• Who Gets Osteoporosis?
• What Causes Osteoporosis?
• Can Osteoporosis Be Prevented?
• What Are the Symptoms of Osteoporosis?
• How Is Osteoporosis Diagnosed?
• How Is Osteoporosis Treated?
• How Can I Prevent Falls?
• Why is Bone Health Impotant?

Osteoporosis is a disease in which the bones become weak and are more likely to break. People with osteoporosis most often break bones in the hip, spine, and wrist.

Osteoporosis can strike at any age, but it is most common in older women. Eighty percent of the people in the United States with osteoporosis are women. One out of every two women and one in four men over age 50 will break a bone in their lifetime due to osteoporosis.

Many risk factors can lead to bone loss and osteoporosis. Some of these things you cannot change and others you can.

Risk factors you cannot change include:

• Gender. Women get osteoporosis more often than men.
• Age. The older you are, the greater your risk of osteoporosis.
• Body size. Small, thin women are at greater risk.
• Ethnicity. White and Asian women are at highest risk. Black and Hispanic women have a lower risk.
• Family history. Osteoporosis tends to run in families. If a family member has osteoporosis or breaks a bone, there is a greater chance that you will too.

Other risk factors are:

• Sex hormones. Low estrogen levels due to missing menstrual periods or to menopause can cause osteoporosis in women. Low testosterone levels can bring on osteoporosis in men.
• Anorexia nervosa. This eating disorder can lead to osteoporosis.
• Calcium and vitamin D intake. A diet low in calcium and vitamin D makes you more prone to bone loss.
• Medication use. Some medicines increase the risk of osteoporosis.
• Activity level. Lack of exercise or long-term bed rest can cause weak bones.
• Smoking. Cigarettes are bad for bones, heart, and lungs.
• Drinking alcohol. Too much alcohol can cause bone loss and broken bones.

There are many steps you can take to keep your bones healthy.

To keep your bones strong and slow down bone loss, you can:

• Eat a diet rich in calcium and vitamin D
• Exercise
• Not drink in excess or smoke.

Nutrition

A diet with enough calcium and vitamin D helps make your bones strong. Many people get less than half the calcium they need.

Good sources of calcium are:

• Low-fat milk, yogurt and cheese
• Foods with added calcium such as orange juice, cereals, and breads

Vitamin D is needed for strong bones. Your body makes vitamin D in the skin when you are out in the sun. Some people get all the vitamin D they need from sunlight. Others need to take vitamin D pills. The chart on this page shows the amount of calcium and vitamin D you should get each day.

Exercise helps your bones grow stronger.

To increase bone strength, you can:

• Walk
• Hike
• Jog
• Climb stairs
• Lift weights
• Play tennis
• Dance

Healthy Lifestyle

Smoking is bad for bones as well as the heart and lungs. Also, people who drink a lot of alcohol are more prone to bone loss and broken bones due to poor diet and risk of falling.

Osteoporosis is called the "silent disease" because bone is lost with no signs. You may not know that you have osteoporosis until a strain, bump, or fall causes a bone to break.

How Is Osteoporosis Diagnosed? A bone mineral density test (called a DXA) is the best way to check your bone health.

This test can:

• Diagnose osteoporosis
• Check bone strength
• See if treatments are making the bones stronger.

How Is Osteoporosis Treated?

Treatment for osteoporosis includes:

• A balanced diet rich in calcium and vitamin D
• An exercise plan
• A healthy lifestyle
• Medications, if needed.

Men and women with osteoporosis need to take care not to fall down. Falls can break bones. Some reasons people fall are:

• Poor vision
• Poor balance
• Certain diseases that affect how you walk
• Some types of medicine, such as sleeping pills.

Some tips to help prevent falls outdoors are:

• Use a cane or walker
• Wear rubber-soled shoes so you don't slip
• Walk on grass when sidewalks are slippery
• In winter, put salt or kitty litter on icy sidewalks.

Some ways to help prevent falls indoors are:

• Keep rooms free of clutter, especially on floors
• Use plastic or carpet runners on slippery floors
• Wear low-heeled shoes
• Do not walk in socks, stockings, or slippers
• Be sure carpets and area rugs have skid-proof backs or are tacked to the floor
• Be sure stairs are well lit and have rails on both sides
• Put grab bars on bathroom walls near tub, shower, and toilet
• Use a rubber bath mat in the shower or tub
• Keep a flashlight next to your bed
• Use a sturdy step stool with a handrail and wide steps
• Add more lights in rooms
• Buy a cordless phone to keep with you so that you don't have to rush to the phone when it rings and so that you can call for help if you fall.

Why is bone health important?

Bone health is important so that your bones will be healthy and strong throughout your lifetime.

It is especially important to build strong and healthy bones in the childhood and teen years to avoid osteoporosis and other bone problems later in life.  Osteoporosis is a condition in which bones are fragile, making them fracture or break much easier. Taking care of your bones when you're young will help prevent problems in the future. 

