During the first 30 years of life, our bodies undergo constant bone formation and bone loss (also known as bone resorption). However, around age 30, more bone loss begins to take place than does bone formation. This unfortunate cycle continues as we age, and when bone loss becomes quite severe, it is known as osteoporosis.

According to the National Osteoporosis Foundation, low bone mass and osteoporosis are major public health threats for nearly 55 percent of the U.S. population age 50 and older. One out of every two women and one in four men older than 50 will suffer an osteoporosis-related fracture in his or her lifetime.

What are some symptoms of osteoporosis?

Because osteoporosis causes bones to become brittle and weak, a broken bone is often the first sign of the disease. Other signs are curvature of the spine, and loss of height. Osteoporosis is often referred to as a “silent disease” because many may be completely unaware that their bone health is in jeopardy.

What role does estrogen play in the development of osteoporosis?

When a woman enters into menopause, the ovaries stop producing estrogen. The decrease in estrogen levels leads to an increase in bone loss that can result in osteoporosis.

Why is osteoporosis so dangerous for aging people and can it be treated or prevented?

Osteoporosis can affect males and females of all ages, but as a person grows older, his or her bones become weaker and thinner. People with low bone density are much more likely to suffer from fractures after a fall, and in severe cases, a slight bump, sneezing or even coughing may cause a bone to fracture. However, an active lifestyle, avoiding smoking and excess alcohol, and a proper diet may help to prevent the disease. If one has osteoporosis, those measures and medication can strengthen bones and reduce the risk of fracture.

What physical activities help?

Strengthen your postural muscles and improve flexibility to reduce the risk of falling.

Perform weight-bearing exercises or activities at least three times a week for 30 minutes.

What sort of diet or supplements should one take?

Consume foods that are rich and high in calcium, such as:

o Dairy products (skim milk, yogurt, low-fat cheese)

o Dark, green leafy vegetables (spinach, broccoli)

o Salmon and shellfish

o Tofu

o Almonds

o Limit alcohol consumption

Stop smoking and try to avoid caffeine, as both accelerate bone loss.

Calcium and vitamin D supplements are very important, as most adults do not get enough of these in their diet.

How can a person find out more about their bone density?

A bone density test, known as DXA, measures bone loss by X-ray technology. This painless procedure is today’s standard for measuring bone mineral density and helps in the diagnosis of osteoporosis and to assess an individual’s risk for suffering a fracture. DXA is most often performed on the hip and lower spine.

What medications might a physician prescribe for osteoporosis?

Medications used for prevention or treatment of osteoporosis are mostly “anti-resorptive,” meaning they slow the destructive phase of bone turnover, slowing bone loss yet allowing for new bone formation.

The first line anti-resorptive agents to treat osteoporosis are bisphosphonates, including Fosamax and Actonel, which reduce the risk of vertebral, hip and wrist fractures by 40 to 50 percent, and Boniva, which reduces vertebral fractures by as much as 50 percent. When taken properly, they are generally well tolerated, although their side effects may include stomach irritation.

Evista is a medicine that acts like estrogen in the bone but it does not affect the breasts and it reduces the risk of spine but not hip fractures. Calcitonin nasal spray is similar to Evista in its effect on bone and fractures.

Hormone replacement is still good for the bones but typically is not recommended because of the concern about its effect on the breasts and heart.

Finally, the “bone forming” medicine Forteo is used in severe cases of osteoporosis and in patients who have suffered fractures on other treatments.

Where can I go for more information?

Speak with your primary care provider and, if indicated, schedule a DXA test to help identify and treat this silent disease. Avoiding a fracture is the goal, as that is how one can remain active and independent.

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