By Nermin Lazarus, DO, Family Medicine and Lead Physician, Exuberan by Virtua

Like the frame of a home, your body needs strong bones to provide a stable foundation that will stand the test of time as you age.

But without proper care and maintenance, your bones can break down, lose density, and become too weak to support your body. This puts you at high risk for breaks.

In its earliest stages, this weakening is called osteopenia. As bones get more “porous” and weak, it’s called osteoporosis.

What’s the difference between osteopenia and osteoporosis?

The difference between osteopenia and osteoporosis is related to your T-score, which is how the results are reported for a bone mineral density test (DEXA scan).

A T-score compares your bone mineral density to that of a healthy 30-year-old.

• A T-score of -1 or above means you have normal bone mineral density.
• A T-score between -1 and -2.5 means you have osteopenia or low bone mineral density.
• A T-score of -2.5 or below means you have osteoporosis or very low bone mineral density.

Moderate to advanced osteopenia and osteoporosis are treated with prescription medication. But it’s much better to do all you can to prevent the onset altogether.

What’s my osteoporosis risk?

Our bones are alive and constantly changing. Old bone tissue is always being replaced by new bone tissue, which needs calcium to form.

But, by the time you’re 35, old bone tissue breaks down faster than new bone tissue can form. As a result, your bones might not have enough calcium, which makes them weaker and more likely to fracture or break.

A broken bone can be a very serious problem in an older person. People over age 65 who experience a bone fracture are more likely to have a dramatically shorter life expectancy and are more likely to experience frequent hospitalizations.

For women, your doctor will probably recommend regular bone mineral density tests once you hit menopause, as postmenopausal women are at the greatest risk of developing osteopenia and osteoporosis. 

That said, anyone can develop osteopenia or osteoporosis at any age.

Other risk factors include:

• Family history of osteoporosis
• A small or thin body frame
• Smoking
• Taking certain medications, like steroids or antacids, for extended periods

Since young women and men aren’t routinely screened for osteopenia or osteoporosis, and since you can’t feel bone loss, it’s a good idea for everyone to do their best to keep their bones healthy and strong.

What can I do to strengthen my bones?

You can’t always prevent osteopenia or osteoporosis, but it’s worth the effort. Improving your T-scores with regular exercise and increased calcium intake is possible. These recommendations are a good starting point:

Exercise
Weight-bearing exercise is best for your bones, and the simplest weight-bearing exercise is walking. As you get stronger, you should go farther and faster and add a weighted vest or ankle or wrist weights for greater benefits. Dancing, tennis, pickleball, yoga, and weight training are other great options. Aim for 30 to 60 minutes daily, at least 5 times a week.

Hormone replacement therapy (HRT)
Newer studies have shown that HRT, when prescribed appropriately, can offer numerous health benefits before and after menopause. This includes a decreased risk of osteoporosis as HRT helps maintain bone density, reducing the risk of fractures. It’s important to weigh the potential benefits and risks with your health care provider.

Calcium
Younger adults should consume around 1,000 milligrams (mg) of calcium daily, while women over 50 or men over 70 need 1,200 mg a day. 

You can reach the calcium recommendation for your age/gender by eating a varied diet that includes healthy dairy products, like skim milk, cottage cheese, yogurt, low-fat cheese, and green vegetables, like bok choy and kale. Even sardines have a healthy amount of calcium.

However, you shouldn’t rely on dietary calcium alone, especially if you have other risk factors for bone loss. Research has shown that calcium is absorbed best in smaller doses of 600 mg or less. One calcium supplement of 600 mg daily added to your dietary intake is recommended, along with vitamin D, which helps your body absorb the calcium.

Take the next step to improve your bone health

• Schedule an appointment to talk to your primary care provider about your bone health and what you can do to keep your bones strong.
• Learn more about all your menopause treatment options and how hormone replacement therapy can support your overall health.