Falls can be especially serious for people with weak bones. You can make small changes to lower your risk of falling, like doing exercises that improve your balance.

For example, tai chi is a mind-body exercise that improves balance. Learn more about preventing falls. This information on back pain prevention was adapted from materials from the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Reviewed by: Trish Reynolds National Institute of Arthritis and Musculoskeletal and Skin Diseases Science Communications and Outreach Branch National Institutes of Health.

Linking to a non-federal website does not constitute an endorsement by ODPHP or any of its employees of the sponsors or the information and products presented on the website.

Department of Health and Human Services Office of Disease Prevention and Health Promotion. MyHealthfinder Doctor Visits Screening Tests Get a Bone Density Test. Doctor Visits Get a Bone Density Test. The Basics Take Action. The Basics Overview A bone density test measures how strong your bones are.

What is osteoporosis? What happens during a bone density test? Am I at Risk? Am I at risk for osteoporosis? Treatment Options What if I have osteoporosis?

Depending on the results of your bone density test, you may need to: Add more calcium and vitamin D to your diet Get more physical activity Take medicine to slow down bone loss and lower your chances of breaking a bone Learn about medicines for osteoporosis. Take Action. Take Action Get Tested Take these steps to protect your bone health.

Schedule a bone density test if your doctor recommends it. What about cost? Under the Affordable Care Act, insurance plans must cover s creening for osteoporosis for: Women age 65 and older Women age 64 and younger who have gone through menopause who are at increased risk for osteoporosis Depending on your insurance plan, you may be able to get screened at no cost to you.

To learn more, check out these resources: Free preventive care for adults covered by the Affordable Care Act How the Affordable Care Act protects you Understanding your health insurance and how to use it [PDF - KB].

Calcium and Vitamin D You need both calcium and vitamin D for strong bones. Get enough calcium. Get enough vitamin D. Vitamin D helps your body take in calcium. You can also get vitamin D from: Fish like s almon , tuna , and trout Milk with added vitamin D Some b reakfast cereals , yogurt, and juices with added vitamin D Vitamin D pills Find out how much vitamin D you need each day.

Get Active Get active. Try these tips to get active: Aim for at least minutes of moderate-intensity aerobic activity a week — remember, a nything that gets your heart beating faster counts! Do muscle-strengthening activities at least 2 days a week Team up with a friend or join a fitness class — getting active with others can help you stick with it Learn more about getting active.

Find activities that work for you. For more tips on staying active, check out these resources: Learn how to stay active as you get older Get ideas for staying motivated to be active Find more physical activity tips for older adults [PDF - 1.

Healthy Habits Stay away from cigarettes and alcohol. Smoking cigarettes and drinking too much alcohol can weaken your bones. If you smoke, make a plan to quit If you choose to drink, drink alcohol only in moderation — that means 1 drink or less in a day for women and 2 drinks or less in a day for men Take steps to prevent falls.

The Basics. Reviewer Information This information on back pain prevention was adapted from materials from the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

August You may also be interested in: Lower Your Risk of Falling Calcium: Shopping List Preventing Falls: Conversation Starters.

The Office of Disease Prevention and Health Promotion ODPHP cannot attest to the accuracy of a non-federal website. You will be subject to the destination website's privacy policy when you follow the link.

A low T score means you probably have some bone loss. If your results show you have low bone density, your health care provider will recommend steps to prevent further bone loss.

These may include:. Learn more about laboratory tests, reference ranges, and understanding results. A DEXA scan is the most common way to measure bone density. But your health care provider may order more tests to confirm a diagnosis or to find out if bone loss treatment is working.

The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health. Bone Density Scan.

What is a bone density scan? What is it used for? A bone density scan is used to: Diagnose osteopenia low bone mass Diagnose osteoporosis Predict risk of future fractures See if treatment for osteoporosis is working. Why do I need a bone density scan? You may also be at risk for low bone density if you: Have a very low body weight Have had one or more fractures after the age of 50 Have lost a half inch or more in height within one year Are a man over the age of 70 Have a family history of osteoporosis Other risk factors include: Lack of physical activity Smoking cigarettes Heavy drinking Not getting enough calcium and vitamin D in your diet.

What happens during a bone density scan? During a DEXA scan: You will lie on your back on a padded table. You will probably be able to leave your clothes on. You may need to lie with your legs straight, or you may be asked to rest your legs on a padded platform. A scanning machine will pass over your lower spine and hip.

