Osteoporosis Prevention And Bone Health
Aging Well Women's Health Orthopedics
February 03, 2025
People used to think osteoporosis, fractures and stooped posture were an inevitable part of aging. The good news is this is no longer true! Today, a lot more is known about prevention, detection and treatment of bone health problems that occur with aging.
According to the National Osteoporosis Foundation, approximately 10 million Americans have osteoporosis and another 44 million have low bone density, placing them at increased risk. Studies suggest that approximately one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis.
What Is Osteoporosis?
Bone is continually being broken down and replaced. And when the development of new bone doesn't keep pace with the loss of old bone, it is diagnosed as osteoporosis.
“Bone is actually living tissue. With age, that becomes weak. And when it's weak enough that it causes problems, that's when we classify it as osteoporosis,” said Abhigyan Banka, MD , a family medicine physician at Franciscan Physician Network Beech Grove Family Medicine. “What osteoporosis translates to is porous bone, which means bones become weak and brittle.”
Osteoporosis is considered a silent disease because it often has no symptoms until someone breaks a bone.
This chronic disease causes bones to become so weak and brittle that a fall or even coughing can cause a fracture. These fractures commonly occur in the hip, wrist or spine.
This loss of bone strength can take two main forms: osteopenia and osteoporosis. Osteopenia can be characterized as having weakened bones, but not as weak as bones with osteoporosis. Osteoporosis and osteopenia are conditions of decreased density and strength of the bones associated with increased bone fragility and risk of fractures. These are silent conditions until the patient develops fracture spontaneously or with minor trauma.
What Are Symptoms Of Osteoporosis?
According to the Office on Women’s Health, you may not have any symptoms of osteoporosis until you break, or fracture, a bone. A fracture can happen in any bone of the body. But fractures are most common in the hip, wrist and spine (vertebrae).
“The most common symptoms that people may complain of is a stooped posture, so people might take time getting out the bed. Their height might go shorter by a few inches as they become older. That's basically from the spine being compressed from being weak,” said Dr. Banka. “Now, once you have a fracture or bone compression fracture, that's when you have pain, body aches and weakness.”
What Are Risk Factors For Osteoporosis?
Osteoporosis affects more women than men. Of the estimated 10 million Americans with osteoporosis, more than 8 million (or 80 percent) are women.
Women in menopause
Menopause often brings on a loss in bone density, and most women with osteoporosis are post-menopausal and age 65 or older.
The connection between menopause and bone health is strong.
“Once women hit menopause, the level of estrogen goes down. The estrogen is good for several things in the body, but one of the primary roles of estrogen is bone health,” said Dr. Banka. “Some studies have shown that once you hit menopause, there's a 20 percent reduction in bone mass, even 5 to 7 years of hitting menopause. That's a significant amount of bone loss.”
People with risk factors for bone loss
People with risk factors for bone loss, such as a family history of fractures or the use of certain medications such as steroids, should get screening earlier.
Smoking and alcohol use
Other risk factors for osteoporosis are smoking and alcohol use.
“If you smoke, that generally is harmful for your bone and most living tissues. Alcohol consumption, if you have more than a couple of drinks a day a few times a week, that would put you at a higher risk for osteoporosis,” said Dr. Banka.
Race
“Caucasians and Asians are at a higher risk of bone disease like osteoporosis than other races," he said.
Lower body weight
"If you are on the lighter side with body weight, if your weight is less than 120, 127 pounds, that puts you at a higher risk for osteoporosis," Dr. Banka said.
Should I Be Screened For Osteoporosis?
The U.S. Preventive Services Task Force recommends osteoporosis screening for:
- Women over age 65.
- Women of any age who have other risk factors that increase the chance of developing osteoporosis.
How Does Exercise Help Bone Health?
Exercise is one thing that gets overlooked as a preventive step for bone health.
