Bone Fractures

Bone Density

Bone mineral density screening is a billion-dollar industry, so it shouldn’t be that surprising that it is the focus of osteoporosis and treatment. Literally meaning porous bone, osteoporosis is characterized by reduced bone formation, excessive bone loss, or a combination of both, which leads to bone fragility and contributes to millions of fractures a year. Overall, the disease is estimated to affect 200 million people worldwide.

But, among women 65 and older, only 15 percent of low trauma fractures (meaning from a fall from no more than standing height) are due to osteoporosis. Between the ages of 60 and 80, hip fracture risk increases thirteenfold in men and women, whereas the age-related decline in bone mineral density accounted only for a twofold increased risk. So, 85 percent of the age-related rise in hip fracture risk has nothing to do with the measured density of your bones.

Fall Prevention

The primary cause of fractures—including vertebral fractures—are falls. The disparity between men and women in hip fracture rates seems primarily not because men have stronger bones but because women fall more often. Even a weak osteoporotic bone is strong enough to survive normal life activities without the excessive loading that comes from the impact of a fall or, in the case of the spine, bending with your back rather than your knees to lift something.

A number of associations have been made between increased fracture rates or weaker bones and intake of stomach acid–blocking “proton pump inhibitor” (PPI) drugs (with brand names like Prilosec, Prevacid, and Nexium), cigarette smoking, heavy cannabis use, and calcium supplementation, and consuming dairy milk products. However, the single most important thing we can do to prevent osteoporotic fractures is prevent injurious falls. And, based on dozens of randomized controlled trials, exercise is the single intervention most strongly associated with a reduction in falls rate. A recent meta-analysis found that exercise interventions—ones mostly using a combination of resistance exercise to improve lower limb muscle strength training and balance training—cut fracture rates nearly in half.

For substantiation of any statements of fact from the peer-reviewed medical literature, please see the associated videos below.

Image Credit: Manuel González Reyes / Pixabay. This image has been modified.