US Future Full of Fractures

Last Editorial Review: 10/15/2004

Oct 15, 2004 -- Unless Americans start getting enough calcium, vitamin D and physical activity, their future is likely to include osteoporosis accompanied by a lot of broken bones. This is the gist of a report by the US Surgeon General entitled Bone Health and Osteoporosis The full report is more than 400 pages long and took two years to prepare.

This comprehensive report makes a dire prediction -- that by the year 2020, one in two Americans over age 50 will be at risk for fractures from osteoporosis or low bone mass. Ten million Americans already do have osteoporosis. Many don't discover that they have osteoporosis until they experience an unexpectedly broken bone.

The Surgeon General's report tries to dispel myths associated with osteoporosis. For example, the segment of the population suffering from osteoporosis or other bone disease is NOT small, osteoporosis is NOT only a problem for older white women, diagnosing osteoporosis is NOT a lengthy and painful process, osteoporosis is NOT unresponsive to treatment, and osteoporosis CAN be prevented in the first place

In order to make sure that all the information contained in the report is readily available to the general public, there is not only a free pamphlet entitled The 2004 Surgeon General's Report on Bone Health and Osteoporosis. What it Means To You, but 4 different fact sheets and even a streaming video entitled Osteoporosis in the Family.

Comment: Many of us know of situations in our own families where osteoporosis has had serious consequences. An uncle who broke his hip when he slipped on a wet sidewalk while getting the morning newspaper, a mother whose COPD worsened as her spinal column compressed and her rib cage collapsed, a stepmother who could not walk because it became impossible to surgically repair and re-repair her osteoporotic hips. All of these family members might have lived longer if their osteoporosis had been diagnosed and aggressively treated at an earlier age. Certainly, their quality of life in their final years would have been greatly improved.

Barbara K. Hecht, Ph.D.
Frederick Hecht, M.D.
Medical Editors,

Related Links

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By 2020, One In Two Americans Over Age 50 Will Be At Risk For Fractures From Osteoporosis Or Low Bone Mass

The Surgeon General issues first-ever report on nation's bone health

U.S. Surgeon General Richard H. Carmona, M.D., M.P.H., F.A.C.S., warned today in a new report that by 2020, half of all American citizens older than 50 will be at risk for fractures from osteoporosis and low bone mass if no immediate action is taken by individuals at risk, doctors, health systems, and policymakers. This new report, "Bone Health and Osteoporosis: A Report of the Surgeon General" says that 10 million Americans over the age of 50 have osteoporosis, the most common bone disease, while another 34 million are at risk for developing osteoporosis. And each year, roughly 1.5 million people suffer a bone fracture related to osteoporosis.

This report is the first-ever Surgeon General's report on the topic of bone health. Osteoporosis and other bone diseases, such as Paget's disease and osteogenesis imperfecta can lead to a downward spiral in physical health and quality of life, including losing the ability to walk, stand up, or dress, and can lead to premature death.

"This report will shape the way we approach, talk, and act about bone diseases," HHS Secretary Tommy G. Thompson said. "The more we learn, the more we realize that so many diseases are preventable, from obesity, to many types of cancer, and now bone disease. I want to thank Dr. Carmona and all the scientists and researchers who worked on this report. I look forward to the impact this new information will make in the health of communities."

Other findings in the report include:

  • About 20 percent of senior citizens who suffer a hip fracture die within a year of fracture.
  • About 20 percent of individuals with a hip fracture end up in a nursing home within a year.
  • Hip fractures account for 300,000 hospitalizations each year.
  • The direct care costs for osteoporotic fractures alone are already up to $18 billion each year. That number is expected to increase if action to prevent osteoporosis is not taken now.

"Osteoporosis isn't just your grandmother's disease. We all need to take better care of our bones," Dr. Carmona said. "The good news is that you are never too old or too young to improve your bone health. With healthy nutrition, physical activity every day, and regular medical check-ups and screenings, Americans of all ages can have strong bones and live longer, healthier lives. Likewise, if it's diagnosed in time, osteoporosis can be treated with new drugs that help prevent bone loss and rebuild bone before life-threatening fractures occur."

According to the new report, osteoporosis is a "silent" condition because many Americans are unaware that their bone health is in jeopardy. In fact, four times as many men and nearly three times as many women have osteoporosis than report having the condition. One of the most dangerous myths about osteoporosis is that only women need to worry about bone health. Osteoporosis affects men and women of all races, and while bone weakness manifests in older Americans, strong bones begin in childhood.


Osteoporosis Super-Foods for Strong Bones With Pictures See Slideshow

The Surgeon General's report is a call for Americans to take action to improve and maintain healthy bones. The report includes recommendations on what Americans can do to decrease the likelihood of developing osteoporosis.

These recommendations include:

  • Getting the recommended amounts of calcium and vitamin D. High levels of calcium can be found in milk, leafy green vegetables, soybeans, yogurt and cheese. Vitamin D is produced in the skin by exposure to the sun and is found in fortified milk and other foods. For individuals who are not getting enough calcium and vitamin D in the diet, supplements may be helpful. The average adult under 50 needs about 1000mg of calcium per day and 200 International Units (IU) of Vitamin D (one cup of vitamin D fortified milk provides 302 mg of calcium and 50 IU of Vitamin D).
  • Maintaining a healthy weight and being physically active at least 30 minutes a day for adults and 60 minutes a day for children, including weight-bearing activities to improve strength and balance.
  • Taking steps to minimize the risk of falls by removing items that might cause tripping, improving lighting, and encouraging regular exercise and vision tests to improve balance and coordination.

"I always worried about heart disease and cancer, but was never concerned about the health of my bones," said Abby Perelman, who is being treated for osteoporosis. "I wish I knew then what I know now -- that a healthy diet and physical activity can make bones stronger and healthier."

The report also calls on health care professionals to help Americans maintain healthy bones by evaluating risks for patients of all ages, recommending bone density tests for women over the age of 65 and for any man or woman who suffers even a minor fracture after the age of 50. In addition, the report calls on health care professionals to look for "red flags" that may indicate that someone is at risk, including people who are under 50 who have had multiple fractures, or patients who take medications or have a disease that can lead to bone loss.

"All health care professionals need to be aware of the early indicators of bone disease," said Dr. Lawrence Raisz of the University of Connecticut Health Center, one of the scientific editors of the report. "Many of my patients had no idea their minor fracture was an indication of a larger problem. The health care system can do a better job of helping patients protect themselves from bone disease."

In addition to the release of the report, the Surgeon General has published a companion "People's Piece" specifically written for the American people. The magazine-style, full-color booklet offers ready-to-use information on how people can improve their bone health. This is the second People's Piece that Dr. Carmona has produced as part of his commitments to improving the health literacy of Americans and providing the best scientific information available in a way that everyone can understand and use to live longer, healthier lives. The first People's Piece discussed the health consequences of smoking and was released in May 2004.

The free People's Piece, The 2004 Surgeon General's Report on Bone Health and Osteoporosis: What It Means To You, is available by calling toll free 1-866-718-BONE or visiting

"Thirty years ago, doctors thought weak bones and osteoporosis were a natural part of aging, but today we know they are not. We can do a lot to prevent bone disease," said Dr. Carmona. "Everyone has a role to play in improving bone health, and this report is a starting point for national action on bone health. Let's get started by taking action today in homes, health care settings, and communities across our nation."

Source: US Department of Health & Human Services

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