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Risk factors for osteoporosis

Several risk factors can increase the likelihood of developing osteoporosis; these are generally categorised into non-modifiable and modifiable factors. Find out all about them below.
selection of unhealthy food
women exercising in park

Non-modifiable risk factors

Non-modifiable risk factors are areas that we have no control over:

  • Age: After reaching peak bone mass in our early 20s, bone loss gradually begins. The number of cells that build bone (osteoblasts) decrease, causing bone breakdown to exceed bone growth, leading to loss of bone mass. 
  • Sex: Women are at a higher risk of developing osteoporosis than men. This increased risk is largely due to hormonal differences. Oestrogen, a hormone that helps protect bone density, decreases significantly after menopause, leading to rapid bone loss.
  • Genetics: A family history of osteoporosis or fractures indicates a higher genetic predisposition to the condition. If your parent or sibling has osteoporosis, your likelihood increases.
  • Body frame size: Smaller-framed individuals are at higher risk as they tend to have a lower peak bone mass. Smaller bones are also more prone to fractures.
  • Ethnicity: Caucasian and Asian populations have a higher incidence of osteoporosis compared to African American and Hispanic populations. This difference is partly due to variations in bone density and structure among different ethnic groups1.
women exercising in park

Non-modifiable risk factors

Non-modifiable risk factors are areas that we have no control over:

  • Age: After reaching peak bone mass in our early 20s, bone loss gradually begins. The number of cells that build bone (osteoblasts) decrease, causing bone breakdown to exceed bone growth, leading to loss of bone mass. 
  • Sex: Women are at a higher risk of developing osteoporosis than men. This increased risk is largely due to hormonal differences. Oestrogen, a hormone that helps protect bone density, decreases significantly after menopause, leading to rapid bone loss.
  • Genetics: A family history of osteoporosis or fractures indicates a higher genetic predisposition to the condition. If your parent or sibling has osteoporosis, your likelihood increases.
  • Body frame size: Smaller-framed individuals are at higher risk as they tend to have a lower peak bone mass. Smaller bones are also more prone to fractures.
  • Ethnicity: Caucasian and Asian populations have a higher incidence of osteoporosis compared to African American and Hispanic populations. This difference is partly due to variations in bone density and structure among different ethnic groups1.

Modifiable risk factors

Modifiable risk factors are areas we can exert control over:

  • Diet: What we eat has a significant impact on bone health, particularly our intake of calcium and vitamin D. Magnesium, vitamin K and protein all play vital roles too2. 
  • Physical activity: Regular weight-bearing exercises, such as walking, jogging, and strength training, help build and maintain bone density. A sedentary lifestyle, on the other hand, will lead to bone loss3.
  • Alcohol intake: Excessive alcohol consumption can interfere with the body’s ability to absorb calcium to increase bone loss4. 
  • Smoking: Smoking affects metabolism of hormones, body weight, vitamin D levels, calcium absorption and blood circulation, greatly harming bone health5. 
  • Certain medications: Long-term use of certain medications, such as glucocorticoids (corticosteroids), can lead to bone loss6.
  • Some surgical procedures: Surgeries that reduce the size of the stomach or bypass part of the intestine can limit the absorption of nutrients, including calcium7. 
couple cycling through forest

Modifiable risk factors

Modifiable risk factors are areas we can exert control over:

  • Diet: What we eat has a significant impact on bone health, particularly our intake of calcium and vitamin D. Magnesium, vitamin K and protein all play vital roles too2. 
  • Physical activity: Regular weight-bearing exercises, such as walking, jogging, and strength training, help build and maintain bone density. A sedentary lifestyle, on the other hand, will lead to bone loss3.
  • Alcohol intake: Excessive alcohol consumption can interfere with the body’s ability to absorb calcium to increase bone loss4. 
  • Smoking: Smoking affects metabolism of hormones, body weight, vitamin D levels, calcium absorption and blood circulation, greatly harming bone health5. 
  • Certain medications: Long-term use of certain medications, such as glucocorticoids (corticosteroids), can lead to bone loss6.
  • Some surgical procedures: Surgeries that reduce the size of the stomach or bypass part of the intestine can limit the absorption of nutrients, including calcium7. 
couple cycling through forest
diabetic having blood taken

Other health conditions

Several medical conditions can increase the risk of developing osteoporosis. These conditions often affect bone metabolism, calcium absorption, or hormone levels, which are crucial for maintaining bone density. 

