A 29-year study found that women who went through menopause before age 47 were twice as likely to have osteoporosis later in life. These women also had a greater risk of fracture and higher rates of mortality.

The study started in 1977 with 390 white women from northern Europe who were 48 years old at the time. The women were divided into two groups based on those who went through menopause before age 47 and those who started menopause at age 47 or later. The women were followed for about 30 years in which their bone mineral density was measured.

Of the 198 women who remained at the end of the study, researchers found that 56% of the women with early menopause had osteoporosis compared with 30% of those who experienced later menopause.

Women who started menopause early were also found to have a higher risk of fragility fracture and mortality. The fracture incidence rate was 44.3% in the early menopause group compared to 30.7% in the late menopause group. The mortality rate was 52.4% in the early menopause group compared to 35.2% in the late menopause group.

The study’s strength is the length of time the women were observed. However, the study did not prove a cause-and-effect relationship.

The higher mortality rate in women with an early menopause will need to be explored further as many other factors could affect this such as medication, nutrition, smoking and alcohol consumption.

Osteoporosis Prevention

There are other risk factors for osteoporosis and steps you can take now to support strong, healthy bones. Learn more with It’s Never Too Early (or Too Late) to Bone Up on Calcium.

Source:

British Journal of Obstetrics and Gynaecology

Variations in estrogen levels can affect women’s health in many ways, from monthly PMS and acne breakouts to more serious conditions such as endometriosis, osteoporosis and some cancers. So it’s important for women to know which lifestyle factors may affect estrogen levels.

A new study found that caffeine had different effects on estrogen levels that varied by caffeine source and the study participants ethnicity.

During the two year study, more than 250 women ages 18 to 44 consumed an average of 90 milligrams of caffeine a day. This is equivalent to one cup of caffeinated coffee.

Asian women who consumed about 200 milligrams or more of caffeine a day had elevated estrogen levels compared to those who consumed less. But white women who consumed the same amount of caffeine had slightly lower estrogen levels than women who consumed less. Black women had a slight, but statistically insignificant rise in estrogen levels with consumption of the same amount of caffeine.

Coffee vs. Tea

When the researchers considered the source of the caffeine: coffee, black tea, green tea or caffeinated soda, the findings differed slightly.

Caffeine from coffee mirrored the overall findings, but consumption of more than one cup each day of caffeinated soda or green teas was associated with higher estrogen in all three groups of women.

Health Implications

The caffeine induced changes in estrogen levels did not appear to affect women's ovulation, said the researchers, who followed the women for up to two menstrual cycles. However, the researchers are concerned about the long-term effects of caffeine consumption on women’s health.

"Short term, these variations in estrogen levels among different groups do not appear to have any pronounced effects. We know that variations in estrogen level are associated with such disorders as endometriosis, osteoporosis, and endometrial, breast and ovarian cancers. Because long-term caffeine consumption has the potential to influence estrogen levels over a long period of time, it makes sense to take caffeine consumption into account when designing studies to understand these disorders," Enrique Schisterman, of the Division of Epidemiology, Statistics and Prevention Research at the U.S. National Institute of Child Health and Human Development.

About 89 percent of U.S. women ages 18 to 34 consume the caffeine equivalent of 1.5 to two cups of coffee a day, according to the authors.

Source:

Health Day

Last year in this space we covered news of multiple recalls of children’s jewelry and novelty items that contained the heavy metal cadmium, a known carcinogen. Now it seems that the jewelry industry along with the standards organization, ASTM International, are advocating that states overturn existing laws limiting cadmium in favor of new voluntary guidelines that they helped create.

Currently there is no single national standard for cadmium limits in jewelry, only a patchwork of individual state laws that are inconsistent and a “moving target” for manufacturers and importers as additional states pass new cadmium laws.

"Our whole mission in this is to have standards that are not floating in quicksand," said Brent Cleaveland, head of the ASTM subcommittee that wrote the rules and executive director of the Fashion Jewelry and Accessories Trade Association. He described the limits he oversaw as "way more conservative than necessary" to protect kids' health.

While the voluntary rules have the support of federal regulators and the Consumer Product Safety Commission, states that passed much stricter limits over the past year would have to backtrack and allow higher levels of the metal. There are currently cadmium laws in California, Connecticut, Illinois, Maryland and Minnesota. Legislation is pending in other states, including Massachusetts, New York and Florida.

