Affecting 55 percent of people age 50 years and older, osteoporosis is a serious condition where the bones become very porous, weak and break easily. In some cases of osteoporosis, the bones may become so brittle that even a mild stress, like coughing, may cause a fracture. The good news is this devastating disease is preventable.
Risk Factors—Genetic vs. Controllable
Osteoporosis affects men and women of all races. White and Asian women, however, are at the highest risk. While osteoporosis is most common after menopause in women, it can strike at any age and any ethnicity. In men, osteoporosis typically strikes after age 50.
There are a number of uncontrollable risk factors which increase your chance of developing osteoporosis including age, gender, race, family history of the disease, and body frame size. Men and women with small body frames are at a higher risk of developing osteoporosis because they may have less bone mass to draw from as they age.
Other diseases and medications may increase risk of osteoporosis. Lower sex hormone levels, such as testosterone in men and estrogen in women, weaken bones. Other hormone disorders, such as thyroid problems also increase osteoporosis risk. For these reasons, it is important to review your entire medical and medication history with your doctor.
There are a number of diet and lifestyle risk factors which can be controlled. These include low dietary calcium and vitamin D intake, high salt or high caffeine intake, sedentary lifestyle, alcohol consumption, low body mass index and smoking. Bone is living tissue and, throughout life, bone is being broken down and replaced. A lack of calcium and low vitamin D may inhibit the body’s ability to form new bone. In addition, drinking greater than three alcoholic drinks per day as well as a high salt diet and smoking may also diminish bone health.
Osteoporosis is diagnosed with a radiologic procedure called central DEXA (dual energy x-ray absorbitometry) that measures the hip, spine and wrist, which are the areas most prone to bone density loss and future fractures. Women over 65 and men over age 70 with risk factors should be screened every 24 months. For women younger than 65, DEXA scanning may be indicated based on their risk factor profile.
Regardless of age, preventing osteoporosis requires a bone healthy diet, modifying lifestyle factors and regular exercise. A healthy diet including calcium rich foods, such as dairy products, as well as fruits, vegetables and whole grains as well as a vitamin D supplement can help reduce osteoporosis risk. It is recommended that women age 19-49 maintain a daily calcium intake of 1000 mg and women age 50 and above intake 1200 mg daily. The recommended daily intake of vitamin D3 for women 50 and older is 800- 1000 IU daily. For women under 50, the recommended daily intake of vitamin D3 is 400-800 IU daily.
Exercise promotes bone health by decreasing fall risk, improving bone mass and strength, enhancing muscular strength, improving balance, posture and flexibility. It is recommended that women participate in weight bearing and muscle strengthening exercises (e.g. walking, running, dancing, aerobics, sports, weight training, and yoga) at least 3 times a week.
There are many FDA approved medications and supplements for the prevention and treatment of osteoporosis. The decision to treat medically is based on the particular individual’s risk-benefit analysis and should be reviewed annually with your doctor.