OSTEOPOROSIS A CHILDHOOD CONDITION, EXPERT SAYS

COLUMBUS, Ohio -- Osteoporosis is a pediatric condition with geriatric consequences and medical professionals should treat it as such, an Ohio State University expert says.

"When we don't take care of our bones during the growing period of childhood and adolescence, we increase our risk of developing osteoporosis and subsequent bone fractures later in life," said Jasminka Z. Ilich, a research scientist with Ohio State's Bone and Mineral Metabolism Laboratory and lead author of a recent review article on prevention of osteoporosis in adolescence. "Overall, it is likely that variations in calcium nutrition early in life may account for as much as a 5 to 10 percent difference in peak adult bone mass. Such a difference probably contributes to more than 50 percent of the difference in the hip-fracture rate later in life."

Osteoporosis, which is estimated to affect 30 percent of post- menopausal white women, is a disease characterized by a reduction of bone tissue relative to the volume of a given bone.

This "hollowing out" of the bone increases its susceptibility to fracture.

"Fractures are more common among Caucasian and Asian women than African-American women," Ilich said. "Africans have denser skeletons than Caucasians, and as a direct consequence of this, they suffer fewer bone fractures."

Ilich's co-authors on the review article are Nancy E. Badenhop, a research associate with the Bone and Mineral Metabolism Laboratory, and Velimir Matkovic, principal investigator at the Bone and Mineral Metabolism Laboratory and an associate professor of physical medicine and rehabilitation, both from Ohio State. The group's work appeared in a recent issue of the journal Women's Health Issues.

Previous studies in the Bone and Mineral Metabolism Laboratory have shown that young people accumulate about 37 percent of their total bone mass during the adolescent growth spurt, Ilich said. "Most of the bone mass at multiple skeletal locations is accumulated by late adolescence," she said. Because of this, it's crucial to identify factors that will maximize peak bone mass in adolescence, she said.

One obvious factor is calcium intake. "Below a certain threshold level of dietary calcium intake, young people are not able to reach their peak bone mass, whereas adults lose bone tissue at a faster rate than is necessary," Ilich said. "Adequate calcium intake at or above a certain threshold level is therefore absolutely required for bone health during the skeletal growth of adolescence, as well as for prevention of excessive bone loss with advancing age."

Previous studies at Ohio State have shown that this "threshold level" for adolescents is about 1,500 milligrams of calcium per day -- far above the current Recommended Daily Allowance (RDA) for this age group of 800 to 1,200 milligrams of calcium per day.

"The current RDAs are from 1989, and they will probably change soon," Ilich said. "There is compelling evidence to increase the RDA for calcium for all age groups, not just adolescents."

However, just raising the RDA for calcium in adolescents may not be enough. A Bone and Mineral Metabolism Laboratory study last year found that the more sodium a person eats, the more calcium he or she excretes in urine. "Sodium actually pulls the calcium out," Ilich said. "Every 2,300 milligrams of sodium can draw out up to 60 milligrams of calcium." According to these figures, Ilich said, an adolescent girl eating about 10,000 milligrams of sodium a day in potato chips and fast food could be losing close to 300 milligrams of her calcium intake each day -- calcium she can ill afford to lose.

"The results of our study suggest that calcium requirements for adolescents should possibly be adjusted for sodium intake," she said.

Ilich said the next few years will be a crucial window of opportunity for preventing a painful, costly future epidemic of osteoporosis.

"According to the U.S. Census Bureau, the teen population will grow at nearly twice the rate of the overall population in the next decade. It is expected to reach 30.8 million at its peak in the year 2015," she said. "This population should be targeted as the risk group for osteoporosis. Preventive strategies that promote adequate calcium intake, proper diet and exercise programs should be implemented in an effort to increase peak bone mass in this group."

Contact: Jasminka Z. Ilich, (614) 293-3838; Ilich.1@osu.edu

Written by Kelly McConaghy Kershner, (614) 292-8308; Kershner.4@osu.edu


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