Health Condition


About This Condition

Osteoporosis is a condition in which the normal amount of bone mass has decreased.

People with osteoporosis have brittle bones, which increases the risk of bone fracture, particularly in the hip, spine, and wrist. Osteoporosis is most common in postmenopausal Asian and Caucasian women. Premenopausal women are partially protected against bone loss by the hormone called estrogen. Black women often have slightly greater bone mass than do other women, which helps protect against bone fractures. In men, testosterone partially protects against bone loss even after middle age. Beyond issues of race, age, and gender, incidence varies widely from society to society, suggesting that osteoporosis is largely preventable.


Osteoporosis is a silent disease that may not be noticed until a broken bone occurs. Signs may include diminished height, rounded shoulders, dowager’s hump, and evidence of bone loss from diagnostic tests. Symptoms may include neck or back pain.

Other Therapies

Healthcare providers also recommend adequate dietary calcium intake and weight-bearing exercise.


1. Reid IR, Ames RW, Evans MC, et al. Long-term effects of calcium supplementation on bone loss and fractures in postmenopausal women: a randomized controlled trial. Am J Med 1995;98:331-5.

2. Hosking DJ, Ross PD, Thompson DE, et al. Evidence that increased calcium intake does not prevent early postmenopausal bone loss. Clin Ther 1998;20:933-44.

3. Owusu W, Willett WC, Feskanich D, et al. Calcium intake and the incidence of forearm and hip fractures among men. J Nutr 1997;127:1782-7.

4. Rulm LA, Sakhaee K, Peterson R, et al. The effect of calcium citrate on bone density in the early and mid-postmenopausal period: a randomized, placebo-controlled study. Am J Ther 1999;6:303-11.

5. Nieves JW, Komar L, Cosman F, Lindsay R. Calcium potentiates the effect of estrogen and calcitonin on bone mass: review and analysis. Am J Clin Nutr 1998;67:18-24.

6. Bonjour JP, Carrie AL, Ferrari S, et al. Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial. J Clin Invest 1997;99:1287-94.

7. Welten DC, Kemper HCG, Post GB, van Stavberen WA. A meta-analysis of the effect of calcium intake on bone mass in young and middle aged females and males. J Nutr 1995;125:2802-13 [review].

8. Heaney RP, Nordin BEC. Calcium effects on phosphorus absorption: implications for the prevention and co-therapy of osteoporosis.J Am Coll Nutr 2002;21:239-44.

9. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

10. El-Hajj Fuleihan G. Strontium ranelate—a novel therapy for osteoporosis or a permutation of the same? N Engl J Med 2004;350:504-6 [Editorial].

11. Ferrari S, Zolezzi C, Savarino L, et al. The oral strontium load test in the assessment of intestinal calcium absorption. Minerva Med 1993;84:527-31.

12. McCaslin FE, Janes JM. The effect of strontium lactate in the treatment of osteoporosis. Proc Staff Meetings Mayo Clinic 1959;34(13):329-34.

13. Meunier PJ, Roux C, Seeman E, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 2004;350:459-68.

14. Gaby AR. Preventing and Reversing Osteoporosis. Rocklin, CA: Prima Publishing, 1994, 88-9 [review].

15. Skoryna SC. Effects of oral supplementation with stable strontium. Can Med Assoc J 1981;125:703-12.

16. Reginster JY, Deroisy R, Dougados M, et al. Prevention of early postmenopausal bone loss by strontium ranelate: the randomized, two-year, double-masked, dose-ranging, placebo-controlled PREVOS trial. Osteoporos Int 2002;13:925-31.

17. Brot C, Jorgensen N, Madsen OR, et al. Relationships between bone mineral density, serum vitamin D metabolites and calcium: phosphorus intake in healthy perimenopausal women. J Intern Med 1999;245:509-16.

18. Sahota O. Osteoporosis and the role of vitamin D and calcium-vitamin D deficiency, vitamin D insufficiency and vitamin D sufficiency. Age Ageing 2000;29:301-4.

19. Dawson-Hughes B, Dallal GE, Krall EA, et al. Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Ann Intern Med 1991;115:505-12.

20. Adams JS, Kantorovich V, Wu C, et al. Resolution of vitamin D insufficiency in osteopenic patients results in rapid recovery of bone mineral density. J Clin Endocrinol Metab 1999;84:2729-30.

