Attention Men:

Osteoporosis

WebMD Feature

Although much attention has been focused on preventing and reversing osteoporosis in women, researchers are realizing that osteoporosis affects men, as well. "Some of the more recent studies show that older men and women have about equal rates, after age 70, of hip fractures," says Dr. Jesse Krakauer, director of the Beaumont Hospital Bone Health Clinic in Royal Oak, Michigan. According to the National Institutes of Health, osteoporosis affects over 2 million men in the United States. Before the age of 90, 6 percent of all men will suffer a hip fracture as a result of this "silent disease."

What Causes Osteoporosis?

Osteoporosis is a disorder in which bone density decreases, sometimes to the point where a minor fall, bump or even a sneeze can cause a spinal vertebra to collapse like an aluminum can, or a hip to snap like a dry wishbone.

Dr. Frederick Kaplan, orthopedist and professor of Orthopedic Molecular Medicine at the University of Pennsylvania School of Medicine, says that "primary" osteoporosis, which accounts for about half of all cases of osteoporosis, has no well-understood cause. Secondary osteoporosis is related to diseases, immobilization, poor nutrition, medications, alcoholism, smoking and other causes.

Men who appear healthy who don't drink excessively or smoke can make the following smart choices to discourage osteoporosis-related fractures late in life:

Doctors typically recommend walking, climbing, running or other weight-bearing exercises because these involve a beneficial stress to bones that helps maintain their density, which declines naturally with age. Researchers aren't sure why a certain amount of stress is good for the bones, but they theorize that the nerve receptors in the bones and related connective tissue may, when exercise occurs, signal the release of chemicals that act on the type of bone cells that lay down new bone.

Dr. Krakauer notes that it's hard to show that one exercise program is better than another. "We recommend a sustainable exercise and haven't found anything better than walking." He says that treadmill walking has the same effects as regular walking. "Our usual target is about 20 miles a week, which comes out to about 2000 exercise calories a week for most people. That means you have to walk about four miles five times a week." This may be an unrealistic goal for some older men or younger men who don't exercise regularly, so for starters, try walking at least 20 minutes a day, and work your way up to an hour a day.

Calcium is needed, along with phosphorus, to form the crystalline scaffolding of bones. A daily calcium intake of 1000 mg, through diet or supplement (such as calcium carbonate or calcium citrate), is recommended in order to discourage osteoporosis.

But you can't stop there: Other foods you eat may interfere with calcium absorption, so it's important to look at your diet as a whole. "My opinion is that dietary composition is more important than the total amount of calcium intake," says Krakauer. He explains that "most of the studies on calcium intake and bone mass show very little correlation (between the two)... the way you get your calcium, your protein intake and salt determine your calcium balance."

So how do you balance-out your diet? One way is to cut back on the meat. Excessive meat-and-salt consumption causes calcium to be lost through the urine, and American men are notorious for their love of meat and salty products (think burger and fries). Melanie Breitenbach, R.D., who works in the Preventative and Nutritional Medicine division at Beaumont Hospital, explains, "Even if you're getting enough calcium in your diet, you might be losing more than you're intaking if you have a high-protein diet. If you're having 6 ounces of chicken and 8 ounces of beef per day, that's excessive." Her program encourages men to include either beans, legumes or soy in one meal each day. Eating more non-animal proteins adds calcium, vitamin K, magnesium and isoflavones. (Isoflavones are natural plant hormones that may help maintain bone density.) Soy burgers and soy nuts are rich in isoflavones.

Dr. Krakauer also recommends 400 units of vitamin D per day for men over age 50 and 600 units per day for men over 70. He says that this amount can be obtained from two (fortified) glasses of milk or from a multivitamin (check the label for dosage of vitamin D). Other sources of vitamin D include fortified cereals, fatty fish -- such as salmon or sardines -- and exposure to sunlight. Sunning your hands, face and arms 5 to 15 minutes three times per week is adequate, if sunscreen is left off.

Finally, remember that lifestyle changes such as these aren't just good for your bones. They're also good for your whole body.

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