April 22, 2021
6 min. read

Is It Time for Your Preventative Bone Density Screening?


Osteoporosis is known for being a silent danger because there are generally no visible symptoms of low bone density. Without any tell-tale signs, bones can be gradually deteriorating. Many people think brittle bones are only a danger if you fall or have an accident. But with bones in a weakened condition, it doesn’t take a fall to cause a broken bone.

For someone with osteoporosis, something as simple as bending down to put on their shoes or a strong sneeze could be all it takes to break a bone. And many times these types of fractures can severely impact mobility. Thankfully, not only is there an easy bone density screening test, but loss of bone density can be prevented or slowed with lifestyle changes and medication.

What is bone density?

Bone density is the amount of bone mineral found within bones that gives them their strength. Loss of this mineral building block makes bones brittle and susceptible to fractures. Bone density is highest in young adults. Around the age of 40, bone density begins to be lost in small amounts. A person in their 40s can expect to lose 1% of their bone density each year. This is due to a number of factors, some preventable:

  • Age-related changes in hormone levels
  • Nutrition deficiencies
  • A sedentary lifestyle
  • Obesity

 bone density test

Why is it important to get a bone density test?

A bone density test is a simple, painless screening that uses a bed-type scanner to x-ray the bones. The exposure to the x-ray on a full body bone scan is safe and far less than that of other types of x-rays. Women are four times more likely than men to suffer from osteoporosis. However millions of men in the US still suffer from osteoporosis. Hip fractures are one of the most serious injuries associated with the disease, with over half of people with a hip injury never regaining their full mobility. Bone density test procedures are recommended for people in certain risk groups for osteoporosis. These include:

  • Women over 65
  • Men over 70
  • People over 50 with a history of bone fractures, arthritis, or history of low BMI
  • People who have lost over an inch of height
  • Long-term users of steroid medications

normal bone density

What is a normal bone density?

Bone density is measured by what’s known as a T-score. This score uses the baseline score of a healthy 30 year-old. Your bone density is compared to this ideal score.

The lower the T-score, the lower your bone density:

  • Score -1.0 or above: Normal
  • T-score between -1.0 to -2.5: Low bone density, also known as osteopenia
  • T-score -2.5 or less: Osteoporosis

Osteopenia and osteoporosis are not reversible, however they can be slowed down with the right medication and lifestyle changes. You may hear about a Z-score, which compares your density to that of other people of the same age, gender, and weight. A Z-score is considered less useful than the T-score.

What foods improve bone density? It’s relatively easy to get the calcium and supporting nutrients that help bones stay strong and dense. Even if your bone density test came back low, adding in foods that support bone health can give your body what it needs to stop further damage.

Here are some of the foods that can help:

  • Greens like kale, broccoli, cabbage
  • Citrus fruits such as grapefruit, oranges, even fortified orange juice
  • Fatty fish like salmon, trout, and sardines
  • Nuts and Nut Butter including almonds, walnuts, and pecans
  • Beans such as black beans, kidney beans, edamame, and pinto bean

Bone Density

Eight Natural Ways to Improve Bone Density

Weightlifting and strength training Exercising with free weights, resistance bands, or weight machines not only builds muscle, it also strengthens bones at the same time. That’s because these exercises put a controlled amount of stress on bones. This signals the body that your bones are active and new bone cells should be made. It’s a use-it or lose-it strategy that works just as well for weight-bearing aerobic exercise like jogging or cardio-heavy dance workouts.

Eating more vegetables It’s a common strategy for good health - eat your veggies. Thankfully it’s an inexpensive way to make a positive impact on your bones. Not all veggies are equal bone-builders however. Improve bone density by adding more dark green vegetables to your diet. These include Chinese cabbage, kale, and collard greens. Sweet potato is also a versatile veggie that can be included in multiple meals throughout the week. Not only does the spud contain calcium for bone density, but it also adds magnesium and potassium to your diet. Both of these nutrients help maintain calcium levels and prevent further bone loss.

It’s important to note that some veggies diminish calcium absorption. Although they’re packed with nutrients, foods with oxalates, like spinach, rhubarb, and beet greens won’t contribute much to your daily calcium intake.

Consuming calcium throughout the day Most multivitamins on the market contain the daily recommended value of calcium for the day. There’s also specific supplements just for calcium intake. But you don’t need to just rely on supplements. Many foods are also fortified with calcium. For instance, plant-based milks and orange juice both have added calcium.

patient provider

Eating foods rich in vitamins D and K Most people know calcium is good for bone density, but it’s easy to overlook the role both vitamin D and K play in the process. Vitamin K helps build stronger bones by being a binding link between calcium and other minerals important to bone strength. Vitamin D helps promote strong bones by binding calcium and other minerals together, which helps aid bone density.

Maintaining a healthy weight Osteoporosis is on the rise may in part because of the increased rates of obesity in the U.S. A lifestyle of inactivity and poor diet contributes to both bone density loss and being overweight. But it’s not just obesity that can be a risk factor to bone density loss. Underweight individuals are also at risk, particularly those with an eating disorder. In fact, some studies show a correlation between an unhealthy low body mass index in younger years and an increased risk for osteoporosis later in life.

Avoiding a low calorie diet According to the FDA the average man needs between 2400-3000 calories a day and the average woman should consume 1800-2400 calories daily. Studies have found that calorie-restrictive diets that encourage dieters to go well below these levels can cause an increase in bone marrow fat. This fat diplaces bone marrow, making bones less dense and weaker. Adding rigorous exercise onto a low calorie diet also negatively impacts bone density.

Eating more protein Protein is a key element to bone health. Most people think of meat and cheese when looking to add protein but there’s other options. Tofu is not only a good source of protein, it’s also rich in calcium. Aim for 40-60 grams of protein a day.

Eating foods rich in omega-3 fatty acids Omega-3s help boost the calcium levels in your bones. Since these fatty acids provide multiple benefits (everything from fighting arthritis and inflammation to helping prevent cancer) they’re worth adding to your diet. Cold-water fatty fish like salmon, flaxseed, soybean oil and eggs all offer abundant amounts of omega-3s.

bone density medications

Medications to help with bone density

Medications for osteoporosis treatment and prevention

Oral Bisphosphonate:

  • Alendronate (Fosamax)
  • Risedronate (Actonel)
  • Ibandronate (Boniva)

Injectable Bisphosphonate:

  • Ibandronate (Boniva Injection)
  • Zoledronic Acid (Reclast)

Estrogen Agonist/Antagonist containing products

  • Raloxifene (Evista)
  • Conjugated Estrogens/Bazedoxifene (Duavee)

Parathyroid Hormone 1-34

  • Teriparatide (Forteo)
  • Abaloparatide (Tymlos)

RANKL Inhibitor

  • Denosumab (Prolia)

Lifestyle measures:

  • Weight bearing exercises
  • Muscle strengthening exercises
  • Calcium and Vitamin D supplementations

References: Bone Density Test & Exam Optimizing Dietary Protein for Lifelong Bone Health Exercising While Restricting Calories Could be Bad for Bone Health Simple Steps to Strengthen Your Bones Food and Your Bones Bone Densitometry Understanding Bone Density Results Strength Training Builds More than Muscle

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