Bone Health Basics

Bones are living tissue, constantly renewing through breakdown and rebuilding. Peak bone mass occurs by age 25–30, then gradually declines—accelerating around menopause due to reduced oestrogen.

Osteoporosis literally means ‘bones with holes’: bones lose density and become fragile. Many people don’t notice until a fall causes a fracture—so prevention and early detection are vital.

How to Reduce Fracture Risk

1. Nutrition: Support Bone Strength

  • Calcium

Aim for 1,000 mg/day (under 50s) or 1,300 mg/day (women over 50, men over 70) from dairy, fortified plant milks, leafy greens or supplements if dietary intake is low.

  • Vitamin D

Crucial for calcium absorption. Australians need safe sun exposure and may require 800–1,000 IU/day in winter or if deficient.

  • Protein & Other Nutrients

Adequate protein (0.8 g/kg body weight) supports bone matrix. Nutrients like vitamins C, K, magnesium and trace minerals are also important.

2. Exercise: Build and Maintain Bone

  • Weight-bearing & resistance training

Brisk walking, dancing, gym work and light weights 3–5 times weekly help maintain or improve bone density.

  • Balance and flexibility

Activities like Tai Chi or Pilates reduce falls risk by improving posture and coordination—key in preventing fractures.

  • Supervised exercise for frail individuals

Certified physiotherapy or exercise physiology programs are essential for frailer older people with high fall risk.

3. Lifestyle Adjustments

  • Quit smoking & limit alcohol

Smoking impairs bone‑building cells; more than two drinks/day increases fracture risk

  • Moderate caffeine intake

More than 2–3 cups of coffee or cola can impact calcium absorption

  • Fall-proof your environment

Remove trip hazards, install handrails, improve lighting and wear sturdy shoes

4. Screening & Monitoring

  • DXA scans assess bone density; Medicare rebates available ≥ 70 yrs or with risk factors
  • Risk tools
  • Use FRAX or Garvan calculators to estimate 5–10‑year fracture risk.

Regular reassessment and periodic scans guide ongoing management.

5. Medications: When Lifestyle Isn’t Enough

Prescribing depends on fracture risk, BMD scores, prior fractures or steroid use ().

  • Bisphosphonates (alendronate, risedronate, zoledronic acid)

First-line treatments to slow bone loss and reduce vertebral, hip and non‑vertebral fractures.

  • Denosumab

For high-risk individuals; must be continued or followed by bisphosphonate to avoid rebound vertebral fractures.

  • Romosozumab & Teriparatide

Anabolic therapies for very high-risk cases—romosozumab builds bone, teriparatide stimulates new bone formation.

  • Hormone therapy/SERMs

Considered for postmenopausal women within 10 years of menopause; alternatives include raloxifene for spinal bone loss.

Frequently Asked Questions (FAQs)

Q1: At what age should I start thinking about osteoporosis prevention?

A1: Ideally from young adulthood. Peak bone mass is reached by age 30. After that, focus shifts to maintenance and slowing bone loss.

Q2: Are supplements enough to prevent osteoporosis?

A2: Supplements (calcium + vitamin D) can help, but only when dietary intake or sun exposure is inadequate, and especially helpful when combined with exercise.

Q3: Will exercise alone stop osteoporosis progression?

A3: Exercise strengthens bones and balance, but those with established osteoporosis often need medications to significantly reduce fracture risk.

Q4: What side effects do osteoporosis medications have?

A4: Bisphosphonates may cause GI upset or very rarely jaw issues. Denosumab requires follow-up to avoid rebound fractures. Anabolic agents are generally used short-term under specialist care.

Q5: Can osteoporosis be reversed?

A5: Full reversal isn’t possible—but bone density can stabilise or improve, significantly reducing fracture risk with proper treatment.

AHPRA Advertising Compliance

This article is an educational resource. It outlines general strategies based on reputable medical sources. If you need personal advice or prescription medication, consult your GP or specialist. Any mention of treatment options is factual and avoids sensational claims. No unauthorised comparisons or implied superiority of specific treatments are made.

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