Osteoporosis is a disease that develops when bone mass and bone mineral density decreases, or when the strength and structure of bone changes. This kind of situation may lead to a decrease in bone strength that can increase the risk of fractures (broken bones).

Osteoporosis is a “silent” disease because this disease typically does not show symptoms, and one may not even know the disease exists until one day the fracture occurs. Osteoporosis is the may be one of the major causes of fractures in postmenopausal women and in older men. Fractures can occur in anywhere in the body but may happen most often in bones of the hip, vertebrae in the spine, and wrist.

Prevention of the disease and fractures:

• Staying physically active such as walking.
• No drinking or drinking alcohol in moderation.
• Quitting smoking, or don’t smoke if you have not started.

Taking medications, if prescribed, which can help avert fractures in people who have osteoporosis.

Eat a nutritious diet rich in vitamin D and calcium, maintain good bone health.

Who Gets Osteoporosis?

Osteoporosis is a disease that affects women, men of all races and ethnic groups. Osteoporosis may occur at any stage of life, although the chance for developing osteoporosis increases with age. For many women, osteoporosis begins to start developing a year or two before menopause. Other factors include:

• Osteoporosis is very much common in non-Hispanic white women and Asian women.
• Hispanic women and African American have a lower chance of developing osteoporosis, but still the chances are high.
• Among men, the disease is more common in non-Hispanic whites.

Certain medications, such as some cancer medications and glucocorticoid steroids, may increase the risk of developing osteoporosis.

As less men get osteoporosis than women, many men think they do not have risk for the disease. However, both older women and men from all backgrounds are at risk for this disease.

Some children and teens develop an unusual form of idiopathic juvenile osteoporosis. The reason may not be known; however, most children recover from this problem without treatment.

Symptoms of Osteoporosis

Osteoporosis is known as a “silent” disease as there are typically no symptoms until a fracture occurs. The symptoms of vertebral (spine) fracture are severe back pain, loss of height, or spine malformations such as a hunched or stooped posture (kyphosis).

Bones affected by osteoporosis may get so fragile that fractures may occur spontaneously or due to:

• Minor falls, for instance a fall from standing height that should not normally cause a break in a healthy bone.
• Normal stresses such as lifting, bending, or even coughing.

Causes of Osteoporosis

Osteoporosis develops when a lot of bone mass is lost and changes occur in the bone tissue structure. Certain risk factors may develop osteoporosis or may increase the chances that you will develop the disease.

Some people with osteoporosis have several risk factors, but others who develop osteoporosis may not have at all specific risk factors. Some risk factors can’t be changed and others that you may be able to change. However, by understanding and analyzing these factors, the disease and fractures may be prevented.

Factors for increased osteoporosis:

• Sex. The chances of developing osteoporosis are more if you are a woman because women have lower peak bone mass and smaller bones. However, men are still at risk, especially when the age crosses 70 years.
• Age. The bone loss happens more quickly with growing age, and new bone growth is slower. Your bones can weaken over time and consequently your risk for osteoporosis increases.
• Body size. Slender, thin-boned women and men are at more risk to developing osteoporosis as they have less bone to lose if compared to larger boned women and men.
• Race. Asian and White women are at highest risk, whereas African American and Mexican American women have a lower risk of developing osteoporosis. White men are at higher risk than Mexican American and African American men.
• Family history. Researchers are finding that your risk for fractures and osteoporosis may increase if any one of your parents has a history of osteoporosis.
• Changes to hormones. Low levels of certain hormones may increase your risks of developing osteoporosis as follows:

1. Due to low estrogen levels in women after menopause.
2. Due to low levels of estrogen from the abnormal absence of menstrual periods in premenopausal women due to extreme levels of physical activity or hormone disorders.
3. Due to low levels of testosterone in men are at risk for osteoporosis. However, with the gradual decrease of testosterone due to aging is most likely not a major reason for loss of bone.

