Osteoporosis is a disease in which bone tissue is reduced, thus increasing the risk of fracture which usually involves the hip, spine or writst. One out of every three westernised postmenopausal woman will have a spinal fracture due to osteoporosis. Up to 20% of hip fracture victums die within a year. The fracture rate in both females and males has increased significantly in the past decade. Osteoporosis causes no pain or discomfort until fractures occur and has been called "the silent epidemic"

The following may suggest that you are at risk:

* early menopause (before 45years)

* other causes of low sex hormone levels in men and woman

* longterm cortisone use

* previous fracture after minimal trauma

* alcohol or tobacco abuse

* certain hormonal, intestinal or malignant diseases

* thin framed individuals with a strong family history of osteoporosis

* malnutrition and poor calcium intake

Many individuals without risk factors may still develop osteoprosis. A bone density measurement (using a bone denistometer) is currently the best predictor of fractures. Although useful to detect fractures, up to 40% of bone tissue must be lost before this is revealed by routine X-rays.

Preventative measures aim to stimulate bone formation and to reduce excessive bone loss. There are four main areas in which you can help maintain healthy bones:

* balanced diet, rich in calcium and dairy products; calcium supplements

* regular exercise, preferably weightbearing

* stop smoking

* decrease alcohol intake

Lifestyl measures and calcium supplementation are often not sufficient to prevent osteoporosis. Furtunately, specific pharmacological drugs (e.g. bisphosphonates, teriparatide, strontium ranelate) are available to prevent and treat osteoporosis.