Make no bones about it
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WASHINGTON -- Bone tests aren't just for women anymore. New guidelines are calling for older men to get a routine check for bone-thinning osteoporosis.
There's news for women, too: A new computerized tool uses more than bone-density tests to predict who is at highest risk of breaking a bone in coming years - by adding in such important risk factors as whether a parent ever broke a hip.
It's an effort to better target who really needs treatment and who can safely skip it, even before someone's bones become thin enough to be officially labeled an osteoporosis patient.
And it promises a major shift in bone care.
"You treat the people who have high risk, and you would reassure the women at low risk and ask them to come back for a re-check in a few years," explained Dr. Ethel Siris of Columbia University and president of the National Osteoporosis Foundation, which issued the new guidelines last week.
Moreover, the new work stresses that a disease long associated with little old white ladies actually can strike anyone as they age. The biggest change: The NOF guidelines recommend a bone-mineral density X-ray test for all men 70 and older, just like women 65 and older have long been urged to get. (Men and women may need the tests sooner if other factors put them at high risk.)
"There's a recognition more so now than in the past that men are at risk," said Dr. Jay Magaziner of the University of Maryland medical school, who has long researched hip fractures - osteoporosis' most-feared break.
Don't misunderstand. Postmenopausal women are still at greatest risk of osteoporosis, when bone-strengthening estrogen plummets. But a quarter of hip fractures occur in men, and as men live longer, the number who break a hip is steadily rising, Magaziner told a recent meeting of the American Academy of Orthopaedic Surgeons.
Screening men "as we do with women can have some real payoffs in terms of prevention," he said.
Another conundrum: More than half of fractures due to bone loss occur in people whose bones are thinning but aren't quite thin enough to be labeled osteoporosis. They're in a gray zone known as osteopenia.
In the U.S. alone, some 10 million people have osteoporosis but 34 million are estimated to have osteopenia. With the population rapidly aging, the government estimates half of Americans over 50 will be at risk of fractures from too-thin bones by 2020.
The World Health Organization funded a Web-based tool called FRAX, unveiled last week, that helps calculate the odds of a hip, wrist, shoulder or spine fracture within the next 10 years for anyone 40 or older in nine different countries - regardless of whether they have full-fledged osteoporosis or just low bone mass.
Both geography and ancestry matter for bone health. Consider differences such as diet, exercise and exposure to Vitamin D-making sunlight, and odds of a break differ dramatically from China and Japan, to France and Spain, and on to the highest-risk U.S. and Sweden. Here, white women have the highest risk and black women the lowest. FRAX lets users take all that into account.
How? Researchers at Britain's University of Sheffield used data from 60,000 people in developed countries - where life expectancy is long enough for osteoporosis to be an issue - to determine factors that play the biggest role in an individual's odds of thinning bones as they age.
Breaking a bone during adulthood that's not the result of, say, a bad car crash is one risk factor. A parent who broke a hip suggests a genetic risk. Smoking also thins bones, as does heavy alcohol consumption and long-term use of steroid-containing medicines.
Plug in a patient's score from a bone-density measurement of the hip for the final calculation.
That number alone doesn't say whether someone needs bone-building treatment. So in the U.S., the National Osteoporosis Foundation went a step further. It used the FRAX predictions to update guidelines on who needs bone-density testing, and to calculate when fracture risk becomes high enough that bone-building drugs would be cost-effective.
In addition to a routine bone check for older men, the guidelines recommend:
Premarital has six muscles of lean guys and married less than a year, had strong stomach muscles are gone, replaced by a circle ugly fat - this is actually common many married men trouble, and the only middle-aged former General belly In recent years, even the younger trend, some less than 30-year-old married men had potbellied. So, why married men can be easily fat ? And fat will not bring some of the physical problems? This reporter recently interviewed experts. According to the Guangzhou No. 2 People s Hospital of Endocrinology Branch Bin Tang, the first men s age and obesity related to the growth. Scientific statistics show that men 20 to 40 years old when the muscle content changed much, but after the 40-year-old began to 1% of the annual rate of decline to 60-year-old male muscle in the body when he was young, only equivalent to 75 per cent. At the same time, with the growth of age, hormone levels in men will be any change, the male hormone secretion decreased fat consumption slowed.