21. Macdonald HM, Wood AD, Aucott LS, et al. Hip bone loss is attenuated with 1000 IU but not 400 IU daily vitamin D3: a 1-year double-blind RCT in postmenopausal women. J Bone Miner Res 2013;28:2202–13.

22. Nordin BE, Baker MR, Horsman A, Peacock M. A prospective trial of the effect of vitamin D supplementation on metacarpal bone loss in elderly women. Am J Clin Nutr 1985;42(3):470-4.

23. Lips P, Graafmans WC, Ooms ME, et al. Vitamin D supplementation and fracture incidence in elderly persons. Ann Intern Med 1996;124:400-6.

24. Komulainen M, Tuppurainen MT, Kroger H, et al. Vitamin D and HRT: no benefit additional to that of HRT alone in prevention of bone loss in early postmenopausal women. A 2.5-year randomized placebo-controlled study. Osteoporosis Int 1997;7:126-32.

25. Droisy R, Collette J, Chevallier T, et al. Effects of two 1-year calcium and vitamin D3 treatments on bone remodeling markers and femoral bone density in elderly women. Curr Ther Res 1998;59:850-62.

26. Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 1992;327:1637-42.

27. Maki BE, Holliday PJ, Topper AK. A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol 1994;49:M72-84.

28. Leboff MS, Hawkes WG, Glowacki J, et al. Vitamin D-deficiency and post-fracture changes in lower extremity function and falls in women with hip fractures. Osteoporos Int 2008;19:1283-90.

29. Pfeifer M, Begerow B, Minne HW, et al. Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res 2000;15:1113-8.

30. Broe KE, Chen TC, Weinberg J, et al. A higher dose of vitamin D reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc 2007;55:234-9.

31. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

32. Eaton-Evans J, McIlrath EM, Jackson WE, et al. Copper supplementation and bone-mineral density in middle-aged women. Proc Nutr Soc 1995;54:191A.

33. Baker A, Turley E, Bonham MP, et al. No effect of copper supplementation on biochemical markers of bone metabolism in healthy adults. Br J Nutr 1999;82:283-90.

34. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

35. Villareal DT, Holloszy JO, Kohrt WM. Effects of DHEA replacement on bone mineral density and body composition in elderly women and men. Clin Endocrinol (Oxf) 2000;53:561-8.

36. Jankowski CM, Gozansky WS, Schwartz RS, et al. Effects of dehydroepiandrosterone replacement therapy on bone mineral density in older adults: a randomized, controlled trial. J Clin Endocrinol Metab 2006;91:2986-93.

37. Weiss EP, Shah K, Fontana L, et al. Dehydroepiandrosterone replacement therapy in older adults: 1- and 2-y effects on bone. Am J Clin Nutr 2009;89:1459-67.

38. Von Muhlen D, Laughlin GA, Kritz-Silverstein D, et al. Effect of dehydroepiandrosterone supplementation on bone mineral density, bone markers, and body composition in older adults: the DAWN trial. Osteoporos Int 2008;19:699-707.

39. Van Papendorp DH, Coetzer H, Kruger MC. Biochemical profile of osteoporotic patients on essential fatty acid supplementation. Nutr Res 1995;15:325–34.

40. Kruger MC, Coetzer H, de Winter R, et al. Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis. Aging 1998;10:385-94.

41. Agnusdei D, Bufalino L. Efficacy of ipriflavone in established osteoporosis and long-term safety. Calcif Tissue Int 1997;61:23-27.

42. Head KA. Ipriflavone: an important bone-building isoflavone. Altern Med Rev 1999;4(1):10-22 [review].

43. Avioli LV. The future of ipriflavone in the management of osteoporotic syndromes. Calcif Tissue Int 1997;61(Suppl 1):S33-5 [review].

44. Adami S, Bufalino L, Cervetti R, et al. Ipriflavone prevents radial bone loss in postmenopausal women with low bone mass over 2 years. Osteoporos Int 1997;7:119-25.

45. Nozaki M, Hashimoto K, Inoue Y, et al. Treatment of bone loss in oophorectomized women with a combination of ipriflavone and conjugated equine estrogen. Int J Gynaecol Obstet 1998;62(1):69-75.

46. Gennari C, Adami S, Agnusdei D, et al. Effect of chronic treatment with ipriflavone in postmenopausal women with low bone bass. Calcif Tissue Int 1997;61(Suppl 1):S19-22.

