Osteoporosis is a major problem in the Western world. Osteoporosis means porous bones, or brittle bones and affected bones break more easily than they should.

Often there are no visible signs of the weakness of the bones until a relatively minor fall causes a fracture. Typically this involves the wrists or fore arms or the hip. Hip fractures are a major contributor to death in the elderly. The hip being broken leads to bed rest that in turn can lead to loss of mobility, or further complications such as pneumonia or bedsores. The seeming shrinking of old people, particularly ladies, is a consequence of brittle vertebrae in the spine breaking. This causes pain and a shortening of stature. The classic widow's hump is a consequence of this phenomenon.

Our bones are in a constant state of change throughout our lives. Osteoclasts build bone, and osteoblasts dissolve it. Until about the age of thirty-five this building process outstrips the dissolution process. After this time of peak bone mass the dissolution begins to outstrip the building process. In women the process of bone loss is accelerated at the time of the menopause.

Research has shown that there is long list of risk factors that will increase your chances of developing osteoporosis. Some of these factors you can do something about and some you can't control. The secret of avoiding osteoporosis is to control those factors that you can to achieve as high a peak bone mass as possible and to slow losses.

Gender
Women are four times more likely than men to suffer from osteoporosis. This is due to a combination of factors. Women have on average a lower starting bone density than men, and then they go through a period of accelerated bone loss at the menopause. Women also live longer. By the time people reach seventy-five then the rate of osteoporosis for women and men becomes equivalent. These gender factors cannot be controlled, but women need to more care of their bones.

Age
Bone density decreases as we age. The only way to overcome this is to start with more bone and try to keep what we have.

Exercise
Weight bearing exercise is the main trigger for bone building and strengthening. The more active we are from an early age the stronger our bones will be. This benefit continues into old age with studies showing that elderly patients that do regular exercise can increase bone density, or at the very least stop it falling.

Frame Size
Slightly built people, and those of a low weight are more likely to develop osteoporosis. This is because the bones don't need to be strong to support them.

Family History
A family history of osteoporosis can indicate a higher chance of getting it yourself. This is probably the sum of other risk factors, such as frame size, family diet and family lifestyle as well as a genetic tendency.

Race
Asians and white people are more likely to develop osteoporosis than Hispanic or black people. It is thought this has something to do with vitamin D production.

Smoking
No one knows why but smokers are at a higher risk of developing osteoporosis.

Dietary Factors
Building bones requires calcium, magnesium, manganese, copper, boron and iron. The most important of these is Calcium. People who avoid dairy products must ensure they get adequate Calcium intake from elsewhere. A supplement may be required, as calcium is not easily absorbed from vegetable sources. A lifelong intake of these minerals is important as bone continues to be made throughout life, as well as lost.

Estrogen Exposure
An accelerated loss of bone occurs at the time of the menopause. If menopause occurs early either naturally or as due to surgery then this acceleration occurs at a younger age than is usual. The accumulation of bone loss after this age will lead to a higher incidence of osteoporosis. This can be combated naturally by taking Black Cohosh, or by using HRT.

Drugs
Several drugs have been implicated in thinning bones. The most well known of these are steroids, which are commonly used to treat immune based illnesses such as arthritis or Crohn's disease and for asthma. The modern inhaled route of steroid use for asthma has reduced the risks of developing osteoporosis, inhaled steroids do not seem to be implicated in osteoporosis. It is important to always use the minimum possible doses of these drugs for the minimum time necessary. Steroids can be life saving but the consequences of long term use can be life ending. Less well known is the fact that high thyroxine levels can cause osteoporosis. This happens in the condition of hyperthyroidism, but also if patients take too much medication to treat low thyroxine levels.

Osteoporosis is commonly treated by pharmaceutical means. Osteoporosis prevention is achieved by our own actions, there are factors we cannot control but there are many we can. By ensuring we have a suitable diet, maintain a healthy weight, avoid smoking and exercise we can prevent osteoporosis and at the same time reduce our risks for many other diseases.