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MONDAY, Aug. 18 (HealthDay News) -- Low levels of vitamin D can boost older women's risk for hip fracture by more than 70 percent, University of Pittsburgh researchers report.

The finding adds weight to the recommendation that people maintain adequate intake of vitamin D, which is primarily made by the skin when it is exposed to sunlight.

The fracture-vitamin D link "has been observed for 15 years," noted Dr. Michael F. Holick, director of the Vitamin D Skin and Bone Research Laboratory at Boston University. "The good news is it's consistent, the higher your vitamin D status, the lower the risk of your developing a hip fracture."

The new report appears in the Aug. 19 issue of the Annals of Internal Medicine.

Hip fractures can be devastating for older individuals. In fact, 50 percent of older people who suffer a hip fracture will end up in a nursing home and 20 percent will die within the first year due to complications such as a pulmonary embolism resulting from the fracture, Holick said.

For this study, a research team led by Jane A. Cauley from the University of Pittsburgh collected data on 800 women aged 50 to 79. Researchers followed the women for up to nine years to determine their risk for hip fractures.

They found that the risk of hip fracture rose 33 percent with every 25 nanomoles per liter drop in vitamin D levels. Women with the lowest levels of vitamin D had a 71 percent increase risk for hip fractures compared with women with the highest levels of vitamin D, the researchers report.

"We conclude that low serum vitamin D concentrations are associated with an increased risk for hip fracture in community-dwelling women. The mechanism of association is unclear," the authors wrote.

Holick notes that vitamin D is essential for the body's absorption of calcium, a key component of bone health. "If you don't have adequate vitamin D, you cannot efficiently absorb calcium," he said. "Vitamin D also helps maintain bone health by keeping bone cells active."

According to the U.S. Institute of Medicine, people should get between 200 and 400 international units of vitamin D a day. The best way to get vitamin D, naturally, is by being out in the sun.

As little as 10 to 15 minutes of sun a day can give you all a vitamin D you need. Vitamin D is also available in small quantities in foods such as fish and milk.

Preventing hip fracture is another good reason to keep your vitamin D levels up, Holick said. "To get vitamin D levels to where they need to be to reduce the risk of hip fracture, you need to be taking at least 1,000 international units of vitamin D a day from a supplement," he advised.

Dr. John Jacob Cannell, executive director of the nonprofit Vitamin D Council, agreed that most people are not getting enough of the nutrient.

"Women need to know their vitamin D status," Cannell said. "They need to ask their doctor for the right test," known as the 25 hydroxy D test. "Women should strive to keep your vitamin D levels above 125 nanomoles per liter, year round. To do that, they are going to require supplements."

Cannell recommends that before they get a blood test for vitamin D, women take 2,000 international units of vitamin D a day for three months.

More information

For more about vitamin D, visit the U.S. National Institutes of Health.

WEDNESDAY, Aug. 13 (HealthDay News) -- Women 60 and older taking the hormone-replacement therapy drug tibolone to relieve menopausal symptoms are at an increased risk for stroke, a new study finds.

Tibolone is a synthetic drug that acts like the female hormones estrogen and progesterone in relieving menopausal symptoms. But, unlike estrogen and progesterone, it also reduces the risk of some cancers, the study authors said.

"Tibolone, which is used around the world for menopausal symptoms, decreases the risk of fractures, decreases the risk of breast cancer, but increases the risk of stroke in this group of women who are all over the age of 60," said lead researcher Dr. Steven R. Cummings, of the California Pacific Medical Center Research Institute in San Francisco.

The drug shouldn't be used in women over the age of 60, particularly those with an increased risk for stroke, Cummings said. "For older women, you should stop taking tibolone or not consider starting it," he said, adding that the drug is not available in the United States.

Earlier studies have shown that hormone replacement therapy (HRT) with estrogen increases the risk for stroke, no matter at what age women start using it. Many physicians recommend that only women with the most severe menopausal symptoms use any form of HRT.

For the new study, published in the Aug. 14 issue of the New England Journal of Medicine, Cummings's team randomly assigned 4,538 postmenopausal women to daily 1.25 milligram doses of tibolone or a placebo. Over the 34 months of the study, the researchers looked for spine fractures among the women and the rates of cardiovascular problems and breast cancer.

The researchers found fewer cases of spine fractures among women taking tibolone compared with women receiving a placebo -- 70 cases versus 126 cases per 1,000 person years, respectively. And, women taking tibolone were at a reduced risk of breast cancer and colon cancer.

But, women taking tibolone had a 2.2 times increased risk of stroke. This increased stroke risk caused the study to be stopped in February 2006, before the trial was complete.

For younger women, tibolone may be a good choice for relieving menopausal symptoms, Cummings said.

"Women who are having menopausal symptoms in their 50s can continue to take tibolone, because it is relatively safe and also does have other benefits, such as a reduction in the risk of fracture and breast cancer," he said.

Cummings noted that tibolone is not available in the United States, although it is available in 90 other countries. "It will not be available in the United States, because the company is not asking the U.S. Food and Drug Administration to approve it," he said.

Tibolone is made by Organon, which is owned by Schering-Plough of Kenilworth, N.J. The company has decided not to try to get tibolone approved in the United States because of the increased risk of stroke, Cummings said.

Dr. Michael Strongin, a gynecologist at Lenox Hill Hospital in New York City, said, "All drugs that are being used for menopausal symptoms all have positives and negatives. The task is to find drugs that don't have problems."

