Osteoporosis is a condition, characterized by low bone mass and deteriorated bone tissue, which makes bones brittle, porous, and fragile. (The ribbon for osteoporosis is, appropriately, made of lace.) It's called the silent thief because bone loss occurs without symptoms, and many people only find out they have osteoporosis when they suffer a fracture. People with osteoporosis are at a high risk of fracturing their bones, and those who suffer one fracture are likely to suffer another. The most common osteoporotic fractures are fragility fractures of the wrist, spine, or hip. They may be the result of something as simple as bending down to pick up a bag or receiving a hug, or can occur as a result of a non-serious injury or a fall from a standing height or lower. Spinal or vertebral fractures cause the "hump" (kyphosis) you can see in the upper back of many older people, while hip fractures are the most debilitating. Many elderly people never regain their normal independent lives after a hip fracture.
Osteoporosis is commonly thought to be a "woman's disease", but this is erroneous: as many as one in four (caucasian) women over 50 years of age and one in eight (caucasian) men over 50 have osteoporosis. (The parenthetical qualifiers acknowledge that osteoporosis has been little studied in non-caucasian populations.) As the western world's population ages, osteoporosis will become even more of a serious health concern.
Why do older people get osteoporosis? Every body lays down bone mass through youth and adolescence, and achieves peak bone mass between the ages of 20 and 30. Thereafter, bone mass naturally begins to decrease. Hormones like estrogen and androgen preserve bone mass, so bone loss among women begins during perimenopause and accelerates after menopause, when hormone production drops dramatically; a similar, but less drastic, process occurs in men. In spite of this natural process of building up and then losing bone mass, most experts, including a team from the World Health Organization, argue that osteoporosis is preventible.
Building and maintaining peak bone mass is key to osteoporosis prevention, so it's important that young people have a good diet, adequate exercise, and normal pubertal development. Living off chips and pop, or experiencing delayed puberty - for example, because of anorexia - can compromise bone health and greatly increase both women's and men's risk of developing osteoporosis later in life. Other risk factors for osteoporosis include smoking, excess caffeine or alcohol consumption, lack of exercise, and inadequate intake of calcium and vitamin D.
Some argue that the emphasis on calcium as a preventive measure is a milk conspiracy driven by dairy farmers' need to sell their product. However, most medical experts argue, and many reputable studies show, that calcium is necessary to guard against bone loss. Of course, dairy foods are an excellent source of calcium but other sources include green leafy vegetables like broccoli, kale, and spinach; legumes and seeds like kidney beans, quinoa, and sesame seeds (and gomasio); tofu; and soft fish bones (for example in canned sardines). True vegans may find it difficult to get enough calcium from plant sources alone, and might consider taking supplements; in fact in my view, good calcium supplements, taken in conjunction with vitamin D, are an excellent way to lessen the risk of osteoporosis.
It's important too to have some kind of exercise which puts mild stress on the bones - resistance training is good, but even walking will help keep your bones strong - as well as exercise which will help maintain your balance. Many physicians also prescribe drugs - hormone replacement therapy is favoured - for postmenopausal women and elderly men as a way to preserve bone mass. But I'm putting my money on prevention.
I learned what I know about osteoporosis by being the main researcher and author of the Ontario Women's Health Council's report on the condition. Find the report at
womenshealthcouncil.on.ca under publications.