Osteoporosis: What You Need to Know

Janet Tiberian Author
By Janet Tiberian, MA, MPH, CHES
April 16, 2021

Osteoporosis is referred to as a silent disease because it often develops without you knowing it. Since you can’t feel bones weakening or becoming brittle, you may not realize you have osteoporosis until your first bone fracture. 

About 54 million Americans struggle with debilitating osteoporosis or low bone mass, according to the National Osteoporosis Foundation. And each year there are about 1.5 million costly, painful and sometimes life-threatening osteoporosis related fractures. This is why it’s important to understand how to prevent and control osteoporosis. Here’s what you need to know.

Healthy Bones

Bones are living, growing organs that continuously remove old tissue and replace it with new tissue. The process is known as remodeling and it involves two steps -- resorption and bone formation.  

Resorption occurs old bone tissue is broken down and removed from the skeleton. As it’s being removed, it releases calcium, magnesium, phosphate and collagen into the blood to be used by other organs if you have poor dietary habits or are pregnant or lactating. And the second part of the process -- bone formation – in simplest terms, is the rebuilding of bone.

Most bone formation occurs during our twenties, resulting in bone mass peaking around age 30. After that, bone resorption begins outpacing formation, which weakens the bones. And for women, the resorption process speeds up even more during the first five to seven years after menopause. Experts attribute the rise in post-menopausal osteoporosis to falling estrogen levels, which help bones maintain calcium.


Osteoporosis is a condition in which the bones have become so weak and brittle, they’re vulnerable to fractures. Bones of the spine, hip and wrist have the higher risk of breaking. And breaking a hip in your senior years can be life threatening, as the bed rest required to heal a broken hip raises the risk for pneumonia and blood clots.

Osteoporosis Risk Factors  

There is a handful of osteoporosis risk factors. Some you don’t have any control over, such as being post-menopausal, female, Caucasian or petite and thin. A family history of osteoporosis or a condition treated with steroids also raises your risk. But you can adopt a bone health lifestyle to help mitigate these risks by following these suggestions:

Avoid smoking. Smoking restricts oxygen- and nutrient-rich blood flow to the bones and joints. It also interferes with calcium absorption and slows the production of bone-forming cells.   

Limit alcohol. Excessive alcohol consumption destroys osteoblasts (large bone cells) and raises cortisol production which can decrease bone formation and speed up reabsorption. It also increases parathyroid hormone levels, which strips calcium from bones. 

Add weight-bearing exercise to your routine. Weight-bearing exercises are activities that are performed on your feet. The force on the bones stimulates additional calcium deposits and triggers bone formation. Walking, running, hiking, racquet sports and dance classes are examples of weight bearing activities. Strength training also is considered a bone building activity because the same force occurs as the bones push and pull the weight. If you’re concerned about fractures, opt for low-impact weight bearing exercises such as walking, low-impact aerobics and stair steppers. 

Eat foods that are good for your bones. A diet composed key bone building nutrients such as calcium, vitamin D and magnesium can help stave off osteoporosis by keeping your bones strong. Below are some foods to add to your diet to help prevent osteoporosis.

  • Super bone healthy foods: dark green leafy vegetables like arugula, collard greens, kale, chicory greens; cruciferous vegetables such as broccoli and dairy products -- milk, cheese and yogurt.
  • Bone healthy foods: grains that are high in calcium such as amaranth, brown rice and oatmeal or fortified with calcium like cereals and bread, and seafood, particularly sardines and salmon.

Limit foods high in phytates and phosphorus.

  • Phosphorus is a chemical element found in milk, meat, grains, vegetables and beans. Phosphorus helps calcium and vitamin D maintain strong bones. However, there needs to be a balance of calcium and phosphorus in your blood. If your phosphorus level is too high, calcium can be pulled from bones to keep the blood balanced.
  • Phytates are substances found in plant foods such as legumes, seeds, nuts and unprocessed grains. Pinto beans, navy beans, peas and peanuts (yes, peanuts are technically a legume) are high in phytates. Phytates store phosphorus in plants but are often label antinutrients because the block nutrients including calcium, magnesium, from absorption.

Avoid highly processed foods, as they tend to be high in:

  • Sugar - increases urinary excretion of calcium and magnesium, lowers active vitamin D levels which disrupts the absorption of calcium and impairs osteoclast formation.
  • Salt - can increase urinary calcium excretion. 
  • High fructose corn syrup - affects the magnesium balance in the body, causing it to accelerate bone loss.
  • Caffeine – leaches calcium from bones.

Bone Density Test

As of now, our the only means for diagnosing osteoporosis or low bone mass is a bone density test, also known as a DEXA scan. The purpose of the test is estimating the density of your bones and to predict your risk for a fracture. And if you’ve been diagnosed with osteoporosis, DEXA scans can track how well the condition is managed. 

The National Osteoporosis Foundation recommends having a bone density test if you:

  • are a woman 65 or older
  • are a man 70 or older
  • are a postmenopausal woman young than 65 with risk factors
  • are a woman of menopausal age with risk factors
  • had a bone break after age 50

“Many variables are involved in keeping your bones strong,” says Kaminetsky. “Work closely with your doctor to lower your risk for or control osteoporosis.”

Don't have a primary care physician? Try an MDVIP-affiliated physician. They have time to work with you and develop a wellness plan that can help you address issues such as bone health. Find a physician near you and begin your partnership in health » 


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About the Author
Janet Tiberian Author
Janet Tiberian, MA, MPH, CHES

Janet Tiberian is MDVIP's health educator. She has more than 25 years experience in chronic disease prevention and therapeutic exercise.

View All Posts By Janet Tiberian, MA, MPH, CHES
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