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Silence is golden, unless it comes in the form of osteoporosis. More common in older women, the National Osteoporosis Foundation estimates that one in two women age 50 and older will break a bone due to osteoporosis. “You may not know you have osteoporosis until you experience a fracture due to a stumble or fall,” says Tania Crussiah, M.D., with Meritus Family Medicine-Williamsport.

Your bones are in a constant state of change: new bone is created while old bone is broken down. After your 20s bone loss outpaces bone renewal. “Osteoporosis is a combination of fragile bones and low bone mass,” says Dr. Crussiah. Under a microscope, healthy bones appear as a honeycomb-like structure, but osteoporotic bones contain larger holes in the honeycomb.

“It’s really the destruction of architecture inside the bones,” says Dr. Crussiah. As a result, people with osteoporosis often break bones in the hip, spine and wrist.

Osteoporosis risk factors

While the leading cause of osteoporosis is a drop of estrogen in women at the time of menopause and a drop of testosterone in men, other risk factors for developing osteoporosis include:

Low body weight or a small frame

Family history of osteoporosis or fractures

Caucasian or Asian ethnicity

Long-term use of steroid therapy (prednisone), anti-seizure medications and Depo-Provera (contraceptive injection)

Medical conditions such as rheumatoid arthritis and parathyroid disease

Smoking

Excessive alcohol consumption

Detection

A dual energy x-ray absorptiometry or DEXA scan measures the density of your spine, hips and wrists and compares the results to a young adult’s peak bone mass. It is often prescribed for women ages 65 and older and for men ages 70 and older. Certain risk factors may suggest earlier testing.

DIY prevention

A loss in bone density is inevitable, but the following tactics can slow the progression of osteoporosis.

Exercise. Dance aerobics, walking and running are forms of weight-bearing exercise that help build stronger bones. Resistance training strengthens bones while yoga or tai chi improves balance. “Improved muscle mass gives you strength and protects your bones,” says Dr. Crussiah. “The older you are, the more you need to work on balance and strength.”

Nutrition. Cheese, low-fat milk, yogurt, tofu, salmon, tuna fish and sardines are foods containing vitamin D and calcium. Almonds, spinach, broccoli, and soy products are other sources of calcium. Aim for 500 milligrams of calcium and vitamin D three times a day.

Lifestyle. If you smoke, enroll in a smoking cessation class or ask your physician about quit-smoking aids. Scale back your alcohol consumption to no more than one drink per day for women and up to two drinks per day for men.

Treating osteoporosis

A diagnosis of osteoporosis isn’t life threatening and the outlook is good as long as you stick to a healthy lifestyle and discuss therapy options with your physician.

Prescription medications like Fosomax, Reclast and Boniva slow bone loss, but are not suitable for people with digestive issues; however, some medications may be taken intravenously.

But the two most common prescriptions in life, exercise and a healthy diet, can reduce your risk of developing osteoporosis or help treat the disease—and they’re both within your reach.