Реферат на тему Osteoporosis Essay Research Paper Twenty years ago

Osteoporosis Essay, Research Paper

Twenty years ago osteoporosis was a word used mainly by researchers and

physicians. Over the past few years, there has been an explosion of information

about this condition that can cause severe pain and crippling. No cure is known

yet, but ways to lessen your potential for osteoporosis have been identified.

Today, one in three Americans are 50 or older. The baby boom generation will

begin to enter their retirement shortly after the turn of the century that is

rapidly approaching. Thanks in part to medical advances and the emphasis on

exercise and healthy diets, vast numbers of these baby boomers can expect to

reach their eighties, nineties, and beyond. Yet, if present day trends unhealthy

eating and lack of exercise continues, osteoporosis threatens to be one of the

biggest public health dangers of modern times. Osteoporosis, literally meaning

?porous bone?, is a disease of the skeleton in which the amount of calcium

present slowly decreases to the point where the bones become extremely brittle

and subject to fractures. The skeleton serves two functions. It provides

structural support for organs and muscles and also serves as a depository for

the body?s calcium and other minerals, manly phosphorous and magnesium. The

bone holds 99% of the body?s calcium. The other 1-% of remaining calcium is

freed to circulate in the blood and is essential for crucial functions in the

body such as blood clotting, muscle, contractions and nerve functions. Bones

have two main sections. The outer section of the bone is the cortical bone. It

is composed of a hard shell that serves to protect the other section of the

bone, called the trabecular bone. This part of the bone is an inner lacy,

structural matrix of calcium that helps support the bone structure. Bone tissue

is constantly being broken down and reformed to help the body cope with everyday

stress and for maintaining a properly functioning body. The breakdown of the

bones is called resorption and is performed by cells known as osteoclasts that

did holes into the bone allowing calcium to be released into the body. Then,

cells produced by the bone called osteoblasts help rebuild the bone. The

osteoblasts first fill in these holes left by the osteoclasts with collagen and

then by laying down crystals of calcium and phosphorous. A complex mix of

hormones and chemical factors controls this osteoclast-osteoblast balance. The

trabecular and cortical parts of the bone both give off calcium to the body when

it is needed, but as aging progresses the amount slowly declines. The rebuilding

of bones makes them denser until about the age of 35 and peak period of bone

mass building is somewhere between the ages of 25 to 35. After the age of 35,

the body becomes slower and slower in replenishing bone as time goes on.

Osteoporosis develops when bone resorption occurs too quickly or if formation

occurs too slowly. Because weakened bones, an increased susceptibility to

fractures of the hip characterize osteoporosis, spine, and wrist are prevalent.

Doctors have identified two types of osteoporosis that correlate with specific

types of fractures. Type I osteoporosis, often referred to, as post enopausal

osteoporosis, is most associated with wrist and spine fractures. Type II

osteoporosis, also called senile osteoporosis, is generally attributed to

reduced calcium by old age and causes mainly hip fractures. There are more than

300,000 hip fractures, 300,000 wrist fractures, and over 700,000 spinal

fractures in the US each year (Peck and Avioli 19). Osteoporosis causes more

than 1.5 million fractures each year and the cost to the healthcare system for

these fractures is over 13.8 billion dollars per year, greater than the cost for

congestive heart failure and asthma. Of the individuals who fractured a hip,

one-half will be permanently disabled, 20% will require long-term nursing care,

and 20% of hip fracture victims die within a year, usually from complications

caused by surgery. Hip fractures are responsible for about 65,000 deaths per

year in the United States. Hence, osteoporosis represents a major public health

problem. There is no single cause of osteoporosis, and it seems that there are

many factors that contribute to the disease. Some people are more prone to

develop osteoporosis than others are. Factors that increase the likelihood of

developing osteoporosis can be separated into controllable and uncontrollable

factors. Uncontrollable factors include age, sex, body frame, and race. The

longer a person lives, the greater their chance is in developing osteoporosis.

