Osteoporosis and African American Women
While African American women tend to have higher bone mineral density (BMD) than white women throughout life, they are still at significant risk of developing osteoporosis. The misperception that osteoporosis is only a concern for white women can delay prevention and treatment in African American women who do not believe they are at risk for the disease.
What Is Osteoporosis?
Osteoporosis is a metabolic bone disease characterized by low bone mass, which makes bones fragile and susceptible to fracture. Osteoporosis is known as a silent disease because symptoms and pain do not appear until a fracture occurs. Without prevention or treatment, osteoporosis can progress painlessly until a bone breaks, typically in the hip, spine, or wrist. A hip fracture can limit mobility and lead to a loss of independence, while vertebral fractures can result in a loss of height, stooped posture, and chronic pain.
What Are the Risk Factors for Osteoporosis?
Risk factors for developing osteoporosis include:
- a thin, small-boned frame
- previous fracture or family history of osteoporotic fracture
- estrogen deficiency resulting from early menopause (before age 45), either naturally, from surgical removal of the ovaries, or as a result of prolonged amenorrhea (abnormal absence of menstruation) in younger women
- advanced age
- a diet low in calcium
- Caucasian and Asian ancestry (African American and Hispanic women are at lower but significant risk)
- cigarette smoking
- excessive use of alcohol
- prolonged use of certain medications, such as those used to treat diseases like lupus, asthma, thyroid deficiencies, and seizures.
Are There Special Issues for African American Women Regarding Bone Health?
Many scientific studies highlight the risk that African American women face with regard to developing osteoporosis and fracture.
- Osteoporosis is underrecognized and undertreated in African American women.
- As African American women age, their risk for hip fracture doubles approximately every 7 years.
- African American women are more likely than white women to die following a hip fracture.
- Diseases more prevalent in the African American population, such as sickle-cell anemia and lupus, can increase the risk of developing osteoporosis.
- African American women consume 50 percent less calcium than the Recommended Dietary Allowance. Adequate intake of calcium plays a crucial role in building bone mass and preventing bone loss.
- As many as 75 percent of all African Americans are lactose intolerant. Lactose intolerance can hinder optimal calcium intake. People with lactose intolerance often may avoid milk and other dairy products that are excellent sources of calcium because they have trouble digesting lactose, the primary sugar in milk.
How Can Osteoporosis Be Prevented?
Osteoporosis prevention begins in childhood. The recommendations listed below should be followed throughout life to lower your risk of osteoporosis.
- Eat a well-balanced diet adequate in calcium and vitamin D.
- Exercise regularly, with an emphasis on weight-bearing activities such as walking, jogging, dancing, and lifting weights.
- Live a healthy lifestyle. Avoid smoking, and, if your drink alcohol, do so in moderation.
Talk to your doctor if you have a family history of osteoporosis or other risk factors that may put you at increased risk for the disease. Your doctor may suggest that you have your bone density measured through a safe and painless test that can determine your risk for fractures (broken bones), and measure your response to osteoporosis treatment. The most widely recognized bone mineral density test is called a dual-energy x-ray absorptiometry or DXA test. It is painless: a bit like having an x ray, but with much less exposure to radiation. It can measure bone density at your hip and spine.
What Treatments Are Available?
Although there is no cure for osteoporosis, there are treatments available to help stop further bone loss and reduce the risk of fractures:
- bisphosphonate drugs: alendronate (Fosamax1), alendronate plus vitamin D (Fosamax Plus D), risedronate (Actonel), risedronate with calcium (Actonel with Calcium), and ibandronate (Boniva)
- calcitonin (Miacalcin)
- raloxifene (Evista), a Selective Estrogen Receptor Modulator
- teriparatide (Forteo), a form of the hormone known as PTH, which is secreted by the parathyroid glands
- estrogen therapy (also called hormone therapy when estrogen and another hormone, progestin, are combined).
Sources: NIH; National Library of Medicine