Under the ASTM guidelines, children's jewelry--defined as "primarily intended" for kids 12 and under--would first be lab tested to see whether it contains more than 0.03 percent cadmium. Items that fail the "total content" test could be scrapped or sent for further analysis. For smaller pieces, a second test gauges how much cadmium dissolves in stomach acid 24 hours after the jewelry is swallowed; for larger pieces, another test measures how much cadmium is released under conditions that simulate licking.

For states such as Connecticut and Maryland that limit total cadmium content to .0075 percent cadmium, the voluntary guidelines fall short. "Maryland ought to set whatever standard we feel is correct," said Delegate James Hubbard, who sponsored that state’s legislation. "We made a judgment call based on what we felt was in the best interest of the people we represent."

Expect to see more about this controversy in the months to come as the jewelry industry, regulators, and consumer and environmental groups struggle with this important public health issue.

Cadmium Health Effects

Cadmium poisoning is associated with cancer (lung and prostate) and chronic kidney disease. Cadmium also releases calcium from bone within hours of exposure which might lead to bone disease (osteomalacia and osteoporosis). Other health effects include anemia, teeth discoloration and loss of smell (anosmia).

Sources:

NPR

OSHA

For millions of Americans taking oral bisphosphonates prescribed for osteoporosis, the jury is still out on whether these drugs are linked to an increased risk for esophageal cancer, according to the FDA’s latest drug safety announcement. Common brand names of medications in this class include Fosamax, Actonel, Boniva, Atelvia, Didronel and Skelid.

The FDA announcement cites conflicting research and the need for further study before a determination is made. One study found no increase in the risk of esophageal cancer. The second study found a doubling of the risk of esophageal cancer among patients who had 10 or more prescriptions of the drugs, or who had taken the drugs over 3 years. Other external researchers investigating this issue, using different patient databases, have reported no increase in risk, or a reduced risk.

While the FDA continues to review studies on the possible connection, here’s what they suggest those taking bisphoshonates should do in the meantime.

• Follow directions for use of any oral bisphosphonate drug carefully. All oral bisphosphonate drugs, except Atelvia, should be taken first thing in the morning after awakening, with a full glass of plain water. Atelvia should be taken immediately following breakfast. Do not lie down or eat or drink anything for at least 30 to 60 minutes after taking any oral bisphosphonate drug.
• Talk to your healthcare professional if you develop swallowing difficulties, chest pain, new or worsening heartburn, or have trouble or pain when you swallow. These may be signs of problems of the esophagus.
• You should not take oral bisphosphonates if you have esophageal conditions that delay emptying of the esophagus, or if you cannot stand or sit upright for at least 30 to 60 minutes, or have low calcium levels in your blood.
• Talk to your healthcare professional about the benefits and risks of taking oral bisphosphonates and how long you should expect to take them.
• Discuss any questions or concerns about your oral bisphosphonate drug with your healthcare professional.
• Report any side effects you experience to the FDA MedWatch program using the information in the "Contact Us" box at the bottom of the page.

At this time, the FDA believes that the benefits of oral bisphosphonate drugs in reducing the risk of fractures in people with osteoporosis continue to outweigh their potential risks. It is also important to note that esophageal cancer is rare, especially in women.

Source:

FDA

As we get older, we often assume that “aches and pains” in our joints are something we just have to live with.  In a recent survey, one in five participants had chronic pain like that associated with arthritis but almost half said they didn’t know what caused their pain. The majority, (87 percent) took over-the-counter pain relievers.

Experts say there are a few reasons why you shouldn’t ignore what your body is trying to tell you. Pain is a serious problem that can negatively affect every aspect of your life: work, relationships and overall health. There’s no need to just accept the pain when there are new treatment options that can minimize or eliminate joint pain.

Ignoring the pain can also keep you from learning what’s really wrong and getting the proper treatment. Most people may not be able to tell if the pain is in the joint or in a nearby muscle or tendon. A physician needs to evaluate you to determine the source of the pain and what’s causing it.

If the pain is due to joint inflammation (arthritis), narrowing the diagnosis to one of over 100 different forms of arthritis is necessary to determine the best treatment that may prevent further joint damage and manage pain. Seeing a doctor is also important if a person has other conditions that may aggravate arthritis. More...

No matter what your age, exercise and physical activity are good for your mind, body and spirit. Getting regular exercise through your senior years can help you:

• Keep and improve your strength so you can stay independent.
• Have more energy to do the things you want to do.
• Improve your balance.
• Prevent or delay some diseases like heart disease, diabetes, breast and colon cancer, and osteoporosis.
• Lift your spirits and reduce depression.