At the same time, another scanning machine called a photon generator will pass beneath you. The images from the two machines will be combined and sent to a computer. A health care provider will view the images on the computer screen. While the machines are scanning, you will need to stay very still.

You may be asked to hold your breath. Will I need to do anything to prepare for the test? Are there any risks to the test? What do the results mean? Your results may show one of the following: A T score of This is considered normal bone density.

A T score between This means you have low bone density osteopenia and may be at risk for developing osteoporosis.

A T score of This means you probably have osteoporosis. These may include: Getting more exercise, with activities such walking, dancing, and using weight machines. Is there anything else I need to know about a bone density scan? References Kaiser Permanente [Internet].

Kaiser Foundation Health Plan Inc; c Bone Density: How It is Done; [cited Aug 24]; [about 6 screens]. hw hw Kaiser Permanente [Internet]. Bone Density: Results; [cited Aug 24]; [about 9 screens]. Bone Density: Risks; [cited Aug 24]; [about 8 screens]. Bone Density: Test Overview; [cited Aug 24]; [about 3 screens].

Bone Density: Why It Is Done; [cited Aug 24]; [about 4 screens]. hw hw Lab Tests Online [Internet].

You do not need to undress, but you must not have buttons or zippers in the area over your spine and hips. The test is non-invasive and painless; no needles or instruments are placed through the skin or body.

There is very little radiation — far less than what you would get on a cross-country airplane flight. You simply lie on a DXA table and follow the instructions of the technologist to see that you are correctly positioned. Then a movable arm passes above you to scan your bones. Although this is very easy for you, the technology of the scan and computer system is actually very sophisticated.

It requires highly trained staff to do the test properly and a qualified person to interpret it correctly. A good way to check on the qualifications of the person doing the DXA test is to ask whether they are certified by an organization such as the International Society for Clinical Densitometry ISCD.

There are 3 ways that osteoporosis can be diagnosed. For each of these, confirmation of the diagnosis requires an evaluation to be sure there is no other disease or condition that appears to be osteoporosis but is not. DXA can be used to evaluate your bone health in ways that go beyond measuring bone density.

Here are some of the other applications of DXA. These tests are available at some but not all DXA facilities. Many tests other than DXA can be used to assess your bone health. Some of them are not as widely used as DXA, but they may provide useful information beyond bone density, or help to determine who needs a DXA.

QCT provides a 3-dimensional measurement of bone density and can generate numbers that can be used to diagnose osteoporosis and for input with FRAX. Most types of QCT tests provide the same type of T-scores for bone mineral density at the hip as does DXA, but at the spine can provide a measurement of bone mineral density of just the spongy bone inside your vertebra.

This type of spinal measurement may be preferred if your spinal bones have degenerative disease. QCT is not as widely used as DXA due to limited availability, higher radiation dose, and being less practical to monitor treatment for most patients.

BCT is an advanced technology that uses data from a CT scan to measure bone mineral density. BCT also uses engineering analysis finite element analysis or FEA to estimate bone strength or measure the breaking strength of bone.

REMS is a portable method that does not use radiation that gives bone density measurements of the hip and spine. N Engl J Med. Barzel U, Massey L. Excess dietary protein can adversely effect bone. J Nutr. Dolan E, Sale C. Protein and bone health across the lifespan.

Proc Nutr Soc. Fenton T, Eliasziw M, Lyon A, Tough SC, Hanley DA. Meta-analysis of the quantity of calcium excretion associated with the net acid excretion of the modern diet under the acid ash diet hypothesis.

Am J Clin Nutr. Macdonald HM, New SA, Fraser WD, Campbell MK, Reid DM. Low dietary potassium intakes and high dietary estimates of net endogenous acid production are associated with low bone mineral density in premenopausal women and increased markers of bone resorption in postmenopausal women.

The impact of dietary protein on calcium absorption and kinetic measures of bone turnover in women. Heaney R. Bone Health. Zimmerman E, Busse B, Ritchie R. The fracture mechanics of human bone: influence of disease and treatment.

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Owens DJ, Fraser WD, Close GL. Vitamin D and the athlete: emerging insights. Eur J Sport Sci. Pearce SH, Cheetham TD. Diagnosis and management of vitamin D deficiency.

Scientific Advisory Committee on Nutrition. Vitamin D and Health. Accessed 17 Oct The Institute of Medicine. Dietary Guidelines for Americans Holick MF. Vitamin D deficiency. Angeline ME, Gee AO, Shindle M, Warren RF, Rodeo SA.

