What factors can affect peak bone mass?

David Slovik, MD
Endocrinology Diabetes & Metabolism
These are some of the factors that can influence your peak bone mass:
Inherited traits. Sex, race, and genes help determine peak bone density. As a rule, bone density is 30% higher in men than in women and 10% higher in blacks than in whites. Even so, there is wide variation within these groups. The difference may be due to the work of several genes that influence bone mass, bone turnover, and bone loss.
Diet. What you eat early in life has a lot to do with the state of your bones later on. Research indicates that women whose diets contain the greatest amounts of calcium and vitamin D during childhood and adolescence have denser bones during adulthood. Consuming enough calories is also vital: when girls and women have too little body fat to support menstruation because of anorexia or bulimia, their bones suffer and they are in greater jeopardy of developing osteoporosis.
Exercise. Regular weight-bearing exercise during your early years contributes to peak bone density. This includes any activities that involve overcoming gravity's pull -- not just weight lifting, but also running, walking, aerobics, soccer, basketball, gymnastics, tennis, golf, or comparable forms of exercise. Exercise puts stress on bone, and bones respond by toughening up -- in this case, by adding tissue through formation. However, for women, exercising to an extreme -- which is increasingly common among young dancers, elite athletes, long-distance runners, and gymnasts -- can result in declining estrogen levels, amenorrhea (abnormal absence of menstrual periods), and eventually bone loss.
Medical conditions. Certain chronic disorders that result in excessive resorption can reduce peak bone mass. Some common culprits include hyperthyroidism, certain cancers, chronic liver disease, rheumatoid arthritis, and malabsorptive disorders (conditions that develop because nutrients from food aren't absorbed into the bloodstream properly).
Certain medications. Some drugs can also lead to bone loss. One is too much thyroid hormone taken as therapy for an underactive thyroid gland. Others include glucocorticoids, which are taken to control asthma, immune disorders, and other diseases, as well as medications used to treat breast and prostate cancers. Also, because several drugs that speed bone loss are commonly given after organ transplants, people who have had these operations are at considerable risk of developing osteoporosis.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.