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story.lead_photo.caption Manav Nayyar, MD, Hospitalist

It's never too late to take care of your bones, especially when osteoporosis is a risk — which it likely for many women.

You can start right now to avoid getting this bone-weakening condition or help prevent it from getting worse.

About 8 million women in the U.S. and 200,000 women in Missouri have osteoporosis, which means "porous bone." It occurs when the body loses too much bone material, makes too little new bone or both. The bone's honeycomb-like structure becomes less dense, which means it can break more easily than healthy bone. This often happens unexpectedly because the disease has no outward symptoms. A fall or a simple bump can lead to a broken hip, backbone (spine), wrist or other bone.

Why are women at high risk?

Older women are most vulnerable to developing osteoporosis. Their estrogen levels, which help protect bone density, decline after menopause. That's why it's recommended that women 65 and older get bone mineral density tests to see if they already have the disease or are at risk of getting it. In particular, white and Asian women have the highest chance of developing the disease.

Other key factors include a family history of osteoporosis or broken bones after age 50, as well as the following:

- Having early menopause or ovaries removed before menopause.

- Not getting enough calcium or vitamin D — or both — throughout life.

- Not exercising or being on extended bed rest.

- Smoking.

- Taking medications — including medicines for arthritis and asthma or some cancer drugs — that may decrease bone density.

- Having a small body frame.

- Drinking excessive coffee (more than four cups per day).

- Drinking dark soda.

How to prevent osteoporosis or stop it from progressing

You can do a lot to help protect your bones:

- Eat a diet rich in calcium (1,000-1,200 mg per day) and vitamin D, and stay physically active with weight-bearing activities such as weight training, walking and climbing stairs.

- Stop smoking if you smoke and know the risks of alcohol. Both can reduce bone mass.

- Maintain a healthy weight. Being underweight can increase the risk of fracture and bone loss.

- Work with your doctor to assess your risk and options. Your doctor can offer treatment options for rebuilding bone or slowing bone loss. Also, discuss strategies for avoiding bone-loss side effects from drugs you may take for other conditions.

Do these things, and your bones will thank you.

Sources: National Institutes of Health; National Osteoporosis Foundation

Dr. Manav Nayyar, M.D. is an endocrinologist with Capital Region Physicians Internal Medicine clinic. He specializes in thyroid ultrasound and biopsy and treatment of hyperparathyroidism and osteoporosis.

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