The effects of vitamin D deficiency in athletes. Am J Sports Med. Cannell JJ, Hollis BW, Sorenson MB, Taft TN, Anderson JJ. Athletic performance and vitamin D. Miller JR, Dunn KW, Ciliberti LJ, Patel RD, Swanson BA.

Association of vitamin D with stress fractures: a retrospective cohort study. J Foot Ankle Surg. Maroon JC, Mathyssek CM, Bost JW, Amos A, Winkelman R, Yates AP, et al. Vitamin D profile in National Football League players.

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Nutritional factors that influence change in bone density and stress fracture risk among young female cross-country runners. Institute of Medicine. Dietary reference intakes for calcium and vitamin D: Institute of Medicine of the National Academies, Rector RS, Rogers R, Ruebel M, Hinton PS.

Participation in road cycling vs running is associated with lower bone mineral density in men. Tenforde AS, Carlson JL, Sainani KL, Chang AO, Kim JH, Golden NH, et al.

Sport and triad risk factors influence bone mineral density in collegiate athletes. Barry DW, Hansen KC, van Pelt RE, Witten M, Wolfe P, Kohrt WM. Acute calcium ingestion attenuates exercise-induced disruption of calcium homeostasis. Haakonssen EC, Ross ML, Knight EJ, Cato LE, Nana A, Wluka AE, et al.

The effects of a calcium-rich pre-exercise meal on biomarkers of calcium homeostasis in competitive female cyclists: a randomised crossover trial. PLoS One. Verbalis JG, Barsony J, Sugimura Y, Tian Y, Adams DJ, Carter EA, et al. Hyponatremia-induced osteoporosis.

Barsony J, Sugimura Y, Verbalis JG. Osteoclast response to low extracellular sodium and the mechanism of hyponatremia-induced bone loss. J Biol Chem. Scott JP, Sale C, Greeves JP, Casey A, Dutton J, Fraser WD. Effect of fasting versus feeding on the bone metabolic response to running.

Townsend R, Elliott-Sale KJ, Currell K, Tang J, Fraser WD, Sale C. The effect of post-exercise carbohydrate and protein ingestion on bone metabolism. Download references. This supplement is supported by the Gatorade Sports Science Institute GSSI.

The supplement was guest edited by Lawrence L. Spriet, who attended a meeting of the GSSI Expert Panel in March and received honoraria from the GSSI, a division of PepsiCo, Inc. Spriet received no honoraria for guest editing the supplement. Spriet suggested peer reviewers for each paper, which were sent to the Sports Medicine Editor-in-Chief for approval, prior to any reviewers being approached.

Spriet provided comments on each paper and made an editorial decision based on comments from the peer reviewers and the Editor-in-Chief.

Where decisions were uncertain, Dr. Spriet consulted with the Editor-in-Chief. Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK.

You can also search for this author in PubMed Google Scholar. Correspondence to Craig Sale. This article is based on a presentation by Craig Sale to the GSSI Expert Panel in March Funding for attendance at that meeting together with an honorarium for preparation of this article were provided by the GSSI.

Open Access This article is distributed under the terms of the Creative Commons Attribution 4. Reprints and permissions. Sale, C. Nutrition and Athlete Bone Health. Sports Med 49 Suppl 2 , — Download citation. Published : 13 November Issue Date : December Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative.

Download PDF. Abstract Athletes should pay more attention to their bone health, whether this relates to their longer-term bone health e. Bone Health in Athletes Chapter © Food Versus Pharmacy: Assessment of Nutritional and Pharmacological Strategies to Improve Bone Health in Energy-Deficient Exercising Women Article 22 August Vitamin D and the Athlete: Current Perspectives and New Challenges Article Open access 24 January Use our pre-submission checklist Avoid common mistakes on your manuscript.

FormalPara Key Points The diet required by the athlete to support bone health is not markedly different from the general population, with a few specific challenges.

Much more athlete-specific research is required. Table 1 Some key nutrients to support bone health Full size table. References Santos L, Elliott-Sale KJ, Sale C.

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CAS PubMed Google Scholar Angeline ME, Gee AO, Shindle M, Warren RF, Rodeo SA. The process is similar to having an X-ray and takes about 15 minutes. Early detection of osteoporosis is possible. Through a DEXA scan, you can find out whether you have osteoporosis, a "silent disease" that gradually weakens bones and causes them to become brittle and prone to fractures.

Early osteoporosis detection will lead to the care you need to stay healthy. Preventing fractures is vital as you age. A DEXA scan can let you know whether you're at risk for fractures, which can be dangerous to your health.