“If you don't exercise on a frequent basis, your bones become weaker, so if you have a weak of bones that would put you at a higher risk for osteoporosis,” said Dr. Banka.
Weight-bearing and resistance exercises can help build and preserve bone mass. Walking, dancing and muscle strength training are all great options.
“When I say exercise, I mean, something that you would do in your home. You don't have to have a personal trainer. You don't have to go to the gym,” said Dr. Banka. “Exercise with a focus on balance and posture, but also strength and resistance training.”
Dr. Banka stated that the more strength training you have, the more balance you have, the stronger your bones will be.
Listen Now: Bone Health
Osteoporosis affects men and women of all races. White and Asian women, especially those who are past menopause, are at highest risk for developing osteoporosis. Medications, a healthy diet and weight-bearing exercises can help prevent bone loss and strengthen weakened bones. Dr. Abhigyan Banka discusses the importance of bone health, and how to be aware of it.
How Does Diet Help Prevent Osteoporosis?
Our diet plays a role in osteoporosis prevention. Eating a nutrient-rich diet that includes all the major food groups is important.
“When we talk about diet, we mean three major things. We talk about calcium, vitamin D and protein in our diet,” said Dr. Banka. “Bones are basically calcified living tissue and the way that the calcium gets deposited on the bones is with the help of calcium that we eat and vitamin D that we eat or we make in our skin through sunlight.”
Lifestyle changes that can help include getting adequate calcium and vitamin D. After a certain age, it might be harder to get calcium and vitamin D and the amounts required to maintain bone health, so taking a calcium or vitamin D pill, like a supplement pill over-the-counter is not a bad idea.
“Please take a calcium and vitamin D pill over-the-counter, especially after you hit menopause for women or after the age of 70 for men,” said. Dr. Banka.
Calcium
Calcium is a mineral that is necessary for life. In addition to building bones and keeping them healthy, calcium enables our blood to clot, our muscles to contract, and our heart to beat. About 99 percent of the calcium in our bodies is in our bones and teeth.
“For most women, before they hit menopause, about 1000 milligrams of calcium a day is okay. That's what the recommended dose is. Now, post-menopausal or if you're above 50 for women and men if they're above 70, about 1200 milligrams of calcium a day is what is required and recommended,” said Dr. Banka.
Vitamin D
Vitamin D plays an important role in protecting your bones, both by helping your body absorb calcium and by supporting muscles needed to avoid falls. Vitamin D is measured by international units, instead of milligrams and grams.
“For younger women before menopause, the recommended dose is 600 international units. And if you're menopausal, if you're above the age of 50, especially in women, about 800 units of vitamin D,” said Dr. Banka.
Protein
In most people who fracture bone, an inadequate consumption of protein contributes to the broken bones. Many studies show that women and seniors do not consume enough protein daily. In fact, in the elderly, protein deficiency may be an important indicator of weak bone health.
“Any protein is good protein, but I would recommend lean proteins. That includes eggs, chicken, white fish and shrimp. For people who are vegan, legumes, nuts and tofu are a good source of protein as well,” said Dr. Banka.
How Do You Diagnose Osteoporosis?
A bone density test is the only test that can diagnose osteoporosis before a broken bone occurs. This test helps to estimate the density of your bones and your chance of breaking a bone. You can find out whether you have osteoporosis or if you should be concerned about your bones by getting a bone density test.
“The good thing about the DEXA scan is it's easily available, it's painless and it's not like a CT scan or an MRI in which you have to go inside a tube. You basically lie flat on the bed and scanner goes through your body and scans your bones and it uses very low level of radiation,” said. Dr. Banka.
The results from these tests will determine the treatment plan and the medications prescribed. There are several medication options available.
Do I Need To See A Specialist For Osteoporosis?
Osteoporosis or osteopenia often can be successfully treated through your primary care physician.
Cases of severe osteoporosis, medication intolerance or treatment failure can benefit from referral to osteoporosis specialists.
HealthDay News contributed information to this article.
