Helen grew up on a farm in the Midwest. She drank lots of milk as a child. She also walked a lot. After graduating from high school, she got married and found a job. Family and work kept her too busy to exercise. Helen went through menopause at age 47. At age 76, she was enjoying retirement - traveling and working in her garden. But then she slipped on a small rug in her kitchen and broke her hip. After Helen recovered, she needed a cane to walk, and gardening was a lot harder to enjoy.

Helen had osteoporosis, but she didn't know it before she fell. Osteoporosis is a disease that weakens bones to the point where they break easily-most often bones in the hip, backbone (spine), and wrist. Osteoporosis is called the "silent disease" - you may not notice any changes until a bone breaks. But your bones have been losing strength for many years.

Bone is living tissue. To keep bones strong, your body is always breaking down old bone and replacing it with new bone tissue. As people enter their forties and fifties, more bone is broken down than is replaced. A close look at the inside of bone shows something like a honeycomb. When you have osteoporosis, the spaces in this honeycomb grow larger. And the bone that forms the honeycomb gets smaller. The outer shell of your bones also gets thinner. All this loss makes your bones weaker.

Who Has Osteoporosis?

Millions of Americans have osteoporosis. They are mostly women, but more than 2 million men also have this disease. White and Asian women are most likely to have osteoporosis. Other women at great risk include those who:

• have a family history of the disease,
• have broken a bone while an adult,
• had surgery to remove their ovaries before their periods stopped,
• had early menopause,
• have not gotten enough calcium throughout their lives,
• had extended bed rest,
• used certain medicines for a long time, or
• have a small body frame.

The risk of osteoporosis grows as you get older. At the time of menopause women may lose bone quickly for several years. After that, the loss slows down, but continues. In men the loss of bone mass is slower. But, by age 65 or 70 men and women are losing bone at the same rate.

What Is Osteopenia?

Millions more Americans have osteopenia. Whether your doctor calls it osteopenia or just says you have low bone mass, consider it a warning. Bone loss has started, but you can still take action to keep your bones strong and maybe prevent osteoporosis later in life. That way you will be less likely to break a wrist, hip, or vertebrae (bone in your spine) when you are older.

Can My Bones Be Tested?

For some people the first sign of osteoporosis is to realize they are getting shorter or to break a bone easily, like Helen. Don't wait until that happens to see if you have osteoporosis. You can have a bone density testto find out how solid your bones are. Your doctor may suggest a type of bone density test called a DEXA-scan (dual-energy x-ray absorptiometry) if you are age 65 or older or if he or she thinks you are at risk for osteoporosis.

The DEXA-scan tells what your risk for a fracture or broken bone is. It could show that you have normal bone density. Or, it could show that you have low bone mass or even osteoporosis.

How Can I Keep My Bones Strong?

There are things you should do at any age to prevent weakened bones. Eating foods that are rich in calcium and vitamin D is important. So is including regular weight-bearing exercise in your lifestyle. These are the best ways to keep your bones strong and healthy.

Calcium. Getting enough calcium all through your life helps to build and keep strong bones. People over age 50 need 1200 mg of calcium every day. Foods that are high in calcium are the best source. For example, eat low-fat dairy foods, canned fish with soft bones such as salmon, dark green leafy vegetables, and calcium-fortified foods like orange juice, breads, and cereals.

If you think you aren't getting enough calcium in your diet, check with your doctor first. He or she may tell you to try a calcium supplement. Calcium carbonate and calcium citrate are two common forms. You have to be careful though. Too much calcium can cause problems for some people. On most days you should not get more than 2,500 mg of total calcium. That includes calcium from all sources-foods, drinks, and supplements.

Vitamin D. Your body uses vitamin D to absorb calcium. Most people's bodies are able to make enough vitamin D if they are out in the sun for a total of 20 minutes every day. You can also get vitamin D from eggs, fatty fish, and cereal and milk fortified with vitamin D. If you think you are not getting enough vitamin D, check with your doctor. Each day you should have: 400 IU (international unit) if you are age 51 to 70, 600 IU if you are over age 70.

As with calcium, be careful. More than 2000 IU of vitamin D each day may cause side effects.

Exercise. Your bones and muscles will be stronger if you are physically active. Weight-bearing exercises, done three to four times a week, are best for preventing osteoporosis. Walking, jogging, playing tennis, and dancing are examples of weight-bearing exercises. Try some strengthening and balance exercises, too. They may help you avoid falls which could cause a broken bone.

Tags: Osteoporosis, Aging

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.