15 Things You're Doing That Put You at Risk for Osteoporosis

Sticks and stones aren't the only things that can break bones. You've probably heard of osteoporosis—which literally means porous bones—a disorder that decreases bone strength and increases risk of fracture.

But did you know that this "silent disease" can progress and weaken your bones without symptoms until a fracture occurs? And—scary to learn—sometimes a fracture can happen without you even knowing it. In fact, 2 out of 3 spinal fractures have no pain, which makes getting tested all the more critical.

Here are the breaks: there are some unavoidable risk factors that make you more likely to develop osteoporosis. The good news is that many risk factors are actually within your control. Read on to see whether you may be at increased risk for this disease and what you can do about it—like our super-simple two-minute-a-day tip.

Lady luck? Not so much. Osteoporosis is far more common in women than men—in fact, of the 10 million Americans with osteoporosis, 8 million (yes, 80%!) are women. Simple truth: being female puts you at risk of developing osteoporosis, and hence, broken bones. Some sobering stats: approximately one in two women over 50 will break a bone because of osteoporosis—and a woman's risk of breaking her hip? Her risk is equal to the combined risk of breast, ovarian, and uterine cancers!

There are a number of reasons why women are at higher risk of developing osteoporosis, but chief among them is that they have smaller, thinner bones than men—and when women reach menopause, estrogen decreases sharply, which can lead to bone loss. Prevention efforts should target all women, especially if they have multiple risk factors.

Recommendation: The chance of developing osteoporosis increases as women reach menopause, so start early to help stem bone loss. According to Harvard Medical School, you can most influence your bone health by getting enough calcium and vitamin D, and by doing bone-strengthening weight-bearing exercise like walking, Zumba, or jumping rope. Make sure to read on to get top diet tips for keeping osteoporosis at bay.

While women are affected sooner and more often—20% of men will be affected by osteoporosis. And here's the deal: when they are, men are more likely to experience a fracture, and mortality is far greater in men than in women for such fractures. Despite these compelling figures, the NIH reports that a majority of American men view osteoporosis as a "woman's disease." And among men whose lifestyle choices put them at increased risk (we're looking at you alcohol and smoking—more on this shortly), few recognize osteoporosis as a real threat to their mobility and independence.

Recommendation: The good news? In the past few years, this issue of osteoporosis in men has become recognized as an important public health issue. Especially as life expectancy continues to rise. As awareness grows, so do bone-smart health moves, like eating a balanced diet, getting enough vitamin D, and quitting smoking.

When you want to get fitter and reduce your risk of a fall, schedule some time in your gym routine for these 42 Low-Impact Exercises That Will Slim You Down.

Essential for maintaining healthy bones, vitamin D tells the cells in our guts to absorb calcium and phosphorus—two of the most vital minerals in keeping our bones healthy. There's a good reason why vitamin D is known as the "sunshine vitamin." This crucial vitamin is made when the cholesterol in your skin is exposed to sunlight, which is why getting enough sunlight is key for keeping optimal vitamin D levels in your body. There's a simple fix for this risk factor: get outside. It's estimated that at least 40% of American adults are deficient in vitamin D—which raises the risk of developing osteoporosis down the line.

The most natural and efficient way for your body to make vitamin D is via sunshine-on-skin, though taking supplements can help, too. According to the Vitamin Council, Vitamin D3 is the best form of vitamin D supplementation to take.

Recommendation: Want to maintain healthy vitamin D levels? It has been suggested by some vitamin D researchers that to maintain healthy vitamin D levels, you should expose a good amount of skin (think shorts and tank top, or less…) to sunlight, without any sunscreen on, for 5-30 minutes at least twice a week if you are lighter-skinned; those with darker skin may need longer. Don't forget that prolonged exposure to the sun isn't safe. Add these easy-to-find foods to your diet to reap the health-protecting benefits of Vitamin D without getting a painful sunburn.

If one of your parents has had a broken bone, particularly a broken hip, you should get screened earlier for osteoporosis according to the CDC. Studies show that if either your mother or father had osteoporosis, you are more likely to get it, as well. Fracture risk may be partly due to heredity. People whose parents have a history of fractures also seem to have reduced bone mass putting them at increased risk.

Recommendation: If you know that you're at increased risk of osteoporosis due to a family history of the disease—your goal is to maintain strong bones as you age. Make sure you eat a well-balanced diet with plenty of dairy, fish, fruits, and vegetables. Aim to get the nutrients you need from food, but you may need to complement your diet by taking multivitamins or supplements. Talk to your doctor to see what's right for you.

Ouch, you've broken a bone! Only those who have had the pain of experiencing a fracture can fully comprehend how challenging it can be to recover. But in addition to healing that broken bone, you and your doctor may also want to ascertain whether this fracture is a symptom of osteoporosis. If you do have this underlying bone disorder, you are at higher risk for future fractures! And if you are over age 50—there's a very good chance that your broken bone is linked to osteoporosis.

