Encouraging Health and Happiness

Yes, You Are Getting Shorter

You’re not just getting older. You’re probably getting shorter, too.  Height Loss May Signal Health Risks, Especially for Men.

Why are you shrinking? Starting in their late 30s, it’s normal for men and women to lose about a half-inch in height every 10 years. Melinda Beck on Lunch Break looks at what point does it get worrisome and what can be done to help.

Height loss is a natural part of aging—some people start shrinking slightly as early as 30. Losing too much height too rapidly, however, can signal a high risk for hip fractures, spinal fractures and even heart disease, particularly in men, several recent studies have found.

“If you are a female, between the ages of 45 and 65, and you notice you are shrinking, that’s pretty usual,” says Marian Hannan, an epidemiologist at Hebrew Senior Life, an affiliate of Harvard Medical School. “If you’re a man, it may be a warning sign to speak to your health-care provider.”

It’s not uncommon to shrink by a quarter to a third of an inch every decade after age 40. Think of a house settling on its foundation. Disks—the gel-like pads between vertebrae—lose fluid over the years and flatten. Muscles lose mass and weaken, especially in the abdomen, which can exacerbate poor posture. Even the arches of the foot flatten out slightly, reducing height by a few millimeters more.

The process accelerates with age, particularly after age 70. In one long-running study of more than 2,000 Baltimore residents, men lost an average of 1.2 inches between ages 30 and 70, and a total of 2 inches by age 80. Women lost an average of 2 inches between 30 and 70 and 3.1 inches total by age 80.

Smoking cigarettes, drinking alcohol or caffeine excessively, extreme dieting and taking steroids and other medications can exacerbate height loss. Sticking to a healthy diet, with adequate calcium and vitamin D, and doing regular weight-bearing exercise can help stave it off, although having strong genes also helps.

Photo Illustration by John Kuczala

When people shrink more or faster, the biggest concern is osteoporosis, in which bones become weak, brittle and vulnerable to breakage.

Dr. Hannan’s study, in the Journal of Bone and Mineral Research last week, found that men over age 70 who lose 2 or more inches in two years have a 54% higher risk of fracturing a hip in the next two years than men who lose less height. Elderly women who lose that much height that fast have a 21% higher risk of hip fracture, said the study, which examined data from over 3,000 adults from the Framingham Heart Study.

Height loss is also a marker for heart disease in men. A large study of British men, published in the Archives of Internal Medicine in 2006, found that men who lost 1.2 inches or more over 20 years were 46% more likely to have suffered from coronary heart disease, and 64% more likely to have died from any cause than men who lost less height.

Why is height loss in men more telling than in women? Because men typically have more muscle mass than women and lose bone more slowly, underlying health problems may be much more advanced by the time the height loss becomes apparent, says Sundeep Khosla, an endocrinologist at the Mayo Clinic in Rochester, Minn.

For both men and women, many of the common diseases of aging—including osteoporosis, heart disease and respiratory problems—go hand in hand. “If you have one of these risk factors, that may increase your risk of having others,” says Dr. Khosla, who is president of the American Society for Bone and Mineral Research, a professional organization of osteoporosis specialists.

He and other experts say that keeping close tabs on patients’ heights can be a simple and inexpensive way for doctors to stay alert to other health problems.

Height loss can alert doctors to osteoporosis that other tests miss, particularly those that measure bone density in the wrist or hip. In a study in the journal Bone in February, University of Pittsburgh researchers found that for each ½ inch that patients over 65 had lost from their tallest adult height, their chance of having a vertebral fracture increased by 20%. While some are extremely painful, vertebral fractures are often asymptomatic until the spine begins to collapse.

Not everyone loses height as they get older. Some 20% of people don’t shrink noticeably thanks to a combination of genetics and following healthy habits throughout their lives, experts say.

Although about 70% of a person’s height is determined by genetics, children need good nutrition, with plenty of protein, vitamins and calcium, to reach their full adult potential. Prenatal care makes a difference too: If your mother smoked or was malnourished while she was pregnant, you’re probably slightly shorter than you should be.

Experts say the best way to stave off height loss and osteoporosis in later years is to build strong bones in childhood. As well, eating a healthy diet and consuming sufficient calcium and vitamin D continue to be crucial for bone health in middle age and beyond.

Regular weight-bearing exercise, including running and walking, is important too. Israeli researchers who measured more than 2,000 men and women in 1965 and again in 1995 found that those who engaged in moderately vigorous aerobic activity, either throughout their lives or just after age 40, lost only about half as much height as those who stopped exercising in middle age or never exercised at all.

Osteoporosis Medicines

What if you already have osteoporosis?

Concern is rising that the group of popular drugs called bisphosphonates that slow bone loss carry a small risk of serious side effects, including a condition in which part of the jaw bone dies or thigh bones suffer a sudden, unusual fracture. Earlier this month, an advisory panel recommended that the Food and Drug Administration require stronger warning labels for the drugs.

SPL / Photo Researchers, Inc.An FDA panel wants stronger warnings for some bone-loss drugs.

An FDA spokesman said the agency is considering the panel’s recommendation. Last year more than five million U.S. women took bisphosphonate drugs, including Fosamax, Actonel and Boniva as well as many generic brands. Merck & Co. which makes Fosamax, said clinical trials out to 10 years still showed a “favorable benefit-to-risk profile” for patients with osteoporosis at risk for fractures, but urged patients who develop severe digestive problems, or bone, joint or muscle pain to call their doctor.

For people with clear osteoporosis or who have suffered a related fracture—an estimated 10 million Americans—the benefits of preventing further bone damage may outweigh the very small risk of serious side effects, many experts say. The calculus is less clear for the 34 million Americans with osteopenia, an earlier stage that doesn’t always progress to osteoporosis. Patients should weigh their individual risks, experts advise.

Other kinds of osteoporosis drugs are available, and more expected in the next few years.

—Melinda Beck


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