Throughout life, old bone is removed and new bone is added to the skeleton. During childhood and adolescence, new bone is added faster than old bone is removed. As a result, bones become heavier, larger, and denser. Peak bone mass is reached at around age 30. From that point on, more bone is lost than is replaced. If not treated, bone losses may lead to osteoporosis. Osteoporosis is more likely to occur if optimal bone mass was not achieved during the bone-building years. Bone density also plays a role in bone health. Bone density is determined in part by the amount of calcium, phosphorus, and other minerals contained within the framework of the bone.

As the mineral content of a bone (especially calcium) decreases, the bone becomes weaker. Getting enough calcium and vitamin D and exercising regularly can help ensure that bones stay strong throughout life. Osteoporosis does not usually cause symptoms. Pain is the only symptom, and generally occurs when the bones have broken or collapsed. Osteoporosis can be prevented! Building strong bones throughout the early years is the best defense against osteoporosis. There are four steps to prevent osteoporosis, none of which is likely to be effective by itself.

  • A balanced diet rich in calcium and vitamin D
  • Weight-bearing exercise
  • Healthful lifestyle (no smoking and moderate alcohol)
  • Bone density testing and medications where appropriate

To maximize peak bone mass, which is generally reached between 20 and 25 years of age, a recommendation is made of 1200 mg calcium and 800 IU of vitamin D per day for 11-24 year old individuals. Medical management for ages 25-50/menopause is bone maintenance and is attempted by supplements of dietary calcium intake of 1000 mg and vitamin D intake of 400 IU per day. For peri or post menopausal women a combination therapy of estrogen replacement therapy, anti-resorptive agents, as well as calcium intake of 15mg/per day are usually recommended. A regular program of exercise throughout life is always recommended to resist the onset of osteoporosis, especially in those with a sedentary life style.