The Meaning of Bone Health, Bone Density and Fracture Risk

Bone's Major Functions

Bone has three major functions. The first involves providing a structural support for your heart, lungs, marrow and other organs and the attachment sites for muscles so that you can move your arms, legs and head. Think of what a blob you would be without your bones to give you structure. The second function involves providing protection for your brain and other internal organs. Finally, bone acts as a mineral storage bank for calcium and phosphorus helping to maintain a proper acid/base balance in your body called pH. So you can see that your bones have more than just one function.

The Importance of Bone Quality

The term bone quality may be new to you but it is an important one to understand. Bone quality then describes all the components that keep it strong and fracture free. So by weight, bone is composed of about 10% collagen matrix, 65% minerals and 25% water. It is not just the minerals but all three components working together that keep your bones strong and fracture free.

Bone Density Numbers

Bone quality however is very different from the term bone density. You may have had a DEXA test and been told they found a change in your bone density. Your bone density was either normal or you received a diagnosis of osteoporosis or osteopenia. Take heart because all is not lost. The DEXA score you received only tells you about the mineral density and content of the bone. It cannot tell you the amount or the health of your matrix or water content. The mineral density is considered one risk of many. It is used, along with other risk factors, when calculating fracture risk. It is important to remember that no one risk factor by itself can predict fracture risk.

Bone Density; Just One Risk Factor

Sometimes in the rush to osteoporosis treatment, it is lost in the shuffle that your DEXA scores is just one risk factor of many to consider when it comes to predicating fractures. It is also important to remember that you want to prevent fractures, nothing more nothing less. It also bears repeating that only one risk factor by itself can predict fracture risk, not even DEXA. According to Dr. Susan Ott, MD at the University of Washington, "In an individual, the quality of the bone, the shape of the bone, the presence of a fracture or other risk factors, weight, muscle strength, and the tendency to fall (balance) are all important to predicting the risk of fracture."

Fracture Risk... Using the FRAX® Index

The FRAX® tool is a better predictor of fracture because it uses 12 independent risk factors, including bone density, to determine your course of treatment. The FRAX® tool was developed by WHO to evaluate fracture risk of patients. The FRAX® models have been developed from studying population-based cohorts from Europe, North America, Asia and Australia. The FRAX® tool gives the 10-year probability of a hip fracture and/or a major osteoporotic fracture (clinical spine, forearm, hip or shoulder fracture).

The Limitations of FRAX®

The International Osteoporosis Foundation says that the FRAX® tool has the following limitations: Does not accommodate all known risk factors.

Lacks detail on some risk factors
Depends on adequacy of epidemiological information
Limited country models available
Model relevant only for untreated patients
Does not replace clinical judgment
Improving Bone Health

So now you know that keeping your bones healthy is more complicated than just trying to increase bone density. Your bones and the rest of your body work together and are dependent upon each other. So your general health will, to a great degree, determine your bone health. Lifestyle factors like drinking enough water, eating a balanced diet, safe and effective exercise, drinking and smoking habits and how well you manage your stress are all important in keeping your bones healthy. Just focusing on one lifestyle change, like eating healthier foods, is rarely enough to improve your bone health. It takes multiple changes, in the right proportions, to really make a significant difference in your bone and body health.

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Woody McMahon has been working as a healthy lifestyle professional for over 25 years. Before starting his career as a healthy lifestyle coach, Woody earned his Bachelor of Science degree in human biology from the University of Maryland, his Doctorate in Chiropractic Medicine from Palmer College of Chiropractic and is certified as a personal trainer through the National Strength Professionals Association. He is also trained in The Meeks Method of Postural Correction.