There are many ways to become more active, but your chances of sticking with it over time are better if you choose activities you enjoy. As with any lifestyle change, start slow and gradually increase the frequency and intensity of your exercise. You can begin by building more physical activity into your daily routine. Try parking the car farther from the store entrance when you go shopping or raking the leaves instead of hiring someone to do it. More...

The medicinal value of consuming whole foods has gained much traction, with studies like this recent one touting the value of orange juice as a weapon for reducing the damage high-fat can do to your body. So, it may not be surprising to learn tomato juice could be just the thing for post-menopausal women fighting osteoporosis, according to a new study.

Canadian scientists studied the bone health of 60 post-menopausal women assigned to one of four groups: Two received their lycopene by consuming 15 or 35 mg, respectively, from tomato juice, and two more taking either a 15 mg lycopene supplement or a placebo over four months.

Patients consuming increased amounts of lycopene (at least 30 mg) from a capsule or tomato juice experienced reduced levels of bone resorption marker NTx (a marker in the blood that increases when bone is breaking down), compared to the placebo group.

And, it didn't matter whether patients consumed lycopene in the form of a supplement or tomato juice, because the total amount of absorption over the four-month study was relatively similar. Interestingly, the reduction in NTx levels was comparable to results among women in their postmenopausal years taking a calcium or vitamin D supplement too.

Despite the good news, scientists are hesitant to promote the value of tomato juice for fighting osteoporosis for one important reason: Because these results originating from a small pilot study, scientists aren't sure if drops in NTx levels may affect bone mineral density.

Osteoporosis International, June 16, 2010 Free Full Text Study

Beveragedaily.com November 23, 2010

NHS Choices November 19, 2010

It wouldn't be surprising if the recent results of the GLOW study on the bone health of 60,000 women from around the world -- particularly the conclusion that women over age 50 have a 50-50 risk of experiencing an osteoporosis-related fracture -- had a lot to do with a proposed draft of expanded recommendations for osteoporosis screenings issued by the U.S. Preventative Services Task Force in early July. What may be surprising to some of you: Men are mentioned briefly in these new recommendations.

Guidelines issued eight years ago called for routine screenings for women older than age 64 and those between ages 60-64 with an increased risk of fractures, but no recommendations for men.

This newest proposal expands recommended osteoporosis screenings to include all younger postmenopausal women if their risk of breaking a bone over a decade -- due to family medical histories or poor lifestyle habits -- is equal to or greater than that of the typical 65-year-old woman. And, as far as the bone health of men goes, even though it was mentioned, the evidence was far from conclusive about the benefit or harm of screening older men, so no recommendations are forthcoming.

One major concern voiced by some medical experts: This review didn't include results from studies in which more than 20 percent of the patients had experienced an osteoporosis-related fracture, resulting in an exclusion of major treatment trials, thus narrowing any reporting on their effectiveness.

Agency for Healthcare Research and Quality Draft Recommendation Statement July 6, 2010 Free Full Text Article

Annals of Internal Medicine July 5, 2010 Free Full Text Study

MedPage Today July 6, 2010

MSNBC July 5, 2010

Despite warnings seemingly everywhere, postmenopausal women remain hurtfully unaware of their elevated osteoporosis-related risks, according to the Global Longitudinal Study of Osteoporosis in Women (GLOW) of some 60,000 female patients living in Australia, Europe and North America. That's one scary conclusion, considering the chances women over age 50 will experience a fracture related to osteoporosis are 50-50, not to mention the escalating likelihood they will experience these problems as they get older.

By the numbers:

* Just a third of the women who reported two or more risk factors for fractures believed they were at a higher risk for fractures than peers in their own age group.

* Only 43 percent of female patients judged their risks of sustaining a fracture to be greater than those of women of a similar age.

* The disconnect among American women who reported at least two risk factors was particularly acute and alarming, with only 35 percent believing themselves to be at greater risk for fractures than their peers.

* Also among the 28,000 Americans who participated in the GLOW study, 38 percent reported a recent fall, 23 percent had already experienced a fracture and 20 percent had been diagnosed with osteoporosis.

All the more reason, you should exercise as often as your body and schedule allows and eat the best foods for your heart, mind and body.

Osteoporosis International March 31, 2010

University of Massachusetts Medical School April 2, 2010