Osteoporosis primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Raviteja Guddeti, M.B.B.S.[3]

Overview

Changes in lifestyle and calcium supplementation are the best early and long-term measures for the prevention of osteoporosis. There are also medications available that can be used to prevent worsening of osteoporosis. Pharmacologic treatment can stabilize bone mineral density, prevent further bone loss, and reduce the risk of fractures, however it is unlikely to restore bone quality and strength. The prevention of osteoporosis is particularly important because the microarchitechtural changes that occur in osteoporosis are largely irreversible.

Primary prevention

Lifestyle

Lifestyle prevention of osteoporosis is in many aspects inversions from potentially modifiable risk factors.

• Exercise - achieving a higher peak bone mass through exercise and proper nutrition during adolescence is important for the prevention of osteoporosis. Exercise and nutrition throughout the rest of the life delays bone degeneration.
• Nutrition - a proper nutrition is a diet sufficient in calcium and vitamin D. Patients at risk for osteoporosis (e.g. steroiduse) are generally treated with vitamin D and calcium supplements. In renal disease, more active forms of Vitamin D such as paracalcitol or (1,25-dihydroxycholecalciferol or calcitriol which is the main biologically active form of vitamin D) is used, as the kidney cannot adequately generate calcitriol from calcidiol (25-hydroxycholecalciferol) which is the storage form of vitamin D.
• Quiting tobacco smoking
• Drinking alcohol in moderation