Cardiovascular disease is the leading cause of death among American women. Nevertheless, osteoporosis is the disease they are most likely to develop as they age. Forty percent of white women in the U.S. will suffer a broken bone due to osteoporosis.

Osteoporosis is a gradual decrease in bone mass and density. Bone mass should be at its peak in our late 20s or early 30s, but thanks to a poor diet and lack of exercise, many women are already losing bone in their 20s. Bone loss occurs more rapidly in women than in men, especially right around the time of menopause.

Bones are living tissue and they need a good supply of nutrients and regular exercise. New bone is constantly being made, while old bone is being removed and excreted by the body. Large bones are very dense, and they are completely replaced about every 10-12 years. Smaller bones, such as our spine and the ends of our long bones, are less dense and turn over every 2-3 years.

We all hear about how having enough calcium in the diet and taking estrogen can help prevent osteoporosis, but there is a much bigger nutritional and lifestyle picture to look at when we are talking about preventing this bone-robbing disease. For the vast majority of women, there is no need to take estrogen to prevent osteoporosis.

The most important element of bones is minerals. Without minerals, we don't have bones. The most important bone minerals are calcium, magnesium, potassium, phosphorous and fluoride. Equally important is the balance between the minerals. Vitamins are also involved. For example, vitamin B6 works with magnesium to get calcium onto the bones.

Hormones are actively involved in the making and unmaking of bone. Testosterone and progesterone build bone, while estrogen appears to indirectly slow bone loss.

In osteoporosis, the old bone is being lost faster than new bone is being made. The integrity and strength of our bones is related to bone mass and density. A progressive loss of bone mass may continue until the skeleton is no longer strong enough to support itself.  When that happens, bones can spontaneously fracture. As bones become more fragile, falls or bumps that would not have hurt us before, can cause a fracture. Bone loss seems to be most severe in the spine, wrists and hips.

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