NATIONAL OSTEOPOROSIS FOUNDATION RELEASES NEW CLINICAL RECOMMENDATIONS FOR LOW BONE MASS AND OSTEOPOROSIS INCORPORATING ABSOLUTE FRACTURE RISK
Washington, DC (February 21, 2008) - The National Osteoporosis Foundation (NOF) is releasing its new Clinician's Guide to Prevention and Treatment of Osteoporosis representing a major breakthrough in the way healthcare providers evaluate and treat people with low bone mass or osteoporosis and the risk of fractures. NOF's new Clinician's Guide introduces guidelines beyond Caucasian postmenopausal women to include African-American, Asian, Latina and other postmenopausal women, and addresses men age 50 and older for the first time.

Osteoporosis is a major public health problem that has both a medical and economic impact in the U.S. Fractures caused by either osteoporosis or low bone mass can lead to chronic pain, disability and even death, as well as psychological symptoms, including depression. Each year broken bones due to low bone mass or osteoporosis cause over 432,000 hospital admissions, almost 2.5 million medical office visits and about 180,000 nursing home admissions.

"NOF's new Clinician's Guide dramatically alters the approach to assessing fracture risk and treatment," said Bess Dawson-Hughes, M.D., chair of the Clinician's Guide Development Committee and past president of NOF. "The Guide provides evidenced-based recommendations to help healthcare providers better identify people at high risk for developing osteoporosis and fractures and assures that those at highest risk are recommended for treatment to lower that risk."

The new Clinician's Guide applies the recently released algorithm on absolute fracture risk called FRAX® by the World Health Organization (WHO). FRAX® is also referred to as a 10-year fracture risk model and 10-year fracture probability. This algorithm estimates the likelihood of a person to break a bone due to low bone mass or osteoporosis over a period of 10 years.

Absolute fracture risk methodology provides a markedly improved method to assure that people with the highest fracture risk get treated. Those at highest risk include postmenopausal women and older men with a diagnosis of osteoporosis, based on a BMD test T-score of -2.5 or lower, or those with a clinical diagnosis based on having sustained a hip or spine fracture. In addition, absolute fracture risk calculations help to resolve many of the questions about management for people with low bone mass, also called osteopenia. These are people with a T-score between -1.0 and -2.5 on their bone mineral density (BMD) test.

The WHO algorithm takes into account not only bone mineral density (BMD) at the hip but also nine specific clinical risk factors for osteoporosis and related fractures. NOF has adapted this algorithm for the U.S. and incorporates not only fracture outcome and mortality data from U.S. women and men, but also cost effectiveness analysis to determine when it is cost effective to treat a person with an osteoporosis medication to prevent a fracture.

"In developing the new Clinician's Guide, NOF is providing healthcare professionals in the U.S. with the newest advances for diagnosing and managing osteoporosis," said Ethel Siris, M.D., president of the National Osteoporosis Foundation. "To be able to better identify and treat those patients at risk for osteoporosis and costly fractures will have a positive impact on the medical, emotional and economic burden that osteoporosis bears on this country."

In the near future, some central DXA (dual-energy x-ray absorptiometry) machines that test the bone mineral density of the hip and spine should be able to provide a report that gives information on a person's absolute fracture risk by incorporating the NOF application of the WHO algorithm into the bone density machine's computer. Alternatively, clinicians can also enter a patient's bone mineral density hip T-score and other risk factor information in a simple web-based version of the algorithm in the doctor's office to obtain absolute fracture risk in seconds. The information about absolute fracture risk will help both healthcare providers and patients decide whether treatment with an osteoporosis medication is needed.

The new Clinician's Guide also provides recommendations for clinicians on when to do bone mineral density testing, clinical evaluation, risk factors for falls and universal recommendations for the prevention of osteoporosis. NOF summarizes the universal recommendations in its 5 Steps to Bone Health. These 5 Steps advise people to:
1. Get the daily recommended amounts of calcium and vitamin D.
2. Engage in regular weight-bearing and muscle-strengthening exercise.
3. Avoid smoking and excessive alcohol.
4. Talk to your healthcare provider about bone health.
5. Have a bone density test and take medication when appropriate.

The new Clinician's Guide recommends that adults over age 50 get 1,200 mg of calcium and 800-1,000 IU of vitamin D3 daily. Vitamin D3 is the form of vitamin D that best supports bone health. It is also called cholecalciferol.

The Clinician's Guide was developed by an expert committee of NOF in collaboration with a multi-specialty council of medical experts in the field of bone health convened by NOF. The Clinician's Guide provides recommendations that are intended to serve as a reference for clinical decision making with individual patients. The recommendations are not intended to be rigid standards, limits or rules and should not be interpreted as quality standards. Earlier versions of the updated Clinician's Guide to Prevention and Treatment of Osteoporosis were called the Physician's Guide to Prevention and Treatment of Osteoporosis.

Established in 1984, the National Osteoporosis Foundation is the nation's leading voluntary health organization solely dedicated to osteoporosis and bone health. Our mission is to prevent osteoporosis, to promote lifelong bone health, to help improve the lives of those affected by osteoporosis and related fractures, and to find a cure. For more information on osteoporosis and bone health, contact NOF online at www.nof.org or by telephone (800) 223-9994.