  • Endocrine disorders like diabetes, hyperthyroidism or overactive parathyroid glands can accelerate bone turnover, weakening bones. 
  • Gastrointestinal disorders like inflammatory bowel disease (IBD) or celiac disease can lead to inflammation or malabsorption of nutrients, affecting bone health. 
  • Rheumatoid arthritis causes chronic inflammation and requires the use of corticosteroids to manage symptoms, contributing to bone loss. 
  • Impaired kidney function such as in chronic kidney disease affects calcium and phosphorus balance, vitamin D metabolism, and parathyroid hormone levels, all of which are crucial for maintaining healthy bones.
  • Eating disorders such as anorexia nervosa or bulimia can lead to nutrient deficiencies, affecting bone health.
  • Hypogonadism, or low levels of sex hormones (oestrogen in women and testosterone in men), can lead to decreased bone density.
  • Some cancers and their treatments can increase the risk of osteoporosis. 
  • Physical disabilities lead to reduced mobility and therefore lack of weight-bearing activity, causing rapid bone loss.
diabetic having blood taken

Other health conditions

Several medical conditions can increase the risk of developing osteoporosis. These conditions often affect bone metabolism, calcium absorption, or hormone levels, which are crucial for maintaining bone density. 

  • Endocrine disorders like diabetes, hyperthyroidism or overactive parathyroid glands can accelerate bone turnover, weakening bones. 
  • Gastrointestinal disorders like inflammatory bowel disease (IBD) or celiac disease can lead to inflammation or malabsorption of nutrients, affecting bone health. 
  • Rheumatoid arthritis causes chronic inflammation and requires the use of corticosteroids to manage symptoms, contributing to bone loss. 
  • Impaired kidney function such as in chronic kidney disease affects calcium and phosphorus balance, vitamin D metabolism, and parathyroid hormone levels, all of which are crucial for maintaining healthy bones.
  • Eating disorders such as anorexia nervosa or bulimia can lead to nutrient deficiencies, affecting bone health.
  • Hypogonadism, or low levels of sex hormones (oestrogen in women and testosterone in men), can lead to decreased bone density.
  • Some cancers and their treatments can increase the risk of osteoporosis. 
  • Physical disabilities lead to reduced mobility and therefore lack of weight-bearing activity, causing rapid bone loss.

Understanding the risk factors for osteoporosis is essential for effective prevention, early detection, personalized treatment, and overall management of bone health. It helps healthcare providers and patients make informed decisions, ultimately leading to better outcomes and enhanced quality of life.

If you think you are at high risk of developing osteoporosis, we advise speaking to your GP. 

Understanding the risk factors for osteoporosis is essential for effective prevention, early detection, personalized treatment, and overall management of bone health. It helps healthcare providers and patients make informed decisions, ultimately leading to better outcomes and enhanced quality of life.

If you think you are at high risk of developing osteoporosis, we advise speaking to your GP. 

References

  1. med.libretexts.org/Courses/American_Public_University/APUS%3A_An_Introduction_to_Nutrition_(Byerley)/APUS%3A_An_Introduction_to_Nutrition_2e_(Byerley)/09%3A_Nutrients_and_Bone_Metabolism/9.07%3A_Risk_Factors_for_Osteoporosis
  2. www.ncbi.nlm.nih.gov/pmc/articles/PMC5804294/
  3. www.betterhealth.vic.gov.au/health/conditionsandtreatments/osteoporosis-and-exercise
  4. creakyjoints.org/diet-exercise/alcohol-and-osteoporosis/ 
  5. www.ncsct.co.uk/publications/smoking_and_bone_health 
  6. www.health.ny.gov/publications/1985/index.htm
  7. www.uhsussex.nhs.uk/wp-content/uploads/2023/02/Gastric-bypass-and-nutrition.pdf

References

  1. med.libretexts.org/Courses/American_Public_University/APUS%3A_An_Introduction_to_Nutrition_(Byerley)/APUS%3A_An_Introduction_to_Nutrition_2e_(Byerley)/09%3A_Nutrients_and_Bone_Metabolism/9.07%3A_Risk_Factors_for_Osteoporosis
  2. www.ncbi.nlm.nih.gov/pmc/articles/PMC5804294/
  3. www.betterhealth.vic.gov.au/health/conditionsandtreatments/osteoporosis-and-exercise
  4. creakyjoints.org/diet-exercise/alcohol-and-osteoporosis/ 
  5. www.ncsct.co.uk/publications/smoking_and_bone_health 
  6. www.health.ny.gov/publications/1985/index.htm
  7. www.uhsussex.nhs.uk/wp-content/uploads/2023/02/Gastric-bypass-and-nutrition.pdf
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