47. Gennari C, Agnusdei D, Crepaldi G, et al. Effect of ipriflavone—a synthetic derivative of natural isoflavones—on bone mass loss in the early years after menopause. Menopause 1998;5(1):9-15.

48. Ohta H, Komukai S, Makita K, et al. Effects of 1-year ipriflavone treatment on lumbar bone mineral density and bone metabolic markers in postmenopausal women with low bone mass. Horm Res 1999;51:178-83.

49. Melis GB, Paoletti AM, Bartolini R, et al. Ipriflavone and low doses of estrogens in the prevention of bone mineral loss in climacterium. Bone Miner 1992;19 (Suppl 1):S49-56.

50. Gambacciani M, Ciaponi M, Cappagli B, et al. Effects of combined low dose of the isoflavone derivative ipriflavone and estrogen replacement on bone mineral density and metabolism in postmenopausal women. Maturitas 1997;28:75-81.

51. Hanabayashi T, Imai A, Tamaya T. Effects of ipriflavone and estriol on postmenopausal osteoporotic changes. Int J Gynaecol Obstet 1995;51:63-4 [letter].

52. Alexandersen P, Toussaint A, Christiansen C, et al. Ipriflavone in the treatment of postmenopausal osteoporosis: a randomized controlled trial. JAMA 2001;285:1482-88.

53. Cohen L, Laor A, Kitzes R. Magnesium malabsorption in postmenopausal osteoporosis. Magnesium 1983;2:139-43.

54. Cohen L, Kitzes R. Infrared spectroscopy and magnesium content of bone mineral in osteoporotic women. Isr J Med Sci 1981;17:1123-5.

55. Geinster JY, Strauss L, Deroisy R, et al. Preliminary report of decreased serum magnesium in postmenopausal osteoporosis. Magnesium 1989;8:106-9.

56. Dimai H-P, Porta S, Wirnsberger G, et al. Daily oral magnesium supplementation suppresses bone turnover in young adult males. J Clin Endocrinol Metab 1998;83:2742-8.

57. Stendig-Lindberg G, Tepper R, Leichter I. Trabecular bone density in a two year controlled trial of peroral magnesium in osteoporosis. Magnesium Res 1993;6:155-63.

58. Carpenter TO, DeLucia MC, Zhang JH, et al. A randomized controlled study of effects of dietary magnesium oxide supplementation on bone mineral content in healthy girls. J Clin Endocrinol Metab 2006;91:4866-72.

59. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

60. Amstrup AK, Sikjaer T, Heickendorff L, et al. Melatonin improves bone mineral density at the femoral neck in postmenopausal women with osteopenia: a randomized controlled trial. J Pineal Res 2015;59:221–9.

61. Prior JC. Progesterone as a bone-trophic hormone. Endocr Rev 1990;11:386-98.

62. Lee JR. Osteoporosis reversal: the role of progesterone. Int Clin Nutr Rev 1990;10:384-91.

63. Riis BJ, Thomsen K, Strom V, Christiansen C. The effect of percutaneous estradiol and natural progesterone on postmenopausal bone loss. Am J Obstet Gynecol 1987;156:61-5.

64. Leonetti HB, Long S, Anasti JM. Transdermal progesterone cream for vasomotor symptoms and postmenopausal bone loss. Obstet Gynecol 1999;94:225-8.

65. Lydeking-Olsen E, Beck-Jensen JE, Setchell KD, Holm-Jensen T. Soymilk or progesterone for prevention of bone loss: a 2 year randomized, placebo-controlled trial. Eur J Nutr 2004;43:246-57.

66. Atkinson C, Compston JE, Day NE, et al. The effects of phytoestrogen isoflavones on bone density in women: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 2004;79:326-33.

67. Hart JP. Circulating vitamin K1 levels in fractured neck of femur. Lancet 1984;2:283 [letter].

68. Tamatani M, Morimoto S, Nakajima M, et al. Decreased circulating levels of vitamin K and 25-hydroxyvitamin D in osteopenic elderly men. Metabolism 1998;47:195-9.

69. Feskanich D, Weber P, Willett WC, et al. Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr 1999;69:74-9.

70. Booth SL, Tucker KL, Chen H, et al. Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women. Am J Clin Nutr 2000;71:1201-8.

