Osteoporosis and Fracture Risk Factors
 

Risk factors for osteoporosis and osteopenia as measured with bone scan are not the same as risk factors for bone fracture.  This is confusing, I know.  An example: elderly women and men with high intake of foods with vitamin K (found mostly in dark leafy green vegetables) had much lower fracture risk, but not much better bone density.  Again, we're dealing with the issue of bone strength and bone structure vs. bone mass.  On this page, I'm giving you a couple of different assessment systems for risk of osteoporosis and/or fracture.  You can see they overlap, but differ.

Most Common Risk Factors For Both Fracture And Osteoporosis:

1. personal history of fracture with low trauma
2. mother had bone fracture before age 80
3. poor general health

Risk Factors For Osteoporosis:
(not the same as fracture risk, although they overlap): Miriam Nelson, Strong Women, Strong Bones

Medical history:

• family history of osteoporosis

• previous bone fracture

• race (Caucasian and Asian have 30% greater risk)

• began menstruation after 15 or ended periods before 45

• ovary removal

• ammenorrhea during menstruating years

• small bone structure

• low estrogen

• frailty from aging or illness

• being a woman

Illnesses:

• rheumatoid arthritis (increases osteoclast activity)

• hyperthyroidism or overmedicated hypothyroidism (increases osteoclast activity)

• parathyroid disorder (excess increases osteoclast activity)

• poorly controlled diabetes

• lactose intolerance

• chronic digestive problems (poor mineral absorption).

Medications:

• steroids

• excessive thyroid hormone

• anti-convulsants

• diuretics

• aluminum containing antacids (Rolaids, Maalox, Mylanta, Di-Gel, Gelusil)

• birth control pills (decreases estrogen)

Life style:

• sedentary

• poor nutritional status

• low Ca and Vitamin D

• low fruit and vegetable intake

• more than 7 alcoholic drinks/wk

• more than 4 small cups of coffee/day, 10 cups tea, or 400 ml caffeine from soda (over 400 ml a day doubles risk of osteoporosis—diuretic, increases urinary excretion)

• current or former smoker (decreases estrogen levels)

• history of dieting or eating disorders (rapid weight loss releases excessive parathyroid hormone which leads to bone breakdown, plus poor nutritional support)

Risk Factors For Fracture (not low bone mineral density):

Cummings, Steven, et al., “Risk Factors for Hip Fracture in White Women,” The New England Journal of Medicine 332.12 (1995): 767-774 (Brown p. 213):

1.     Current use of anti-convulsant drugs
2.     Inability to rise from chair without using arms
3.     History of maternal hip fracture (before age 80)
4.     Previous hyperthyroidism
5.     Current use of tranquilizers and mood altering drugs
6.     Resting pulse over 80 beats per minute
7.     Poor overall self-rated health
8.     Stand less than 4 hours a day
9.     Advancing age
10.  Fracture since age 50
11.  Weigh less than you did at 25
12.  Current caffeine intake over 300 mg/day (15-20 ounces of coffee--caffeine is diuretic and causes calcium loss)
13.  Poor distant depth perception (severe vision impairment)
14.  Low-frequency contrast sensitivity (impaired vision)
15.  Shorter than at age 25
16.  Lack of exercise
17.  Low bone density

In this study, other risk factors were smoking, current thyroid medication, having fallen in previous year, poor neuromuscular function, low body weight, poor functional-status score

Risk Factors for Osteoporosis and Fracture:

Susan Brown, Better Bones, Better Body (p. 232)

1.     Nutrition: acid/alkaline imbalance, history of dieting, nutritional deficiencies, caffeine, low calcium, low Vitamin D, very high protein, junk food, underweight, sugar, poor quality fats

2.     Medical factors: hysterectomy, ovary removal, irregular periods, early menopause, endocrine imbalance, tubal ligation, oral contraceptives or injectable contraceptive depo medroxy-progesterone, corticosteroids, aluminum containing antacids, diuretics, excess thyroid hormone, excess use of antibiotics causing poor intestinal functioning, anti-convulsants, weak adrenal glands, use of sedative or anti-depressive drugs that increase risk of falling

3.     Lifestyle: inactivity, stress, tobacco

© 2004 Elaine Mansfield