While women may be more focused on bone health, men are also at risk for osteoporosis, a disease characterized by brittle bones and bone loss

While women may be more focused on bone health, men are also at risk for osteoporosis, a disease characterized by brittle bones and bone loss.The American Academy of Orthopaedic Surgeons explains these risk factors for osteoporosis in men:

90. Except those who join a group, between you and whom there is a treaty (of peace), or those who approach you with their breasts restraining from fighting you as well as fighting their own people. Had Allah willed, indeed He would have given them power over you, and they would have fought you. So if they withdraw from you, and fight not against you, and offer you peace, then Allah has opened no way for you against them.

91. You will find others that wish to have security from you and security from their people. Every time they are sent back to temptation, they yield thereto. If they withdraw not from you, nor offer you peace, nor restrain their hands, take (hold) of them and kill them wherever you find them. In their case, We have provided you with a clear warrant against them. 

92. It is not for a believer to kill a believer except (that it be) by mistake, and whosoever kills a believer by mistake, (it is ordained that) he must set free a believing slave and a compensation (blood money, i.e Diya) be given to the deceased's family, unless they remit it. If the deceased belonged to a people at war with you and he was a believer; the freeing of a believing slave (is prescribed), and if he belonged to a people with whom you have a treaty of mutual alliance, compensation (blood money - Diya) must be paid to his family, and a believing slave must be freed. And whoso finds this (the penance of freeing a slave) beyond his means, he must fast for two consecutive months in order to seek repentance from Allah. And Allah is Ever All-Knowing, All-Wise.4. Surah An-Nisa' (The Women)

• Being over age 75.
• Having a low body-mass index.
• Having lost more than 5 percent of total body weight in the last four years.
• Being a current smoker.
• Living a sedentary lifestyle.
• Having a male family member with osteoporosis

What is osteoporosis?

Osteoporosis is a common disease affecting over 1 million Australians. This disease makes bones become brittle leading to a higher risk of breaks than in normal bone. Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace them, causing a loss of bone thickness (bone density or mass).

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Osteoporosis can lead to fractures

As bones become thinner and less dense, even a minor bump or fall can cause a serious fracture. A ‘fracture’ is a complete or partial break in a bone. Any bone can be affected by osteoporosis, but the most common sites are the hip, spine and wrist. Fractures in the spine due to osteoporosis can result in height loss or changes in posture. Osteoporosis usually has no symptoms until a fracture occurs this is why osteoporosis is often called the 'silent disease'. 

Anyone with specific risk factors for osteoporosis should be investigated by their doctor. Anyone over 50 who experiences a broken bone from a minor bump or fall should be investigated for osteoporosis.

Fractures can lead to chronic pain, a loss of independence, disability and even premature death - so managing bone health to avoid fractures is a priority.

Stop the fracture cascade

The risk of future fractures rises with each new fracture - this is known as the 'cascade effect'. For example: women who have suffered a fracture in their spine are over 4 times more likely to have another fracture within the next year. It is essential that osteoporosis is diagnosed and treated to prevent further fractures.

Osteoporosis facts

• Osteoporosis is a condition of fragile bone with an increased susceptibility to fracture.
• Osteoporosis weakens bone and increases risk of bones breaking.
• Bone mass (bone density) decreases after 35 years of age, and bone loss occurs more rapidly in women after menopause.
• Key risk factors for osteoporosis include genetics, lack of exercise, lack of calcium and vitamin D, personal history of fracture as an adult, cigarette smoking, excessive alcohol consumption, history of rheumatoid arthritis, low body weight, and family history of osteoporosis.
• Patients with osteoporosis have no symptoms until bone fractures occur.
• The diagnosis of osteoporosis can be suggested by X-rays and confirmed by tests to measure bone density.
• Treatments for osteoporosis, in addition to prescription osteoporosis medications, include stopping use of alcohol and cigarettes, and assuring adequate exercise, calcium, and vitamin D.

What is osteoporosis?

Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone to fracture. The fracture can be either in the form of cracking (as in a hip fracture) or collapsing (as in a compression fracture of the vertebrae of the spine). The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-related fractures can occur in almost any skeletal bone.Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones. Osteopenia is a condition of bone that is slightly less dense than normal bone but not to the degree of bone in osteoporosis.

