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A generation ago, osteoporosis – a disease in which bones become fragile and more likely to break – was not generally recognized until a broken hip or wrist signaled its presence. After years of depleting the bones of their strength, osteoporosis can take away mobility and independence in an instant. But today this “silent disease” can be prevented and detected early while time is on your side. 

Until young adulthood, your body is creating new bone faster than it is breaking down old bone. This causes the mass and density of the bones to continuously increase until between the ages of 25 and 35 when the body reaches its peak bone mass. After that, bone is broken down faster than it is created, leading to a 0.3 percent to 0.5 percent loss of bone mass every year. For women, bone loss accelerates during menopause to about 1 to 3 percent a year, but slows again around age 60.

Your risk of developing osteoporosis depends on how much bone mass you attain during your peak bone-building years. The higher your bone mass, the more bone you have stored for later in life.

An important factor in fighting osteoporosis and maximizing your bone mass is getting enough calcium and vitamin D throughout your life. It is recommended that people ages 31 to 50 get 1,000 milligrams of calcium each day, and those over 50 get 1,200 milligrams a day. Three to four servings a day from the dairy group is approximately 1,200 milligrams. Or try dark-green leafy vegetables, canned fish with bones you can eat (such as salmon and sardines), or calcium-fortified orange juice or bread.

Your body must have vitamin D in order to absorb calcium. Some good sources are eggs, fatty fish and cereal and milk fortified with vitamin D. And just being out in the sun 20 minutes a day without sunscreen will help your body produce the necessary amount.

Exercise is also essential to building strong bones. It is never too late to start exercising, but it is best to begin young and continue throughout your life. Practice both strength-training exercises, such as lifting weights, to strengthen the bones in your arms and upper spine, as well as weight-bearing exercises, such as walking, jogging, stair climbing, skiing or other sports, that will strengthen the bones in your legs, hips and lower spine. Exercises such as Tai Chi may be helpful for balance and preventing falls. 

Because bone loss exhibits few or no symptoms during its early stages, early detection is also important in fighting osteoporosis. A DEXA scan (which stands for dual-energy X-ray absorptiometry) is a simple, painless bone density test that can quantify your risk and detect any early signs. This test uses an imager that passes over your body and delivers a tiny dose of radiation to determine the solidity of your bones. Smaller, portable and less expensive devices for testing bone density are also available, such as the peripheral DEXA, which just measures the bone density of the arm, or the Sahara Clinical Bone Sonometer, which uses sound waves to measure the bone density in the heel of the foot. Although these tests are useful in assessing the risk for osteoporosis, they do not measure the bone density in the hip or spine, where osteoporosis first hits, and are therefore not as accurate or reliable as a full-body DEXA scan.

The National Osteoporosis Foundation recommends bone density tests for women:

1. who are postmenopausal and older than 65 and have never had a bone density test;
2. those with type 1 diabetes, liver disease, kidney disease, early menopause or a family history of osteoporosis;
3. or those who are postmenopausal, older than age 50, not on hormone replacement therapy and have at least one of the following risk factors: an inactive lifestyle, a diet low in calcium, a thin or small frame, Caucasian or Asian descent, long-term use of corticosteroids, diuretics, blood-thinning medications or antiseizure medications, Crohn’s disease, Cushing’s disease, anorexia nervosa or alcoholism. 

Bone density tests are covered by most insurance companies if women are not on hormone replacement therapy and are covered by Medicare for all women over 65. The Health Alliance offers full-body DEXA scans at many sites, including The Christ Hospital, The Fort Hamilton Hospital, The Jewish Hospital, The University Hospital and the Crestview Hills Diagnostic Center. To find the location nearest you, call 1-888-640-CARE. 

Sources: Harvard Women’s Health Watch, May 1999; Health Alliance of Greater Cincinnati, Mayo Clinic; National Institutes of Health 

For more information about Women's Services
 of the Health Alliance, call 1-888-640-CARE.