For example, approximately 20 percent more women who've suffered hip fractures die within one year of the fracture than those of a similar age who haven't.

Call ADVOCATE to schedule an appointment and get a DEXA scan at one of our locations near you. A fragility fracture is any fall from a standing height or less that results in a fracture. Healthy, strong bones should rarely break without a major trauma. A person should be able to sustain a fall from this height without a fracture unless there's an underlying cause that makes the bones fragile.

If your doctor recommends a follow-up DXA usually two years or more between studies , try to have the follow-up study done at the same facility as the first one.

There are different models of DXA instruments, and the bone density measurements are easier to compare if they have been taken on the same model. Quantitative computerized tomography — This is a type of computed tomography CT that provides accurate measures of bone density in the spine.

Although this test may be an alternative to DXA, it is seldom used because it is expensive and requires a higher radiation dose. Ultrasound — Ultrasound can be used to measure the bone density of the heel. This may be useful to determine a person's fracture risk. However, it is used less frequently than DXA because there are no guidelines that use ultrasound measurements to diagnose osteoporosis or predict fracture risk.

In areas that do not have access to DXA, ultrasound is an acceptable way to measure bone density. WHAT TO EXPECT FROM A DXA TEST. During dual-energy x-ray absorptiometry DXA , you lie on an examination table.

An x-ray detector scans a bone region, and the amount of x-rays that pass through bone are measured and displayed as an image that is interpreted by a radiologist or metabolic bone expert. The test causes no discomfort, involves no injections or special preparation, and usually takes only 5 to 10 minutes.

The x-ray detector will detect any metal on your clothing zippers, belt buckles , so you may be asked to wear a gown for the test. It is also recommended that you avoid taking calcium supplements in the 24 hours before your test, as these supplements can sometimes interfere with the images.

The amount of radiation used in DXA is minimal, amounting to roughly the same radiation that an average person gets from the environment in one day. After the test is completed and the doctor interprets the results, you will be given a score that speaks to the condition of your bones.

WHAT DO THE RESULTS MEAN? The results of a bone density test are expressed either as a "T" or a "Z" score. T-scores represent numbers that compare the condition of your bones with those of an average young person with healthy bones.

Z-scores instead represent numbers that compare the condition of your bones with those of an average person your age. Of these two numbers, the T-score is usually the most important. T-scores are usually in the negative or minus range.

The lower the bone density T-score, the greater the risk of fracture table 1. People who have a score in this range do not typically need treatment, but it is useful for them to take steps to prevent bone loss, such as having adequate amounts of calcium and vitamin D and doing weightbearing exercise.

Low bone mass osteopenia — Low bone mass osteopenia is the term health care providers use to describe bone density that is lower than normal but that has not yet reached the low levels seen with osteoporosis. A person with osteopenia does not yet have osteoporosis but is at risk of developing it.

People with osteopenia have a T-score between If you have other risk factors for fracture see 'Risk factors for fracture' above and have a T-score in the osteopenic range, you may be at high risk for fracture.

People with low bone mass are usually advised to take steps to prevent osteoporosis. Sometimes that includes taking medications. Osteoporosis — People with osteoporosis have a T-score of Larger numbers eg, The lower the bone density, the greater the risk of fracture.

If you discover that you have osteoporosis, there are several things you can do to reduce the chances that you will break a bone. For instance, you can take osteoporosis medications combined with calcium and vitamin D supplements, and you can do an exercise program.

See "Patient education: Calcium and vitamin D for bone health Beyond the Basics " and "Patient education: Osteoporosis prevention and treatment Beyond the Basics ". Note that if you have previously had a low trauma bone fracture, you are also classified as having osteoporosis and need to take osteoporosis medications, regardless of your bone density T-score.

Fracture prediction tool — Fracture Risk Assessment Tool FRAX is an online tool that was developed to estimate your year likelihood of having a minimal trauma fracture. You can use it to determine your fracture risk even if you have not had a dual-energy x-ray absorptiometry DXA test, but you will get a more accurate prediction if you include DXA results.

If you decide to use the FRAX tool on your own, without a DXA study, and the results indicate a high risk of fracture, then it may be helpful to ask your health care provider whether you can also have a DXA test.

This DXA will serve as a baseline by which your doctor can follow your response to treatment. If the FRAX tool indicates that you have a high risk of fracture, your doctor may also recommend that you start on antifracture medications, regardless of your bone density results.

