Osteoporosis Prevention &
Interview with Dr. Michael Truong
- Section 2
- Exercise, Cigarette Smoking, and Alcohol
- Estrogen Replacement Therapy
- Section 3
- Medications that Prevent Bone Breakdown
- Monitoring Osteoporosis Treatment Success
MedicineNet interviewed Dr.
Michael Truong regarding updates in the management of
osteoporosis. Dr. Truong finished his medical school
training at the University of California, San Francisco
medical school. He then studied at the University of
California, Davis for his residency training in Internal
Medicine, and his Fellowship training in Diabetes,
Endocrinology, and Metabolism. He spent two years
performing research at ADRI (Aoki Diabetes Research
Institute), and teaching at the University of California,
Davis Medical School. He is currently director of the
osteoporosis center with the Mission Internal Medicine
Group, a multispecialty group serving southern Orange
Osteoporosis is a bone disorder featuring progressive
loss of bone tissue and bone mass leading to weakening of
bone. Normal bone tissue is made of protein (called
collagen) and calcium salts. The osteoporosis process
depletes both the calcium salts and the protein from the
bone. The weakened bone is more prone to breakage
(fracture), either by cracking or collapsing (compression).
In patients with osteoporosis, bone fractures can occur
from minor falls or injuries that normally would not cause
a bone fracture. Bones that commonly break in patients with
osteoporosis include the spine, hips and the wrists.
Even though osteoporosis can affect both men and women,
it is most common among postmenopausal women. The female
hormone, estrogen, is important for the preservation of
bone mass. Inadequate estrogen during menopause causes
accelerated bone loss. Without effective prevention, a
woman can lose 20%-30% of her bone mass during the first 10
years of menopause. The osteoporosis process can operate
silently for decades. These women may not be aware of their
weakened bones until suffering a painful fracture.
Over 20 million people have osteoporosis in the United
States, and approximately 1.3 million people each year will
suffer a bone fracture as a result of osteoporosis. In
1993, the United States incurred an estimated loss of 10
billion dollars due to loss of productivity and health care
costs related to osteoporosis.
The goal of osteoporosis treatment is to prevent bone
fractures by 1) stopping bone loss, and 2) by increasing
bone mass and strength.
The prevention and treatment of osteoporosis involves
programs which include a nutritious diet, cessation of
cigarette smoking, curtailing of alcohol consumption,
regular exercise, adequate intake of calcium and vitamin D,
estrogen replacement or raloxifene (Evista) treatment in
postmenopausal women, and medications (such as aledronate,
etidronate, or calcitonin) that decrease breakdown
(resorption) of bone. Medications that decrease bone
breakdown or resorption are also called antiresorptive
DIET, CALCIUM, AND VITAMIN D
MedicineNet: How important is diet in the
prevention and treatment of osteoporosis?
Dr. Truong: Balanced nutrition, adequate
calcium and vitamin D intake, regular exercise, and
cessation of cigarettes are important measures to maintain
healthy bones for everybody. This is true for children,
men, premenopausal and postmenopausal women, and the
elderly, regardless of presence or absence of
Conversely, malnutrition, such as found in patients with
anorexia nervosa, contributes to osteoporosis.
MedicineNet: Why is adequate calcium intake
important in osteoporosis prevention and treatment?
Dr. Truong: Calcium is an essential nutrient
necessary for the proper functioning of the heart, muscles,
nerves, and other body functions, as well as maintaining strong
bones. Adequate calcium intake is important
for everyone, regardless whether she/he already has
Each day, the body loses calcium in the urine, feces,
and sweat. These losses have to be replaced by calcium in
the diet. If calcium in the diet is not sufficient
to cover these losses, the body takes calcium from the
bones. Over time, insufficient calcium in the diet leads
to negative calcium balance and bone loss (osteoporosis).
Adequate calcium intake can help prevent osteoporosis and
increase bone mass and strength.
MedicineNet: How much calcium intake is
necessary to prevent and treat osteoporosis?