Osteoporosis is a condition in which our bones become very fragile and are more likely to break.

Strong bones depend on bone density. Bone loss begins in early adult life and continues as we age. As we age, we lose bone so it becomes less dense. 

What are the risk factors for osteoporosis?

• Family history of osteoporosis
• White or Asian background
• Past menopause
• Prolonged use of certain medications:
• Steroids
• Anticonvulsants
• Aluminum-containing antacids
• Synthetic thyroid
• Female (but men are still at some risk)
• Slight body built
• Lack of exercise
• Cigarette smoking
• Underweight
• High alcohol consumption
• Poor calcium or vitamin D intake 

Health conditions that may increase the risk of osteoporosis:

• Hyperthyroidism
• Chronic renal failure
• Parathyroid disease
• Spinal cord injury
• Down syndrome
• Diabetes
• Chronic diarrhea or malabsorption
• Chronic obstructive lung disease
• Multiple sclerosis
• Cerebral palsy

How can I prevent osteoporosis?

• Eat a variety of foods including those rich in calcium and vitamin D.
• Avoid smoking and drinking a lot of alcohol.
• Get regular exercise.
• Have bone density testing done and use supplements when appropriate.

What are calcium-rich foods?

• Calcium is found in all dairy foods: milk, cheese, yogurt, and buttermilk. Choose the lower-fat variety of these foods.
• What if I am lactose intolerant?
• Some people have difficulty digesting dairy products because they lack the enzyme lactase. If you are lactose intolerant you still may tolerate some dairy foods that have bacterium acidophilus in them such as yogurt and hard cheeses. You can also treat lactose-containing foods with commercial preparations of lactase or even buy milk products that have been treated.
• Read the food label. Calcium is added to products that usually do not contain calcium. Look for “calcium enriched” on the packaging. Breakfast bars and cereals, waffles, breads, processed cheese singles, and orange and apple juice are some of the most common foods that have been calcium enriched.
• Fish: One of the best alternative sources of calcium is tinned or canned fish such as sardines, mackerel, and salmon. Make sure that you mash and eat the bones.
• Dark green leafy vegetables such as broccoli, collards, kale, mustard greens, turnip greens, and bok choy or Chinese cabbage are good sources of calcium. Some greens such as spinach are less effective sources. We do not easily digest and absorb their calcium.
• Tofu: A half-cup of tofu made with calcium sulfate contains 300 mg of calcium. Read the label and make sure that it is made with calcium sulfate.

What exercises are good for the bones?

Two types of exercise that help build and maintain bone mass and density are weight-bearing and resistance exercises.

• Weight-bearing exercise is any exercise in which your legs and feet are bearing your weight: walking, jogging, stair climbing, dancing, hiking, and skiing.
• Resistance exercises increase muscle and strengthen bone; for example, weight lifting using dumbbells or weight machines found at health clubs.

CAUTION: If you have had a fracture or have osteoporosis, talk to your health care provider before starting an exercise program.

Who should get the bone density test?

According to the National Osteoporosis Foundation:

• Women who are in their perimenopausal years (soon before menopause).
• All post-menopausal women younger than age 65 with at least one risk factor (such as smoking, family history, etc.).
• Women over age 65 regardless of risk. Medicare will pay for this.
• All women receiving hormone replacement therapy for a long time.