Despite the importance of bone health, the U.S. is currently seeing epidemic levels of osteoporosis.
The bones in the body are dynamic, living tissues that support an individual throughout their entire life. Yet, the U.S. is currently experiencing epidemic levels of osteoporosis, according to Dr. Rita Roy, Chief Executive Officer of the National Spine Health Foundation.
Osteoporosis is a condition that leads to a decrease in bone strength, making them fragile and prone to fractures, according to the National Institutes of Health (NIH). Osteoporosis is the major cause of fractures in postmenopausal women and in older men. Fractures can occur in any bone but occur most often in bones of the hip, vertebrae in the spine, and wrist.
“There is consensus among physicians that osteoporosis is a silent disease and epidemic in our country. And although there were many, many efforts to combat this epidemic, the rates have only continued to increase,” according to Dr. Roy.
Rates of osteoporosis are higher among women than men, with one in two women and one in four men 50 years and older breaking a bone at some point in their lifetime due to osteoporosis, according to the Bone Health Policy Institute. As of recent, rates are not just increasing in post-menopausal women, the largest population of osteoporosis, but also in much younger age groups, says Dr. Roy.
“We often hear about falling and breaking your hip following a fracture, but what a lot of people don’t know is that osteoporotic fractures in your body occur more commonly in the spine than anywhere else,” said Dr. Roy. “Advocacy organizations and physicians are aiming to increase healthcare industry knowledge of vertebral compression fractures (VCFs), especially those caused by osteoporosis, as they increase the risk of subsequent (secondary) fractures and are very harmful to patients.”
“Osteoporosis is thought of largely as a women’s health issue, because it affects women more proportionately than men,” said Dr. Roy. “Women are often the caretakers of their children and families, so it is important both for men and women to recognize that in order to care for all the people you love, you must put your health needs first to avoid broken bones.”
A healthy skeletal system
Nearly 10 million Americans have osteoporosis, and another 44 million have low bone density, which puts them at increased risk of suffering from a bone break due to osteoporosis, according to the Bone Health and Osteoporosis Foundation.
Throughout one’s life, your bones are in a constant state of building and repair. This ongoing process can be supported by healthy lifestyle choices and dietary intake of specific nutrients, according to The National Spine Health Foundation.
There are many factors that contribute to osteoporosis, such as getting older, hormonal changes, past fractures, family history, glucocorticoid steroid use, and being a female. Though many factors contributing to osteoporosis are uncontrollable, there are modifiable risk factors that individuals can take to maintain their bone health, such as decreasing alcohol consumption, reducing or quitting smoking, participating in physical activity, getting adequate supply of key nutrients that support bone health such as vitamin D and calcium, and increasing sunlight exposure.
“There are risk factors that you cannot control, and there are risk factors that we can control, so we tend to focus our public education messaging around the risk factors that you can control,” said Dr. Roy. “The number one contributing factor to developing osteoporosis is your genetics. The rest of the population may have low bone mineral density for a variety of factors. For those with risk fac-tors, there are many things we can do to enhance our bone health.”
As CEO, Dr. Rita Roy oversees The National Spine Health Foundation’s strategic initiatives around public health messaging, research operations, and advocacy initiatives related to spine and bone health.
“Your bones serve as a repository for calcium in the body. When you don’t get enough calcium in your diet, the body will pull calcium from the bones to support the many other physiologic processes in our bodies that require calcium,” said Dr. Roy. “If too much calcium is removed for other functions, the bones become weak and fragile.”
Dairy products such as yogurt, milk, and cheese are the most well-known sources of calcium, and calcium is also found in other foods such as leafy green vegetables, fish, beans, and nuts and seeds. Vitamin D is also essential to the body’s ability to absorb calcium and can be increased through sunlight exposure and consuming foods like egg yolks, cheese, and fish.
“The bones in our body are dynamic, changing every day, expanding and contracting. Many people think of bone as rigid and hard, but it is breathing and living tissue,” said Dr. Roy. “People achieve peak bone mass by age 30 years which is when someone has the maximum amount of bone which we then withdraw from our “bone bank” as we get older.”
Advocating for bone health
Healthcare professionals have acknowledged the importance of bone health to a patient’s overall health for a long time. However, for patients themselves, there can be very long waits to see a bone health specialist such as a rheumatologist or endocrinologist. Primary care doctors, who are the front lines of healthcare, are so busy and overloaded with treating other conditions, says Dr. Roy, that osteoporosis diagnosis and treatment often do not occur or is delayed.
“Osteoporosis is a silent disease, and it is all about preventing the first fracture. The bone density scan known as DXA is the de-facto standard for measuring bone density, but we have learned that in most major cities and in small towns across the country, it is sometimes hard for patients to get a DXA scan,” said Dr. Roy. “Osteoporosis doesn’t always appear to be the most imminent health threat, so it can be put in the back seat to allow physicians to treat other more pressing diseases. Unfortunately, as a result, there has been a lack of urgency across the nation for getting osteoporosis diagnosed and treated.”
The mission of the National Spine Health Foundation is to increase patient education, patient advocacy and patient-reported outcomes research on spine and bone health. Bone health is spine health, says Dr. Roy, and what matters to the health of your bones also matters to the health of the spine. Maintaining a healthy lifestyle and diet can reduce the risk of both spinal degeneration and osteoporosis.
“Advocacy groups, including The National Spine Health Foundation, are pushing for DXA scans to be a part of routine health screening in anyone 50 years and older,” said Dr. Roy. “DXA scans are low risk, and should be part of routine testing along with mammograms, colonoscopies, etc.” Dr. Roy also noted that all patients are able to obtain a baseline DXA scan as part of their Welcome to Medicare preventive care benefits, but many patients and physicians are unaware of this opportunity.
The National Spine Health Foundation features the ‘Bone Hub’ resource for patients and healthcare providers on its website, offering easy-to-understand information on risk factors, prevention strategies, and treatment options to support bone health.
“One of the greatest points of opportunity for patient education is in the clinical encounter. This May, for National Osteoporosis Awareness and Prevention Month, the National Spine Health Foundation is doing a very large digital media campaign around vertebral compression fractures and secondary fractures,” said Dr. Roy. “Across the organization, we’ll spread bone health messaging we’ve created in the form of support videos, educational tools, patient webinars, infographics, and more to support doctors and inform the patient community on the importance of lifelong bone health.”