding is not a risk factor.
-- are taking, or have a history of taking, prescription drugs such as steroids, thyroid hormone and anti-convulsants, which rob the bones of calcium.
Although slowly falling levels of the male hormone testosterone in men over age 50 put them at risk for joint and spinal problems in their 70s and 80s, a man's chances of breaking his hip at the age of 70 are largely determined by the strength of his bones at 18. "Osteoporosis is a pediatric disease with geriatric consequences," says Dr. Duane Alexander, director of the National Institute of Child Health and Human Development. In fact, nearly 90 percent of adult skeletal mass is formed by the end of the teen-age years. Once optimum bone mass is reached, between the ages of 20 and 30, people can work to maintain their bones, but further growth is impossible.
The best ways to stem bone loss include limiting alcohol intake, stopping smoking and engaging in weightbearing exercise at least three times a week. Before starting a weight-training program, however, check with your physician. Once you get the go-ahead, find a licensed personal trainer who is experienced with older clients.
"It's essential that you find a trainer who understands your goals and limitations," says Nordine Zouareg, a two-time Mr. Universe body-building champion and personal trainer based in Tucson, Ariz. Zouareg, who trains many male clients over 50, adds, "A good place to find knowledgeable, affordable trainers is through your local YMCA or senior center."
Men wishing to prevent further bone loss must also be sure to consume about 1,500 milligrams of calcium a day. Although there is some controversy over whether it is better to obtain calcium through the diet or through supplements, many physicians, such as Art Hister, M.D., writing in "Midlife Man" (Greystone Books, 1998), recommend relying on a calcium-rich diet. High-calcium foods include dairy products, green leafy vegetables, broccoli, tofu, beans, shrimp, sardines and salmon bones, which are plentiful in canned salmon.
It's worth noting that not all the calcium in foods is absorbed: a glass of skim milk, for example, contains 300 milligrams of calcium, but you probably absorb only 20 percent to 40 percent of it. Absorption is always improved by eating a food containing vitamin C (such as an orange) in the same meal. An example of a delicious bone-building lunch or dinner would be a low-fat mozzarella cheese sandwich with sliced ripe tomatoes and basil.
Men who can't seem to eat enough calcium in their daily diet should start taking calcium supplements. Calcium citrate is easier on the stomach than calcium carbonate, but no matter which type you take, you must also be sure to get enough vitamin D by getting some sun exposure (10 minutes a day is probably enough). If you live in a rainy, overcast climate, however, you want to take extra care to eat vitamin D-enriched foods or take vitamin D supplements.
        Guarding against osteoporosis is one of the most important male health behaviors; after all, 20 percent of men who break their hips die within a year of the fracture, and 50 percent never regain their full mobility. Keep doing your weight-bearing exercise, eat a calcium-rich diet, avoid alcohol and smoking and excessive caffeine use, and your bones will stay strong for as long as you need them.