Pressures lead to General belly
In addition, experts believe that pressure is leading to obesity in men married an important factor. Expert analysis, the man was married once, a head of household, living with the burden of responsibility like a boulder blocks, one of constant pressure on their shoulders. Moreover, when the men were mostly in the cause of Climb period, and therefore life, a house, a car, tickets, his wife and children, together with the cause of the competition, all these common intertwined, and the formation of the great men pressure. Medical research shows that: neural and endocrine systems of the human body conditioning, very sophisticated and magic. Short-term mental pressure on the stimulation of human blood would lead to adrenal glucocorticoid secretion of a transient increase in response to this is a positive physiological coping style. Glucocorticoids can make an immediate blood glucose increased alertness and become sober-minded and help us overcome the difficulties. However, the pressure to stimulate long-term thinking will lead to human adrenal glucocorticoid secretion volume increased. This has become a health hazard to the health of chronic stress response. At the same time, adrenal glucocorticoid secretion too many people will change the distribution of adipose tissue in vivo. Glucocorticoid like a dedicated porters, it can other parts of the body fat in the short term removal to the abdomen, the large accumulation of fat in and around the abdominal organs in the abdominal wall. The diet of moderation and do not neglect sports, potbellied men will appear in the General belly , Beer , the medical-called abdominal obesity or apple-shaped obesity. Tangzhulin also of the view that many married men would become Love home to campaign, and friends of collective outdoor activities will be reduced. Not only that, his wife s meticulous care , they are eating less and less of the vitamin, meat, eggs, but more and more. For this reason, when the energy comes from fat intake of more than 40% of energy intake, body energy consumption necessary, its surplus energy will be changes in the body and fat storage, so that weight gain.
There are three major muscle meat against change
Many of the fat that the men, before their marriage is not so robust as flexible, but there will not be much problem. But the contrary, the experts told reporters, male fat , muscle decreased fat increase, in fact means that the three major hazards: First of all, would lead to reduced male basal metabolic rate, external manifestations of the blessing Secondly, such as heart muscle an important component of the organ, and its recession, a male high incidence of cardiovascular disease accomplice three forces will lead to decline and even the upper and lower level are struggling is that many middle-aged men are the main notalgia reasons. Experts suggest that middle-aged men have the necessary push-ups and sit-ups through the method generally understand their own muscle condition. Up 3 to 5 minutes, if the two can be completed for each 20 to 30 times, while the qualified status of muscle. Or test on the stairs , which uses slightly faster than walking speed in peacetime, for the 40-storey height, if within 40 to 50 seconds feeling relaxed, it indicates that muscle endurance Yes, if that is struggling worse, need to pay attention to, and diet and exercise plan on the agenda of the.
Abdominal muscle exercise is the key
Tangzhulin said that controlling diet and treatment of obesity increased movement is the best method of treatment. Although there has been a married male Xianqi care, enough to live comfortably, it is also necessary to pay attention to reasonable arrangements for catering. To the best cereal-eating, low intake of animal fats and sweets, and appropriately increase vegetables and fruits, avoid high calorie fried foods low nutrition, diet should contain adequate vitamins and other nutrients. Attention to the way the consumption and the environment, such as increasing the number of chewing: slow down the speed of eating, avoid eating, while listening to the radio or watching television. Restrictions on drinking, the best non-drinkers. In addition, modern medicine that men lose abdominal muscle flexibility and the formation of General belly , and hypertension, heart disease, diabetes and many other common diseases close. Therefore, we should pay attention to the middle-aged male muscle training focus, the most important abdominal muscles. Experts suggest that downward bending abdominal exercise the simplest method. Bending the waist down, legs straight, arms and head down, hanging in the air, do not force their own hands touch, try to relax, and then naturally get up, stretch the muscles of the back and legs, stopping about 1 minute, then repeat three times . Twice, for 2 to 3 months will be effective. In addition, sit-up exercise abdominal method also easy. If a difficult beginning, middle-aged men can also try to lie in bed, feet close together legs straight, raise close to the chest upward. In order to enhance the body muscle strength, the time should be for the middle-aged legs, back and arms in the muscles of some low-intensity aerobic exercise, such as swimming, running, climbing, etc.. If supplemented by strength training equipment, the effect more visible.
Related: Make no bones about it
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