Osteoporosis: Risk Factors, Prevention, and Detection

HYG-5808
Date: 
09/16/2020
Kendall DeWine, Program Assistant, Ohio State University Extension Family and Consumer Sciences, Clark County

Osteoporosis means “porous bone.” It is a skeletal disease characterized by low bone mass and reduced bone strength, which leads to an increased risk of fractures and poor bone quality. Throughout one’s life, old bone tissue is constantly being broken down and new tissue is being built to replace it. Most people reach their “peak bone mass” around age 35, then very slowly start to lose bone mass faster than they can build it.

Statistics

A happy relationship between a caregiver in a medical uniform and an elderly woman with a cane – both smiling and sitting closely together.Osteoporosis is one of the most common diseases affecting bone health in the United States and around the world. It is more common in women, affecting about 25% of women 65 and older, but only 5% of men 65 and older. Most people do not even know they have osteoporosis until they break a bone. The U.S. National Osteoporosis Foundation estimates that 54 million Americans are at increased risk of developing osteoporosis due to low bone mass and about 9 million already have osteoporosis. These numbers continue to grow as the older population in the United States increases

Are You at Risk?

Let’s look at the major risk factors for osteoporosis:

  • Age. Osteoporosis can affect people of all ages but is much more common among older people. A middle-aged woman of color climbing stairs while holding her back due to back pain

  • Sex. Your chances of developing osteoporosis are greater if you are a woman. After the age of 50, one in two women will break a bone due to osteoporosis, while only one in four men will.
  • Race. You are at higher risk if you are white.
  • Bone structure/Body weight. Men and women with light and thin bones are at greater risk of developing osteoporosis.
  • Decreases in sex hormones. Estrogen (the sex hormone for women) and testosterone (the sex hormone for men) protect bones. Therefore, a decrease in either of these hormones causes bone mass to be reduced. An example of when this occurs is after menopause for women.
  • Medications and disease. Osteoporosis is associated with certain medications such as cortisone-like drugs. Medical conditions that may cause bone loss include endocrine disorders, cancer, and autoimmune diseases. For a full list of medications and disorders, visit nof.org.
  • Lifestyle. You are at greater risk of developing osteoporosis if you do not get enough calcium and vitamin D, if you do not eat enough fruits and vegetables, if you consume too much protein, sodium, or caffeine, if you have an inactive lifestyle, or if you smoke.
  • Heredity. You are more likely to develop osteoporosis if either of your parents has or had osteoporosis or a history of broken bones.

How Can You Help Prevent Osteoporosis?

  • Hormones. Estrogen replacement therapy (ERT) is recommended for women soon after menopause. ERT must be discussed with your medical specialist. For men, testosterone replacement therapy can improve symptoms of low testosterone and can help prevent bone loss.
  • Diet. Make sure to eat a well-balanced diet with fruits and vegetables. You will also want to increase your calcium and vitamin D intake. Vitamin D deficiency is common among individuals in North America. It is recommended that those age 51 and older consume 1,200 mg of calcium and 800-1,000 IU of vitamin D daily.
  • Exercise. Check with your doctor before beginning an exercise program. It is never too late to introduce exercise into your life. Weight-bearing exercises such as fast-walking and lifting weights are recommended exercises to keep your bones strong.
  • Alcohol and tobacco use. Smoking tobacco and drinking alcohol reduces estrogen levels in women and testosterone levels in men and is toxic to the cells that build bone. They may also make it harder to absorb calcium.

Detecting Osteoporosis

There are few warning signs for osteoporosis. They include having bad posture, loss in height, or back pain from the curving and weakening of the spine. Most people find out they have the disease after easily breaking a bone. But it is now possible to measure the density of your bones with a safe and painless procedure called absorptiometry. Your doctor can advise you whether and when you should be tested.An elderly woman standing while holding a metal cane in her hand

Conclusion

Although osteoporosis is common, it is preventable and treatable. There are several steps that you can take to slow the progression of osteoporosis. You can live successfully with osteoporosis. Your body is a miracle. Take care of it and enjoy life. 

References

Lee, S., Teschemaker, A.R., Daniel, M., Maneno, M.K., Johnson, A.A., Wutoh, A.K., & Lee, E. (2016). Calcium and vitamin D use among older adults in U.S.: results from national survey. Journal of Nutrition, Health & Aging, 20(3), 300-305. doi.org/10.1007/s12603-015-0614-9

Mayo Clinic Staff. (2019, June 19). Osteoporosis. mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968

National Council for Aging Care (n.d.). Osteoporosis Defined: Causes, Symptoms and Treatments. aging.com/osteoporosis-defined-causes-symptoms-and-treatment

National Osteoporosis Foundation. (2013). Bone Basics, Who Gets Osteoporosis: Factors That Put You at Risk. cdn.nof.org/wp-content/uploads/2016/02/Who-Gets-Osteoporosis.pdf

Office of Genomics and Precision Public Health. (2020, May). Does Osteoporosis Run in Your Family? Centers for Disease Control and Prevention, Office of Science. cdc.gov/genomics/disease/osteoporosis.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Ffeatures%2Fosteoporosis%2Findex.html

Qaseem, A., Forciea, M.A., McLean, R.M., & Denberg, T.D. (2017). Treatment of low bone density or osteoporosis to prevent fractures in men and women: a clinical practice guideline update from the American College of Physicians. Annals of Internal Medicine, 166(11), 818-839. doi.org/10.7326/M15-1361

Tsai, A.J. (2019). Disparities in osteoporosis by race/ethnicity, education, work status, immigrant status, and economic status in the United States. European Journal of Internal Medicine, 64, 85-89. doi.org/10.1016/j.ejim.2019.04.011

Wright, N.C., Saag, K.G., Dawson-Hughes, B., Khosla, S., & Siris, E.S. (2017). The impact of the new National Bone Health Alliance (NBHA) diagnostic criteria on the prevalence of osteoporosis in the USA. Osteoporosis International: A Journal Established as Result of Cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 28(4), 1225-1232. doi.org/10.1007/s00198-016-3865-3

Adapted from Osteoporosis Fact Sheet by Lisa Marie Gibson, Ohio State University Extension, Franklin County, 1999