Bone Up: How to Prevent Osteoporosis

A Silent, Serious Disease

In her wildest fantasies Michele Rosenthal never dreamed that her sweet little wheaten terrier, Baylee, could put her bones at risk. Rosenthal was walking Baylee in her New York City neighborhood when he lunged at a squirrel. As she reached for a nearby railing to keep from falling, her hand slipped and she severely fractured two fingers. The orthopedist who treated her was concerned that she had such serious damage after a minor tumble and recommended that she take a bone-density test. The verdict was advanced osteoporosis.

"My doctor said that if I didn't start doing something soon my bones would spontaneously start to crumble," says Rosenthal. "I couldn't believe it. I was 36. I didn't think this could happen to someone my age."

Her case underscores what many experts have been trying to tell women for years: You can't wait until your AARP card arrives in the mail to start thinking about keeping your bones strong. "Osteoporosis is not just a disease of little old ladies and it's not a normal part of aging," says Lisa Callahan, MD, codirector of the Women's Sports Medicine Center at the Hospital for Special Surgery in New York City. "Though we used to define it as a disorder of postmenopausal women, we now know that it can develop at any age. But the problem is, younger women rarely think about it. So they don't do the simple things, such as exercising and boosting their calcium and vitamin D intake, that can make a tremendous difference in keeping their bones strong."

"Bone is living tissue," says Ethel S. Siris, MD, director of the Toni Stabile Osteoporosis Center at Columbia University Medical Center. "From the time you're born, your body is constantly removing old bone and creating new bone." During childhood and the teen years, your body grows more than it loses. But after 20 you can start to lose more bone than you make -- and the loss really accelerates after menopause. "If you lose too much bone or make too little of it, you can develop osteoporosis," says Dr. Siris. "That's why it's crucial to bank enough during childhood and adolescence -- and crucial to protect the reserves you do have."

An estimated 10 million Americans have osteoporosis (literally, "porous bones") and about 80 percent of them are women. Another 34 million have low bone density, or osteopenia, putting them at increased risk of osteoporosis and broken bones. "This is a silent, potentially crippling disease," says Dr. Siris. Most women have no idea their bones are weak until a fracture occurs. Despite advances in diagnosing and treating osteoporosis, there's still a major lack of awareness. Your risk of a fracture from osteoporosis is more than four times higher than your risk of getting breast cancer. But while 93 percent of women surveyed know osteoporosis is a serious disease, eight out of 10 don't believe they'll ever get it, according to the International Osteoporosis Foundation.

What's more, doctors report that they're increasingly seeing signs of the disease in women in their 20s, 30s, and 40s. "A few years ago I'd see a young woman with low bone mass once a month," says Kathryn Diemer, MD, director of the Bone Health Program at Washington University School of Medicine in St. Louis. "Now I see three or four every day."