Osteoporosis is a global public health problem that is largely preventable. It is a skeletal disorder characterized by compromised bone strength which predisposes the patient to an increased risk of bone fracture. One half of American women and one in eight American men will experience an osteoporosis-related fracture in his or her lifetime.

These fractures, often of the hip or vertebrae, may lead to health complications such as pneumonia, lung disease, chronic pain, disability and loss of independence. Osteoporosisis a serious, disabling disease that is easier to prevent than to treat. Ensuring propernutrition and lifestyle throughout life is the best way to optimize bone health. Key Risk Factors: Listed below are some of the key risk factors for developing osteoporosis. If you have afamily history of osteoporosis, or if you have other risk factors, please talk to your physician about assessing your personal risk and developing a plan for prevention.

• Family history of osteoporosis• Female• Female and post-menopausal• Increased age• Estrogen deficiency• Caucasian or Asian• Low weight (less than 127lbs.) and low body mass index (BMI)• Use of alcohol and caffeine-containing beverages• Personal history of prior bone fracture• Cigarette smoking• Some medications such as long-term use of glucocorticoids• Sedentary lifestyle• Poor nutrition• History of amenorrhea, infrequent menses, late menstrual onset, anovulation• History of anorexia nervosa, Diabetes Mellitus, Cushing's Disease,hyperthyroidism, hyperparathyroidism,• Nulliparous (woman who has never had a full-term pregnancy)• Dental conditions: dentures before age 60, high tooth loss, bone loss in the jaw

Preventative strategies: Most of the strategies for the prevention of osteoporosis are also strategies for optimal health and prevention of other diseases. Talk to your physician to tailor a plan most appropriate for your health needs.

Lifestyle:• Stop smoking• Moderate or no alcohol use• Regular, weight-bearing exercise throughout life• Avoid being underweight• Avoid falls and injuries• Get regular annual health checks, laboratory testing and bone density testing maybe appropriate• Consider hormone replacement therapy, natural or conventional, if you have several risk factors

Diet:• Moderate use of alcohol and caffeine• Ensure proper nutrition with whole grains, fresh fruits and vegetables• Take in adequate nutrients during pregnancy and breast feeding, especially calcium and vitamin D• Avoid high phosphate foods such as carbonated beverages and excess animal proteins• Eat soy foods such as soy milk, soy beans, tofu, tempe, miso• Eat sources of calcium-rich foods, such as: leafy greens, Swiss and cheddar cheese, carob powder, dulse, molasses, almonds, brewer's yeast, Brazil nuts, tofu, goat's milk, figs, buttermilk, sunflower seeds, yogurt, wheat bran, whole milk, buckwheat, sesame seeds, olives, broccoli, walnuts, cottage cheese

Supplements:• Calcium – this recommended dosage is for calcium carbonate, you may cut dose in half if using calcium citrate, which is more easily absorbed o age 9-18 - 1300 mg dailyo age 19-50 – 1000 mg dailyo age 51+ - 1500 mg daily• Vitamin D – 200-400 IU daily, it is also synthesized by the skin when exposed to sunlight• Folic Acid• B vitamins• Vitamin C• Vitamin K• Magnesium Citrate/malate• Manganese• Boron, Zinc, and Copper• Most of the vitamins and minerals may be obtained in a good multi-nutrient supplement.• Hormone replacement therapy (HRT) has been shown to be protective against the development of osteoporosis, helps to reverse bone loss and prevents fractures. It does have side effects and there are questions regarding continued long-term use.

References:Dore, Robin K. "Osteoporosis: Fractures and Key Risk Factors." The Female Patient March 2002: 5-12.Hudson, Tori. Women's Encyclopedia of Natural Medicine. Keats Publishing, Los Angeles 1999.Rosenfield, Jo Ann. Handbook of Women's Health. Cambridge University Press 2001.