FRAX should not be used if you have already had a minimal trauma fracture or are already on treatment aimed at preserving your bone health and preventing future fractures. DO I NEED TO HAVE BONE DENSITY TESTING AGAIN?

Even if your bone density test shows that you do not have osteoporosis today, you may need to have the test again. How long to wait between tests depends on your initial bone density results and whether you have risk factors that represent an ongoing threat to your bones.

Repeat bone density measurements may be most valuable for people who are taking a medication to treat osteoporosis to determine the efficacy of treatment and for people who are not being treated but have medical conditions that can cause bone loss to determine if they need treatment.

Bone density tests help health care providers spot bone loss in people who might otherwise have no symptoms. The tests are painless, quick, and safe, and they can alert people to bone loss before they have a fracture. The tests are also useful in tracking the effects of medications used to manage bone disease.

Your health care provider is the best source of information for questions and concerns related to your medical problem. This article will be updated as needed on our website www. Related topics for patients, as well as selected articles written for health care professionals, are also available.

Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient education: Bone density testing The Basics Patient education: Osteoporosis The Basics Patient education: Calcium and vitamin D for bone health The Basics Patient education: Vitamin D deficiency The Basics Patient education: Primary hyperparathyroidism The Basics Patient education: Hip fracture The Basics Patient education: Vertebral compression fracture The Basics Patient education: Cadmium toxicity The Basics Patient education: Medicines for osteoporosis The Basics.

Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon. Patient education: Osteoporosis prevention and treatment Beyond the Basics Patient education: Calcium and vitamin D for bone health Beyond the Basics.

Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based.

Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading. Clinical manifestations, diagnosis, and evaluation of osteoporosis in postmenopausal women Osteoporotic fracture risk assessment Screening for osteoporosis in postmenopausal women and men.

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Learn how UpToDate can help you. Select the option that best describes you. View Topic. Font Size Small Normal Large. Patient education: Bone density testing Beyond the Basics. Formulary drug information for this topic. Check with your insurance company to find out more. Medicare may also cover bone density tests at no cost.

If you have Medicare, learn about Medicare coverage for bone density tests. Find a health center near you and ask about bone density tests. Calcium helps keep your bones strong. You can get calcium from:.

Learn more about getting enough calcium. And use this shopping list to find foods high in calcium. You can also get vitamin D from:. Find out how much vitamin D you need each day. Physical activity can help slow down bone loss. Muscle-strengthening activities — like lifting weights or using resistance bands long rubber strips that stretch — are best for bone health.

Weight-bearing activities like running or doing jumping jacks can also help keep your bones strong. Learn more about getting active.

You don't need special equipment or a gym membership to stay active. Check with your local community center or senior center to find fun, affordable ways to get active. If you have a health condition or a disability, be as active as you can. Your doctor can help you choose activities that are right for you.

For more tips on staying active, check out these resources:. Falls can be especially serious for people with weak bones. You can make small changes to lower your risk of falling, like doing exercises that improve your balance. For example, tai chi is a mind-body exercise that improves balance.

Learn more about preventing falls. This information on back pain prevention was adapted from materials from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Reviewed by: Trish Reynolds National Institute of Arthritis and Musculoskeletal and Skin Diseases Science Communications and Outreach Branch National Institutes of Health.

Linking to a non-federal website does not constitute an endorsement by ODPHP or any of its employees of the sponsors or the information and products presented on the website. Department of Health and Human Services Office of Disease Prevention and Health Promotion.

MyHealthfinder Doctor Visits Screening Tests Get a Bone Density Test. Doctor Visits Get a Bone Density Test. The Basics Take Action. The Basics Overview A bone density test measures how strong your bones are. What is osteoporosis? What happens during a bone density test? Am I at Risk?

Am I at risk for osteoporosis? Treatment Options What if I have osteoporosis? Depending on the results of your bone density test, you may need to: Add more calcium and vitamin D to your diet Get more physical activity Take medicine to slow down bone loss and lower your chances of breaking a bone Learn about medicines for osteoporosis.

Take Action. Take Action Get Tested Take these steps to protect your bone health. Schedule a bone density test if your doctor recommends it. What about cost? Under the Affordable Care Act, insurance plans must cover s creening for osteoporosis for: Women age 65 and older Women age 64 and younger who have gone through menopause who are at increased risk for osteoporosis Depending on your insurance plan, you may be able to get screened at no cost to you.

To learn more, check out these resources: Free preventive care for adults covered by the Affordable Care Act How the Affordable Care Act protects you Understanding your health insurance and how to use it [PDF - KB].