Bone and Joint Matters, Part 1

It has been a while since we have discussed the importance of healthy bones and joints. For the next few weeks, we will be writing about bone health and how we can maintain healthy bones and joints.

Bone Matters

One aspect of health that is often misunderstood or ignored is bone health. The skeletal system is the body’s second-largest organ consisting of 206 bones in adults. Many people perceive our bones as a static, rigid structure when the exact opposite is true. Our bones are a dynamic organ that is in a state of constant renewal and rebuilding. This is called bone remodeling and through this process, we replace our entire skeletal structure every 10 years or about seven to eight times in our lifetime.

The skeleton serves many physical and physiological functions. It provides structural support, movement, and protective armor for our vital organs. The bones are the site for the production of red blood cells to deliver oxygen to our cells and produce white blood cells for a healthy immune system. Recent advances point to the skeleton as an endocrine organ that modulates glucose tolerance and testosterone production by secretion of a bone-specific protein, osteocalcin.

Our bones are the mineral bank for our entire body. All vital organs and tissues require minerals to be released from the bones daily. Our body’s organs receive calcium from the bones. For example, the heart needs 100 mg of bone calcium a day for steady beats. The brain needs 150 mg of bone calcium to keep sharp and our intestines require 600 to 900 mg of bone calcium daily.

Through the process of bone, remodeling minerals are released from old bone by specialized cells called osteoclasts, and new bone is replaced by bone builder cells, osteoblasts. Good bone health is a balance of this resorption of older bone and the formation of new bone for stable and strong bones. Healthy bones are vital to our joints and our whole body.

Regardless of age, we all need to keep our bones healthy. Children continue to build bone mass as they grow. Bone mineral density peaks between the ages of 20 and 30. Up to the age of 30, the body makes new bone faster than it breaks down old bone, so bone mass increases. After that, the pace of healthy bone formation slows down so that more bone is lost than formed. This decrease in bone density results in weaker bones that are more susceptible to fracture. Maintaining bone health becomes more challenging and critical as we grow older for a variety of reasons.

The main issue in this decrease in bone density is directly correlated with calcium and the body’s ability to absorb and utilize dietary calcium which diminishes with age.

Societal Issues

Bone and joint health are major problems in our society. The Surgeon General of the United States reported that astounding numbers of Americans have bone and joint issues. Twelve million have osteoporosis with 40 million having low bone mass (osteopenia) and 66 million with joint problems such as arthritis, cartilage loss and calcium deposits. That represents nearly 1/3rd of the population.

The National Osteoporosis Foundation states that 54 million Americans have osteoporosis and low bone mass. Studies suggest that one in two women and one in four men aged 50 or older will break a bone due to osteoporosis.

Osteoporosis is a Global Disease

In December 2012, a study on the Global Burden of Disease and the worldwide impact of all diseases and risk factors found musculoskeletal conditions such as arthritis and back pain affect more than 1.7 billion people worldwide, are the second greatest cause of disability, and have the 4th greatest impact on the overall health of the world population when considering both death and disability. Bone and joint disorders account for more than one-half of all chronic conditions in people older than 50 years of age in developed countries and are the most common cause of severe, long-term pain and disability.

According to the International Osteoporosis Foundation, 1 in 3 women and 1 in 5 men over the age of 50 will suffer an osteoporotic fracture. In fact, a bone will break every 3 seconds because of this disease. This has an enormous human and socio-economic impact. Many people don’t know they have osteoporosis until their first fracture, which is why it’s called the ‘silent disease’. Osteoporosis is estimated to affect 200 million people globally, with 55% of people over 50 currently at increased risk of fracture due to low bone mass.

You will not fall and break your bone

You will break your bone ...and fall

Osteoporosis is a silent disease because we do not perceive our bones as weakening. In fact, very few of us even think about the health of our bones. Breaking a bone is often the first sign of loss of bone density or osteoporosis. Osteoporotic bone breaks are most likely to occur in the hip, spine, or wrist, but other bones can break too. Twenty percent of seniors who break a hip die within one year from complications related to the broken bone or the surgery to repair it. Many require long-term nursing home care.

While our bones naturally age as we do, there are things you can do to prevent osteoporosis and joint problems regardless of age. This will be the subject of next week’s Impetus for our series on bone health.