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Bone Density

Table of Contents

What Is Bone Density?
How Bone Density Is Measured
Risk Factors for Low Bone Density
How to Maintain and Improve Bone Density
Prevention and Screening

What Is Bone Density?

Bone density refers to the amount of mineral matter per square centimeter of bone tissue. It is a primary indicator of skeletal strength and fracture risk. Your bones reach peak density around age 30, after which gradual decline begins. This makes early intervention essential for maintaining bone health throughout life ^[1].

How Bone Density Is Measured

The gold standard for measuring bone density is dual-energy X-ray absorptiometry (DEXA or DXA). This painless scan uses low-level X-rays to measure mineral content in your bones, typically focusing on the hip and spine. The results produce a T-score that compares your bone density to that of a healthy young adult ^[2].

Understanding Your T-Score

Your T-score determines your bone health category:

Normal: T-score of -1.0 or higher
Osteopenia: T-score between -1.0 and -2.5, indicating low bone mass
Osteoporosis: T-score of -2.5 or lower, indicating significantly increased fracture risk

Risk Factors for Low Bone Density

Several factors increase your risk of developing osteoporosis. Age and sex are primary determinants, with women over 50 and men over 70 at highest risk. Family history of osteoporosis or hip fractures also elevates risk. Lifestyle factors including smoking, excessive alcohol consumption, and sedentary behavior contribute to bone loss ^[1].

Certain medical conditions and medications can accelerate bone loss. These include glucocorticoid steroids, some cancer treatments, thyroid disorders, and gastrointestinal diseases that impair nutrient absorption. Postmenopausal women experience accelerated bone loss due to declining estrogen levels ^[2].

How to Maintain and Improve Bone Density

Weight-bearing and resistance exercises provide mechanical stress that stimulates bone formation. Activities like walking, jogging, dancing, and strength training help maintain bone mass. The key is consistency and progressive loading over time ^[1].

Nutrition plays an equally important role. Adults need 1,000 to 1,200 mg of calcium daily, depending on age and sex. Vitamin D is essential for calcium absorption, with recommended intakes of 600 to 800 IU daily. Protein, vitamin K, magnesium, and other nutrients also support bone matrix formation and mineralization ^[3].

Prevention and Screening

The U.S. Preventive Services Task Force recommends bone density screening for all women 65 and older, as well as for younger postmenopausal women at increased risk. Men should consider screening by age 70, particularly if they have risk factors. Early detection allows for lifestyle modifications and, when necessary, medical interventions to prevent fractures ^[2].

References

Get your calcium throughout the day

Your body absorbs calcium best in doses of 500 mg or less. Split your calcium intake across meals rather than taking it all at once for optimal absorption.

ods.od.nih.gov

Lift heavy to build bone

Progressive resistance training with weights that challenge you stimulates bone formation. Focus on compound movements like squats, deadlifts, and presses that load your spine and hips.

www.niams.nih.gov

Prioritize food sources first

Dairy products, fortified plant milks, canned fish with bones, and leafy greens provide highly bioavailable calcium. Aim to meet most of your needs through food before considering supplements.

ods.od.nih.gov

Don't forget vitamin D

Vitamin D is essential for calcium absorption. Get 10-30 minutes of midday sun exposure several times per week, or consider supplementation if you live in northern climates, especially during winter months.

www.niams.nih.gov

Quit smoking to protect your bones

Smoking is a major risk factor for osteoporosis and fractures. It interferes with calcium absorption and reduces blood supply to bones. Quitting at any age helps preserve bone mass.

www.niams.nih.gov

At what age should I get my bone density tested?

Women should get their first bone density test at age 65, or earlier if they have risk factors like family history of osteoporosis, early menopause, or long-term use of certain medications. Men should consider screening by age 70, or earlier if they have specific risk factors. Your doctor can help determine the right timing for you.

Can bone density be improved once it's lost?

Yes, bone density can be improved through lifestyle changes and medical treatments. Weight-bearing exercise, adequate calcium and vitamin D intake, and certain medications can help rebuild bone mass. While you may not fully restore density to youthful levels, significant improvements are possible at any age with proper intervention.

What foods are highest in calcium?

Dairy products like yogurt, cheese, and milk are excellent sources. Canned sardines and salmon with bones, fortified plant milks and juices, tofu made with calcium sulfate, and leafy greens like kale and bok choy also provide significant amounts. Most adults need 1,000-1,200 mg daily.

What is the difference between osteopenia and osteoporosis?

Osteopenia indicates low bone mass (T-score between -1.0 and -2.5) and is a warning sign that bones are weaker than normal but not yet at high fracture risk. Osteoporosis is more severe, with T-scores of -2.5 or lower, indicating significantly weakened bones and high fracture risk. Both conditions benefit from lifestyle interventions, but osteoporosis may require medication.