Preventing osteoporosis

As the prevalence of osteoporosis increases, the medical community has recognized the importance of prevention. Although at one time the diagnosis of osteoporosis was made on the basis of bone fracture, the use of bone mineral density (BMD) techniques is becoming more widespread. Before using BMD to diagnose, many practitioners will assess the likelihood of osteoporosis development through assessment of risk factors. Certain risk factors cannot be changed, such as genetic predisposition, ethnicity, or gender. Those risk factors that are potentially modifiable include estrogen deficiency, current smoking, physical inactivity, alcoholism, and poor calcium intake. Why each of these factors are believed to increase risk is discussed, as well as recom-mendations for optimal behavior in each area. Several clinical practice guidelines for the prevention of osteoporosis are compared.