Osteoporosis is a gradual loss of bone mineral content, density, and subsequently strength of the bone. Most people who are generally familiar with the term osteoporosis may think of the old, stooped-over woman who falls and fractures the hip. However, there is much more to osteoporosis, both in terms of what contributes to the disease and at what age we need to start focusing on prevention.

Osteoporosis actually can develop early (sometimes as early as 20’s or 30’s) but may remain undetectable, particularly in asymptomatic patients. Often osteoporosis may be detected in a patient who receives an x-ray, particularly of an extremity and the loss of mineralization is seen.

The National Osteoporosis Foundation has identified factors that can put people at risk:

• Thin or small frame
• Advanced age
• Family history of osteoporosis
• Menopause, including early or surgically induced menopause; woman can lose up to 20% of bone mass in the 5 to 7 years following menopause
• Amenorrhea (abnormal absence of menstrual periods)
• Low calcium diet
• Long-term use of certain medications, such as corticosteroids and anticonvulsants
• Low testosterone levels in men
• Inactive lifestyle
• Smoking
• Excessive alcohol use

Tests to determine prescence of and level of osteoporosis:

• Bone densinometry, of which there are 2 types

1. Dual energy x-ray absorptiometry, which measures density in the spine, hip, or total body
2. Peripheral dual energy x-ray absorptiometry, which measures density in the wrists, heels, or fingers.
   • Quantitative Ultrasound measures density of the heels, shinbone and kneecaps
   • Quantitative CT scan primarily measures bone density at the spine, but a peripheral quantitative CT examines other sites, such as the wrists
   • Radiographic absorptiometry uses a hand x ray and a small metal wedge to calculate bone density

On-going preventive measures include:

• Ample weight bearing exercise during younger years-bone density responds during younger years in direct response to the amount of force placed on it
• Calcium supplementation- In addition to proper diet, at least 1200-1500 mg of Calcium with a Vitamin D supplement taken in two or three divided daily doses is recommended
• Proper Nutrition- current research is shedding more light on proper nutrition as a key to successfully managing/preventing osteoporosis. Below are some highlights of recent research:

Elderly women who have a higher intake of dietary protein from animal products have a higher risk of bone loss and hip fracture; there appears to a correlation due to the fact that animal proteins have a high amount of acid. Vegetables have some acid, but they have higher levels of base- which is a substance that works to neutralize acid

Other Studies at UCLA found that after 7 months of feeding one group of mice a high-fat diet to elevate cholesterol and one group of mice a normal diet, the high-fat diet group showed a 43% decrease in mineral content and a 15% decrease in bone density in the femoral bones.

As these studies continue, it appears that helping prevent/treat osteoporosis more effectively will require a dual approach to both supplying the bone-building cells with calcium and the factors that degenerate bone.