What are osteoporosis symptomsand signs?

Fractures of the spine (vertebra) can cause severe "band-like" pain that radiates from the back to the sides of the body. Over the years, repeated spinal fractures can lead to chronic lower back pain as well as loss of height and/or curving of the spine due to collapse of the vertebrae. The collapse gives individuals a hunched-back appearance of the upper back, often called a "dowager hump" because it commonly is seen in elderly women.Osteoporosis can be present without any symptoms for decades because osteoporosis doesn't cause symptoms until bone fractures. Moreover, some osteoporotic fractures may escape detection for years when they do not cause symptoms. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. The symptom associated with osteoporotic fractures usually is pain; the location of the pain depends on the location of the fracture. The symptoms of osteoporosis in men are similar to the symptoms of osteoporosis in women.

A fracture that occurs during the course of normal activity is called a minimal trauma, or stress fracture. For example, some patients with osteoporosis develop stress fractures of the feet while walking or stepping off a curb.

Hip fractures typically occur as a result of a fall. With osteoporosis, hip fractures can occur as a result of trivial slip-and-fall accidents. Hip fractures also may heal slowly or poorly after surgical repair because of poor healing of the bone.

What are the consequences of osteoporosis?

Osteoporotic bone fractures are responsible for considerable pain, decreased quality of life, lost workdays, and disability. Up to 30% of patients suffering a hip fracture will require long-term nursing-home care. Elderly patients can develop pneumoniaand blood clots in the leg veins that can travel to the lungs (pulmonary embolism) due to prolonged bed rest after the hip fracture. Osteoporosis has even been linked with an increased risk of death. Some 20% of women with a hip fracture will die in the subsequent year as an indirect result of the fracture. In addition, once a person has experienced a spine fracture due to osteoporosis, he or she is at very high risk of suffering another such fracture in the near future (next few years). About 20% of postmenopausal women who experience a vertebral fracture will suffer a new vertebral fracture of bone in the following year.

Why is osteoporosis an important public-health issue?

• In the U.S., 44 million people have low bone density (10 million have osteoporosis, and 34 million have osteopenia). This amounts to 55% of the U.S. population aged 50 years and older.
• One in two Caucasian women will fracture a bone due to osteoporosis in her lifetime.
• In the U.S., direct health-care costs from osteoporosis fractures amount to a billion dollars, without even taking into account the indirect costs, such as lost days at work and productivity.
• Approximately 20% of those who experience a hip fracture will die in the year following the fracture.
• One-third of hip-fracture patients are discharged to a nursing home within the year after fracture.
• Only one-third of hip-fracture patients regain their pre-fracture level of function.

With the aging of America, the number of people with osteoporosis-related fractures will increase exponentially. The pain, suffering, and overall impact on health and economic costs will be enormous.

What factors determine bone strength?

Bone mass (bone density) is determined by the amount of bone present in the skeletal structure. Generally, the higher the bone density, the stronger the bones. Bone density is greatly influenced by genetic factors, which in turn are sometimes modified by environmental factors and medications. For example, men have a higher bone density than women, and African Americans have a higher bone density than Caucasian or Asian Americans.

Normally, bone density accumulates during childhood and reaches a peak by around age 25. Bone density then is maintained for about 10 years. After age 35, both men and women will normally lose 0.3%-0.5% of their bone density per year as part of the aging process.

Estrogen is important in maintaining bone density in women. When estrogen levels drop after menopause, loss of bone density accelerates. During the first five to 10 years after menopause, women can suffer up to 2%-4% loss of bone density per year! This can result in the loss of up to 25%-30% of their bone density during that time period. The accelerated bone loss after menopause is a major cause of osteoporosis in women, referred to as postmenopausal osteoporosis.

How is osteoporosis diagnosed?

A routine X-ray can reveal osteoporosis of the bone because the bones appear much thinner and lighter than normal bones. Unfortunately, by the time X-rays can detect osteoporosis, at least 30% of the bone has already been lost. In addition, X-rays are not accurate indicators of bone density. Thus, the appearance of the bone on X-ray often is affected by variations in the degree of exposure of the X-ray film.

