If you think you’re at risk for fracturing a bone, you should know that the vast majority of “osteoporotic” fractures occur in individuals who have either “normal” bone mineral density (BMD) or those with BMD just somewhat lower than that of a young person.
So, if we can’t predict fracture using bone mineral density results, how can we tell who is likely to fracture? Researchers tried to unravel this confusing question by following postmenopausal women over the course of 5.6 years. They found that 73.1% of all fractures occurred in women without osteoporosis (including 56.5% in women with osteopenia and 16.6% in women with normal BMD).
While we know the most accurate fracture risk assessment focuses on multiple risk factors — including vitamin D deficiency, an acid-forming diet and low level of physical activity —
(1) Increasing age. Even though our bone density may be the same at 50 and 80, the architecture of the bone generally weakens as we age.
(2) Decreasing bone mineral density. It is one thing to have low bone mineral density and another to keep losing bone at an excessive rate.
(3) Prior fracture. Having experienced a low trauma fracture doubles your risk of a subsequent bone fracture.
I think having had a fracture is perhaps the greatest risk factor foretelling another break in the future. I see many women who have fractured a bone, perhaps stumbling on the sidewalk while walking their dog, or slipping on ice, or tripping on a rug. While these fractures are painful and inconvenient, after the body heals itself and the person generally goes on as before.
However, if you’ve experienced a fractured bone, I encourage you to rethink the concept of just “going on as before” without further investigation. Instead, seek comprehensive testing to detect any hidden causes of bone weakening and develop a comprehensive bone building program. Finally, everyone can learn more about their potential risk of fracture with my quick Fracture Risk and Bone Health Profile.
Reference:
Pasco, JA. et al. 2006. The population burden of fractures originates in women with osteopenia, not osteoporosis. Osteoporosis International 17:1404-1409.