There are three stages of bone health.
Stage 1 is the first 25 years of a man or woman’s life when you build the strongest, most dense bones and minimize any actions that may compromise bone building.
Stage 2 is from 30 years of age to menopause for women or andropause for men, where you take steps to avoid the breakdown of bone.
Stage 3 is post menopause or andropause for men, which is generally over 50 years or age, where you support both bone maintenance and limit bone loss.
For most individuals the risk for osteoporosis is strongly influenced by family history of a parent with a hip fracture and that risk is worsened by lifestyle issues. Other individuals can have medical conditions that cause or put them at risk for osteoporosis, but again, lifestyle can further increase that risk. Osteoporosis is a chronic, progressive disease with the most significant outcome being a fracture. It affects millions of Americans, particularly women. and it is estimated that anywhere between 20%-50% of post menopausal women are affected by low bone density (although not all have osteoporosis).1 Although osteoporosis is often thought to be a disease primarily affecting women, men also incur substantial bone loss due to aging and decreased hormone production. Over two million men have this disease and men are more likely to incur fractures related to osteoporosis than to get prostate cancer.1,2,3 The most serious complication of osteoporosis is fracture, specifically fractures of the hip which cause severe pain, disability and increased mortality.
The major causes of osteoporosis relate to age are hereditary (osteoporosis and especially a hip fracture), low body weight (<127 lb), being a current smoker and/or being on steroid therapy (e.g. Prednisone).4 The list of additional risk factors is long and includes vitamin D deficiency, hyperthyroid, hyper-parathyroid, renal calcium leak, poor nutrition, low hormone production, excess alcohol and lack of exercise. Osteoporosis is often preventable by taking simple steps to build and support bone density. It is frequently underdiagnosed and therefore often undertreated. For that reason the most important first step is to:
Find out the status of your bone density and evaluate your current lifestyle and diet.
Maybe you are getting enough calcium in your diet, but are you getting enough magnesium, vitamin D, zinc and co-factors? Maybe you are exercising and eating well, but do you smoke or drink too much alcohol? Only by undertaking a personal assessment of your bone density, current lifestyle and nutritional status, will you get a clear picture of where you are and what measures you need to take.
A bone health assessment is often covered by insurance companies, can be carried out by your health professional and includes a medical history, physical exam and the gold standard - a bone mineral density test, or DEXA Scan. Standard guidelines for DEXA scans are the following:
- All women 65 years and older
- Postmenopausal women with medical causes of bone loss (e.g. steroid use, hyperparathyroidism, malabsorption, immobilization)
- Postmenopausal women over 50 years with additional risk factors (fracture - other than skull, less than 127lb, history of hip fracture in parent, current smoker, alcohol intake more than 2 units/day (1 unit: beer = 12oz; wine = 4 oz; liquor = 1 oz).
- Postmenopausal women with a fragility fracture (a fall from standing height)
More extensive evaluation of underlying causes and management may include urinary and serum calcium levels, vitamin D levels, hormone analyses including parathyroid and thyroid tests, selected nutrient analysis and a lifestyle, exercise and nutritional assessment.