Jonathan’s Bones

What is Osteoporosis?  Well here is the accurate definition.  Osteoporosis is a disease of bone that leads to an increased risk of fracture. In osteoporosis the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. Osteoporosis is defined by the World Health Organization (WHO) in women as a bone mineral density 2.5 standard deviations below peak bone mass (20-year-old healthy female average) as measured by DXA; the term "established osteoporosis" includes the presence of a fragility fracture.[1] Osteoporosis is most common in women after menopause, when it is called postmenopausal osteoporosis, but may also develop in men, and may occur in anyone in the presence of particular hormonal disorders and other chronic diseases or as a result of medications, specifically glucocorticoids, when the disease is called steroid- or glucocorticoid-induced osteoporosis (SIOP or GIOP). Given its influence is the risk of fragility fracture; osteoporosis may significantly affect life expectancy and quality of life.  (Taber Cyclopedia of Medicine) . 

Jonathan, a 54 year-old male client walks into our office for his initial meeting.  After a brief round of questions and answers and we begin our conversation concerning any possible bone instability and or damage as we go over this with every client.  Confident of himself; Jonathan tells us that he does not have to worry about getting osteoporosis because healthy bones are things that a person is born with and have absolutely nothing to do with nutrition, and osteoporosis is an extremely rare disease that only affects elderly women and not men.   Therefore it is not a very serious or significant disease.  Now this statement will send up some red flags, because here is a gentleman who is not concerned that he could be at risk for osteoporosis.  I would most definitely disagree with the two statements made.  The reasoning of this client is otherwise influenced possibly by television or some form of literature claiming incorrect information.  The fact is that osteoporosis affects quite a large number of people, and in most cases it is due to inadequate dietary intake.    Osteoporosis can be a cause of significant morbidity and mortality in postmenopausal women as well as men. In both men and women, increasing age and low bone mineral density (BMD) are the 2 most important independent risk factors for an initial vertebral or nonvertebral fracture (Bonnick SL. Department of Biology, University of North Texas).  Osteoporosis is in fact a major public health problem, affecting millions of individuals. Dietary intake is an important factor for bone health. Inadequate intake of nutrients important to bone increases the risk for bone loss and subsequent osteopomsis. The process of bone formation requires an adequate and constant supply of nutrients, such as calcium, protein, magnesium, phosphorus, vitamin D, potassium, and fluoride. However, there are several other vitamins and minerals needed for metabolic processes related to bone, including manganese, copper, boron, iron, zinc, vitamin A, vitamin K, vitamin C, and the B vitamins. Although the recommended levels of nutrients traditionally related to bone were aimed to promote bone mass and strength, the recommended levels of the other nutrients that also influence bone were set on different parameters, and may not be optimal for bone health, in view of recent epidemiological studies and clinical trials.

(The Role of Nutrients in Bone Health, from A to Z Cristina Palacios Critical Reviews in Food Science and Nutrition. Boca Raton: 2006. Vol. 46, Iss. 8; pg. 621, 8 pgs).

 

Here are some things that Jonathan may need to take into consideration also;

 

Causes of Secondary Osteoporosis in Men:

 

    * Glucocorticoid medications

    * Other immunosuppressive drugs

    * Hypogonadism (low testosterone levels)

    * Excessive alcohol consumption

    * Smoking

    * Chronic obstructive pulmonary disease and asthma

    * Cystic fibrosis

    * Gastrointestinal disease

    * Hypercalciuria

    * Anticonvulsant medications

    * Thyrotoxicosis

    * Hyperparathyroidism

    * Immobilization

    * Osteogenesis imperfecta

    * Homocystinuria

    * Neoplastic disease

    *Ankylosing spondylitis and rheumatoid arthritis

    * Systemic mastocytosis

 

This should be more than enough to help Jonathan re think that last statement.

References:

National Institute for  Arthritis and Musculoskeletal Diseases and Skin Disease

The Role of Nutrients in Bone Health, from A to Z Cristina Palacios Critical Reviews in Food Science and Nutrition. Boca Raton: 2006. Vol. 46, Iss. 8; pg. 621, 8 pgs

Bonnick SL. Department of Biology, University of North Texas