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Bone health in the spotlight

Calcium causing heart attacks? Fat women healthier than thin women? These are some of the surprising research findings presented at an osteoporosis conference in Cape Town.

The conference was held by the Society of Endocrinology, Metabolism and Diabetes of South Africa (Semdsa) and National Osteoporosis Foundation of SA (Nofsa).

One of the speakers, renowned New Zealand researcher, Professor Ian Reid, presented some remarkable findings which may help pave the way for future treatments and preventative measures of the bone-thinning disease, osteoporosis.

Osteoporosis is a condition in which bone tissue is reduced. The micro-architecture of bone is disrupted, making the bones porous, leading to an increased risk of fracture which usually involves the spine, hip or wrist. It is widely – and wrongly – thought that osteoporosis is a disease that affects only older women. The truth is that it can affect young women and men too.

There is good news: it’s a preventable disease and most doctors recommend sufficient calcium intake and lifestyle adaptations to prevent its onset.

However, according to Reid, one of his studies found that calcium supplements, which are regularly prescribed to post-menopausal women to help strengthen their bones, may in fact be boosting their risk of heart problems and stroke. The findings were published in the British Medical Journal (BMJ) earlier this year.

Calcium linked to heart problems in older women
The study was conducted by Reid and fellow researchers at the University of Auckland. They analysed data from a study on bone density in which 1 500 healthy women aged over 55 were enrolled and divided into two equal groups.

For the study they were given either daily calcium supplements or a harmless look-alike pill (placebo), and their health was then monitored every six months over five years.

In stark contrast to previous studies of this nature, in the "calcium" group, 60 of the women had 76 so-called cardiovascular events, a term meaning heart attack, stroke or sudden death, during the five-year monitoring period. In the placebo group, 50 of the women had 54 such events.

Previous studies have suggested the opposite effect, that high calcium intake boosts vascular health in post-menopausal women by increasing the proportion of "good" cholesterol in the blood over "bad" cholesterol.

However, Reid did note that while the evidence was compelling, further research had to be conducted to weigh up the negatives and benefits of calcium on bone density.

'Fat is good…'
"…in terms of bone density," says Reid, adding that it is clinically dangerous to one's bone health to be too thin.

"This is one of the things we're trying to impress on young women, that you can't be a healthy skeleton as this will lead to problems later on in life. Scientifically, adding fat mass can protect the bones and may be a lead to future treatments for osteoporosis," he says.

However, he adds that being overweight or obese can also be damaging to one's bones, and therefore recommends a healthy diet with lots of exercise of the weight-bearing variety.

Hassle-free treatment on horizon
For those women – and men – who are already battling with osteoporosis, there is also hope, says Reid.

He spoke of a new treatment in the form of an annual injection, which would replace the current system of a pill twice a day, every day for sufferers.

"The pills do work well, but most people find the preparation is a hassle as there are many 'rules' around taking the pills. The new injection only has to be done once a year and is just as effective a treatment," he says.

Another benefit scientists hope the injection will offer is that, since it requires less daily commitment, more people will be inclined to take the treatment, as many currently forego the tablet regime at the expense of their health.

So, when will this miracle injection be available in SA? Reid says it's already here, but is currently being used in the treatment of another bone disease, Paget's disease.

Source: Professor Ian Reid, University of Auckland, New Zealand; Health24.com

(Amy Henderson, Health24.com, April 2008)

Read more:
Fast facts about osteoporosis
Osteoporosis risk factors for men

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