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.

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• 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), risedronate (Actonel), 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).

Resources

For additional information on osteoporosis, including lactose
intolerance, nutrition, exercise, treatment, and fall prevention for the
elderly, visit the National Institutes of Health Osteoporosis and Related Bone
Diseases ~ National Resource Center Web site at www.niams.nih.gov/bone or
call 1-800-624-2663.

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For additional information on minority health, visit the Office of
Minority Health Resource Center Web site at http://www.omhrc.gov/OMHRC or call
1-800-444-6472.

For Your Information

This publication contains information about medications used to
treat the health condition discussed here. When this fact sheet was printed, we
included the most up-to-date (accurate) information available. Occasionally, new
information on medication is released.

For updates and for any questions about any medications you are
taking, please contact the U.S. Food and Drug Administration at 1-888-INFO-FDA
(1-888-463-6332, a toll-free call) or visit their Web site at www.fda.gov.

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