Osteoporosis is a disease of increasingly porous bones that are at greater risk for fracture. The normal bone remodeling of breaking down and building up bone as we age is out of balance. Similar to a bank account with withdrawals outpacing deposits, as time goes on there is more breaking down than building back up. This leaves the bone more vulnerable for fracture.
We tend to think of Osteoporosis as an old person’s disease and in fact age is certainly a risk factor. We see a sharp decline in bone density the first few years following menopause; a withdrawal from the “bone bank account.” But let me share a startling statistic. At the age of 20 we have 98% of the bone density we will ever achieve. We reach Peak Bone Mass by age thirty when our bones have reached their maximum strength and density.
Factors affecting peak bone mass include both non-modifiable and modifiable. The non-modifiable factors are gender (peak bone mass is higher in men), race (peak bone mass is higher in African Americans), and hormonal factors (early onset of menstruation and use of oral contraceptives tend to have higher peak bone mass). Family history is another important factor with individuals whose mother had osteoporosis are more predisposed to it.
Modifiable factors include nutrition (adequate calcium in the diets of young people), physical activity during the early years (specifically weight bearing and resistance exercises), and lifestyle behaviors (smoking, high alcohol intake, and sedentary lifestyle) have been linked to low bone density in adolescents).
The graph below shows a comparison of the Peak Bone Mass of males to females and to individuals with suboptimal lifestyle factors. You can see that the suboptimal group never catches up and enters the osteoporosis stage at around age 40.
According to the Department of Human Services “Osteoporosis is a pediatric disease with geriatric consequences. Peak bone mass is built during our first three decades. Failure to build strong bones during childhood and adolescent years manifests in fractures later in life.”
What can we do?
Start early: Encourage young children to move more and sit less. The American Physical Therapy Association has a section on Container Baby Syndrome due to babies and young children remaining in a “container”- car seats, baby carriers, strollers, etc., for extended lengths of time. Due to the SIDS scare, many young parents are afraid to allow their child to spend time on their abdomen. Share the “Supine to Sleep, Prone to Play” mantra.
Spread the word: Speak to Young Mothers’ Clubs, Girl Scout Troops; anywhere to influence adolescent and teens about the importance of exercise and nutrition (for a variety of reasons).
Write a blog (such as this): Share this information in newspapers, social media, or on your website. Get the word out!
Because the bones of our future generation depend on it.
References:
- NIH Osteoporosis and Related Bone Diseases National Resource Center
- Department of Human Services
- American Physical Therapy Association