"For the U.S. consumer, it's sort of a moot point," Strongin added. "It [tibolone] is not the magic bullet, but I think it's another drug that could potentially be used if it ever does get FDA approval. My caution would be that it's potentially helpful, but it's not a slam dunk that it's better than what we have been using."

More information

To learn more about hormone replacement therapy, visit the U.S. Women's Health Initiative.

THURSDAY, Aug. 7 (HealthDay News) -- Shelley Volz, now 59, got the news about her breast cancer diagnosis 10 years ago, right before she was headed from San Francisco to New York for the wedding of her younger brother.

After much thought, she decided to tell only her mother before the wedding and to hold off telling other family members. "My mother had a typical mother's reaction, tears and hugs, and we moved on," Volz said. "She really appreciated the fact that I didn't want to steal the limelight there."

Volz waited until after the wedding celebration to calmly tell others. Ten years later, after successful treatment, she is doing fine.

While she says she doesn't think she found it as difficult as many people to disclose the diagnosis, she did think about others' reactions.

In that sense, she is typical, according to a new study. "Even when women are facing a breast cancer diagnosis, they are still concerned about caring for everyone else, especially the emotions of others," said study author Grace J. Yoo, a medical sociologist at San Francisco State University's Biobehavioral Research Center.

She presented the findings Monday at the American Sociological Association annual meeting, in Boston. The research is especially timely, given the recent news that actress Christina Applegate, 36, is being treated for early breast cancer.

Yoo and her team interviewed 164 San Francisco-area breast cancer survivors, average age 57, of different ethnicities to evaluate the "emotion work" involved in telling others about the diagnosis.

In interviews with the researchers, the women talked about their feelings and actions after getting the diagnosis.

"Even telling someone, 'I have breast cancer,' it's well thought out," Yoo said. "They know the statement, to some, can overwhelm." Women react in different ways -- stifling their own emotions so they don't appear vulnerable, paying attention to the timing of their news, or sometimes letting it all out, she said.

>Women find it somewhat easier to tell friends than family members, she found. "Women are trying to protect older, aging parents and younger children and even their spouses, even during illness. Women are socialized to care about others."

Ideally, Yoo said, women should do less of that at this time. "It's a time they should be caring about themselves, what decisions they should be making about breast cancer. They shouldn't emotionally burn themselves out by caring for others' emotions."

One woman, for instance, told the interviewer that she didn't tell her mother about her breast cancer until after the surgery, because she knew her mother would worry. Many women said once they were told about the diagnosis, they were surprised about the outpouring of help, even from acquaintances. But some feared that if they told, people may not care enough to help.

The findings ring true with what another expert has seen in clinical practice. This has "documented what we have known instinctively," said Lori Worden, an oncology social worker in Grants Pass, Ore.

Her advice to women? "You don't need to tell people today." Feel free to process it yourself first. Practicing what you will say, by saying it out loud to yourself or writing it down, can help, she said.

Yoo's advice: "We tell women to seek out other breast cancer survivors, other women who understand, to increase their resources." And focus more on getting emotional support than giving it.

More information

To learn more about how to tell others about your diagnosis, visit the Lance Armstrong Foundation  .

FRIDAY, Aug. 1 (HealthDay News) -- When American men spend long hours at work, their wives often pick up the slack at home by quitting their own jobs, but a new study shows the reverse is rarely true.

Men aren't any more likely to stop working when their wives begin to spend 60 hours a week or more on the job, said lead researcher Youngjoo Cha, a doctoral candidate in sociology at Cornell University.

"Women are more likely to sacrifice their careers, because men's careers are considered to be more important, and the culture of taking care of children says that mothers should bear the primary responsibility for housework and health care," Cha said.

She believes more women may choose to quit their jobs, harkening back to a time when fewer women worked outside the home, and men were more likely to be breadwinners.

In the new study, Cha looked at a 1995-2000 U.S. census survey of married couples. She was expected to report her findings Friday at the American Sociological Association annual meeting, in Boston.

She found that if a man worked more than 60 hours a week, his wife was 44 percent more likely to quit her own job. But when women worked more than 60 hours a week, their husbands weren't any more likely to quit their jobs.

Women with children were especially likely to quit their jobs if their husbands were putting in many hours at work. These professional women were 90 percent more likely to quit working if their husbands worked more than 60 hours or more a week compared to women without children.

"Even among very egalitarian couples, children are considered to be the woman's primary responsibility," Cha said.

Among professionals, 30 percent of husbands worked more than 50 hours per week, compared to just 12 percent of wives.

According to previous research, about 12 percent of American employees report working more than 50 hours per week, up from 9 percent in 1983.

Even after she adjusted the statistics to account for factors like education levels and income, the gender differences remained, Cha said.

Overall, the study findings suggest that "men's careers are comparatively more important than women's careers," Cha said.

Christine Percheski, a sociologist at Harvard University, said the study findings are plausible, although her own research suggests that the workload of husbands is having less of an effect on wives than in the past.

"This highlights how difficult it can be for couples in which both spouses have demanding careers," she said. "It's especially hard for women."

Is American society moving back toward the days when men were breadwinners and women stayed at home? Percheski doesn't think so.

"I don't think there's evidence that we're reverting to more traditional patterns," she said. "Women are working more than ever and bringing in more family income than ever."

More information

Learn more about families and work from the Families and Work Institute  .