The National Osteoporosis Foundation, the American Medical Association, and other major medical organizations recommend a dual-energy X-ray absorptiometry scan (DXA, formerly known as DEXA) be used for the diagnosis of osteoporosis. DXA typically measures bone density in the hip, the spine, and the forearm. The test takes only five to 15 minutes to perform, exposes patients to very little radiation (less than one-tenth to one-hundredth of the amount used on a standard chest X-ray), and is quite precise.

The bone density of the patient is compared to the average peak bone density of young adults of the same sex and race. This score is called the "T score," and it expresses the bone density in terms of the number of standard deviations (SD) below peak young adult bone mass.

• Osteoporosis is defined as a bone density T score of -2.5 or below.
• Osteopenia (between normal and osteoporosis) is defined as bone density T score between -1 and -2.5.

It is important to note that while osteopenia is considered a lesser degree of bone loss than osteoporosis, it nevertheless can be of concern when it is associated with other risk factors (such as smoking, cortisone steroid usage, rheumatoid arthritis, family history of osteoporosis, etc.) that can increase the chances for developing vertebral, hip, and other fractures. In this setting, osteopenia may require medication as part of the treatment program.

Who should have bone density testing?

The National Osteoporosis Foundation guidelines state that there are several groups of people who should consider DXA testing:

• All postmenopausal women below age 65 who have risk factors for osteoporosis
• All women aged 65 and older
• Postmenopausal women with fractures, although this is not mandatory because treatment may well be started regardless of bone density
• Women with any of more than 50 medical conditions associated with osteoporosis; a primary-care physician can scan a patient's list of medical illnesses to determine if one of these conditions is present (see causes above)
• Women whose decision to begin treatment for osteoporosis might be aided by bone density testing to determine the presence or absence of osteoporosis or osteopenia

The National Osteoporosis Foundation guidelines state that bone-density testing does not need to be performed if a person has a known osteoporotic fracture because the patient will be treated for osteoporosis with or without a bone-density study. In addition, bone-density testing is not appropriate if the person undergoing the test is not willing to take treatment based on the results. Therefore, if bone-density testing is done, it should be performed on people willing to take some specific action based on the results.

What is the treatment for osteoporosis, and can osteoporosis be prevented?

Lifestyle changes, including quitting cigarette smoking, curtailing excessive alcohol intake, exercising regularly, and consuming a balanced diet with adequate calcium and vitamin DThe goal of treatment of osteoporosis is the prevention of bone fractures by reducing bone loss or, preferably, by increasing bone density and strength. Although early detection and timely treatment of osteoporosis can substantially decrease the risk of future fractures, none of the available treatments for osteoporosis are complete cures. In other words, it is difficult to completely rebuild bone that has been weakened by osteoporosis. Therefore, prevention of osteoporosis is as important as treatment. The following are osteoporosis treatment and prevention measures:

1. Medications that stop bone loss and increase bone strength, such as alendronate (Fosamax), risedronate(Actonel), raloxifene (Evista),ibandronate (Boniva), calcitonin(Calcimar), zoledronate (Reclast), and denosumab (Prolia)
2. Medications that increase bone formation such as teriparatide (Forteo)

Calcium supplements

Building strong and healthy bones requires an adequate dietary intake of calcium beginning in childhood and adolescence for both sexes. Most importantly, however, a high dietary calcium intake or taking calcium supplements alone is not sufficient in treating osteoporosis and should not be viewed as an alternative to or substituted for more potent prescription medications for osteoporosis. In the first several years after menopause, rapid bone loss may occur even if calcium supplements are taken.

The following calcium intake has been recommended by the National Institutes of Health Consensus Conference on Osteoporosis for all people, with or without osteoporosis:

• 800 mg/day for children 1-10 years of age
• 1,000 mg/day for men, premenopausal women, and postmenopausal women also taking estrogen
• 1,200 mg/day for teenagers and young adults 11-24 years of age
• 1,500 mg/day for postmenopausal women not taking estrogen
• 1,200 mg-1,500 mg/day for pregnant and nursing mothers
• The total daily intake of calcium should not exceed 2,000 mg.

