By John Morgan, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.

When Meredith Vieira shares her opinions on The View, her audience listens. Now Vieira hopes women across the country will listen even more closely to her message about osteoporosis.

“Osteoporosis is the one area of women’s health where we are not proactive and I’m not sure why,” says Vieira, who is a paid spokesperson for the National Osteoporosis Foundation's Be Beautiful to the Bone: Know Yourself to a T awareness campaign. The program is sponsored by Merck & Co., Inc., manufacturers of an osteoporosis medication. “We take such great care of our children and husbands. But we’re just not proactive about our bones – maybe that’s because there aren’t symptoms or we think of it as an old lady’s disease.”

Osteoporosis is a disease caused by an imbalance in the body’s bone-rebuilding cycle, resulting in bone loss which can increase a person’s risk of fracture.  In fact, approximately 50% of 50-year-old women will suffer a fracture in their remaining lifetime. The most common fractures related to osteoporosis are of the spine and hip.

“My mom, who is 90, has osteoporosis and has had it for many years,” Vieira says. “When I became menopausal my doctor recommended I get a bone mineral density (BMD) test. I had never even heard of it to be quite honest. I thought, ‘I’m in great health, great shape. I have no symptoms. Why do I need this?’ But I went ahead and did the test anyway.”

Vieira says at first she was “a little nervous” about the BMD test.

“To illustrate how ignorant I was when I had the test done, I asked where I could change and the nurse told me I didn’t need to take off my clothes,” explains Vieira, who also hosts Who Wants to be a Millionaire. “They did a test on my heel, hip and spine, which only took a matter of five minutes. And it was totally painless. It’s so simple to do.”

Test results

Because osteoporosis is a silent disease, the NOF recommends that all women get a BMD test before age 65. The gold standard for BMD testing is the dual-energy X-ray absorptiometry (DEXA) scan to measure hip and spine bone density.

“DEXA is very easy and very safe,” says Felicia Cosman, the NOF’s clinical director and an osteoporosis specialist at Helen Hayes Hospital in West Haverstraw, New York. “It is extremely minimal in terms of radiation exposure. In fact, it’s so low you could do it every day.”

From this x-ray doctors learn exactly how much bone mineral your bones contain and  can assess your risk for a fracture at some point in your lifetime. The results are given as a T-score, the comparison of the patient's bone mass with that of a healthy young person of the same gender at peak bone mass. The lower or "more negative" the score is, the greater the risk of fracture.

Scores above -1.0 are considered normal. T-scores between -1.0 and -2.5 reveal osteopenia (low bone density). Scores below -2.5 indicate osteoporosis.

Vieira found out she has low bone density and is headed toward osteoporosis.

“I don’t have it yet,” Vieira says. “But if I continue to lose bone mass then I could develop it.”

And Vieira isn’t alone.

Risk factors

According to the National Osteoporosis Foundation, the disease and low bone mass affect an estimated 44 million Americans. Of those, 68% -- or more than 30 million -- are women. Osteoporosis costs the U.S. nearly $17 billion annually but by 2020 expenditures may exceed $60 billion.

Contributing to this high cost is the fact that without many obvious symptoms, most people never know they have osteoporosis until they experience a serious fracture.

“I had low bone mass and there was some bone deterioration,” Vieira says. “I was a little freaked out because I didn’t feel any pain. But my doctor told me that usually there is no pain. So it is important to get tested and find out if you’re at risk.”

“The truth is that all women and men over the age of 50 are at risk,” says Cosman. “Everyone once they reach this age needs to engage in a dialogue with their doctor about specific risk factors for osteoporosis.”

Risk factors for osteoporosis include:

• Menopause -- hormonal imbalances can lead to rapid bone loss. 
• Low bone mass, as confirmed by a BMD test.
• Family history of osteoporosis.
• Caucasian or Asian ancestry but osteoporosis affects all ethnic backgrounds.
• Thin or small build.
• Smoking or heavy alcohol use.
• Too little exercise or inadequate calcium intake.
• Certain medications, including long-term steroid use.
• Early menopause (before age 45).

Avoiding bad breaks

In terms of the preventive lifestyle measures – Cosman recommends that everyone has an adequate healthy diet -- supplementing with calcium and vitamin D if needed.  It’s also important to exercising regularly, stop smoking, and to avoid drinking excessive amounts of alcohol.

Vieira is setting her sights on keeping her bones as healthy as possible.

“The good news was there were very simple steps I could take to help rectify the situation and improve the condition of my bones,” Vieira says. “These included adding more calcium to my diet. So I’ve added a calcium supplement that I take every day. And I try to eat as much dark leafy green vegetables as I can – which I like – being Portuguese I have a taste for kale.”

Vieira also added more weight training several times a week “because it helps to strengthen the muscles around the bones.”

“And the last step was I went on a medication because my doctor said it was required for me,” Vieira adds. “But not every woman needs to do this – so it’s important to make sure you consult your doctor.”

Cosman says there are several types of medications used to treat bone loss, including estrogens, selective estrogen receptor modulators (SERMs) and bisphosphonates.

There is also a new bone building drug, teriparatide, which is given by injection and indicated only for people with extremely severe osteoporosis.

The program Vieira follows is designed to arrest the progression and hopefully reverse some of her bone loss. “And I have every reason to believe that that will be the case,” she adds.

“If I could urge women to do anything, I would tell them pay attention to the very foundation of their beauty – their bones -- and to go into their doctor and be proactive,” Vieira says. “Ask if you’re a candidate for a bone density test and if you know you are and you’re post-menopausal demand it. Tell them you really want to know your T-score. Because once you know your score, there is a lot that can be done.”

For more information about osteoporosis, click here.

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 6/13/2003  -  John Morgan & Stephen A. Shoop, M.D.
Reviewed: 6/13/2003  -  Donnica Moore, M.D.