This was printed in the University of Washington's DAILY in 1986.
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Osteoporosis affects many of us. Of all Caucasian women over 60, anywhere from 5% to 30% are afflicted, and it may result, directly or indirectly, in the death of a significant number of them (1-6). Of women over 45, osteoporosis is more common than heart attacks, strokes, diabetes, rheumatoid arthritis, or breast cancer (5). Treating osteoporosis in the United States costs anywhere from three
to six billion dollars per year because of the great many people it affects (5-6). We must be realistic, and form habits that will decrease the chances of getting osteoporosis- curing the disease once it has manifested itself is much more difficult than prevention (9).

Fortunately, intensive research into osteoporosis has given us measures to take NOW that will decrease our chances of getting it later in life. Consuming enough calcium in the diet remains one of the most likely ways to prevent osteoporosis-chronic calcium deficiency has been strongly linked to the disease (3,9). Epidemiologic studies have shown rural residents whose diets are rich in dairy products
suffer less from the symptoms of osteoporosis than others who consume smaller amounts of calcium (5). Furthermore, almost every doctor in the country would agree that we should at least get the USRDA of calcium, yet the large majority of people don't even get that much (7). With many people cutting out dairy products because they want to lose weight, cut down on their cholesterol consumption, or because they have milk allergies, calcium supplements play an important role for many in preventing chronic calcium deficiency. Current research
strongly suggests that even the USRDA is too low, and that it would be beneficial for the college aged population to consume 1000 to 1500 milligrams of calcium daily (10); instead, the average intake of Americans is 450 to 550 milligrams (5,10). Also, if it is necessary to take an antacid, calcium based ones would be the preferred type instead of aluminum based ones, because of aluminum's negative effect
upon bone density, and the correlation of high dietary aluminum to Alzheimer's disease. Soft drinks, which may have a negative effect upon calcium absorption (5), should be consumed minimally (1,8), although supplementation of soft drinks with calcium may provide a beneficial effect. In addition, cigarettes, alcohol, caffeine, and salt all have negative effects upon calcium absorption, and should be minimized.

A subgroup of the osteoporotic female population of the United States has undoubtedly incurred their disease due to calcium deficiency. Calcium repletion, through dietary measures or supplements, has been shown to be of value in stabilizing their osteoporosis. More importantly, calcium intake may provide significant prophylaxis for osteoporosis, particularly in the teenage and early 20's female age groups. Calcium is safe (in the absence of kidney stones), relatively inexpensive, and logistically simple to take. Its usage in the female population appears quite reasonable at this time.

Another misconception is that hard work could be the cause of osteoporosis. For most Americans, more physical activity is indicated because it increases bone density and thus prevents, or at worst, delays the onset of the disease. Sedentary lifestyles tend to speed up the progress of the disease (1-6, 9-10). Other possible benefits of receiving at least the USRDA of calcium include a reduction in high
blood pressure and cancer of the colon (11-16); one of the reasons people develop osteoporosis is because when dietary intake of calcium is inadequate, calcium is taken from the bones to the heart (3), which needs calcium to beat! Optimal dietary calcium intake is of vital importance to those of us who wish to live long, healthy lives.

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Charles H. Chesnut III, M.D.
Professor, Medicine and Radiology
Director, Osteoporosis Research Center
University of Washington
University Hospital, Seattle

Tom Heston

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Partial Reference List:

1. Nutrition News (Dec., 1984. Vol.47 #4)

2. Dairy Council Digest (May-June, 1985. Vol. 56 #3)

3. "Calcium, Magnesium, Iron, and Zinc", Nutrition Cassette Training Program, Dr. Bruce Miller

4. Nutrition News (Dec.,1985. Vol. 48 #4)

5. Newsweek (Jan. 27, 1986.)

6. Consensus Conference. JAMA 252:799, 1984

7. U.S.D.A. Nationwide Consumption Survey, 1980

8. "Calcium and Vitamin D Metabolism" Irwin Rosenburg, UW lecture, 5-15-'86

9. Annual Review of Nutrition, William J. Darby, editor. "Calcium and Osteoporosis" by Avioli.Vol. 4, 1984

10. Alive (Jan., 1986. Vol.2 #5)

11. Science News (Dec. 14, 1985. Vol. 128)

12. Alive (Oct., 1985. Vol.2 #3)

13. Alive (Sept., 1984. Vol.1 #3)

14. Science Digest (Aug., 1985)

15. Spokane Chronicle (Dec. 10, 1985)

16. Health (Sept., 1985)