71. Knapen MHJ, Hamulyak K, Vermeer C. The effect of vitamin K supplementation on circulating osteocalcin (Bone Gla protein) and urinary calcium excretion. Ann Intern Med 1989;111:1001-5.

72. Orimo H, Shiraki M, Fujita T, et al. Clinical evaluation of Menatetrenone in the treatment of involutional osteoporosis—a double-blind multicenter comparative study with 1-alpha-hydroxyvitamin D3. J Bone Mineral Res 1992;7(Suppl 1):S122.

73. Iwamoto I, Kosha S, Noguchi S, et al. A longitudinal study of the effect of vitamin K2 on bone mineral density in postmenopausal women a comparative study with vitamin D3 and estrogen-progestin therapy. Maturitas 1999;31:161-4.

74. Shiraki M, Shiraki Y, Aoki C, Miura M. Vitamin K2 (menatetrenone) effectively prevents fractures and sustains lumbar bone mineral density in osteoporosis. J Bone Miner Res 2000;15:515-21.

75. Ronn SH, Harslof T, Pedersen SB, Langdahl BL. Vitamin K2 (menaquinone-7) prevents age-related deterioration of trabecular bone microarchitecture at the tibia in postmenopausal women. Eur J Endocrinol 2016;175:541–9.

76. Knapen MHJ, Drummen NE, Smit E, et al. Three-year low-dose menaquinone-7 supplementation helps decrease bone loss in healthy postmenopausal women. Osteoporos Int 2013;24:2499–507.

77. Kadota S, Li JX, Li HY, et al. Effects of cimicifugae rhizome on serum calcium and phosphate levels in low calcium dietary rats and on bone mineral density in ovariectomized rats. Phytomed 1996/97;3(4):379-85.

78. Nielsen FH, Hunt CD, Mullen LM, Hunt JR. Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. FASEB J 1987;1:394-7.

79. Meacham SL, Taper LJ, Volpe SL. Effect of boron supplementation on blood and urinary calcium, magnesium, and phosphorus, and urinary boron in athletic and sedentary women. Am J Clin Nutr 1995;61:341-5.

80. Hunt CD, Herbel JL, Nielsen FH. Metabolic responses of postmenopausal women to supplemental dietary boron and aluminum during usual and low magnesium intake: boron, calcium, and magnesium absorption and retention and blood mineral concentrations. Am J Clin Nutr 1997;65:803-13.

81. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

82. Van Papendorp DH, Coetzer H, Kruger MC. Biochemical profile of osteoporotic patients on essential fatty acid supplementation. Nutr Res 1995;15:325–34.

83. Kruger MC, Coetzer H, de Winter R, et al. Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis. Aging 1998;10:385-94.

84. Gold M. Basketball bones. Science 1980;80:101-2.

85. Raloff J. Reasons for boning up on manganese. Science News 1986;Sep 27:199 [review].

86. Strause L, Saltman P, Smith KT, et al. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. J Nutr 1994;124:1060-4.

87. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

88. Carlisle EM. Silicon localization and calcification in developing bone. Fed Proc 1969;28:374.

89. Hott M, de Pollak C, Modrowski D, Marie PJ. Short-term effects of organic silicon on trabecular bone in mature ovariectamized rats. Calcif Tissue Int 1993;53:174-9.

90. Eisinger J, Clairet D. Effects of silicon, fluoride, etidronate and magnesium on bone mineral density: a retrospective study. Magnes Res 1993;6:247-9.

91. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

92. Toba Y, Takada Y, Yamamura J, et al. Milk basic protein: a novel protective function of milk against osteoporosis. Bone 2000;27:403-8.

93. Toba Y, Takada Y, Matsuoka Y, et al. Milk basic protein promotes bone formation and suppresses bone resorption in healthy adult men. Biosci Biotechnol Biochem 2001;65:1353-7.

94. Aoe S, Toba Y, Yamamura J, et al. Controlled trial of the effects of milk basic protein (MBP) supplementation on bone metabolism in healthy adult women. Biosci Biotechnol Biochem 2001;65:913-8.

95. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

96. Sahap AO. Zinc and senile osteoporosis. J Am Geriatr Soc 1983;31:790-1.

97. Relea P, Revilla M, Ripoll E, et al. Zinc, biochemical markers of nutrition, and type I osteoporosis. Age Ageing 1995; 24:303-7.

