Mr. Chairman and Members of the Committee, this testimony is submitted by Joan Goldberg, Executive Director of the American Society for Bone and Mineral Research (ASBMR), representing the National Coalition for Osteoporosis and Related Bone Diseases, which includes the National Osteoporosis Foundation, the Paget Foundation for Paget¡¦s Disease of Bone and Related Disorders, the Osteogenesis Imperfecta Foundation, and the ASBMR.
Together we represent over 44 million Americans who have bone diseases or are at risk for them, along with the more than 5,000 scientists dedicated to improving the diagnosis, treatment and understanding of bone diseases and disorders.
Bone health is integral to overall health. Our bones support our muscles, protect vital organs, and store the calcium essential for bone density or mass, and strength. What makes bones healthy? It¡¦s a complex interaction involving many nutritional, hormonal, behavioral, genetic and environmental factors. What we eat and drink, the type and duration of our exercise, our family history¡Kthese are some of the pieces of the puzzle that fit together when addressing bone health.
Bone health is a critical component to consider when evaluating military readiness and performance. Why is bone health so critical to our military? Stress fractures occur in up to 15% of military recruits. Stress fractures are most common in the legs and feet, but also occur in the ribs and upper extremities. For healing to occur, recruits often need to stop running or marching for weeks. Not only do these fractures delay military readiness and performance, but they represent a cost of over $10 million per year. Our recent engagement in Iraq highlights some additional considerations when it comes to bone health. For example, soldiers routinely carried packs that weighed 70-90 pounds over rough terrain for miles on end in a harsh climate. For many, a fracture often spelled an exit from the combat theater as quickly as a shrapnel injury.
It is vitally important to understand how to prevent stress fractures in recruits and in combat to reduce suffering, minimize the time it takes to ready soldiers for combat, prevent fractures in training situations and in combat, and reduce the significant costs associated with these fractures.
The DoD has learned a great deal from research to improve soldiers¡¦ bone health, but there is more to be learned. Recent research has investigated: Testimony of the National Coalition for Osteoporosis and Related Bone Diseases (the Bone Coalition)
„X the effects of impact forces, such as running, on bone formation „X the effect of specific nutritional regimens on bone health „X the effects of weight management behaviors on bone health
Ongoing research will help address: „X the role of and effect of non-steroidal inflammatory medications on bone health and performance „X the role of remodeling and nutrition on bone quality „X the role of electrical fields to speed bone repair „X the role of new diagnostic tools
Additional topics critical to our understanding and our recruits¡¦ military health include:
„X novel approaches, such as the possible use of low frequencies to build high quality bone „X explorations of how different types of physical training affect bone at a cellular level „X investigations aimed at identifying the best training and nutritional regimen in terms of exercise duration and intensity, and nutrient amounts, to optimize fitness levels and bone health and to prevent injury Mr. Chairman, stress fractures compromise the health, military readiness and performance of our recruits and troops. A strong and well-trained military proved to be crucial in Iraq and will continue to be a vital component of our country¡¦s future. We thank you for maintaining 2003 funding for the Bone Health and Military Medical Readiness Program of the U.S. Army Medical Research and Materiel Command located in Fort Detrick, Maryland. We know there are many worthy projects in need of funding, especially in the Army¡¦s Bone Health and Military Medical Readiness Program. Without additional support not only are these in jeopardy ¡V and future results that will save money, prevent additional fractures, and further healing -- but we risk losing researchers who are dedicated to bone health and these projects in particular.
We respectfully request that you consider an appropriation of $10 million to maintain an aggressive and sustained DoD bone research program in FY2004. Thank you for your commitment to the U.S. military¡¦s health and safety.
