Osteoporosis of the Spine: Prevention

Main risk for the occurrence of osteoporotic fractures is:

  • Age > 70 years
  • BMI < 20 kg/m2
  • Positive fracture history:

A balanced lifestyle can maintain bone mass longer before the resorption/formation ratio is shifted in favor of resorption and slowly bone mass is lost.

To prevent “osteoporosis of the spine,” attention must be paid to reducing individual risk factors.

Behavioral risk factors

  • Diet
    • High intake of sodium and table salt – High intake of table salt with subsequent increase in natriuresis promotes hypercalciuria and thus negative calcium balance. A 2.3 g increase in sodium intake results in a 24-40 mg increase in calcium excretion. Increased calcium excretion favors the development of osteoporosis. Study results to date conclude that a dietary salt intake of up to 9 g/day in a healthy individual does not increase the risk of osteoporosis. However, the current daily intake of table salt in the general population is 8-12 g.
    • Micronutrient deficiency (vital substances) – inadequate supply of calcium and vitamin D and too high a proportion of phosphates, oxalic acid (chard, cocoa powder, spinach, rhubarb) and phytates/phytic acid (cereals and legumes) – see prevention with micronutrients.
  • Pleasure food consumption
  • Physical activity
    • Physical inactivity
    • Prolonged immobilization
  • Psycho-social situation
    • Stress
    • Insufficient sleep duration: postmenopausal (female menopause) women who slept 5 hours or less at night had a 63% higher risk of osteoporosis compared with women who slept 7 hours per night.
  • Underweight – A low body weight (body mass index < 20) or weight loss of more than 10% in recent years is associated with an increased risk – however, this does not mean that overweight should be aimed for, but rather a normal weight or an age-appropriate ideal weight
  • Lack of exposure to sunlight

Other risk factors

  • Dialysis (blood washing)
  • Gravidity (pregnancy)
  • Lactation (breastfeeding phase)

Risk groups and risk factors for poor vitamin D supply

Risk groups Pregnant women
Breastfed infants without vitamin D prophylaxis.
Children and adolescents
Elderly people
People with dark skin color
Risk factors Wearing particularly covering clothing
Using cosmetics with a sun protection factor
Use of sunscreen
Frequent stay indoors (e.g., work-related).
Autumn and winter months (October to March; lower vitamin D production by the skin).
Latitude > 35 N

Prevention factors (protective factors)