Recommendation: If you've broken bones in the past, or have recently experienced a fracture, get tested! A bone mineral density (BMD) test is the best way to determine your bone health. A BMD test is painless (much like an x-ray, but with far lower exposure to radiation), takes only 15 minutes—and can detect osteoporosis, determine your risk for future fractures, and measure your response to osteoporosis treatment.

Osteoporosis fractures are a recognized major public health issue. While this bone disorder affects all races and ethnicities, research suggests that if you are white or of Asian or Latino descent, you have a higher risk of getting osteoporosis. Ditto if you have a small, thin frame—because people with lighter, thinner bones are more prone to osteoporosis.

Highest fracture rates are found among white women, while rates in black women are 50% lower than white women. Latino and Asian women are in the middle, with fracture rates that are 25% lower than those found in white women.

However, despite lower hip fracture rates, the Journal of Osteoporosis writes: "black women are more likely to die after their hip fracture, have longer hospital stays, and are less likely to be ambulatory at hospital discharge."

Recommendation: Despite advances made in awareness, prevention, diagnosis, and treatment—osteoporosis remains a silent and underdiagnosed disease for many women (and men)—particularly for women in racial and ethnic minority groups in the United States. If you think you may be at risk for osteoporosis, make an appointment and talk with your doctor. The opportunity to prevent this disease is high, particularly with early intervention.

It's an old maxim: hard drinking leads to weak bones. Doctors have long known that alcohol abusers are more likely to suffer frequent bone fractures, along with slower rates of bone healing. Scientists have not been able to pinpoint why this is the case, but have attributed the link between the two to multiple reasons—from the poor or malnutrition commonly seen among alcoholics to biochemical interactions between alcohol and hormones. Heavy alcohol consumption can also inhibit normal bone formation by taxing your body's calcium supply—another case for the adage: less is more. If you consume alcohol, make moderation the name of your game and have 2 drinks a day max.

Recommendation: And now for some fun news—a nip now and again is good for bone health! A study published in the journal Menopause found that one to two drinks a day could help curb bone loss in women over age 50.

An NIH study found that over 1.7 million people were hospitalized in 2011 because of a fragility fracture, and tabulated direct costs associated with osteoporosis treatment as exceeding $70 billion in the USA. That's a lot of people and a lot of money. And it doesn't have to be this way. Strong evidence links lack of physical activity and exercise with osteoporosis, but the fix is simple—and cheap. Move your body.

Exercise transmits forces through the skeleton, which creates mechanical signals like bone strain, that are detected by bone cells. In a healthy body, signals related to strains starts a cascade of biochemical responses that increase bone turnover both locally and systemically, resulting in—yes, you guessed it, new bone formation! Not surprising then, that the National Osteoporosis Foundation, International Osteoporosis Foundation, and other agencies recommend weight-bearing exercises for the prevention of osteoporosis.

Recommendation: Dr. Cristina Matera, board-certified in Obstetrics and Gynecology and Reproductive Endocrinology and Infertility has a two-minute exercise ritual she recommends to patients and does herself: jump rope every day for two minutes. Why? Studies suggest that the type of exercise you do is the most crucial factor in whether it can improve bone health. Jumping rope provides targeted bone loading—defined as "force-generating activities that stimulate a specific bone or bone region beyond the level provided by daily activities."

It is extremely important to eat a diet rich in calcium and vitamin D to help stave off osteoporosis. Why? Because these nutrients work in conjunction to promote healthy bone growth and maintenance: calcium is critical for healthy bones, and vitamin D helps your body effectively absorb calcium. The National Osteoporosis Foundation advises that you aim to get the recommended daily amount of calcium you need from food first, supplementing only as necessary to make up for any shortfall. They offer a calcium calculation tool to estimate your daily calcium intake from food.

And if you are diagnosed with osteoporosis, it's critical to work with your doctor to create a treatment plan that includes a diet rich in calcium and vitamin D, weight-bearing exercise, and possible treatment with medication. Make sure to follow your plan and speak with your doctor before making any changes.

Recommendation: Dairy products may be the richest source of calcium, but a growing number of foods, like orange juice, can now be found calcium-fortified. Fruits, vegetables, and grains, provide other crucial minerals for optimal bone health, like magnesium and phosphorus. Check out this list of calcium-rich foods from the National Osteoporosis Foundation to get some new ideas to help you incorporate more calcium into your diet.

Time stops for no man. Or woman. As we grow older, our bones naturally lose some density, which makes them weaker. That does not mean, however, that every older person will get osteoporosis. It does signify that your chances of getting this bone disease goes up with age. Something to be aware of as you make decisions about your lifestyle. Grow old with grit and grace—get outside, get exercise, and eat a balanced diet. Taking good care of yourself goes a long way to helping prevent osteoporosis.

