We need strong, healthy bones to help us bend over to put on shoes, stand up, walk and do all our everyday tasks, from running up and down stairs to lifting a toddler out of danger to carrying groceries through our doorways. But a lot of us don’t realize how much we depend on our bones until we can’t.
According to the U.S. Department of Health and Human Services, 43 million people (16 million of whom are men) in the country have low bone density, and another 10 million (2 million of whom are men) over age 50 have the bone disease osteoporosis. Other studies have estimated that 60 million Americans live with low bone density.
Laura Yecies, CEO of the company that developed Osteoboost, the first non-pharmacological intervention for low bone density approved by the U.S. Food and Drug Administration last year, said the deterioration of bone health isn’t something you can feel. Consequently, most people do not consider their bone health until they break something.
RELATED: NASA-inspired low-vibration belt lowers bone fracture risk
People with osteopenia, the official name for low bone density, are at much greater risk of fractures than people with healthy bones. Loss of bone mass disproportionately affects aging women — one half of all women will experience a fracture at some point in their lives.
Maintaining and even improving bone health requires a diet with sufficient calcium, protein, vitamins C, D3 and K2, and trace minerals such as magnesium, boron, copper, manganese, potassium, phosphorous, nickel, vanadium, zinc, silicon, selenium and strontium.
An active lifestyle that includes weight-bearing exercises helps stimulate bone turnover, an essential part of retaining healthy bone mass.
What other preventative measures can you take to maintain and build bone mass long into old age, avoiding injuries and osteoporosis?
The standard clinical diagnostic tool to determine bone density is a dual-energy X-ray absorptiometry scan (DEXA, also abbreviated as DEX and DXA) that determines a “T-score.”
A DEXA T-score between -1 to -2.5 means your bone mass is one to two-and-a-half “T,” standard deviations, below the average bone density of young adults in their twenties. By World Health Organization (WHO) standards established in 1994, this designates a person as having osteopenia — often a precursor to osteoporosis. Scores lower than -2.5 signify progressive stages of osteoporosis.
Yecies thinks women should get tested to establish a baseline T-score while their bone density is peaking, usually sometime in their late twenties
“That would give you a good 20 years when you can optimize your bone health,” she said.
Dr. David Karpf, Stanford endocrinologist and internationally recognized osteoporosis expert, acknowledged that DEXAs are essential in examining bone health but said that the scans alone may not provide the whole picture of actual bone quality or fracture risk, especially for younger people and pre-menopausal women.
He explained that this is because the WHO’s diagnostic standards were based on studies that evaluated people mostly in their seventies. He also said that DEXAs measure bone mass (the amount of matter in an object) but not the three-dimensional volume of that matter or its concentration throughout the bone. This means that DEXAs can under-diagnose osteopenia in people with big bones while over-diagnosing poor bone health in people with smaller bones who are bound to receive lower T-scores.
He said this could contribute to Asian people having the highest overall rates of osteopenia and osteoporosis of any racial/ethnic group in the U.S., whereas low bone density affects mostly white and Asian postmenopausal woman. The only way in which bone size alone could contribute to fracture risk in someone is pure physics.
Related Articles
Letters: Government must end payouts to Elon Musk
RFK Jr. says healthy pregnant women don’t need Covid boosters. Science says threat still meaningful
‘Rampant drug use’ at California addiction rehabs led to deaths, complaints claim
San Jose doctor in spicy ‘Dragon Balls’ lawsuit against Los Gatos Thai restaurant drops lawyer, represents self
Antioch hospital the first in East Contra Costa to offer robotic surgery
“It’s easier to snap a small pencil than a thick one, and it’s easier to snap a long pencil than a short one,” Karpf said, explaining why small-boned people have high rates of osteopenia and osteoporosis diagnoses but the highest fracture rates are found among taller, larger-boned people in Scandinavia. But, these physical differences do not directly or solely determine the risk of fragility fractures–bone quality and health does.
Karpf urged people to input their DEXA score and other criteria into the Fracture Risk Assessment Tool (FRAX) and consult physicians who understand the shortcomings of DEXA for a fuller assessment of their actual bone density and risk of fragility fractures.
Both Yecies and Karpf said insurance will cover bone health diagnostic procedures for non-seniors in certain situations, especially if you have a family history of osteopenia or osteoporosis.
