Your bones are your body’s support structure and frame. Bones are constantly remodeling themselves by absorbing old bone and replacing it with new bone. By your mid-30s, however, your body starts to lose more bone than it replaces. The result can be weaker bones.

Doctors call osteoporosis a “silent disease” because the condition often has no symptoms. The first sign a person has the condition is often a painful bone fracture.

Symptoms that could signal osteoporosis include progressive loss of height over time and a rounded upper back known as a dowager’s hump.

If you are at risk for osteoporosis or have experienced a bone fracture, a doctor may recommend a bone mineral density (BMD) test. A dual-energy X-ray absorptiometry (DEXA) scan is the most common BMD test. Similar to an X-ray, this painless test measures your bone density, especially at the hip and spine.

A DEXA scan can help determine how strong your bones are while letting your doctor monitor your bone density. This can confirm whether treatments are necessary and if so, whether or not they are working.

Risk factors you cannot control include:

  • having already experienced menopause
  • family history of osteoporosis
  • female gender, especially females of Caucasian or Asian origin
  • history of age-related height loss
  • history of broken bones
  • history of hormone-related medical conditions, such as hypothyroidism and Cushing’s disease
  • history of osteopenia
  • low body mass
  • age older than 50

Risk factors that are within your control include:

  • excess alcohol consumption
  • excess amounts of caffeine, protein and sodium in your diet
  • lack of calcium and vitamin D in your daily diet
  • lack of fruits and vegetables in your daily diet
  • lack of regular physical activity
  • long-term use of certain medications, including anticonvulsants and glucocorticoids
  • smoking/tobacco use

Osteoporosis prevention involves living a healthy lifestyle, including eating a bone-friendly diet, and exercising regularly.

Take steps to eat enough vitamin D and calcium. Both are bone-strengthening nutrients. According to the National Institutes of Health, male adults ages 19 to 70 and female adults ages 19 to 51 should consume at least 1,000 milligrams (mg) of calcium per day and 600 international units (IU) of vitamin D per day.

Women ages 51 and older should consume 1,200 mg of calcium per day. Calcium sources include low-fat cheese, milk and yogurt. Food manufacturers often add calcium and vitamin D to certain foods to enrich their nutritional values. Examples include orange juice, cereal, and bread.

Exercise stimulates bone tissue to grow stronger. This is only true for weight-bearing exercises. Examples include hiking, jogging, lifting weights and dancing. Exercises such as swimming and riding a bicycle may not be as effective. Falls cause a large percentage of osteoporosis-related injuries. Balance exercises such as tai chi can help prevent falls.

Refraining from smoking or drinking excessively can also prevent or at least delay osteoporosis. This means no more than one drink per day for women and one to two drinks per day for men.