New IOF report shows smoking, alcohol, being underweight and poor nutrition harm our bones

World Osteoporosis Day celebrated in some 80 countries
The new IOF thematic report: "Beat the Break: Know and Reduce Your Osteoporosis Risk Factors" One of seven different posters issued for World Osteoporosis Day

If you smoke, drink more than two units of alcohol a day, are underweight, don’t exercise or eat well, you could be setting yourself up for osteoporosis later in life, according to a new report issued today by the International Osteoporosis Foundation (IOF) on the occasion of World Osteoporosis Day (WOD).

The new report “[link 800]Beat the Break: Know and Reduce Your Osteoporosis Risk Factors[/link]” shares its title with the theme of WOD 2007, celebrated today with international activities by IOF’s member societies in more than eighty countries.

IOF Chief Executive Officer Daniel Navid, speaking at a media conference in Dubai, noted: “By 2050, it is estimated that incidence of hip fracture, a major consequence of osteoporosis, will increase by 310 and 240 percent in men and women. Osteoporosis-related fractures often imply pain, loss of function and, in the worse cases, death.”

Professor Cyrus Cooper, author of the “Beat the Break” report and IOF board member, said, “Worldwide, the incidence of osteoporosis is growing at epidemic proportions – we now know that one woman in three and one man in five over fifty will experience an osteoporotic fracture. But it doesn’t have to be this way. If people recognize osteoporosis risk factors when they are young and take appropriate action, it can have enormous positive impact on their bone health in later years.”

The IOF urges individuals to take the new [link 348]IOF One-Minute Osteoporosis Risk Test[/link]. In addition, by following a bone-friendly lifestyle, which includes eating a nutritious diet, taking regular exercise and avoiding smoking and excess alcohol, they can help build strong bones and prevent fractures.

Risk factors fall into two main categories, modifiable and fixed. Although we can’t control fixed risk factors, which include age, gender, and family history, there are strategies that can lessen their effect.

Modifiable risk factors primarily arise because of unhealthy diet or lifestyle choices. They include poor nutrition, low body mass index, eating disorders, alcohol, smoking, and insufficient exercise. Most of these risk factors directly affect bones and result in a decrease in bone mineral density (BMD).

Studies from Europe, North America and Australia show that more than two units of alcohol per day can increase the risk for osteoporotic and hip fractures in both men and women.

Smoking also increases a person’s fracture risk. International studies have shown that smoking increases the risk for hip fracture by up to 1.5 fold. Studies carried out in Sweden showed that young male smokers, 18-20 years old, have reduced BMD. This finding is particularly troubling because it suggests that smoking in young people may reduce their peak bone mass – established in the early to mid 20s – and thereby increase the risk of osteoporosis in later life.

The body mass index, or BMI, is a measure of how lean someone is and can be used as a guide to measure his or her osteoporosis risk. Doctors believe that a BMI of 20 to 25 is ideal. BMI below 19 is considered too low and a risk factor for osteoporosis.

Poor nutrition and low dietary calcium intake
Poor nutrition is associated with low BMI, and can affect bone health, particularly when diets are insufficient in calcium. Calcium is an essential part of bone mineral content but it is also essential for muscles, nerves and other cells in the body.

Vitamin D deficiency
Vitamin D, mainly made in the skin on exposure to sunlight, is also essential, since it helps calcium absorption from the intestines into the blood. In children and adults, casual exposure of the face, hands and arms to sunlight for as little as 10-to-15 minutes a day is usually sufficient.

Eating disorders
Osteoporosis can also be compounded by eating disorders such as anorexia nervosa and bulimia. These conditions can dramatically reduce calcium intake and accelerate mineral loss from bone.

Insufficient exercise
People with a more sedentary lifestyle are more likely to have a hip fracture than those who are more active. For example, women who sit for more than nine hours a day are 50% more likely to have a hip fracture than those who sit for less than six hours a day.

Frequent falls
Ninety percent of hip fractures result from falls. Visual impairments, loss of balance, neuromuscular dysfunction, dementia, immobilization, and use of sleeping pills which are quite common conditions in elderly persons, significantly increase the risk of falling and the risk of fracture.

Fixed risk factors are those that individuals are born with or cannot alter. They include age, gender, family history of fracture, the presence of a previous fracture, ethnicity, and the onset of early menopause. It is important to be aware of these fixed risks so steps can be taken to reduce loss of bone minerals.

