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PULSE CHECK: Dr. Dianne Woolard, an OB/GYN with SoutheastHEALTH, tells how to maintain healthy bones Interview by Robyn Gautschy
Dr. Dianne Woolard
Job title: Obstetrician/gynecologist
Hometown: Dexter, Mo.
City of residence: Cape Girardeau
Education: Undergraduate at Washington University in St. Louis; medical school at St. Louis University; residency at Barnes-Jewish Hospital in St. Louis/Washington University School of Medicine
Flourish: When do women need to start thinking about bone health?
Woolard: Women start to lose bone mass at 35 years old, and this loss accelerates at menopause.
How can we take good care of our bones at each stage of our life?
Young children and young women must get adequate calcium and vitamin D to build strong bones. This requires exercise so the bones are stimulated to create a dense structure. In our 30s and 40s it is about maintenance with weight-bearing exercise -- e.g., walking and 1,000 milligrams of calcium daily with 2,000 IU of vitamin D daily.
Flourish: How does osteoporosis develop? What are the risk factors and symptoms?
Woolard: Osteoporosis is the slow loss of bone density. Our bones are constantly reorganizing their structure and density. This is influenced by our weight, diet and activity. Cells that break down bone (osteoclasts) are more active than those that build it back (osteoblasts). Factors that impact bone building are low body weight, sedentary lifestyles, smoking, alcohol use, age and genetics. Gastrointestinal disorders that inhibit calcium and vitamin D absorption are also culprits. All races are susceptible, but Caucasians and Asians have higher risks. There are no symptoms.
Flourish: How do you diagnose and treat osteoporosis?
Woolard: Diagnosis is by bone densitometry, which measures density and assigns a T score. Osteoporosis is a T score less than -2.5. A diagnosis can be made without this study by history -- loss of height or major bone fracture, traumatic or nontraumatic. There are a wide variety of treatments that should be tailored to the needs of the individual. Many factors should be considered to determine the best fit.
Flourish: What is something most women don't know about bone health and osteoporosis?
Woolard: Vitamin D carries calcium from the gastrointestinal tract into the bloodstream. Without proper levels, all the calcium in the world will not help. Most Americans are deplete.
Flourish: What's your best overall health advice for women?
Woolard: Maintain weight-bearing exercise throughout life. Encourage your children and grandchildren to run and jump and play. Drink milk and take extra vitamin D. All women over 35 should take 500 milligrams of calcium twice a day with 2,000 IU of vitamin D. Vitamin D at this level can reduce the risk of osteoporosis, depression, heart disease and colon cancer.