Osteoporosis is often called a “silent” disease because people typically have no symptoms and often don’t know they have it until they break a bone in an unexpected way, according to experts at Hospital for Special Surgery (HSS). Osteoporosis develops when bone mineral density and bone mass decrease, leading to weakened bones and an increased risk of a fracture. The hips, spine and wrist are most susceptible.
The chance of developing the disease increases as you get older, and women are at greater risk. Osteoporosis or its precursor, osteopenia, affects more than half of adults ages 50 and older in the United States. Osteopenia is a loss of bone density that is not as advanced as osteoporosis.
National Osteoporosis Awareness Month in May is an opportune time to discuss ways to promote good bone health and take action if at risk, say HSS experts.
Bones As Living Tissue
We often think of our bones as if they were Legos that support our body, but they are much more than that. A bone is living tissue that is affected by our hormones and by the nutrients, vitamins and minerals we consume. Peak bone mass occurs at the time of puberty and into our 20s and early 30s. However, even as we age, our body constantly creates new bone.
It’s normal for women to start experiencing a decrease in bone density when they enter menopause, according to Jessica Starr, MD, an endocrinologist at HSS. This happens due to hormonal changes and is generally a slow process. “Breaking a bone after falling while in a standing position could be a sign of osteoporosis,” she says. “Any fracture should prompt a discussion of bone health with one’s doctor.”
Osteoporosis is diagnosed with a bone density test, a quick and painless type of x-ray that provides information about bone strength and the risk of a future fracture. Recommended screenings and appropriate treatment are important, Dr. Starr says. Healthy women are advised to have an initial bone density screening at age 65. For men, it’s age 70.
Earlier screening is recommended for women with certain risk factors for bone loss, such as a family history of fractures or the use of certain medications such as steroids. Those who consumed very little calcium in younger years, had an eating disorder, smoke or consume excessive amounts of alcohol may also be vulnerable to accelerated bone loss, Dr. Starr notes.
Anyone with a diagnosis of either osteoporosis or osteopenia should talk to her doctor to develop a strategy to prevent further bone loss, she says. The plan may include lifestyle changes and possibly medication. “There’s no one-size-fits-all approach to treating osteoporosis,” Dr. Starr explains. “Different medications are available, and treatment should be tailored to the needs of each individual.”
Lifestyle Changes to Promote Bone Health
A healthy lifestyle is important to maintain good bone health or prevent further bone loss if one has osteoporosis or osteopenia, Dr. Starr explains. Getting adequate calcium and vitamin D; consuming a nutrient-rich diet that includes all the major food groups; not smoking; and engaging in weight-bearing and resistance exercises can help build and preserve bone mass. Excessive alcohol consumption can also lead to decreased bone density.
“It’s best to get calcium and vitamin D from our diet. Individuals should try to get at least half of their daily calcium from foods such as dairy products, dark, green leafy vegetables and high-calcium fish like salmon and sardines,” Dr. Starr says. For information on recommendations for daily calcium and vitamin D intake, visit bones.nih.gov.
Weight-bearing exercises, such as walking and dancing, are excellent. Muscle strength training is also important for bone health and balance. It’s not only important to exercise, but to move safely when lifting a package or engaging in other activities.
Prevent a Fall, Prevent a Fracture
Taking measures for fall prevention is good for everyone, and even more so in a household of older adults, HSS experts note. This includes securing rugs to the floor; making sure there’s good lighting; having a nonslip surface in the bathtub or shower and installing a grab bar, if needed. Adults should wear supportive shoes with nonslip soles and be careful to keep floors clear of objects that could cause a tripping hazard.
It may take some effort, but it’s important to lead a healthy lifestyle today to maintain bone health in the future.
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About HSS
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 13th consecutive year), No. 3 in rheumatology by U.S. News & World Report (2022-2023), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2022-2023). In a survey of medical professionals in more than 20 countries by Newsweek, HSS is ranked world #1 in orthopedics for a third consecutive year (2023). Founded in 1863, the Hospital has the lowest complication and readmission rates in the nation for orthopedics, and among the lowest infection rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 145 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.
