What You Don't Know About Your Bones

Bone & Joint Health, Featured Article
on February 28, 2013
Health facts about bones.
Andrew Roberts

It’s the most common disease in postmenopausal women, and you may not even know you have it. Osteoporosis is truly a silent condition, signaled only by a series of broken bones that can reduce your mobility, quality of life and lead to other serious health problems. Yet “brittle bone disease” doesn’t seem to inspire the kind of concern that other illnesses associated with aging do.

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That’s a dangerous mistake, says Dr. Diane Schneider, author of The Complete Book of Bone Health. “At every age we need to do simple things to keep our bones healthy and strong—they’re the foundation of our health.”

A geriatrician and epidemiologist, Schneider shared these surprising facts about bone health that should convince you it’s time to stop taking your skeleton for granted.

A wrist fracture may be a wake-up call. Because it’s the type of fracture most commonly suffered from about age 40-60, a broken wrist may be your first sign of osteoporosis. It should prompt you to see a doctor and find out if an underlying problem could be making your bones brittle.

Osteoporosis is really a childhood disease. The effects of osteoporosis may not emerge until we’re older, but we lay most of the groundwork for a strong skeleton as children, Schneider says. By the time girls are 18 and boys are 19 or 20, about 90 percent of their adult bone mass has been created, and we all reach peak bone mass by age 30. Encourage the young people in your life to choose calcium-rich beverages and get lots of exercise—two key elements to building healthy bones.

“Shrinking” could be a sign of spinal fractures. Losing two or more inches in your height—something often chalked up to normal aging—could be a sign of spinal fractures, a marker for serious bone loss. Only about a quarter of spinal fractures are discovered, since they’re often asymptomatic, or accompanied by by back pain that’s easy to explain away.

Bones aren’t supposed to break. “People will tell me, ‘I broke my wrist because I had a hard fall’—but that’s not normal,” Schneider says. Freak accidents aside, healthy bones are slightly flexible, and are meant to withstand most impact.

Osteoporosis doesn’t act alone. Diabetes, breast cancer, gluten intolerance, Crohn’s disease, hyperthyroidism and depression have all been linked to bone loss. If you have any of these conditions, you may be at higher risk for fractures.

Preventing hip fractures should be as important as warding off cancer. One in five women and one in three men will die within a year after suffering a hip fracture. Because they commonly occur after age 75, hip fractures are often the catalyst for severe health declines. But rarely are they taken as seriously as cancer or heart disease, Schneider says.

Bone density scans don’t tell the whole story. Dual-energy x-ray absorptiometry (DXA) scans to measure bone density are typically ordered for post-menopausal women (and some men at risk of osteoporosis). But they don’t provide the whole picture: Also important are your family health history and your personal history of fractures, medications, underlying conditions and lifestyle habits. A tool called FRAX uses this information and your bone scan results to calculate your 10-year fracture risk. That calculation, plus subsequent DXA testing to compare to your baseline, provides the best guidance for whether you should be treated for osteoporosis, Schneider says. (Ask your doc about FRAX.)

Vitamin D isn’t just the latest health fad. Don’t dismiss the hype about the so-called “sunshine vitamin.” Vitamin D is crucial for bone health because it helps the body absorb calcium, but it’s hard to get from food or the limited time we now spend in the sun. Your doc can test your D levels with a simple blood test and prescribe a supplement if necessary.

Balance may be your best defense. “No matter what your bone density is, if you don’t topple, you won’t fracture,” Schneider says. Core work and resistance training—especially in your thigh muscles—can improve your stability and reduce your risk of falling.

It’s never too late to build better bones. Regardless of your age or FRAX score, you can always improve and maintain good bone health. Regular weight-bearing exercise and proper nutrition, with an emphasis on protein, calcium and vitamin D, are key.