Bone Health Part 8: Are You at Risk for Osteoporosis?

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Osteoporosis is a condition characterized by low bone mass and poor bone structure that in combination lead to an increased risk of fractures. Do you know your osteoporosis risk factors?

In this article we’ll cover osteoporosis risk factors, how to prevent loss of bone density, fractures and more.

What Are the Osteoporosis Risk Factors?

Osteoporosis risk factors are early warning signs that you may be at risk of developing this potentially debilitating condition. A risk factor is anything that may increase your chance of developing a disease – your gender, age, family history, medical history, or lifestyle choices.

While these factors can increase your risk, they do not necessarily cause the disease. Some people with risk factors never develop the disease, while others do despite having no known risk factors.

  • Gender

  • Age

  • Family history

  • Medical history

  • Lifestyle choices

  • Read more on osteoporosis risk factors

Falling Woman by Aristide Maillol at the Getty Museum, CA

Common Osteoporosis Fracture Risk

The consequences of osteoporosis are bone fractures. The most common osteoporotic fractures occur in the vertebrae of the spine (40% of fractures), the hip (25%), and the wrist (15%). The most debilitating fracture occurs at the hip, usually requiring surgery, and often affecting your ability to walk and live independently.

  • 40% spinal fractures

  • 25% hip fractures

  • 15% wrist fractures

Hip Fracture Risk Factors

Hip fractures are breaks in the thighbone (femur) just below the hip joint. A hip fracture can be life-altering, limiting mobility and independence. Awareness of your risk can help guide you into appropriate preventative actions and routine monitoring.

A woman’s risk of breaking a hip due to osteoporosis is equal to her combined risk of breast, ovarian, and uterine cancer.

There are primary and secondary risk factors for a hip fracture. Primary risk factors are those you cannot change. Secondary risk factors may be modifiable. So we’ll cover both of these.

Primary Risk Factors

  • Being female at advanced age

  • Being Caucasian, Asian, or Latino

  • A family history of osteoporosis

  • Being thin or having a small frame

How Does Age Affect Osteoporosis?

Osteoporosis can occur at any age, but is most prevalent past the age of 50, and is therefore considered an age-related disease.

Osteoporosis is more common in women than in men.

Why Are Women More Susceptible to Osteoporosis?

Women have smaller frames and lighter, thinner bones than men. They are vulnerable to estrogen-related bone loss following menopause and live longer than men, which gives them more years to develop the disease.

Not every older person develops osteoporosis, but it does become more common with age. About half of women in their 80s have it.

What Percentage of Population has Osteoporosis?

While osteoporosis affects all races and ethnicities, it is more prevalent in Caucasians, Asians, and Latinos compared to African Americans. Racial differences may be attributed to differences in bone size, muscle mass, or dietary calcium.

Do you know which race is most likely to get osteoporosis? And which ethnicity is least likely to suffer from bone loss?

Osteoporosis Risk by Race (listed alphabetically):

  • African Americans 4.2%

  • Asians 20%

  • Caucasians 20%

  • Latinos 10%

Family History Osteoporosis

Do you have a family history of osteoporosis, particularly with related fractures in a parent or sibling?

Heredity – gender, race, and genetics – can affect as much as 80% of your ability to build bone. Because of this inherited ability to make bone, some families may develop a lower peak bone mass (PBM) than average. This means you have less bone to draw upon as you age. If either of your parents or fist-degree siblings had osteoporosis or a history of broken bones, you are more likely to get it too.

Do You Have a Small, Thin Frame?

Low body weight and being small and thin increase your risk because you have less bone mass to draw from as you age. Also, after menopause, most estrogen is made in the body’s fat stores; with less body fat you create less estrogen to help keep the bones healthy. Finally, if you fall you have less padding to cushion the tumble.

Secondary Osteoporosis Risk Factors

Non-modifiable Risk Factors

These include conditions that may impair your judgment and sensory function, leading to confusion.

  • Frail or in poor health

  • Suffering from dementia

Modifiable Risk Factors

Modifiable factors that affect bone health include a healthy diet (namely, calcium and vitamin D), physical activity, and reproductive hormone levels. Of course, avoiding harmful habits like smoking and alcohol abuse that can damage bone cells and reduce bone formation.

  • Diet –

    • low in calcium

    • vitamin D

  • Inactive lifestyle

  • Smoking

  • Alcohol abuse

  • Low sex hormones –

    • estrogen (women, including amenorrhea and menopause)

    • testosterone (for men)

Other Osteoporosis Risk Factors

  • Diseases and conditions that interfere with the absorption of calcium, such as:

    • Crohn’s disease

    • Celiac disease

    • Low levels of vitamin D

    • Bulimia (history)

  • Long term use of steroids and other drugs, to treat:

    • Rheumatoid arthritis

    • Epilepsy

    • Thyroid deficiency

    • Bipolar disorder

    • Cancer

FRAX Calculator: The Fracture Risk Assessment Tool

The FRAX Calculator is a scientific method used to estimate your chance of breaking a hip over the next ten years. It is based on the number of individual risk factors in combination with the bone mineral density (BMD) at the femoral neck of the hip bone (the upper region of the femur).

The FRAX tool can be used to guide treatment decisions in people who meet the following three conditions:

  • Postmenopausal women or men age 50 and older

  • People with low bone density (osteopenia)

  • People who have not taken an osteoporosis medicine

An osteoporosis screening includes your risk factor profile as well as your bone density test.

Disclaimer: The information presented in this article should not be construed as medical advice. It is not intended to replace consultation with your physician or healthcare provider.


  • Joan Pagano

    Joan Pagano has specialized in strength training for women since 1988 – training, teaching, and writing books on the subject, including Strength Training Exercises for Women (DK, 2014). When the health benefits of strength training started making headlines in the 1990s, and in particular how weight training could protect the bones and prevent osteoporosis, it was a natural segue for her. At that time, Joan was developing and delivering fitness training guidelines for osteoporosis to national audiences of exercise professionals. Currently Joan is recognized by the industry as a leading authority on exercise program design for osteoporosis. She is certified as an Exercise Physiologist by the American College of Sports Medicine (ACSM) and is on the Ambassadors Leadership Council for the National Osteoporosis Foundation. Visit Joan at:

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