• Diet. From childhood to old age, a low in calcium and vitamin D diet can increase your risk for osteoporosis and fractures. With excessive dieting or poor protein intake can increase your chance for osteoporosis and bone loss.
• Other medical conditions. Some medical conditions that you may be able to manage or treat can increase the chance of osteoporosis, such as gastrointestinal diseases, other endocrine and hormonal diseases, rheumatoid arthritis, HIV/AIDS, certain types of cancer, and anorexia nervosa.
• Medications. Long-term use of certain medications may start developing bone loss and osteoporosis, such as:
  • Glucocorticoids and adrenocorticotropic hormone, which treat various conditions, such as rheumatoid arthritis and asthma.
  • Cancer medications, which use hormones to treat prostate and breast cancer.
  • Antiepileptic medicines, which treat neurological disorders and seizures.
  • Proton pump inhibitors, which assists lower stomach acid.
  • Thiazolidinediones, which treat type II diabetes.
  • Selective serotonin reuptake inhibitors, which treat anxiety and depression.
• Lifestyle. A healthy lifestyle can be helpful for keeping bones strong. Factors that contribute to bone loss are follows:
  • Less physical activity and prolonged periods of inactivity may lead to an increased rate of bone loss.
  • Heavy drinking of alcohol is a major risk factor for osteoporosis.
  • Researches have shown that smoking is a big risk factor for osteoporosis and fracture. Researchers are studying if the impact of smoking on bone health is from the use of tobacco alone or if the people who smoke have greater risk factors for osteoporosis.

Treatment of Osteoporosis

The treatments of osteoporosis include slow or stop bone loss and to prevent fractures. Your health care provider may recommend:

• Proper nutrition.
• Physical Exercise.
• Lifestyle changes.
• Fall prevention to assist prevent fractures.
• Medications.

People who develop osteoporosis due to another condition should consult with their health care professionals to identify and treat the cause. For example, if you take medication for health reasons that causes bone loss, your doctor may reduce the dose of that medication or start prescribing you other medication. If you have a disease that needs long-term glucocorticoid therapy, such as chronic lung disease or rheumatoid arthritis, you can also take certain medications permitted for the treatment or prevention of osteoporosis.

Nutrition

Eating healthy and balanced diet include:

• Plenty of vegetables and fruits.
• There should be an appropriate amount of calories for your age, weight and height. Your health care provider or doctor may assist you determine the quantity of calories you may require each day to keep a healthy weight.
• Foods and liquids that include vitamin D, calcium, and protein. These help reduce bone loss and maintain overall health. It’s very important to have a diet rich in all nutrients to help maintain and protect bone health.

Calcium and Vitamin D

Calcium and vitamin D are vital nutrients for helping bones reach peak bone mass and preventing osteoporosis. If enough calcium is not taken, the body starts taking it from the bones, which leads to bone loss. This can make bones thin and weak, leading to osteoporosis.

Sources of calcium include:

• Low-fat dairy products.
• Green leafy vegetables such as collards, and turnip greens.
• Broccoli.
• Sardines and salmon with bones.
• Calcium-fortified foods such as tofu, soymilk, orange juice, and cereals.

Vitamin D is essential for the absorption of calcium from the intestine. It is produced in the skin after sunlight exposure. Some foods contain enough vitamin D, including fatty fish, egg yolks, fish oils, and liver. Other foods that have vitamin D are a major source of the mineral, including milk and cereals.

The chart for calcium and vitamin D each day.
Life-stage group	Calcium mg/day	Vitamin D (IU/day)
Infants 0 to 6 months	200	400
Infants 6 to 12 months	260	400
1 to 3 yrs old	700	600
4 to 8 yrs old	1,000	600
9 to 13 yrs old	1,300	600
14 to 18 yrs old	1,300	600
19 to 30 yrs old	1,000	600
31 to 50 yrs old	1,000	600
51- to 70-year-old males	1,000	600
51- to 70-year-old females	1,200	600
>70 yrs old	1,200	800
14 to 18 yrs old, pregnant/lactating	1,300	600
19 to 50 yrs old, pregnant/lactating	1,000	600

Note:  mg = milligrams and IU = International Units

Sources: National Institutes of Health (Office of Dietary Supplements, November 2018)
https://www.niams.nih.gov/health-topics/osteoporosis