Low bone density or other risk factors?

It is generally assumed that low bone density indicates fracture risk. However, dense bones may not necessarily be sufficient to prevent hip fractures if there are other risk factors. A 1995 study of 65 year old women by Dr Steven R Cummings of the University of California at San Francisco (Am J Epidem, 1997; 145: 926-34), found a number of risk factors more significant than thin bones. They included:

Taking tranquillisers and sleeping pillsSmoking

Having vision problems such as poor depth perception

A past history of having an overactive thyroid gland

Being tall

Being unable to get out of a chair without holding onto the arms

Having a high pulse rate

Women who had five or more of these risk factors regardless of bone density! had a 10 per cent chance of breaking a hip in the next five years, while those with two or fewer risk factors only had a 1 per cent chance of doing so. In a 1996 panel discussion by the National Women's Health Network, one finding was that low bone density is not a good predictor of bone fractures; better predictors are advanced age accompanied by poor muscle strength, the use of regular medications. The benzodiazepine drugs, in fact, have been found to increase the risk of hip fracture by 70 per cent, according to a Canadian study published in the Journal of the American Medical Association in 1989 (New York Times, April 12, 1996).

Other significant dietary risk factors that have received insufficient attention:

Eating a high proportion of animal protein together with flour products and sweets

Eating a high proportion of nightshade vegetables (potatoes, tomatoes, eggplant, peppers)

Not eating enough vegetables

Not including enough good quality fats in the diet

Not including enough protein in the diet