How to reduce your risk of osteopenia and osteoporosis.

Your Lifestyle Can Influence Your Risk of Osteopenia and Osteoporosis

Bone loss is often associated with aging, but lifestyle habits, nutrition, medical conditions, and certain medications can all affect bone health throughout life.

Reduced bone density increases the risk of osteopenia and osteoporosis, conditions that can weaken bones and increase the likelihood of fractures.

To better understand the risks, prevention strategies, and treatment options, I spoke with Peter Gerbino MD, an orthopedic surgeon specializing in sports medicine.

Q&A with Peter Gerbino, MD

Q1. Based on your experience, how prevalent are osteopenia and osteoporosis?

PG: Decreased bone mineral density is a major problem in the US. Osteopenia is below normal bone density. Osteoporosis is severe osteopenia >2.5 S.D. below normal. As all of us age, we take in less calcium and get less vitamin D and exercise. In addition, women get a major drop in estrogen production after menopause which causes more bone loss.

Unless one is actively doing things to prevent bone loss, it can be assumed that there will be decreased bone density in that person. 1/3 of women and 1/5 of men over age 50 have osteoporosis; many more have osteopenia.

Q2. Who is at greatest risk for bone loss? Are you seeing more cases in younger people due to lifestyle factors?

PG: The elderly are at greatest risk. They take in less calcium and vitamin D, are furthest from menopause, are most sedentary and are most likely to have other medical problems that could limit bone health. Young people can certainly have poor bone strength depending on lifestyle and diet.

Q3. Do you recommend routine bone density screenings at a certain age or for specific risk factors?

PG: All women after menopause need regular DEXA bone density screening. Anyone with a fragility fracture (caused by a minimal trauma) should be scanned. Anyone with bone pain or a stress fracture that doesn’t have a simple explanation should be scanned.

Q4. Is bone loss more commonly associated with medications prescribed to treat certain conditions, or the conditions themselves?

PG: There are certain drugs that accelerate bone loss. Most common is chronic use of oral corticosteroids like prednisone. These drugs are used in a variety of conditions like rheumatoid arthritis and autoimmune disorders.

Q5. Some research suggests there may be a relationship between bone health and blood glucose control. What are your thoughts?

PG: Right now, that concept is a theory. Studies like the Mayo study, are trying to understand the relationship. Many with Type II diabetes are obese and the extra weight actually stresses the bones to become stronger.

Q6. When someone is diagnosed with osteopenia or osteoporosis, what does treatment typically involve?

PG: Treatment depends upon the reason(s) for the decreased bone density. In a young person, we ensure that calcium and vitamin D levels are adequate. We prescribe exercises to increase muscle strength and modify training schedules. In the elderly, we add bone building drugs like bisphosphonates and PTH.

There is a movement underway initiated by the American Academy of Orthopedic Surgeons to “Own the Bone” and care for these patients. Protocols are being developed to select the right lab tests, imaging studies and treatment regimes including lifestyle modifications. Most lifestyle changes involve increasing weight bearing activities [walking, jogging, hiking, tennis and dancing] and strengthening muscles.

Q7. Are there other areas of research that you find particularly interesting?

PG: Many studies are underway trying to understand the relationships between certain drugs, diseases and activities with bone density. Beta blockers and diabetes are studied because both are very common in present members of society. Calcium channel blockers, another common blood pressure medicine, have been shown to decrease bone mineral density compared to beta blockers.

Key Takeaway

While aging is a significant risk factor for bone loss, lifestyle choices can play an important role in maintaining bone health. Regular weight-bearing exercise, strength training, adequate calcium and vitamin D intake, and appropriate screening can help identify concerns early and reduce the risk of fractures later in life.

Movement and Bone Health

Many forms of exercise can help support bone health, including walking, hiking, dancing, resistance training, and Pilates. While Pilates is not a substitute for medical care, it can be an effective way to improve strength, balance, posture, mobility, and body awareness. If you have been diagnosed with osteopenia or osteoporosis, consult your healthcare provider about the most appropriate exercise program for your individual needs.

Learn More

For additional insights from Dr. Gerbino, read:

Does Eliminating Dairy From Your Diet Improve Your Health?

This interview reflects the opinions and clinical experience of Peter Gerbino, MD. It is intended for educational purposes and should not replace personalized medical advice from your healthcare provider.

Updated: June 23, 2026