A Third Epidemic

Philip J. Goscienski, M.D.

April 2007

The scientific community warns that we are in the midst of worldwide epidemics of obesity and type 2 diabetes. The third epidemic has begun: osteoporosis. Just like the others it has been broadcasting warning signals for decades but the general public is not aware of the early signs. The full impact will arrive when today's twenty-somethings reach retirement age, perhaps earlier.

New factors that contribute to osteoporosis have emerged in recent decades. Any single one of these is not a serious threat. When they all converge as they are doing now the total effect is a surge of osteoporosis that will diminish the quality of life. Medical specialists see tell-tale problems among their own patients but few of them pay attention to the overall picture

For instance, orthopedic surgeons have noted that forearm fractures are more common among children now than they were in the past. Some blame it on obesity; others note that today's children are less active and take in less calcium. It's probably a combination of all these things.

Obstetricians encourage their pregnant teenagers to eat more dairy products because 90 percent of today's young women don't get enough calcium. But they don't get enough zinc, omega-3 fats, vitamin D or physical activity either. All of these are major factors in building a strong skeleton and only during childhood and early adult life is it possible to do so. Pregnant adolescents are at greatest risk. Unlike their grandmothers, who were physically active and better nourished, these young women don't make up the loss of calcium following delivery. The hip bones of young mothers are less dense than those of their non-pregnant peers and hip fracture is more likely by the time they enter late middle age.

Pediatricians, internists and family practice specialists care for girls with anorexia who literally starve themselves. We already know that their waif-like bodies have thin bones that will break as they age, if they make it that far. Although diagnosed anorexia is not common, less obvious eating disorders are, up to 17 percent of girls in some studies. Even mild, unrecognized eating disorders will make osteoporosis more likely when these girls become grandmothers.

At the opposite end of the weight spectrum are the severely obese. The ones who undergo stomach reduction surgery, depending on the type of procedure, may have bone loss in subsequent years. The long-term follow-up of these patients is limited but the annual increase of persons submitting to this procedure has been remarkable in the past few years and it is being done on children as young as 11 years.

Nature gives young persons a window during which they can build a strong skeleton but that window closes in the mid-20s. After the window closes, mature adults who do not keep their bones under stress with weight-bearing exercises such as walking and resistance exercises lose bone every year and just taking the recommended dose of calcium will in no way prevent that.

Osteoporosis is not an isolated health problem. The same good habits that keep obesity and type 2 diabetes at bay will protect our children from the third epidemic as well.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.