Osteoporosis or “porous bone” is a common condition of the skeletal system characterized
by low bone mass and the deterioration and weakening of bone tissue. Osteopenia is the mild loss of bone density and strength that precedes osteoporosis. Osteoporosis leads to an increased risk of bone fractures typically in the
wrist, forearm, humerus (upper arm), femur (hip), and spine. Osteoporosis is very
common. Worldwide, 1 in 3 women over 50 will experience osteoporotic fractures,
as will 1 in 5 men.
According to the International Osteoporosis Foundation, osteoporosis and low bone
mass are estimated to be a major public health threat for about 50 million American
women and men aged 50 and older, and each year there are an estimated 10 million
new fractures associated with osteoporosis in the U.S. 6 About half of white women
in the U.S. will have an osteoporosis-related fracture in their lifetime. In women
over 45 years of age, osteoporosis accounts for more days spent in hospitalization
than many other common diseases, including diabetes, myocardial infarction, and
Falls contribute to fractures. For example, 90% of hip fractures are the result of
falls, and nearly half of those with a hip fracture have previously broken another
bone. A third of people over age 65 fall annually, with approximately 10% to 15%
of falls in the elderly resulting in a fracture. It is estimated that almost 60% of those
who fell the previous year will fall again.
Bone is made up mainly of collagen (connective tissue) and mineralized calcium.
The skeletal system is not static, and bone is remodeled throughout life. In a continuous
process, existing bone is resorbed, and new bone is formed in response to the demands placed on it. Bed rest and sedentary behavior promote bone resorption,
and weight-bearing and high impact physical activity promote bone formation.
During childhood and teenage years, new bone is formed, and bones become larger,
heavier, and denser. Bone formation outpaces resorption until about age 30 when
peak bone mass, defined as maximum bone density and strength, is reached.
Calcium and vitamin D are important to bone health because of their role in skeletal
formation, maintenance, and prevention of osteoporosis. Adequate calcium consumption
and weight-bearing physical activity strengthens bones, optimizes bone
mass, and may reduce the risk of osteoporosis later in life. After about age 30, bone
resorption slowly begins to exceed bone formation. Osteoporosis can occur when
bone resorption occurs too quickly or when new bone formation occurs too slowly.
Among women, bone loss is most rapid in the first few years after menopause.
The strength of bone is related to both the quantity of bone as measured by bone
mineral (calcium) density (BMD) and also to the quality of bone structure that relates
to its collagen, architecture (trabecular network pattern), micro-architecture,
and bone mineral quality. The importance of factors other than BMD or the amount
of bone is shown by the fact that older individuals often have a much higher risk
of poorly structured weaker bones and higher fracture risk than young people with
the same BMD. In other words, the difficult-to-measure structural aspects of bone
quality are as important as bone density as determinants of strong bones. The disconnect
between bone density and bone strength has been shown by the finding that
several drug treatments that increase bone density by only 1% to 6% can decrease
fracture risk by 35% to 50%.
This blog presents opinions and ideas and is intended to provide helpful general information. I am not engaged in rendering advice or services to the individual reader. The ideas, procedures and suggestions in that are presented are not in any way a substitute for the advice and care of the reader’s own physician or other medical professional based on the reader’s own individual conditions, symptoms or concerns. If the reader needs personal medical, health, dietary, exercise or other assistance or advice the reader should consult a physician and/or other qualified health professionals. The author specifically disclaims all responsibility for any injury, damage or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this blog or participating in any programs described in this blog or in the book, The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist (available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere). Copyright 2021 by J. Joseph Speidel.