Osteoporosis basically means porous bones and it is a condition where the bones become weak and brittle.

In such cases, the bones become so brittle that even a small stress on that bone or a fall can cause a break in it.

Most common sites of osteoporosis-related breaks are in the hip, wrist or spine.

About more than 50% of all osteoporotic hip fractures in the world are estimated to occur in Asia by 2050.

In India, there were around 5 crore osteoporosis and low bone mass until a decade ago while the yearly incidences of hip fracture rates were 163 and 121 per 100,000 year in women and men respectively.

What are the causes of Osteoporosis?

Bone formation is a constant process and while in a younger age, new bones are continuously made faster than the breakdown of old bone. This process slows in the 20s and 30s and the bone mass is lost faster than it was created.

Developing osteoporosis depends partly on bone mass attained in youth and on ethnicity. The more bone mass present in the youth, the less likely a person is to develop osteoporosis at older age.

What are the risk factors of osteoporosis?

Risk factors for osteoporosis are not in our control, including:

  • Sex: Women are at more risk to develop osteoporosis than men.
  • Age: Older age is a greater risk.
  • Race: White or of Asian descent are at highest risk
  • Family history
  • Body frame size: Small body frames have a higher risk
  • Hormone levels:
    • Low Sex hormones such as oestrogen tend to weaken bone.
    • In men, treatments for prostate cancer reduce testosterone levels and are likely to accelerate bone loss.
    • Thyroid problems
    • Other glands. Osteoporosis has also been associated with overactive parathyroid and adrenal glands.

Risk factors in our control are –

Dietary factors:

  • Vitamin D and calcium: Not enough vitamin D or calcium can weaken the bones. Ask the doctor if you require Vitamin D or calcium supplements.
  • Fruits and vegetables: Eating plenty of fruits and vegetables reduces risk of osteoporosis since it provides magnesium, potassium, and vitamin K; vitamins and minerals essential for bone health.
  • Protein: Sufficient protein is important for bone health. Consult the doctor about the amount of protein required each day. High amounts of non-diary animal protein can weaken the bones.
  • Caffeine: Excess can affect bone health.
  • Alcohol: Excess alcohol intake decreases bone formation. Additionally, in case if a person gets tipsy from the alcohol, the likelihood of a fall increases.
  • Activity level: Strong physical activity helps keeping the bones strong.
  • Smoking is bad for the bones.
  • Eating disorders severely restricting food intake and being underweight weakens bone in both men and women.
  • Steroids and other medicines: Long-term use of oral or injected corticosteroid medicines interferes with the bone-rebuilding process.

What are osteoporosis tests and how is it diagnosed?

Post taking a full medical history, the doctor may consider a physical exam, order a bone density test, and possibly other tests.

Doctor may consider the following during the exam:

  • Check if a woman has reached menopause, if ever broken a bone as an adult, family history, and habits such as drinking, eating, and exercise.
  • Ask about medications taken.
  • Inspecting the spine and measure to see if there is loss of height. An abnormally curved spine could indicate spinal fractures due to osteoporosis.
  • A bone density test measures the concentration of minerals in the bones of the hip, spine and sometimes forearm.

What are the treatment options in Osteoporosis?

Generally, medicines are prescribed to limit bone mass loss and maintain bone density and lower the risk of an osteoporotic fracture. These are bisphosphonate category of drugs. If the doctor does prescribe these drugs, patients should inform about all other medicines they are currently taking. Another option is Hormone replacement therapy (HRT) — either oestrogen alone or a combination of oestrogen and progestin to prevent and treat osteoporosis. However, this treatment is undertaken with caution and not at the preliminary stage as HRT may increase the risk of breast cancer, heart disease, and stroke in some women.

How can osteoporosis be prevented?

Certain things that raise the chances for osteoporosis can’t be changed such as, your genes, age, and sex. However, the disease may be preventable by doing things in everyday life to build strong bones. These things are:

    • Exercising

Muscles, like bones get stronger upon working out. Bones that force the body to work against gravity upon moving (Weight-bearing exercises) are best for the bones.

Weight-bearing exercises include:

      • Aerobics
      • Climbing stairs
      • Dancing
      • Jogging
      • Tennis and other racket sports
      • Running
      • Tai chi
      • Walking
      • Water aerobics
      • Yoga

Strength training may also preventing osteoporosis as it builds bone strength. Following workouts help build the muscle and bone:

    • Lifting canned goods or bags of groceries
    • Lifting free weights
    • Lifting young children
    • Using ankle and wrist weights
    • Using elastic resistance bands
    • Using weight machines or free weights
    • Doing pushups, squats, or other moves that use your own body weight
  • Calcium and Vitamin D

Recommended daily requirement of calcium in adults is around 1,000 to 1,200 mg per day. Without enough calcium the body takes it from the stores, which are the bones. Vitamin D helps your body absorb the calcium you eat and because of change in the occupations like indoor working for long time, people rarely get exposed to sunlight (source of Vitamin D) and result in deficiency states.

Sources of Calcium and Vitamin D:

Calcium :

  • Low-fat or fat-free dairy products
  • Calcium-fortified juices and foods, like cereal, soy milk, and tofu
  • Sardines and salmon with bones
  • Dark green vegetables, like kale and broccoli
  • Supplements

Vitamin D:

Not many foods naturally have the nutrient, but you can get it in:

  • Fatty fish, like salmon, mackerel, and tuna
  • Cheese, and egg yolks
  • Fortified foods like milk, cereal, and orange juice
  • Sometime whenever possible outdoors to get sunlight for Vitamin D absorption.

Other ways of prevention:

  • Avoid excessive alcohol.
  • Quit smoking.
  • Avoid the “female athlete triad” of thin bones, lack of a menstrual cycle, and eating disorders. Young women with excessive exercise and restrictive diets may be prone to osteoporosis.
  • Drink less soda.


  1. Neelam Kaushal, Divya Vohora, Rajinder K. Jalali, Sujeet Jha. Prevalence of osteoporosis and osteopenia in an apparently healthy Indian population – a cross-sectional retrospective study. Osteoporosis and Sarcopenia.2018; 4 (2): 53-60, ISSN 2405-5255.
  2. Osteoporosis Guide. WebMD. March 2024.
  3. Osteoporosis. Mayo Clinic. March 2024.

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