Sticks And Stones

By Ian K. Smith, M.D.

Mention the word osteoporosis in the manly world of testosterone, pro basketball and the XFL, and you're likely to get a wave of the hand and a dismissive "That's a woman's disease." Not so. More than 2 million American men have been found to have the thinning bones and skeletal weakness of osteoporosis, and an additional 3 million are at an increased risk of developing them.

It's true that osteoporosis strikes women with much greater frequency than men--in some studies as much as four to six times as often. But that's no reason to brush it off as "their" disease. It's a mere stroke of gender luck that men's bones tend to grow larger, stronger and denser. Also paying dividends are those sports that boys (and, increasingly, girls) play as children--running up and down basketball courts, soccer fields and baseball diamonds. As it happens, physical activity is one of the more important ways to increase bone density and protect bone health.

But even the most active men cannot ignore certain facts of life. All of us build up our bones during the first three decades of life, typically reaching peak bone mass in the early 30s. Around the age of 35, we begin gradually to lose some of this bone mass. Women ultimately give up between 30% to 50%, while men lose only 20% to 30%. Though mass loss in men is lower, it still makes us vulnerable to back pains and bone fractures. In fact, this year alone American men will suffer as many as half a million osteoporosis-related breaks, mostly in the spine, hip and wrist. These are not only painful and debilitating; thousands die each year from fracture-related complications.

For many of us, however, there's still time. Of all the side effects of aging, osteoporosis is one of the more preventable, through diet, exercise and changes in lifestyle. The two key nutrients for bone health are calcium, which makes bones stronger, and vitamin D, which helps the body absorb the calcium. Men between the ages of 25 and 65 should consume a minimum of 1 gram of calcium a day; after age 65, that dose should be increased to 1.5 grams a day.

Exercising is also important, with emphasis on weight-bearing activities (walking, jogging, racquet sports) in which bones and muscles work against gravity. Lifting weights and working out on resistance machines can help preserve bone density.

Be careful about what's in your medicine cabinet. Prolonged use of some medications, such as steroids (prescribed for asthma, arthritis and kidney disease), anticonvulsants (for seizure disorders) or aluminum-based antacids, can weaken your bones. Smoking and drinking are both bad for bones, as is prolonged weightlessness, for anybody who plans to work on the space station.

There is no cure for osteoporosis, but it can be effectively treated by a powerful class of medications called bisphosphonates; Fosamax and Actonel are the only two that have been approved for men. Some physicians also prescribe testosterone supplements for patients with low testosterone levels, and calcitonin, a drug that slows bone loss.

The best time to fight osteoporosis, in any case, is early in life, when you can be most effective in heading it off.

Dr. Ian is a correspondent for NBC's Today Show. E-mail: [email protected] For more on osteoporosis, see www.nof.org