Recommendation: Older women and men that exercise regularly may lose less bone and might even increase their bone mass. But not all exercise is equal here: weight-bearing exercise is key. What is a weight-bearing exercise? These are movements and activities that make your muscles (and bones) work against gravity—like walking, hiking, jogging. The Cleveland Clinic recommended 30 minutes of this type of exercise every other day to keep your body healthy.

Menopause is marked by a steep drop in estrogen—a female sex hormone that protects bones. When estrogen levels decrease, bones may lose density and become prone to fractures. According to the Cleveland Clinic, there's a direct relationship between the lack of estrogen after menopause and the development of osteoporosis. Why does this happen? After menopause, bone resorption (or breakdown) overtakes the building of new bone. And those who experience early menopause, before the age of 45, or have any extended periods of time when they have low hormone levels are at even higher risk for this bone disease. The good news? There are steps you can take to prevent osteoporosis—and there are treatments available that can successfully slow the rate of bone loss if you are diagnosed with osteoporosis.

Recommendation: Hormone therapy is believed to help prevent or lower the increased rate of bones loss that leads to osteoporosis, and is often recommended to postmenopausal women who experience early menopause, have low bone mass per a bone density test, and have other risk factors like a family history of the disease.

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According to the Centers for Disease Control and Prevention, more than 16 million Americans are living with a disease caused by smoking, and osteoporosis is one of them. First identified as a risk factor for osteoporosis decades ago, studies have shown a direct link between decreased bone density and tobacco use. But analyzing the precise impact of cigarette smoking on bone health is more complicated than you think. Is the decrease in bone density due to smoking itself or to other factors that are more common among those that smoke? Often, people who smoke drink more alcohol than non-smokers, tend to be thinner, less physically active, and have less healthy diets. Women who smoke also tend to hit menopause sooner than non-smokers. And all these factors place many who smoke at increased for osteoporosis outside from their tobacco use—magnifying the impact. And to boot—smoking has been shown to impact bone healing post-fracture negatively.

Recommendation: What to do? Start by quitting. Smoking cessation, even later in life, may help limit smoking-related bone loss. Check out BeTobaccoFree.org to find a wealth of smoking cessation resources.

Taking certain medications, steroids in particular—such as cortisone and prednisone, used to treat arthritis, asthma, lupus, multiple sclerosis, and other conditions—can weaken bones and cause bone loss. Typically you have to use these medications for a long time, usually in high doses, for them to become a bone health threat. Use over a short period of time is generally not an issue.

You have to remember that medicine is often a cost/benefit analysis—not a zero-sum game. If you're on medications that affect bone health, remember that they may be essential for your wellbeing.

Recommendation: Don't stop any treatment or make any changes to your dosage without talking with your doctor first. If your medicines may cause bone loss, make sure you are on the lowest possible dose, for the shortest possible time to help mitigate risk.

Remember what we said about being female? Sigh. Some women develop a temporary form of pregnancy-related osteoporosis while pregnant. A baby in utero needs a lot of calcium to build its skeleton—and this need is greatest during the last trimester of pregnancy. If mom is not getting enough calcium in her diet, her baby will draw what it needs from her bones. Ouch! Osteoporosis associated with pregnancy is a rare condition, in which bones fracture easily, generally in the spine, but sometimes in the hip, in the late third trimester, which can cause pain and disability. Scientists don't fully understand what causes this type of osteoporosis, but the good news is that it's extremely rare and almost always absolves shortly after a woman gives birth.

Pregnant teens need to be especially careful to get enough calcium during pregnancy and nursing because unlike older women, teen moms are still building their own total bone mass. A baby in utero may compete with its young mother's need for calcium to build her own bones, which can compromise her bone health down the line.

Recommendation: Pregnant or nursing? It's critical to get enough calcium, vitamin D, and appropriate exercise to keep your bones healthy.

We weren't kidding about the lack of lady luck. As with pregnancy, breastfeeding can sometimes cause temporary bone loss. Studies show that women can lose 3 to 5% of their bone mass when nursing—though they recover it rapidly once they wean. It's thought that this bone loss may occur due to the developing baby's growing need for calcium, which is drawn from the mother's bones, particularly if she is not eating a healthy, balanced diet. As well, women may lose bone mass when nursing because they are not producing as much estrogen, a hormone that protects bones among a host of other functions.

Recommendation: All's well that ends well: bone lost during breastfeeding usually recovers within several months after breastfeeding ends! If you're breastfeeding exclusively, ask your child's pediatrician how much calcium and vitamin D you should be getting, and also, if it would be smart for you to give your baby supplemental vitamin D.  To live a happier and healthier life—don't miss these essential 70 Things You Should Never Do For Your Health.