98. Elmståhl S, Gullberg B, Janzon L, et al. Increased incidence of fractures in middle-aged and elderly men with low intakes of phosphorus and zinc. Osteoporos Int 1998;8:333-40.

99. Strause L, Saltman P, Smith KT, et al. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. J Nutr 1994;124:1060-4.

100. Weinsier RL, Krumdieck CL. Dairy foods and bone health: examination of the evidence. Am J Clin Nutr 2000;72:681-9 [review].

101. Kynast-Gales SA, Massey LK. Effect of caffeine on circadian excretion of urinary calcium and magnesium. J Am Coll Nutr 1994;13:467-72.

102. Hernandez-Avila M, Colditz GA, Stampfer MJ, et al. Caffeine, moderate alcohol intake, and risk of fractures of the hip and forearm in middle-aged women. Am J Clin Nutr 1991;54:157-63.

103. Harris SS, Dawson-Hughes B. Caffeine and bone loss in healthy postmenopausal women. Am J Clin Nutr 1994;60:573-8.

104. Kanis J, Johnell O, Gullberg B, et al. Risk factors for hip fracture in men from southern Europe: the MEDOS study. Mediterranean Osteoporosis Study. Osteoporos Int 1999;9:45-54.

105. Hegarty VM, May HM, Khaw KT. Tea drinking and bone mineral density in older women. Am J Clin Nutr 2000;71:1003-7.

106. Kao PC, P'eng FK. How to reduce the risk factors of osteoporosis in Asia. Chung Hua I Hsueh Tsa Chih (Taipei) 1995;55:209-13 [review].

107. Zarkadas M, Geougeon-Reyburn R, Marliss EB, et al. Sodium chloride supplementation and urinary calcium excretion in postmenopausal women. Am J Clin Nutr 1989;50:1088-94.

108. Evans CE, Chughtai AY, Blumsohn A, et al. The effect of dietary sodium on calcium metabolism in premenopausal and postmenopausal women. Eur J Clin Nutr 1997;51:394-9.

109. McParland BE, Boulding A, Campbell AJ. Dietary salt affects biochemical markers of resorption and formation of bone in elderly women. Br Med J 1989;299:834-5.

110. Devine A, Criddle RA, Dick IM, et al. A longitudinal study of the effect of sodium and calcium intakes on regional bone density in postmenopausal women. Am J Clin Nutr 1995;62:740-5.

111. Wyshak G, Frisch RE. Carbonated beverages, dietary calcium, the dietary calcium/phosphorus ratio, and bone fractures in girls and boys. J Adolescent Health 1994;15:210-5.

112. Smith S, Swain J, Brown EM, et al. A preliminary report of the short-term effect of carbonated beverage consumption on calcium metabolism in normal women. Arch Intern Med 1989;149:2517-9.

113. Mazariegos-Ramos E, Guerrero-Romero F, Rodríquez-Morán F, et al. Consumption of soft drinks with phosphoric acid as a risk factor for the development of hypocalcemia in children: a case-control study. J Pediatr 1995;126:940-2.

114. Tucker KL, Morita K, Qiao N, Hannan MT, Cupples LA, Kiel DP. Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study. Am J Clin Nutr 2006;84:936-942.

115. Kim SH, Morton DJ, Barrett-Connor EL. Carbonated beverage consumption and bone mineral density among older women: the Rancho Bernardo Study. Am J Public Health 1997;87:276-9.

116. Anderson JJ, Ambrose WW, Garner SC. Biphasic effects of genistein on bone tissue in the ovariectomized, lactating rat model (44243). Proc Soc Exp Biol Med 1998;217:345-50.

117. Potter SM, Baum JA, Teng H, et al. Soy protein and isoflavones: their effects on blood lipids and bone density in postmenopausal women. Am J Clin Nutr 1998;68(Suppl):1375-9S.

118. Morabito N, Crisafulli A, Vergara C, et al. Effects of genistein and hormone-replacement therapy on bone loss in early postmenopausal women: a randomized double-blind placebo-controlled study. J Bone Miner Res 2002;17:1904-12.

119. Marini H, Minutoli L, Polito F, et al. Effects of the phytoestrogen genistein on bone metabolism in osteopenic postmenopausal women: a randomized trial. Ann Intern Med 2007;146:839-47.

120. Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Protein consumption and bone fractures in women. Am J Epidemiol 1996;143:472-9.

121. Abelow BJ, Holford TR, Insogna KL. Cross-cultural association between dietary animal protein and hip fracture: a hypothesis. Calcif Tiss Int 1992;50:14-8.

122. Moriguti JC, Ferriolli E, Marchini JS. Urinary calcium loss in elderly men on a vegetable:animal (1:1) high-protein diet. Gerontology 1999;45:274-8.

123. Munger RG, Cerhan JR, Chiu BC. Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. Am J Clin Nutr 1999;69:147-52.

124. Mannan MT, Tucker K, Dawson-Hughes B, et al. Effect of dietary protein on bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Mineral Res 2000;15:2504-12.

125. Ellis FR, Holesh S, Ellis JW. Incidence of osteoporosis in vegetarians and omnivores. Am J Clin Nutr 1972;25:555-8.

126. Marsh AG, Sanchez TV, Midkelsen O, et al. Cortical bone density of adult lacto-ovo-vegetarian and omnivorous women. J Am Diet Assoc 1980;76:148-51.

127. Marsh AG, Sanchez TV, Chaffee FL, et al. Bone mineral mass in adult lacto-ovo-vegetarian and omnivorous males. Am J Clin Nutr 1983;37:453-6.

128. Hunt IF, Murphy NJ, Henderson C, et al. Bone mineral content in postmenopausal women: comparison of omnivores and vegetarians. Am J Clin Nutr 1989;50:517-23.

129. Lloyd T, Schaeffer JM, Walker MA, Demers LM. Urinary hormonal concentrations and spinal bone densities of premenopausal vegetarian and nonvegetarian women. Am J Clin Nutr 1991;54:1005-10.

130. Tesar R, Notelovitz M, Shim E, et al. Axial and peripheral bone density and nutrient intakes of postmenopausal vegetarian and omnivorous women. Am J Clin Nutr 1992;56:699-704.

131. Tylavsky FA, Anderson JJ. Dietary factors in bone health of elderly lactoovovegetarian and omnivorous women. Am J Clin Nutr 1988;48(3 Suppl):842-9.

132. Lau EMC, Kwok T, Woo J, Ho SC. Bone mineral density in Chinese elderly female vegetarians, vegans, lacto-vegetarians and omnivores. Eur J Clin Nutr 1998;52:60-4.

133. Tkatch L, Rapin CH, Rizzoli R, et al. Benefits of oral protein supplementation in elderly patients with fracture of the proximal femur. J Am Coll Nutr 1992;11:519-25.

134. Schürch MA, Rizzoli R, Slosman D, et al. Protein supplements increase serum insulin-like growth factor-I levels and attenuate proximal femur bone loss in patients with recent hip fracture. A randomized, double blind, placebo-controlled trial. Ann Intern Med 1998;128:801-9.

135. Espauella J, Guyer H, Diaz-Escriu F, et al. Nutritional supplementation of elderly hip fracture patients. A randomized, double-blind placebo-controlled trial. Age Aging 2000;29:425-31.

136. Heaney RP. Nutrient interactions and the calcium requirement. J Lab Clin Med 1994;124:15-6 [editorial/review].

137. Kerstetter JE, Allen LH. Dietary protein increases urinary calcium. J Nutr 1990;120:134-6.

138. Kerstetter JE, Looker AC, Insogna KL. Low dietary protein and low bone density. Calcif Tissue Int 2000;66:313.

139. Hopper JL, Seeman E. The bone density of female twins discordant for tobacco use. N Engl J Med 1994;330:387-92.

140. Chow R, Harrison JE, Notarius C. Effect of two randomised exercise programmes on bone mass of healthy postmenopausal women. Br Med J 1987;295:1441-4.

141. Lloyd T, Triantafyllou SJ, Baker ER, et al. Women athletes with menstrual irregularity have increased musculoskeletal injuries. Med Sci Sports Exercise 1986;18(4):374-9.

142. Salamone LM, Cauley JA, Black DM, et al. Effect of a lifestyle intervention on bone mineral density in premenopausal women: a randomized trial. Am J Clin Nutr 1999;70:97-103.

Copyright © 2018 Healthnotes, Inc. All rights reserved. www.healthnotes.com

Learn more about Healthnotes, the company.

The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.