The University of Arizona Alumnus / Winter 2009
Bone builders
by Margaret Regan
On a drizzly day 12 years ago, Lidia H. Allen was out for a run. She felt good. At 46, she was active, and so fit she regularly ran 5-K races. She liked to hike, and she and her husband, Joel, had even made the long trek in and out of the Grand Canyon. But on this particular day, as the pair cruised the sidewalks near their home northwest of Tucson, the ground was slick from the rain. Allen slipped and fell.
“I felt quite a bit of pain,” she recalls.
No wonder. She had fractured two ribs, not surprising perhaps, given her fall, but her doctor was suspicious. Allen’s bones seemed too fragile for a premenopausal woman still in her 40s. So she sent her in for a bone scan. The test revealed some bad news. Allen did not have osteoporosis — yet — but her bones were already thinning.
“They discovered osteopenia of the hip and spine,” Allen remembers.
Osteopenia is often a precursor of osteoporosis — literally “porous bones” — a serious affliction that weakens the skeleton, more often in women than in men. The bone fractures of osteoporosis diminish quality of life and can trigger a spiral of worsening health that leads to death.
Allen was stunned. Osteopororis is usually associated with the elderly; she didn’t know that osteoporosis, or osteopenia, can also hit the middle-aged and younger. True, at 20 she’d given up dairy — a major source of osteoporosis-fighting calcium — but she figured her physical activities had kept her body in good shape.
“I used to run as a youngster in races for my church group,” she says. “I would play baseball, ride bicycles. I jogged regularly.”
In a way, her fall and the subsequent diagnosis were a blessing. With no obvious symptoms, osteoporosis has been called the silent disease. Fortunately, the fall gave Allen advance warning. Once she got over the shock (“I felt sorry for myself,”) she says, “I did my best to educate myself to do what I could to remedy it.”
ne of the most important things Allen did was learn about Bone Builders, an osteoporosis community outreach program that The University of Arizona runs through the College of Agriculture Cooperative
Extension county agencies throughout the state. The program literally changed Allen’s life, helping to reverse her condition in part. Bone Builders, she says firmly, is “state of the art. It’s wonderful.”
Begun in 1998, the Bone Builders program helps connect the university’s powerhouse cluster of osteoporosis researchers with people in locales around the state.
Among the experts is Dr. Scott Going, an exercise physiologist who is the principal investigator of the well-regarded Bone Estrogen Strength Training study. Nicknamed the BEST Study, it was “the first and most long-term study done on bone density,” and on the relationship between exercise and bone health, says Donna Harris, a Bone Builders coordinator in Pima County.
Dr. Linda Hootkooper, head of nutritional sciences, and Dr. Jennifer Reeves, who also works in the College of Education Department of Physical Education, are mavens of nutrition. Dr. Jeffrey Lisse, a professor of rheumatology, specializes in research on new therapies for both arthritis and osteoporosis, and Dr. Timothy Lohman, now retired, is a pioneering physiologist who studied the remodeling of bones.
“The UA has wonderful osteoporosis researchers,” Allen says.
As a land-grant institution, the UA has a mission to reach out and educate the people of Arizona, says Sharon Hoelscher Day, who oversees the statewide Bone Builders program out of an office in Maricopa County. The key question for Bone Builders, she says, is “How do we take some of the research we know and apply it in the community?”
Bone Builders bridges the gap by offering research-based bone health trainings to lay people, Harris explains. The UA’s osteoporosis eminences turn up live in Tucson – and on videoconferencing elsewhere in the state — to explain every aspect of osteoporosis prevention and rehabilitation. After the training, participants become volunteer educators, fanning out into their local communities to spread the gospel of a calcium-rich diet and weight-bearing exercise.
“Over the years I’ve done a couple hundred presentations,” Allen says, in gyms, senior centers, and parish halls. She and the other volunteers have reached thousands of Arizonans at risk for the disease’s “porous bones.”
