Treating Osteoporosis in Women Aged 80 and Above
Hearts and Bones
“What are your latest recommendations for treating osteoporosis in women aged 80 and above?”
An HSI member named Bill sent that question. And I’ve got two important tips for Bill and anyone (male or female) who’s at risk of developing osteoporosis: One is a dietary factor to avoid, and one is a key nutrient that most of us need more of.
But before I address osteoporosis treatments, we’ll look at a new study that reveals how osteoporosis and another serious health problem may be closely linked. In fact, this is an important and dangerous connection that women especially need to be aware of.
One thing leads to another
Research has already shown that coronary artery disease (CAD) and low bone mineral density (BMD) have certain risk factors in common. But should low BMD be considered a red flag warning of CAD development?
That question was recently put to the test by researchers at the Ministrelli Women’s Heart Center and the William Beaumont Hospital; both in Royal Oak, Michigan. Researchers examined test results in more than 200 subjects (mostly women) who had x-ray bone testing and catheterization within the same 12-month period. (Catheterization provides a highly effective way to examine coronary arteries for blockage.)
More than 100 subjects were found to have CAD. When the results of the two types of tests were compared, subjects with CAD were much more likely to have low BMD and a diagnosis of osteoporosis. More importantly, osteoporosis provided a stronger predictor of CAD than traditional risk factors such as hypertension and family history of CAD.
The conclusion: “Low BMD appears to independently predict significant CAD in women.” In a Reuters Health interview, lead author of the study, Pamela A. Marcovitz, M.D., suggested that women with brittle bones should be screened for heart disease. She added that when low BMD is aggressively treated, perhaps CAD should be monitored to see if it improves.
Bone support
Now, to return to Bill’s question about treating osteoporosis, we’ll start with the obvious: calcium, the mineral that’s on the front line of osteoporosis prevention. What’s not quite so obvious or well known is that calcium is often poorly absorbed. That problem can be alleviated with magnesium, which helps improve calcium absorption. But there’s still another important nutrient we can add.
In the e-Alert “Skeleton Key” (3/17/04), I told you about a three-year study that compared B-12 levels with BMD in more than 80 women over the age of 65. Researchers at the University of California found that women with the lowest levels of B-12 had a significantly higher risk of bone loss and fractures compared to women with the highest levels.
Another study used data collected from the Framingham Offspring Osteoporosis Study. When Tufts University researchers examined the association between BMD and B-12 levels in more than 2,500 men and women, they found that subjects of either gender who had B-12 concentrations of less than 148 pM, had significantly lower BMD on average compared to subjects with B-12 over 148 pM. (“pM” is a gram-fraction measurement, and “148 pM” designates the cutoff point between an adequate B-12 level and B-12 deficiency.)
The Tuft team concluded: “B-12 deficiency may be an important modifiable risk factor for osteoporosis.” (For more details on vitamin B-12, see the e-Alert “Second Wind” 11/29/05, which you can easily find in the e-Alert archives on our web site at hsionline.com.)
Grain gets in the way
Another factor that plays a role in osteoporosis risk is celiac disease (CD).
More than 1.5 million people in the U.S. may have celiac disease, a condition in which gluten (a component of grains) reduces the small intestine’s ability to absorb essential nutrients, such as calcium. Unfortunately, the symptoms of celiac disease are often so subtle that many people don’t even know they have it.
A study reported in the Archives of Internal Medicine earlier this year investigated the link between celiac disease and osteoporosis in 840 subjects (260 had osteoporosis). Blood tests revealed that CD was much more common among subjects with osteoporosis. In addition, subjects with the most severe cases of celiac disease tended to have the most severe cases of osteoporosis.
Subjects who were diagnosed with CD were asked to follow a gluten-free diet for one year. BMD (measured before and after the follow up year) was considerably improved in subjects who followed the non-gluten diet.
Sources:
“Usefulness of Bone Mineral Density to Predict Significant Coronary Artery Disease” American Journal of Cardiology, Vol. 96, No. 8, 10/15/05, elsevier.com
“Osteoporosis Linked to Heart Disease” Karla Gale, Reuters Health, 11/24/05, reutershealth.com
