Osteoporosis and low bone density currently affect an estimated 55 percent of the population over the age of 50 in the United States.  It is estimated that about 54 million Americans are affected by the condition, a statistic that is thought to climb to 61 million people by 2020.

Osteoporosis is a disease characterized by an imbalance in bone turnover.  Your bones are constantly being broken down and rebuilt, however with osteoporosis, there is an imbalance between building new bone and bone loss, resulting in thinner, fragile bones that are more vulnerable to fractures.

For women, menopause means a drop in estrogen level, and subsequently, a decrease in bone density. Estrogen is usually what keeps up bone density, which is why women are so greatly affected by osteoporosis after the age of 50.

Men, alternatively, are most affected by osteoporosis from 60-75 years old.  Most people think of osteoporosis as a female disease; however more than 18 million men have low bone density. Low testosterone is a major risk factor for osteoporosis specific to male patients. As men age, there is a gradual decline in testosterone, but improved testosterone levels can combat bone loss that is often seen with low testosterone.

Osteoporosis is often a silent problem, and only surfaces when person suffers a fall and bones easily (and unexpectedly) break.  Yearly, the condition leads to 2 million broken bones and $19 billion in health-related costs. Key to treating the disease is prevention and identification of high risk patients before fractures occur. It is recommended that bone density studies be done for women around the time of menopause or right before in order to establish a baseline with a dual-energy x-ray absorptiometry (DXA scan). Men should have these same tests done as they hit 60 or so. The DXA scan is an X-ray which traditionally looks at the bone density of the wrist, hip and spine, in order to determine bone density.

I am sure you are wondering at this point if there are ways to decrease your risk and prevent osteoporosis.  The answer is yes. Despite the strong relationship with increasing age and osteoporosis, there are steps you can take to prevent the disease and keep up your bone density. One of the keys is to start building your bones while you are still young.  Bone strength peaks in one’s 20s, making it essential to build strong bones while young.  In addition, as we age, exercise and healthy weight loss can increase bone density. The best types of exercise are those which force your bones to work against gravity, resistance workouts, or weight-bearing exercise. Examples included walking, running, aerobics, dancing or weight lifting.

In addition to exercise, a diet rich in calcium and vitamin D is essential for good bone health. Calcium can be found in dairy products and dark, leafy green vegetables, as well as supplements. Vitamin D aids in calcium absorption and bone health. This vitamin is normally made by the body through sunlight exposure, but it can also be found in foods such as egg yolks, liver and fish. In general, salmon is known to be a bone health power house. It is rich in vitamin D, calcium, and omega 3 fatty acids, which have also been shown to improve bone density.

As smoking, alcohol and a sedentary lifestyles are all risk factors for osteoporosis – modifying your lifestyle can greatly reduce your risk of osteoporosis in the future.  For example, research has demonstrated a strong connection between smoking and decreased bone density.  Overtime, however, it is possible to reverse the effects of smoking by quitting.

As a physician, I recommend changes in lifestyle first, then medication as a second line of defense only if necessary.  Supplements like potassium, vitamin D3 and calcium are all important for maintaining bone health, and a good alternative for those whose diet alone is not sufficient.  In addition, a lesser known supplement, vitamin K2 helps with absorption of calcium into bone and could help those suffering from bone deficiencies. Other alternatives available are medications like bisphosphonates, which can help increase bone density along with hormone replacement therapy, which is much more controversial.