In the face of osteoporosis’ grim statistics, the volunteers’ message is sorely needed.
“One in two women will have an osteoporosis fracture after the age of 50,” Hoelscher Day says. Women who break a hip face serious consequences above and beyond their sudden inability to walk.
“Their quality of life diminishes greatly,” Harris notes. “Half of women who break a hip die within two years.”
Men are less likely to suffer debilitating bone loss as they age — they typically have more bone mass than women, and the greater the mass the more protection the body has. Neverthless, “men are inching up,” Hoelscher Day says. “One in five after the age of 50 will have a bone fracture.”
And as Harris points out, no one is entirely spared. “Everyone, male or female, loses bone with age, but women do so more markedly,” particularly after menopause. “Those with stronger bones will lose less.”
Genetics is the strongest predictor of who will get osteoporosis — Allen’s late mother had it, her older sister does too, and her younger sister has osteopenia. But today’s sedentary occupations, combined with poor diets, also add to the risk.
“If our grandparents saw us going to the gym, they would laugh,” Hoelscher Day says. “They exercised for a living,” hauling hay perhaps, or pushing a plough, or washing laundry by hand.
“We put ourselves at risk by the kind of work we do. Sitting in an office all day does nothing for our bones.”
And if the big cohort of computer-pounding, office-sitting, soda-swilling baby boomers slouching toward retirement will add mightily to the pool of people with osteoporosis, their kids and grandkids may fare no better. Young people are more likely to plug into video games and afterschool TV than they are to run or jump outside, Hoelscher Day notes.
“You don’t get much weight-bearing exercise with TV or video.” With “poor exercise and diet habits” they’re not building bone at the crucial ages, between roughly 10 and 30.
As Harris explains it, all young people should be making “deposits” in their calcium bank. “We’re like a bank. If you make a lot of deposits at 9 or 13, as a 30-year-old you start drawing interest.”
Lidia Allen is lactose-intolerant, which is why she stopped making dairy deposits in her calcium bank at the young age of 20. But with the information on diet and exercise she gleaned from the UA brain trust after her diagnosis, she was able to alter her condition, at least in part. She faithfully follows a protocol of a calcium-rich diet, weight-bearing exercise, supplements, and medication.
She learned that she can make her diet calcium-rich by consuming dark, leafy greens like kale and collard greens, eating easily digested aged cheeses like parmesan, and drinking lactose-free milk in small portions. She began taking a calcium supplement, along with capsules of vitamin D3 — which helps the body absorb calcium — and one of the bisphosphonate drugs.
“Women should have 1000 to 1200 milligrams of calcium a day,” she says, “but no more than 500 at any one time.”
Allen moved carefully to add exercise that “loads the bone” to her routine, using water aerobics at first to build up her skeleton. Now, at 58, she takes a weight-training class several times a week, and walks — not runs — three miles, three to five times a week. Unfortunately, her spine has continued to deteriorate, and when she hit menopause at 50, she was diagnosed with full-scale osteoporosis in her back.
But her hip is a different story.
“I’ve been able to reverse the situation with my hip,” she says happily. “The different things recommended helped me in trying to protect what I had. My hip is in the normal range now.”
Allen is not a UA grad — she earned an accounting degree at Texas Christian
University — but she prides herself on volunteering in the university’s Bone Builders program. And she’s a huge fan of the UA’s osteoporosis researchers who helped restore her to good health. “We have a treasure in the community,” she declares.
She and her husband are both retired now, she from her career as a CPA, he from engineering. With her hip in fine shape, “I’m still hiking,” she says.
“My husband and I just got back from a vacation to Yellowstone and the Grand Tetons. I’m pleased to say I can still hike and enjoy the beauty of nature.”
For more information about Bone Builders classes and the volunteer program, or to schedule a free presentation, call 602-470-8086 ext. 316 or e-mail bones@ag.arizona.edu.
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