Osteoporosis and African-American Women 

What is Osteoporosis 

Osteoporosis is a metabolic bone disease characterized by low bone mass, which makes bones fragile and susceptible to fracture. Osteoporosis is commonly called the "silent disease" because there are no symptoms or pain until fracture occurs. Fractures can result in loss of height, pain, and deformity. 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. Furthermore, as African-American women age, their risk of developing osteoporosis more closely resembles the risk among white women. So, as the number of older African-American women in the United States increases, there will be an increasing number of African-American women with osteoporosis. 

What are the risk factors for osteoporosis? 

Risk factors for developing osteoporosis include: thinness or small frame; family history of osteoporosis; being postmenopausal or having had early menopause; abnormal absence of menstrual periods; prolonged use of certain medications, such as those used to treat diseases like systemic lupus erythematosus, asthma, thyroid deficiencies, and seizures; low calcium intake; physical inactivity; smoking; and excessive alcohol intake. 

Recent scientific studies highlight the risk that African-American women face with regard to developing osteoporosis and fracture. 
 
 

	Approximately 300,000 African-American women currently have osteoporosis.
	Between 80-95% of fractures in African-American women over 64 are due to osteoporosis.
	African-American women are more likely than white women to die following a hip fracture.
	As African-American women age, their risk for hip fracture doubles approximately every seven years.
	Diseases more prevalent in the African-American population, such as sickle-cell anemia and systemic lupus erythematosus, are linked to osteoporosis.

How does nutrition affect African-Americans and their risk of osteoporosis? 

Adequate intake of calcium plays a crucial role in building peak bone mass and preventing bone loss. Studies indicate that African-American women consume 50 percent less calcium than the Recommended Dietary Allowance. The National Academy of Sciences suggests the following intake levels for women:
 
 

Lactose intolerance can also hinder optimal calcium intake. As many as 75 percent of all African-Americans are lactose intolerant. However, a recent study found that many people who are lactose intolerant can actually digest as much as two cups of milk per day, if divided into small servings, without symptoms. Although milk and other dairy products such as cheese and yogurt are the best calcium sources, there are many non-dairy foods that also contain calcium. Turnip greens, mustard greens, and kale are good sources of calcium among green vegetables; however large quantities must be consumed to equal the amount of calcium supplied by dairy products. Sardines and salmon with edible bones and calcium-fortified orange juice are also good sources of calcium. 

How is osteoporosis diagnosed? 

Osteoporosis is diagnosed by a bone mineral density (BMD) test, a safe and painless test used to detect low bone mass. Talk to your doctor about a BMD test if you have reached menopause and/or if you have some of the risk factors for osteoporosis listed earlier. With the results of a BMD test, you and your doctor can decide what prevention or treatment steps are right for you. 

How can osteoporosis be prevented? 

The prevention of osteoporosis begins in childhood. The recommendations listed below should be followed throughout life to lower your risk of osteoporosis. 
 
 

	Eat a balanced diet adequate in calcium and vitamin D.
	Exercise regularly, especially weight-bearing activities such as walking, jogging, dancing and weight-lifting.
	Avoid smoking and excessive alcohol intake.

What treatments are available? 

Although there is no cure for osteoporosis, there are drugs available to help stop further bone loss and may lower a persons risk of fracture. Talk to your doctor about these medications: 
 
 

	alendronate, risedronate (bisphosphonates)
	calcitonin
	raloxifene (Selective Estrogen Receptor Modulator)
	teriparatide (parathyroid hormone)
	estrogen/hormone therapy

What are some special considerations for caring for elderly individuals with osteoporosis? 

For people with osteoporosis preventing falls is essential to decrease the risk of fracture. Some basic preventive measures include: getting regular exercise to increase balance and muscle strength; having regular physical exams, including vision and hearing tests; learning the proper way to use walkers and canes; reviewing with your doctor the medications you are taking; and, removing throw rugs from the house, installing grab bars, stair rails, and applying non-skid tape on the outer edges of stairs are tips that will help avoid potentially dangerous situations in the home. Make sure you consult a doctor before embarking on an exercise program or participating in other physical activities. 

Revision Date: 1/2003

The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases with contributions from the National Institute of Child Health and Human Development, National Institute of Dental and Craniofacial Research, National Institute of Diabetes and Digestive and Kidney Diseases, NIH Office of Research on Women's Health, DHHS Office on Women's Health, and National Institute on Aging.