PUTTING OSTEOPOROSIS IN PERSPECTIVE

Osteoporosis is characterized by a reduction in bone mineral density ( BMD). Dietary patterns that encourage adequate calcium intake are esse ntial to maximal development and later maintenance of bone mass. The m ajority of white women are at risk for osteoporosis-related fractures, especially in the wrist, spine, and hip. The degree of fracture risk at a specific bone site is best assessed by measuring BMD with single- or x-ray-photon absorptiometry. BMD in adults of any age is quite var iable. Numerous diet and lifestyle factors influence BMD and, in turn, fracture risk. Sufficient evidence exists for a relationship between BMD and diet, particularly calcium and vitamin D; amenorrhea; body wei ght; alcoholism; smoking; and physical inactivity. Less convincing evi dence exists for a relationship with dietary protein, dietary phosphor us, and caffeine intake. To minimize fracture risk, young women should have regular menses, consume a nutritionally adequate diet (according to the principles of the Food Guide Pyramid), perform regular physica l activity, only consume a moderate intake of alcohol (if any), and no t smoke. Postmenopausal women should follow those same guidelines and should seriously consider estrogen replacement therapy. Elderly person s especially should ensure adequate calcium and vitamin D nutriture. C urrently, osteoporosis is the rule, rather than the exception, in old age for many white women. Dietitians can help reduce the prevalence of this disorder.