Latest Health News

You may have already suffered some deformity from brittle or porous bones, have lost some height and be stooped. Unfortunately, there is no way to repair crushed vertebrae, expand a spine already compressed, or straighten a ‘dowager’s hump’ (although researchers are experimenting at the University of North Carolina, Chapel Hill, with a new ‘artificial bone’ that is a blend of plaster of Paris and fired ceramic particles of hydroxyapatite, the primary calcium compound in bone).

Repairs of hip fractures can be made: broken sections of bone can be pinned or screwed, and severe fractures may dictate that part of the femur (thigh bone) be replaced. Having had an osteoporotic fracture in one part of your body, you are more likely to suffer another fracture in another area, osteoporosis being progressive and capable of inflicting several disabilities.

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With the frightening statistics now emerging, all women have to ask themselves if they could become victims of osteoporosis. What are your chances of having bone thinning and fracturing? With roughly 1 in 4 women being affected, we are on the verge of an epidemic. The disorder is far more common in women than in men for many reasons. For instance:

Women have smaller bones, with less bone mass at maturity.

They get less exercise, so their muscles are smaller.

They are inclined to go on slimming diets that frequently are

not nutritionally balanced.

•    Extra demands are made on their total calcium level during

pregnancy and breast-feeding – an especially critical situation when teenage girls become pregnant before their bodies have reached their peak mass.

Women are taking up smoking in ever-increasing numbers.

Alcoholism among women is on the increase.

Many women are heavy users of laxatives.

Many women take diuretics to flush water from their

systems.

•    More women are in stressful occupations in difficult jobs or

have conditions at home that cause strain.

•    More women are using antacids to overcome stomach

problems.

•    Hysterectomy, with removal of ovaries, is a common type of

operation for women.

•    After menopause, women no longer have the oestrogen

hormones that have been giving bone protection.

• Women live longer than men, with an extension of life expectancy twenty-five or thirty years after menopause.

How much are you at risk? With many factors involved, it is not easy to predict who will suffer. Some factors you can change, and others such as gender and genes you obviously cannot. While a certain amount of bone loss is normal, some factors play their part in maintaining your bone mass, other factors have a bearing on how quickly you lose it, and it also depends on how long you live.

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Although increasing your intake of calcium from foods and supplements is generally considered safe for most people in amounts up to 2000mg per day, consult your doctor before making any radical changes in your diet, as you may be one of the few people prone to forming kidney stones. If you have multiple kidney stones, you have a very real need to cut down calcium intake.

The mechanism of stone formation in adults is a complex phenomenon. Scientists are not always sure why kidney stones form, or why one person has them and another does not, but heredity appears to play an important role in the tendency to form stones. A high level of calcium in the urine often leads to kidney stones. While certain foods may promote stone formation in susceptible people, scientists do not think that eating any specific food causes stones to form in healthy people. Evidence suggests that stones can form because of drinking too little fluid, they may be part of other metabolic disturbances, urinary tract infections, the misuse of certain medications, or lack of exercise of a person subject to stones. Stone formation may also be linked to overactivity of the parathyroid glands or excessive consumption of vitamin D and vitamin C.

According to D.H.S.S. estimates in England in 1983, over 4600 people had hospital treatment for kidney stones; more than a million Americans are hospitalized every year with the problem. Stones seem to occur more often in whites than in black people, in three males for every female; they are also more likely in tropical climates.

What is a kidney stone? Stones, or calculi, may consist entirely of one compound, but most are a combination of various salt or mineral crystals, building up gradually on the lining of the kidneys or urinary tract, possibly causing bleeding of the tissues there and often creating much pain as the stone breaks loose and moves down the urinary tract. When stones grow so large that they cannot be passed out of the body easily, they can obstruct urine, causing acute pain and possible kidney infection or damage.

A doctor’s attention is immediately needed to assess the seriousness of the situation. Although in many cases the calculi are passed harmlessly from the body by taking an increased amount of fluids, surgery is often necessary; recent medical advances have increased the possibility that many cases can be cured or controlled with non-surgical techniques such as ultrasonic probes and high-energy shock waves.

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Regular exercise is essential for maintaining muscle tone and putting stress on bones – necessary not only for halting bone loss but stimulating the formation of new stronger bone tissues.

Astronauts in space flights lost considerable amounts of bone tissue, at a rate of 0.5 per cent per month, after a short time in a weightless state. More recent missions have included exercise to try to prevent bone depletion; unfortunately, this exercise has proved ineffective without the stress and pull of gravity on bone and muscle.