Daily calcium intake can be calculated by the following method:

1. Excluding dairy products, the average American diet contains approximately 250 mg of calcium.
2. There is approximately 300 mg of calcium in an 8-ounce glass of milk.
3. There is approximately 450 mg of calcium in 8 ounces of plain yogurt.
4. There is approximately 130 mg of calcium in 1 cup of cottage cheese.
5. There is approximately 200 mg of calcium in 1 ounce of cheddar cheese.
6. There is approximately 90 mg of calcium in ½ cup of vanilla ice cream.
7. There is approximately 300 mg of calcium in 8 ounces of calcium-fortified orange juice.

Unfortunately, surveys have shown that the average woman in the U.S. is consuming less than 500 mg of calcium per day in their diet, less than the recommended amounts. Additional calcium can be obtained by drinking more milk and eating more yogurt or cottage cheese or by taking calcium supplement tablets as well from calcium-fortified foods, such as orange juice.

The various calcium supplements contain different amounts of elemental calcium (the actual amount of calcium in the supplement). For example, Caltrate, Os-Cal, and Tums are calcium carbonate salts. Each 1,250 mg of calcium carbonate salt tablet (such as Caltrate 600 mg, Os-Cal 500 mg, or Tums 500 mg extra strength) contains 500 mg of elemental calcium. A person who needs 1,000 mg/day of calcium supplement can take one tablet of Tums 500 mg extra strength (containing 500 mg of elemental calcium) twice daily with meals.

The calcium carbonate supplements are best taken in small divided doses with meals since the intestines may not be able to reliably absorb more than 500 mg of calcium all at once. Therefore, the best way to take 1,000 mg of a calcium supplement is to divide it into two doses. Likewise, a dosage of 1,500 mg should be split into three doses.

Calcium supplements are safe and generally well tolerated. Side effects areindigestion and constipation. If constipation and indigestion occur with calcium carbonate supplements, calcium citrate (Citracal) can be used. Some patients have difficulty swallowing calcium tablets. In this situation, chewable candy-like calcium in the form of Viactiv is available. Certain medications can interfere with the absorption of calcium carbonate. Examples of such medications include proton-pump inhibitors such asomeprazole (Prilosec), lansoprazole (Prevacid), lansoprazole (Protonix), andrabeprazole (Aciphex), which are used in treating gastroesophageal reflux disease (GERD) or peptic ulcers. When these medications are being taken, calcium citrate is preferred.

Many "natural" calcium carbonate preparations, such as oyster shells or bone meal, may contain high levels of lead or other harmful elements and should be avoided.

Vitamin D

An adequate intake of calcium and vitamin D are important foundations for maintaining bone density and strength. However, calcium and vitamin D alone are not sufficient to treat osteoporosis and should be given in conjunction with other treatments. Vitamin D is important in several respects:

• Vitamin D helps the absorption of dietary calcium from the intestines.
• The lack of vitamin D alone can cause calcium-depleted bone (osteomalacia), which further weakens the bones and increases the risk of fractures.
• Vitamin D, along with adequate calcium (1,200 mg of elemental calcium), has been shown in some studies to increase bone density and decrease fractures in postmenopausal women but not in premenopausal or perimenopausal women.

Vitamin D comes from the diet and the skin. Vitamin D production by the skin is dependent on exposure to sunlight. Active people living in sunny regions (Southern California, Hawaii, countries around the equator, etc.) can produce most of the vitamin D they need in their skin. Conversely, lack of exposure to sunlight, due to residence in northern latitudes or physical incapacitation, causes vitamin D deficiency. In less temperate regions such as Minnesota, Michigan, and New York, production of vitamin D by the skin is markedly diminished in the winter months, especially among the elderly. In that population, dietary vitamin D becomes more important.

Unfortunately, vitamin D deficiency is quite common in the U.S. In a study in a general medical ward of one hospital, vitamin D deficiency was detected in 57% of the patients. An estimated 50% of elderly women consume far less vitamin D in their diet than is recommended.

