Osteoporosis is a condition where the bones become thinner and weaker. Many factors, such as age, sex, and family history, can increase a person’s risk of developing osteoporosis.

Osteoporosis is a bone disease that causes a loss of bone density and strength. The body naturally removes old bone and replaces it with new bone. However, when osteoporosis develops, bone loss occurs at a faster rate than new bone growth. This results in the bones becoming weaker, which can increase the likelihood of a fracture.

Various factors can put a person at an increased risk of developing osteoporosis. Risk factors for osteoporosis can be both controllable and uncontrollable.

Read on to learn more about the potential causes and risk factors for osteoporosis, including age, hormonal changes, and diet.

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Most health data that refers to sex categorize individuals by their gender and sex assigned at birth.

Sex is a risk factor for osteoporosis. Evidence suggests that females develop osteoporosis more often than males. This may occur in part because females tend to have less bone mass and smaller, thinner bones than males.

Males can still develop osteoporosis. In fact, about 1 in 4 males over the of age 50 years will sustain a fracture due to osteoporosis. But in females, the rate is higher. About 1 in 2 females aged 50 years and older will break a bone due to osteoporosis.

Most people who develop osteoporosis are over the age of 50 years. This occurs due to a change in how fast new bone development occurs.

In a process called bone remodeling, the body replaces old, damaged bone with new bone. As a person ages, the new bone formation cannot keep up with the bone loss. This leads to a decrease in bone mass.

This causes the bones to become thinner and weaker, which increases the risk of a broken bone. The older a person gets, the more likely they are to develop osteoporosis. About 75% of broken bones due to osteoporosis occur in people aged 65 years and older.

A person’s body size also may increase their risk. People who have small, thin bodies typically have smaller bones. They start with less bone mass compared with individuals who have larger bones.

White, Asian, and Hispanic adults have a higher risk of osteoporosis than those of other races. According to the Centers for Disease Control and Prevention (CDC), in the United States, during 2017–2018, the prevalence of osteoporosis in adults aged 50 years and over was as follows:

  • Non-Hispanic Asian adults: 18.4%
  • Hispanic adults: 14.7%
  • Non-Hispanic White adults: 12.9%
  • Non-Hispanic Black adults: 6.8%

Anyone can develop osteoporosis. But some people may have a genetic predisposition to osteoporosis. This means they may have a higher risk of developing the condition than someone else with the same other risks.

According to the American Academy of Orthopaedic Surgeons (AAOS), a person’s chance of developing osteoporosis increases if they have a family history of the condition. Evidence also suggests that having a family history on the maternal side further increases the risk.

Certain sex hormones help in the process of remodeling and building bones. Hormonal changes, such as those that occur in menopause, also play a role in osteoporosis. After menopause, estrogen levels drop.

Estrogen helps promote bone density. So as estrogen decreases, increased bone loss may occur. In the first 10 years after menopause, females may lose up to 25% of their bone mass.

For males, testosterone also affects bone remodeling. But the loss of testosterone occurs more slowly than in females, as does the bone loss.

Not getting enough calcium or vitamin D in the diet can increase the risk of osteoporosis. Eating a diet high in processed foods may also increase the risk of bone loss.

A 2020 review notes that people consuming a diet high in processed foods, such as processed meats and refined grains, have lower bone mineral density than people who eat less processed foods. The review also indicates that a high fat diet derived from refined carbohydrates can interfere with calcium absorption.

Having certain medical conditions may also affect a person’s risk of developing osteoporosis. Certain conditions may weaken the bones. In other cases, the medications or treatment for the condition may affect the bones.

For example, having an eating disorder can weaken the bones. Other conditions that may increase the risk include:

Taking certain medications may increase the risk of osteoporosis. Some medications may have side effects that affect the strength of the bones. The risk of developing osteoporosis may depend on how long a person takes the medications and the dosage.

Medications that may increase the risk of osteoporosis include:

  • corticosteroids
  • drugs to treat breast and prostate cancer
  • diuretics
  • heparin
  • thyroid medications, if taken in large doses
  • antiseizure medications
  • antacids that contain aluminum

Certain lifestyle factors may also contribute to osteoporosis, such as the following:

  • Being sedentary may increase the rate of bone loss.
  • Smoking may increase the risk of bone fractures.
  • Drinking excessive amounts of alcohol also increases the risk of osteoporosis.

Osteoporosis involves a decrease in bone density. It develops when bone loss occurs faster than the body can make new bone. Due to the weakening of the bones, an individual is at a higher risk of a fracture.

Risk factors for developing osteoporosis include uncontrollable risks, such as age, race, and family history. Controllable risk factors for osteoporosis include diet, exercise level, and smoking. Changing controllable risk factors, such as not smoking and getting enough exercise, can help modify a person’s risk.