Have you seen Elizabeth lately? She is beginning to get round-shouldered, and there is something wrong with her. She is only 59 years old, but lately she looks 70! She started looking old after she fell last winter and broke her wrist. Elizabeth had always been so cute and tiny. Her friends envied her blonde hair, blue eyes and size-6 figure, but she doesn't look good now.

Elizabeth has osteoporosis. The word means brittle bones, and Elizabeth's bones are beginning to look a little bit like Swiss cheese. That's why she broke her wrist. If the disease process continues, she is going to have fractures of the spine. In fact, she has probably already started the process, because her shoulders are beginning to stoop. Poor Elizabeth! No one warned her in time about that early hysterectomy the lack of estrogen in her body. Her osteoporosis could have been prevented.

Osteoporosis is a disease most commonly found in post-menopausal women. Fortunately, it is also a disease that can be prevented if you understand the causes and are aware of the potential problems and situations that times are more susceptible than men. Women who are fair-haired, fair-skinned, of small bone structure, and from Northern European descent are more prone to this disease than those who are dark-skinned, larger-boned and of southern European or African heritage. Oriental women are also high-risk candidates. Due to genetic factors, women with family members who have or had osteoporosis also are more susceptible.

Because the disease causes brittle bones and loss of bone density, it contributes to broken hips, fractured limbs and the loss of height that so often because few people lived long enough for it to become a problem. However, in 1987, the average life expectancy for women is 84 years. If age 50 is used as the average age for menopause, it does not take a mathematician to figure out that women will be susceptible to bone-mass deterioration for 34 years. Women who have had surgical hysterectomies may be even more prone to the disease, particularly if the ovaries that produce hormones have been removed.

Estrogen is produced while the ovaries are active and protects against osteoporosis. Once the ovaries are inactive, either due to the natural aging process or surgical removal, estrogen replacement therapy may be prescribed. Although we don't know exactly why estrogen helps reduce hot flashes, decreases anxiety and depression, preserves normal vaginal function and contributes greatly to maintaining bone density.

Early studies reported a link between estrogen and uterine cancer. However this has been refuted by leading gynecologists and researchers who support the studies showing that estrogen taken in appropriate dosages is safe. Progesterone is often prescribed with estrogen. When taken with estrogen, progesterone actually protects against uterine cancer. The dosage varies with the individual and can only be determined by a doctor. Hormone therapy following menopause can help a woman to maintain a hormone balance that keeps her comfortable and health for many years.

Calcium is currently being investigated to determine whether a particular dosage or type of supplement is better than another. The recommended daily dosage for maintaining healthy bone density is approximately 1500mg. This requirement can be met in two ways-through calcium supplements or a diet high in calcium. A combination of the two is probably the most sensible approach.

Dairy products are the best calcium source, and skim-milk products have a higher calcium content than whole-milk products. This is good news for those who are reluctant to drink milk or eat cheese because of the high caloric value of dairy products. Leafy green vegetables such as broccoli, spinach and kale are also good calcium content and enhance flavor. Low-fat yogurt has become popular and is readily available almost everywhere in the U.S. and even overseas. To better acquaint yourself with the calcium content of food products, read food labels as you shop for groceries.

Another measure essential for the prevention of osteoporosis is weight-bearing exercise. Weight-bearing exercise includes walking, jogging, dancing, aerobics, tennis, golf, volleyball, racquetball, bowling, roller-skating and any other activities that exert positive force on the spine. Swimming and bicycling are not weight-bearing activities. Although they are excellent for increasing strength and lung capacity and are recommended for the average back-pain patient, they are not the best exercises for the osteoporosis patient.

Because osteoporosis is preventable, it is important that young women be informed about it and start thinking about calcium intake and weight-bearing exercise long before problems develop. Encourage your daughters to begin a physical fitness program at an early age and maintain healthy bone density throughout their lives.