The Food and Nutrition Board of the Institute of Medicine has recommended the following as an adequate vitamin D intake:

• 800 IU/day for men and women over the age of 71
• 600 IU/day for women in other age groups, men, and children
• 400 IU/day for infants under 12 months

But if a person already has osteoporosis, it is advisable to ensure 400 IU twice per day as the usual daily intake, most commonly as a supplement alongside prescribed medications for osteoporosis.

An average multivitamin tablet contains 400 IU of vitamin D. Therefore, one to two multivitamins a day should provide the recommended amount of vitamin D. Alternatively, vitamin D can be obtained in combination with calcium in tablet forms, such as Caltrate 600 + D (600 mg of calcium and 200 IU of vitamin D) and others.

Adequate levels of calcium and vitamin D are essential for optimal bone health, especially when used with prescribed medication for osteoporosis. Chronic excessive use of vitamin D can lead to toxic levels of vitamin D, elevated calcium levels in blood and urine, and may also cause kidney stones. Since various dietary supplements may also contain vitamin D, it is important to review vitamin D content in dietary supplements before taking additional vitamin D.

Hormone therapy (menopausal hormone therapy)

Estrogen also is available in combination with progesterone as pills and patches. Progesterone is routinely given along with estrogen to preventuterine cancer that might result from estrogen use alone. Women who have had a hysterectomy (surgical removal of the uterus) may take estrogen alone since they no longer have a uterus to become cancerous. Nasally delivered estrogen and lower-dose combination pills of estrogen and progesterone are also being studied. However, due to adverse effects of HRT, such as increased risks of heart attack, stroke, blood clots in the veins, and breast cancer; HRT is no longer recommended for long-term use in the therapy of osteoporosis. Rather, HRT is used short term to relieve menopausal hot flashes.Estrogen hormone therapy after menopause (previously referred to as hormone replacement therapy or HRT) has been shown to prevent bone loss, increase bone density, and prevent bone fractures. It is useful in preventing osteoporosis in postmenopausal women. Estrogen is available orally (Premarin, Estrace, Estratest, and others) or as a skin patch (Estraderm, Vivelle, and others).

Every woman needs to have an individualized discussion regarding HRT with her doctor because each woman will place different weight on the risks and benefits of the treatment.

One-quarter of homeless children in the United States require mental health services -- far more than kids in the general population, a new study shows.

North Carolina State University researchers examined data on 328 children, aged 2 months to 6 years, at 11 homeless shelters in Wake County, N.C.

"We found that 25 percent of the children in shelters needed mental health services, based on their social-emotional functioning," study co-author and Ph.D. student Jenna Armstrong said in a university news release.

The rate is 10 percent to 14 percent among children 5 years and younger in the general population, according to Columbia University's National Center for Children in Poverty.

Also, the academic and language skills of homeless children aged 5 to 6 were well below average, according to the study published online Feb. 19 in the Early Childhood Education Journal.

"These children have often been exposed to domestic or neighborhood violence, chronic poverty, inadequate health care and other circumstances that place any child at risk of mental health problems," lead author and professor of psychology Mary Haskett said in the news release.

"As a result of their exposure to those difficult life circumstances -- combined with living in a shelter -- homeless children are at a much greater risk of developmental delays, social and emotional problems, and problems at school," said Armstrong, who added that "the scale of the problem is huge."

About 2.5 million children are homeless in the United States each year, according to the National Center on Family Homelessness.

"Children in shelters are often overlooked -- they're basically invisible," Armstrong said.

"But these findings highlight the importance of providing resources to meet the needs of these children. Twenty-five percent of 2.5 million is 625,000. So, we're talking about 625,000 children who need mental health support every year in the United States. We, as a society, can't afford to let these kids down," she concluded.

Most people realize that smoking causes cancer, but it can also wreak havoc on your heart, experts say.

The National Heart, Lung and Blood Institute says smoking:

• Damages blood cells, heart function and blood vessels
• Increases the risk of hardening of the arteries, which restricts blood flow.
• Increases the risks of heart disease, which occurs when plaque builds up in the arteries.