Unlike our skin or our hair, we don’t see our bones all the time, so we do not notice that bone tissue is constantly remodeling or turning over. As old bone tissue is broken down, new tissue is supposed to take its place.
Nancy E. Lane, M.D.
Director, Center for Musculoskeletal Health, University of California Davis School of Medicine
There are many factors that can disrupt this process. When bone remodeling gets out of balance, more bone is broken down than is created. That results in a loss of bone density, also known as bone mass. When the bones lose density, they can weaken and become more likely to fracture or break. They can break due to falls from standing height or even due to an awkward twist or a hard sneeze.
Two of the most important factors that lead to unhealthy bones are age and, for women, the loss of sex hormones around menopause. There are many other disruptive factors that can explain weakened bones. These include:
- Poor nutrition
- Lack of physical activity
- Smoking
- Alcohol use
- Medical conditions, such as diabetes, gastrointestinal diseases, HIV, certain types of cancer, rheumatoid arthritis, and chronic kidney disease
- Certain medicines, such as hormone-blocking cancer treatments, some HIV regimens, corticosteroids, and high doses of thyroid medicines
For some of these factors, we can take action to minimize our risk:
- Eat a healthful diet rich in calcium, protein, and vitamin D
- Get plenty of exercise, especially weight-bearing activities such as running, dancing, jumping rope, or racquet sports
- Work on your balance to avoid falls
- Quit smoking
- Limit alcohol to no more than one drink a day for women or two for men
Regardless of your specific risk factors, you need to be aware of how they affect your bone health. Your healthcare provider might use a tool called FRAX to evaluate your risk of fractures. If you are 45 or older, you can use the consumer-friendly American Bone Health Fracture Risk Calculator™ at www.americanbonehealth.org/calculator.
Even though we can’t see our bones, knowing what puts them at risk can help us keep them healthy and balanced.