February 2014 Vol. 2 No.2

Search Pubmed for articles by:
 

Review

Determinants of bone mass

Rapheeporn Khwanchuea

School of Medicine, Walailak University, Nakhon Si Thammarat 80161, Thailand

E-mail: krapheep@wu.ac.th

Accepted February 10, 2014
 

Abstract

According to WHO criteria, Osteoporosis is defined as bone mineral density (BMD) that is reduced by more than 2.5 standard deviations below the young adult mean. This leads to bone fragility and an increased risk of fractures. Bone mass rapidly accelerates in adolescents until peak bone mass (PBM) is achieved by the end of adolescence between the age of 20–25 and levels remain relatively static until the age of 45 when bone density starts to fall. Bone loss is positively associated with age and aging contributes to the development of osteoporosis. Genetic, hormonal and environmental factors such as low estrogen, low dietary calcium intake, vitamin D deficiency, current cigarette smoking, chronic alcohol consumption, and low physical activity or exercise also contribute to low bone density and skeletal fragility. Mechanical stress has long been recognized to have important effects on bone. Activities or exercises that are weight bearing or involve impact are most useful for increasing or maintaining bone mass. The development of PBM during the growing years is an important determinant for risk of osteoporosis in later life. Adequate nutrition and sufficient activity are critical factors in maximizing bone growth potential. Replacing milk intake by soft drinks appears to be detrimental to bone gain. The association between bone fractures and carbonated beverage consumption, in particular, is found in adolescences. Caffeine-containing beverage consumption has been reported to be associated with reduced bone mass due to its effects on a mild diuretic and short-term increased in urinary calcium excretion. This consumption with more milk may distribute effects of caffeine on body bone gain. Current greater cigarette consumption is at increased risk of hip fracture, and the decline in risk is observed until 10 years after smoking cessation. A small amount of alcohol has benefit to BMD, whereas high alcohol consumption increases risk of fractures that is relative to low body mass index.

Keywords: Bone mass, Peak bone mass, Exercise, Calcium intake, Beverages