Similar problems occur in hospital patients or those confined to wheelchairs – a condition called disuse osteoporosis. Bones weaken and shrink when not used, in a sedentary lifestyle, just as muscles do; bones respond by becoming stronger and larger when stress is placed on them with exercise. Exercise increases blood flow to bones, bringing in nutrients for new formation. Exercise can change the levels of the body’s hormones that form bones, creating a better environment for new bone formation, increasing oestrogen and decreasing harmful adrenal hormones. When athletes build up muscles, the strenuous training also builds bone mass.

A study has been carried out at the University of North Carolina, Chapel Hill, USA, under the direction of orthopaedist Peter Jacobson: 400 sedentary women aged between thirty-five and sixty-five were compared with 80 women of the same age range who played tennis regularly each week. Of those under fifty-five, there were no special differences in bone structure. But women over fifty-five in the study had much stronger bones among the tennis-playing group. Research suggests that tennis, jogging and other ‘weight-bearing’ exercises may help to strengthen older bones.

Other studies of menopausal women have them square dancing, jazz dancing and performing isometrics to determine the changes in their bone mass. Bone loss may not be inevitable in later years, but proportional to a slowdown in exercise and physical activities.

Although many people think of themselves as being fairly active, very often their hectic lives mean they are mentally and socially active but not physically. Exercise is a Do-It-Yourself venture; no one else can do it for you. Make it a part of your lifestyle for the rest of your life!

At the same time you’ve got to strike the right balance: if you exercise as vigorously as some athletes that you stop menstruating, you can place yourself in danger of having bone loss as a result of lower oestrogen levels. Loss of menstruation, called amenorrhoea, occurs in up to 50 per cent of competitive runners and ballet dancers but affects only 3 to 5 per cent of women in general. If a woman does not menstruate for a year, she should have her bone density checked.

In recent research, Robert Marcus, M.D., of Stanford University School of Medicine, Christopher E. Cann, Ph.D., of University of California, San Francisco, and others, studied bone-mass variations in a group of white long-distance runners (running up to 160 kilometres a week). Of the seventeen women, six had regular menstrual periods and eleven had none. Four of the women without periods had started intense training before the onset of menses. The non-menstruating athletes had 17 per cent lower spine density than the menstruating women. Cortical bone mass was not apparently affected by lack of menstruation, but trabecular bone density was lower. The study supported the idea that intense physical training at an early age may delay menarche, and women would be better not to train to such an extent that they don’t menstruate regularly.

Although athletes may be under pressure from coaches and peers to keep weight down, they still need to consume sufficient calories, calcium and protein, and avoid vitamin overdoses. Most importantly, non-menstruating athletes may need a greater intake of calcium daily, similar to postmenopausal women.

Women should not be frightened off exercise, however, as few have such tough multi-mile running programmes, as in the previously mentioned study, or do other aerobics so strenuously. The effect of regular exercise on bone density is positive, providing calcium intake is maintained; the benefits of exercise still far outweigh the hazards.

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The Pill is associated with risks of high blood pressure, blood dotting (thrombosis), and cardiovascular disease; but evidence suggests stronger bones for women who have used the Pill for extensive periods of time. The positive effect on bones is related to the amounts of oestrogen and progestogen in the oral contraceptives, with these hormones also probably stimulating the release of calcitonin to inhibit bone reduction. The Pill may maintain or strengthen your bone mass.

But even the new oral contraceptives are not risk-free, and they can interact with other drugs you may be taking, altering their effectiveness – certain antibiotics, epilepsy drugs, antiinflammatory or anti-arthritic drugs and barbiturates, for instance. Your doctor will probably only prescribe them if you -

are under the age of thirty-five,

do not smoke,

have normal or low blood pressure and normal cholesterol

level,

are no more than 30 per cent overweight,

have never had diabetes, liver or gallbladder disease; cancer

of the liver, breast or reproductive tract (uterus, ovaries or cervix); epilepsy, migraine headaches, or exposure to DES (Diethylstilbesterol) before you were born.

Read the ‘patient leaflet’ that usually comes with oral contraceptives. They tend to change your body chemistry and the use your body makes of food nutrients. Consequently you may have a deficiency in vitamin B6, vitamin C and folic acid that you will need to make up with generous servings of orange juice, wholegrain breads and green vegetables daily.

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