Bone Up: How to Prevent Osteoporosis
If you think you have risk factors, talk to your doctor about getting a Bone Mineral Density (BMD) test. It measures the mineral content in your spine and hip, the areas most likely to fracture when weak. The gold standard is DXA (dual-energy X-ray absorptiometry), which is painless, safe, and relatively inexpensive ($150 to $200, often covered by insurance). "DXA is a snapshot of where you are right now in terms of the mineral content of your bones and your chances of a fracture," says Dr. Diemer. You'll get two numbers: a T score, which compares your bone density with an average 30-year-old woman's; and a Z score, which compares you with women your own age. For postmenopausal women, a BMD of -1 or better is normal; -1 to -2.5 signals osteopenia; -2.5 or lower is osteoporosis. But if you still get your period, the Z score is a better bone strength judge. If it's low, you're losing more bone than average (though that doesn't necessarily mean you're at high risk for fractures). Make sure you're getting the nutrients and weight-bearing exercise you need and monitor progress closely.
While a BMD test alerts you to bone loss, it doesn't tell you why you're losing bone. For that you need other tests, as Gail Warshaw, of Demarest, New Jersey, discovered. When she was in her 40s, Warshaw, a runner, was diagnosed with a stress fracture in her right tibia. Later she also suffered stress fractures in her hip, rib, lower back, and shoulder blade. Her BMD was normal. But after her doctor ordered blood and urine tests, Warshaw learned that her low calcium and years of yo-yo dieting had sabotaged the quality of her bones. She also admits to being a coffee addict. "My level of vitamin D was really low and my doctor told me I was losing more bone than I was making," she says.
She committed to a vigorous strength-training program and nutritional makeover. Her most recent test indicated that her bone density was improving, so she's sticking with the program. "I've turned around the direction my bones were going and now I'm strengthening them," she says.
Michele Rosenthal has turned her loss around, too. Now living in Palm Beach Gardens, Florida, she follows a diet rich in calcium and vitamin D and a strength-training regimen designed by a trainer. Once very thin, she's now at a healthy weight. "I've completely reversed the osteoporosis," she says. "You feel so worried all the time when you have osteoporosis. Now I don't feel so fragile."
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