Osteoporosis is associated with age because bone mass begins to decline after it

peaks at about the age of 35. The more years that passes the more loss of bone

increases. Roughly estimating, people lose 10% of bone mass per year (24). As

people grow older they also become less physically active, and this assist in

bone loss. Also, other changes occur with age that can affect out ability to

absorb calcium. The skin and kidney do not make Vitamin D with the same

efficiency as they do in youth. This affects the ability to absorb calcium from

the diet or from supplements. A decline in stomach acid after the age of 60 may

also affect the ability of the body to absorb calcium. Another risk factor for

osteoporosis is sex. Women are four times as likely to develop osteoporosis than

men are. One reason is that woman generally have thinner, lighter bones then men

do. Also, the rapid loss of estrogen women experience after menopause can be

contributed to osteoporosis. Estrogen protects the body against bone loss. Women

with regular menstrual periods are exposed to healthy levels of estrogen from

puberty to menopause. Around the time of menopause though, the levels of

estrogen sharply declines. Early menopause or surgically induced menopause, such

as a hysterectomy, can increase a woman?s likelihood of developing

osteoporosis because the protective effect of estrogen is lost. Another

contribution of sex to osteoporosis is t women live longer then men do, which

gives them more time to develop weaker bones. Race is also a risk factor of

osteoporosis. Caucasians and Asians have a higher risk of osteoporosis than

African-Americans and Hispanics do. African-Americans in the US ave heavier and

larger bones than Caucasians, although the reason for this is unknown. (33).

Controllable risk factors for osteoporosis includes lack of calcium, lack of

physical activity, cigarette smoking, and alcohol and caffeine intake. Lack of

calcium is one of the great cause of osteoporisisCalcium is needed to build

strong bones during childhood and early adult hood, and to prevent losses

thereafter. Studies have linked an inadequate amount of calcium intakes appear

to be associated with low bone mass, rapid bone loss, and high fracture rates (Germano

99). Today, many people consume less than half of the amount of calcium

recommended to build and maintain healthy bones. Calcium needs change during

ones lifetime. The body?s demand for calcium is greater during childhood and

adolescence when the skeleton is growing rapidly. Pregnant and lactating woman

also need increased calcium, as do postmenoptusal woman and older men and women.

Good sources of calcium include low fat dairy products such as milk, cheese, and

yogurt, dark green leafy vegetables like broccoli, collard greens, and spinach

and other foods fortified with calcium like orange juice, cereals and bread.

Lack of physical activity is another controllable factor. Bone is a living

tissue that responds like muscles to exercise. Individuals who are inactive,

immobilized, or bedridden for a long time are at higher risk. Weight bearing

exercises such as walking, running, tennis, and other exercises that cause

muscle to work against the force of gravity play an important role in preventing

bone loss. Therefore, resumption of physical activity is an important factor in

building bone and preventing bone loss. Other risk factors are smoking, alcohol,

and caffeine. A high intake of caffeine-containing foods, such as coffee, is

thought to increase the amount of calcium eliminated in the urine (Bonnick 59).

For individuals who have osteoporosis, a comprehensive treatment program

includes a focus on nutrition, exercise, and safety issues to prevent falls that

may result in fractures. In addition, medications may be prescribed to slow or

stop bone loss, or increase bone density. Currently the U.S. Food and Drug

Administration for the treatment of postmenopausal osteoporosis approve

estrogen, calcitonin, and alendronate. Estrogen, reloxifene and alendronate are

approved for the prevention of the disease. While osteoporosis can be prevented

and treated, there is, as of now, no cure. Prevention is the only way to avoid

this disease and its debilitating consequences. Yet millions of Americans are

not actively protecting themselves against osteoporosis. Over the past decade,

important information has slowly been uncovered about the causes of osteoporosis

and the ways to prevent it. One of the most significant findings is that

osteoporosis in not an inevitable part of growing older. One of the great myths

associated with this disease is that as people age, they are all susceptible to

suffering fractures or to becoming stooped over. This major misconception that

causes individuals to overlook their risk and to avoid taking the necessary

steps to prevent and treat osteoporosis.