AAP Release Calcium Report

The American Academy of Pediatrics (AAP) recently released the report, “Optimizing Bone Health and Calcium Intakes of Infants, Children and Adolescents.” The key elements within this revised report include:

• Recognition that kids are not meeting calcium recommendations, putting them at risk for fractures and osteoporosis
• Call to action for pediatricians to screen/assess calcium intake
• Recommendation for children to consumer 3 servings of milk, flavored milk, cheese or yogurt each day, choosing lowfat and non fat varieties often (4 servings per day recommended for adolescents
• Importance of vitamin D and physical activity, in addition to calcium
• Call to action for parental/family role modeling

Little Milk, Exercise Hurts Kids' Bones
Tracking How Too Little Milk, Sunshine and Exercise Hurts Kids' Bones
By LAURAN NEERGAARD
The Associated Press
WASHINGTON

Too little milk, sunshine and exercise: It's an anti-bone trifecta. And for some kids, shockingly, it's leading to rickets, the soft-bone scourge of the 19th century.
But cases of full-blown rickets are just the red flag: Bone specialists say possibly millions of seemingly healthy children aren't building as much strong bone as they should a gap that may leave them more vulnerable to bone-cracking osteoporosis later in life than their grandparents are. "This potentially is a time-bomb," says Dr. Laura Tosi, bone health chief at Children's National Medical Center in Washington.

Read Full Article Here

AAP Release Calcium Report

The American Academy of Pediatrics (AAP) recently released the report, “Optimizing Bone Health and Calcium Intakes of Infants, Children and Adolescents.” The key elements within this revised report include:

• Recognition that kids are not meeting calcium recommendations, putting them at risk for fractures and osteoporosis
• Call to action for pediatricians to screen/assess calcium intake
• Recommendation for children to consumer 3 servings of milk, flavored milk, cheese or yogurt each day, choosing lowfat and non fat varieties often (4 servings per day recommended for adolescents
• Importance of vitamin D and physical activity, in addition to calcium
• Call to action for parental/family role modeling

Read Full Article Here

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES News Release

By 2020, One In Two Americans Over Age 50 Will Be At Risk For Fractures From Osteoporosis Or Low Bone Mass
The Surgeon General issues first-ever report on nation's bone health

U.S. Surgeon General Richard H. Carmona, M.D., M.P.H., F.A.C.S., warned today in a new report that by 2020, half of all American citizens older than 50 will be at risk for fractures from osteoporosis and low bone mass if no immediate action is taken by individuals at risk, doctors, health systems, and policymakers. This new report, "Bone Health and Osteoporosis: A Report of the Surgeon General" says that 10 million Americans over the age of 50 have osteoporosis, the most common bone disease, while another 34 million are at risk for developing osteoporosis. And each year, roughly 1.5 million people suffer a bone fracture related to osteoporosis.

Read Full Article Here

HOW TO PREVENT THE BIG "O" - OSTEOPOROSIS!
By Dr. Judith Reighman
"Today Show" Contributor, Sept. 21, 2004

Q: I have been an avid (some would say excessive) exerciser and have kept my weight down. I thought this would keep me healthy. But now I am I my early 50's and I worry whether my bones are as strong as the rest of me. How can I make sure they are?

A: I am going to wax personal in my answer to your question. I, too, have exercised a lot. In fact, in my childhood I was an aspiring dancer. Hours of grueling ballet classes kept me classically thin (or to be more precise, downright skinny.)

But as my height surpassed my talent and I met with rejection in the dance world, I figured I wasn't destined to be a ballerina. And, when I reached my 50's, my skeletal past began to haunt me.

Had my bones, like those of many dancers, been weakened by excessive exercise and weight loss? Had I consumed enough calcium? Probably not. In my teens, Coke and coffee were the beverages of choice.

Read Full Article Here

NOF Urges Women to Talk to Their Doctors About Their Bones
April 6, 2004 (Washington, D.C) - Even though the majority of women aged 45 and older have at least two risk factors for osteoporosis, only 15 percent of those women not diagnosed by a doctor believe they are at risk for the disease, according to a new survey conducted by Roper Public Affairs and Media on behalf of the National Osteoporosis Foundation (NOF).

NOF prevalence estimates show the number of women age 50 and older who have osteoporosis or are at risk for developing the disease will increase from almost 30 million in 2002 to over 35 million in 2010. Osteoporosis, or porous bone, is a devastating disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and increased susceptibility to fractures, especially of the hip, spine and wrist, although any bone can be affected.

Read Full Article Here

HISPANIC INCIDENCE OF OSTEOPOROSIS CATCHING UP TO WHITES, ASIANS
A physician in California has studied the prevalence of osteoporosis among Hispanics, the West and Southwest's largest growing minority, and has found that osteoporosis in this population group is catching up to the occurrence found in Caucasians and Asians, to the surprise of many. Dr. J. R. Lopez further found that in answer to the question, "Have you ever had a bone density test?", the following was true, indicating that the Hispanic population is underserved:

The study compared the NHANES III, NORA 2001, and the CHIS 2001 (California Health Information Survey) data on Hispanics, Caucasians and Asians. All participants were over 50 years old. On both the NHANES and CHIS data sets, White women's prevalence was slightly higher than Hispanics-59% to 49%, and 42% to 36% respectively. Asian women matched the White women in the CHIS data set. Dr. Lopez' conclusions: "Hispanics are California's population growth engine. Osteoporosis is more common in Hispanics that previously believed, and we need an Hispanic community osteoporosis education and intervention program." For more information, contact mdmjrlmd@aol.com

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