Young people in this age group have calcium needs that they can't make up for later in life.  In the years of peak skeletal growth, teenagers build more than 25 percent of adult bone.  By the time teens finish their growth spurts around age 17, 90 percent of their adult bone mass is established.

Bones have their own "calcium bank account," so depositing as much calcium as possible during your tween and teen years will help you reach your peak bone mass.  After age 18 the account closes - so you can't add any more calcium to your bones.  You can only maintain what is already stored to help your bones stay healthy. 

Tweens and teens can get most of their daily calcium from 3 cups of low-fat or fat-free milk, but they also need additional servings of calcium to get the 1,300 mg necessary for strong bones. 

Other reasons low-fat and fat-free milk and dairy products are great sources of calcium include:

• Low-fat and fat-free milk has lots of calcium with little or no fat.
• The calcium in low-fat and fat-free milk and dairy products is easy for the body to absorb and in a form that gives the body easy access to the calcium.
• Low-fat and fat-free milk has added vitamin D, which is important for helping your body better absorb calcium.
• In addition to calcium, milk and dairy products provide other essential nutrients that are important for optimal bone health and development.

In addition to low-fat and fat-free milk and dairy products, there are other good sources of calcium, including:

• Dark green, leafy vegetables, such as spinach, broccoli, and bok choy
• Foods with calcium added, such as calcium-fortified tofu, orange juice, soy beverages, and breakfast cereals or breads

Food labels can tell you how much calcium is in one serving of food. Look at the % Daily Value (% DV) next to the calcium number on the food label. For more information, go to How to Understand and Use the Nutrition Facts Label.

How does physical activity help build healthy bones? Bones are living tissue.  Weight-bearing physical activity causes new bone tissue to form, which makes bones stronger. This kind of physical activity also makes muscles stronger. When muscles push and tug against bones during physical activity, bones and muscles become stronger.

For more information on weight-bearing physical activity and bone health, visit the Milk Matters Web site section, Increasing physical activity for better bone health.  

The Surgeon General's Report on Bone Health and Osteoporosis: What it means for you provides a check list of signs you are at risk for weak bones. View PDF.

Where can I get more information about bone health? Learn more at:

• Medline Plus
• National Osteoporosis Foundation

Osteoporosis is a very common condition that mostly affects women.

Men can be affected by it too, though less frequently. Osteoporosis is a major cause of hip and vertebral fractures in older people. Our bones are continually being replaced. New bone is deposited while the body recycles old bone.

In a healthy person, new bone is as strong as the old bone. In people with osteoporosis, new bone has less calcium in it and is therefore weaker than the bone it replaced. As the new bone becomes weaker, it breaks easier. New bone in the hips and vertebrae has the highest possibility of becoming weak and breaking.

Facts:

• In women, estrogen is very important in preventing osteoporosis.
• Women who have experienced menopause or have had their ovaries taken out surgically are at a higher risk of developing osteoporosis, due to the lack of estrogen.
• Osteoporosis is hereditary, which means it runs in families.
• Some medical conditions increase the risk of osteoporosis. For example, patients who must take steroids for a long time may develop osteoporosis because steroids can weaken the bones.
• Some antacids contain aluminum hydroxide, which prevents calcium from being absorbed by the body. People who take antacids regularly for a long time have a higher risk of developing osteoporosis.
• Too little exercise, as well as bed rest, weakens the bones.
• A diet low in dairy products and calcium can make osteoporosis worse.
• Smoking and excessive use of alcohol tend to also make osteoporosis worse.
• Sustained exercise, such as running marathons, decreases the levels of estrogen in the blood and may predispose to osteoporosis.

Bone densitometry is a radiological test that can diagnose osteoporosis early enough for it to be treated.

Bone densitometry is an outpatient radiological test. It is NOT painful.

Depending on what type of machine is used, you may be asked to either lie down on a table or put your ankle in a special device. Most machines use x-rays but some use ultrasound.

A densitometry machine can calculate the density of bone and creates a chart that compares the patient's density to what the density should be. Density is the amount of calcium found in bone. The higher the density, the stronger the bone is. Depending on the density levels found, the doctor may decide that the patient has normal bone density, a somewhat decreased bone density, or osteoporosis. Bone density readings help doctors devise a plan to prevent or treat osteoporosis. A bone density test can be repeated every few years to check whether bones are the same or worsening. Bone densitometry is very safe. However, the machines that use x-rays should not be used on pregnant woman. This is usually not a problem since osteoporosis usually happens during and after menopause.

Osteoporosis is a very common condition that can be prevented with oral medication, staying active, and a healthy diet. Bone density tests are available and very helpful in detecting osteoporosis early. Most patients with osteoporosis live very healthy and productive lives!