Excerpt

This first-ever Surgeon General’s Report on bone health and osteoporosis illustrates the large burden that bone disease places on our Nation and its citizens. Like other chronic diseases that disproportionately affect the elderly, the prevalence of bone disease and fractures is projected to increase markedly as the population ages. If these predictions come true, bone disease and fractures will have a tremendous negative impact on the future well-being of Americans. But as this report makes clear, they need not come true: by working together we can change the picture of aging in America. Osteoporosis, fractures, and other chronic diseases no longer should be thought of as an inevitable part of growing old. By focusing on prevention and lifestyle changes, including physical activity and nutrition, as well as early diagnosis and appropriate treatment, Americans can avoid much of the damaging impact of bone disease and other chronic diseases.

Contents

• Message From Tommy G. Thompson
• Preface
• Acknowledgments
• 1. What Is Bone Health?
  • 1. A Public Health Approach to Promote Bone Health
    • Key Messages
    • The Magnitude of the Problem
    • The Challenge
    • The Opportunity
    • The Charge
    • Evidence Base for the Report
    • Organization of the Report
    • References
  • 2. The Basics of Bone in Health and Disease
    • Key Messages
    • Why Do We Have Bones?
    • How Bones Work
    • How Bones Change Throughout Life
    • What Keeps Bones Healthy?
    • What Causes Diseases of Bone?
    • What Is Osteoporosis?
    • The Future: Where a Better Understanding of Bone Biology Can Take Us
    • Key Questions for Future Research
    • References
  • 3. Diseases of Bone
    • Key Messages
    • Osteoporosis
    • Rickets and Osteomalacia
    • Renal Osteodystrophy
    • Paget’s Disease of Bone
    • Developmental Skeletal Disorders
    • Malignancy and the Skeleton
    • Oral Health and Bone Disease
    • Key Questions for Future Research
    • References
• 2. What is Bone Health in America?
  • 4. The Frequency of Bone Disease
    • Key Messages
    • Fractures Caused by Bone Disease
    • Osteoporosis
    • Other Metabolic Bone Diseases
    • Developmental Skeletal Disorders
    • Acquired Skeletal Disorders
    • Prospects for the Future
    • Key Questions for Future Research
    • References
  • 5. The Burden of Bone Disease
    • Key Messages
    • Impact on Society
    • Impact on the Individual
    • The Burden of Other Bone Diseases
    • Key Questions for Future Research
    • References
• 3. What Can Individuals Do to Improve Their Bone Health?
  • 6. Determinants of Bone Health
    • Key Messages
    • Nutrition’s Impact on Bone Health: A Review of the Evidence
    • Physical Activity
    • Weight
    • Falls and Fall Prevention
    • Reproductive Factors
    • Medical Conditions and Drugs
    • Smoking, Alcohol, and Environmental Threats to Bone Health
    • Key Questions for Future Research
    • References
  • 7. Lifestyle Approaches to Promote Bone Health
    • Key Messages
    • Nutrition
    • Physical Activity
    • Fall Prevention
    • Other Aspects of a Bone-Healthy Lifestyle
    • Summary
    • Key Questions for Future Research
    • References
• 4. What Can Health Care Professionals Do to Promote Bone Health?
  • 8. Assessing the Risk of Bone Disease and Fracture
    • Key Messages
    • Step 1: Identify At-Risk Individuals Who Require Further Evaluation
    • Step 2: Measuring Bone Mineral Density (BMD) for Individuals at Risk of Osteoporosis
    • Looking to the Future: Potential Complements to BMD
    • Key Questions for Future Research
    • References
  • 9. Prevention and Treatment for Those Who Have Bone Diseases
    • Key Messages
    • A Pyramid Approach
    • Key Questions for Future Research
    • References
  • 10. Putting It All Together for the Busy Health Care Professional
    • Key Messages
    • Children and Adolescents
    • Adults
    • Older Adults
    • Key Questions for Future Research
    • References
• 5. What Can Health Systems and Population-based Approaches Do to Promote Bone Health?
  • 11. Systems-based Approaches to Bone Health
    • Key Messages
    • Overview
    • Systems-Based Approaches for Various Stakeholders
    • Special Populations
    • Conclusions
    • Key Questions for Future Research
    • References
  • 12. Population-based Approaches to Promote Bone Health
    • Key Messages
    • Definition of Population-Based Interventions
    • Evidence of the Effectiveness of Population-Based Interventions
    • Communication Tools for Population-Based Interventions
    • Population-Based Interventions: Conclusions
    • Program Examples
    • Building on Success
    • Key Questions for Future Research
    • References
• 6. Challenges and Opportunities: A Vision for the Future
  • 13. A Vision for the Future: A Framework for Action to Promote Bone Health
    • A Framework for Action
    • Key Action Steps
    • The Roles of Key Stakeholders
    • The Importance of Partnerships Among Stakeholders
    • Conclusion
• Appendices
  • Appendix A Congressional Language Calling for Surgeon General’s Report
  • Appendix B How Do We Know What We Know: The Evidence Behind the Evidence
  • Appendix C Resources and Related Links
• Abbreviations and Acronyms

Suggested citation:

U.S. Department of Health and Human Services. Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, 2004.