Age is one of the primary fixed risks for osteoporosis. The vast majority of hip fractures (90%), occur in people aged 50 and older. This is partly because of reduced bone mineral density – in middle age, people begin to lose bone minerals faster than it is replaced.

Gender is another major fixed risk. Women, particularly post-menopausal women, are more susceptible to bone loss than men because their bodies produce less estrogen.

Family history
Genetics also plays a large part in osteoporosis. Some people more susceptible to osteoporosis than others, due to genetic predisposition.

Previous fracture
People with a prior fracture are at increased risk of any type of fracture compared to people who have never broken a bone. Both genders are almost twice (1.86 times) as likely to have a second fracture compared to people who are fracture free.

Osteoporosis is more common in Caucasian and Asian populations and the incidence of osteoporosis and fractures of the hip and spine is lower in African populations than in Caucasians.

Hysterectomy, if accompanied by removal of the ovaries, may also increase the risk for osteoporosis because of estrogen loss. Post-menopausal women must be particularly vigilant about their bone health.

Long-term glucocorticoid therapy
Long-term corticosteroids use, which can lead to increased bone turnover, is a very common cause of secondary osteoporosis and is associated with an increased risk of fracture.

Rheumatoid arthritis
Rheumatoid arthritis can take a heavy toll on bones.

Primary/secondary hypogonadism in men:
Like estrogen deficiency in women, androgen deficiency in men, (primary or secondary hypogonadism) increases the risk of fracture.

Other disorders and medical treatments
Certain disorders, like gastrointestinal and endocrine disorders for example, may directly or indirectly affect bone health. There are also medications which may have side effects the directly weaken bone or increase risk of fracture due to falling.


Fonterra Brands
“We are committed to the fight against the social and economic impacts of osteoporosis worldwide,” Pradeep Pant, Regional Managing Director Asia-Middle East, Fonterra Brands said. “We began raising awareness about the perils of poor bone health more than 15 years ago. Since then, we have made a significant contribution to lifting its profile through setting up and supporting osteoporosis societies; driving education; and providing our bone scanning programmes. To date, we have provided more than 1.3 million free bone scans across nine countries and this programme is now an integral part of our awareness raising activities. We are proud to partner with IOF for another three years and support their hard-working and valuable efforts in battling poor bone health”.

“The IOF World Osteoporosis Days have been an excellent opportunity for Novartis to generate interest and awareness among both patients and employees,” said Stephan Korte, Global Advocacy, Novartis Pharma AG. “The silent disease osteoporosis represents a major burden of disease for society and the IOF activities on World Osteoporosis Day have significantly increased public awareness and discussions about this important health issue of our modern times.”

Merck & Co.
“Merck & Co., Inc. Whitehouse Station, NJ, USA is a proud continuing sponsor of World Osteoporosis Day,” said Graham Lumsden, Merck global brand leader, osteoporosis. “With our long history in this disease area, Merck remains committed to helping improve the health and well being of osteoporosis patients worldwide. Osteoporosis remains a major public health threat and the most prevalent bone disease that can lead to bone loss and increased fracture risk. An estimated one in two women over age 50 are likely to suffer from osteoporotic fracture in their lifetime which can result in functional decline and a negative impact on quality of life.”

Tetra Pak
Tetra Pak is committed to raising awareness of the nutritional benefits milk and other dairy products play in maintaining a healthy diet and preventing diseases such as osteoporosis. Thanks to our milk processing, packaging and dairy industry expertise, we work with our customers and other key partners such as the IOF to promote bone health among consumers and our employees. We also support school feeding and agricultural development programmes allowing emerging nations to enjoy the nutritional benefits of a dairy-rich diet," said Jörgen Haglind, Senior Vice President, Corporate Communications, Tetra Pak.

[link 255]World Osteoporosis Day[/link], which begins the “Year of Bone-health Awareness” saw the launch of imaginative new information leaflets for the general public and fact sheets summarizing the latest science on osteoporosis risk factors.

Also released by IOF today were three 30-second [link 588]public service announcements[/link] featuring American comedienne Joan Rivers, the Jamaica Bobsled team and former surfing champion Andrea Lopez, from Brazil, who urge individuals to discover if they are at risk of osteoporosis and to “Beat the Break”.

WOD 2007 is supported by an unrestricted educational grant provided by four Global Gold Sponsors: Fonterra Brands, Novartis, MSD and Tetra Pak.