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Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine


Risk factors


Most scientists agree that these things affect the risk of osteoporosis. Some may apply to you, but others may not.

Age
Sex
Family history
Race/ethnicity
Diseases and conditions
Medications
Physical activity
Post-menopausal hormones
Tobacco
Weight
Diet



Factors that increase a person's risk of osteoporosis but cannot be changed include:

Age and osteoporosis
The risk of osteoporosis increases with age. Osteoporosis can be seen at any age but is much more common in in people as they get older.

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Sex and osteoporosis
Women have a higher risk of osteoporosis than do men, but both men and women can develop bone loss and fracture.

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Family history and osteoporosis
A person with a parent who had osteoporosis is at increased risk of developing bone loss.

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Race, ethnicity and osteoporosis
People of all races and ethnicities develop osteoporosis. However, African Americans tend to be at lower risk than other groups.

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Diseases and conditions
A number of diseases and conditions are linked to an increased risk of bone fracture and osteoporosis. Most clearly linked are results from a bone scan showing you already have osteoporosis or low bone mass. Breaking a bone after age 50 is another important marker for osteoporosis and is linked to an increased risk of breaking another bone later in life. For a number of reasons, rheumatoid arthritis and diabetes also raise the risk of breaking a bone. If you have any questions about how your medical history affects your bone health, talk to your doctor.

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Medications and osteoporosis
Some medications, like steroids, some anticonvulsants and certain cancer chemotherapies, are an important part of the treatment of diseases, but they can also cause bone loss. People who need these medications should take them as directed and should also talk to their doctors about ways to help protect their bones.

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Most risk factors for osteoporosis can be modified to reduce risk, either through lifestyle changes or through medication, if needed.

These include:


Physical activity and osteoporosis
Exercise is one of the best ways to protect yourself from osteoporosis. Weight-bearing exercises that work against gravity (like walking, stair climbing and weight training) help maintain strong bones. Exercise also helps prevent other diseases such as heart disease, stroke, diabetes, obesity and colon cancer. Try to get at least 30 minutes of exercise a day.

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Post-Menopausal hormones and osteoporosis
Post-menopausal hormones can contain different hormones that are similar to the female reproductive hormones, estrogen and progesterone. After menopause, a woman's body stops making these hormones in large quantities. For women who are going through (or have already gone through) menopause, post-menopausal hormones can help decrease symptoms, like hot flashes and vaginal dryness, and also protect against osteoporosis and colon cancer. The hormone estrogen is especially important in osteoporosis prevention because it can reduce bone loss and increase bone density. However, post-menopausal hormones also have some significant risks, like increasing the risk of breast and uterine cancer. And, although post-menopausal hormones were once thought to lower the risk of heart disease, it is now unclear exactly how they affect the risk of the disease.

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Tobacco smoke and osteoporosis
Smokers have a higher risk of osteoporosis than do non-smokers. Smoking may work in several ways to increase bone loss. For example, smoking can change the body's hormone levels and may interfere with calcium absorption.

Tobacco exposure also increases your risk of heart disease, stroke, peripheral vascular disease (narrowing of the blood vessels in the legs), emphysema, bronchitis, diabetes, and cancers of the lung, bladder, kidney, pancreas, cervix, lip, mouth, tongue, larynx, throat and esophagus. For many people, quitting smoking is the single best thing they can do to improve their health.


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Weight and osteoporosis
The risk of osteoporosis is highest in thin people with small bones and lowest in heavy people. Heavier people have a lower risk for several reasons. The extra fat most heavy people carry increases estrogen levels (which protects against rapid bone loss), puts weight-bearing stress the bone (which helps make them stronger), and can act as a cushion in case of a fall (which protects bones from fractures).

While extra weight can protect from osteoporosis, it also puts extra strain on the whole body, increasing the risk of diabetes, high blood pressure, high cholesterol, heart disease and stroke. Maintaining a healthy weight has been proven to decrease the risk of cancer of the colon, kidney, breast and uterus. When all this is taken together, the healthiest approach to protecting your bones is not through weight gain but through other, healthier approaches, like exercise and a healthy diet.


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Diet and osteoporosis
Diet can play an important role in bone health. To decrease your risk of osteoporosis, it is especially important to get enough calcium, vitamin D and vitamin K. Good sources of calcium include dairy products, nuts, whole grains, green leafy vegetables, and calcium supplements. Good sources of vitamin D include eggs, fatty fish, fortified dairy products and breakfast cereals, and direct sunlight (which helps vitamin D form in the skin). Good sources of vitamin K are green leafy vegetables like kale, greens, spinach, broccoli, cabbage or lettuce.

Too much vitamin A, in the form of retinol, can increase the risk of osteoporosis. Try to keep retinol intake between 2500 IU and 5000 IU a day. The best way to do this is to make sure you don't consume too many foods fortified with vitamin A (check the labels). And when choosing a multivitamin, pick one that has no more than 5000 IU of vitamin A and has at least 20% of the vitamin A from beta carotene.

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