How Dense Are You?World Osteoporosis Day (20 October) has one again highlighted the need for us all to be building healthy bones.Osteoporosis literally means porous bones. It’s a disease that occurs when our bones lose minerals – principally calcium; and the body can’t replace these minerals fast enough to keep the bones healthy. The bones become fragile and brittle. They break and crack more easily. All bones are at risk, but the most common fractures occur in the spine, the hip and the wrist.According to Osteoporosis Australia (OA), 6.6 million Australians have low bone density which puts us at risk of a bone fracture with serious, sometimes fatal consequences. The message from OA this year is know you bone density and stay fracture free. There’s more information on the website www.HowDenseAreYou.org.au Presently, every 5-6 minutes someone is admitted to an Australian hospital with a fracture due to osteoporosis; and this is likely to increase to every 3-4 minutes within the next ten years.Nevertheless, we can help ensure we don't become part of these statistics; because osteoporosis is largely a preventable disease.Both lifestyle and genetic factors have a role in determining bone density and strength. We can’t do much about choosing our parents, but there are other simple self care strategies we can undertake. Chiefly these strategies involve calcium, vitamin D and exercise.Also, there are a number of risk factors for osteoporosis, many of which we can minimise or manage. Note that certain medical conditions and certain medicines are associated with bone loss and an increased risk of fracture. Long-term use of what is known as corticosteroid treatment (that is cortisone-like medicines) can be a particular problem. Extra calcium and vitamin D may be necessary in this case.In fact we all need calcium to prevent bone loss. The recommended daily intake of calcium is 1000 mg for young adults, and for older adults and people with osteoporosis it's 1300 mg. Three or four serves of dairy foods each day will generally achieve these aims. There are a few other high calcium-content foods, too – for instance almonds, salmon, sardines and tofu. But, clearly there will be times when the dietary intake of calcium is not sufficient and a supplement will be necessary.The need for vitamin D to ensure adequate calcium absorption is now well recognised; and our best source of vitamin D is sunlight. Most Australians achieve adequate vitamin D levels through the sun exposure they receive during typical day-to-day outdoor activities (so the need for vitamin D is no excuse for sunbaking). In the warmer months, (depending on where we live in this vast continent) just a few minutes daily exposure to sunlight on the hands, arms and face is quite sufficient. In the winter, especially in the southern parts of Australia, a few hours exposure, spread over the week, may be needed.If you rarely get out into the sun a vitamin D supplement will be necessary. Come speak with our friendly pharmacists for personalised advice.Being active is important. Regular weight bearing exercise helps reduce bone loss associated with ageing or menopause; and exercise has other health benefits as well. The exercise doesn’t have to be, and in fact shouldn't be, too complicated – walking or dancing is fine – preferably for about 30 minutes on all or most days of the week. And, as well as all the other, perhaps better recognised, health problems caused by smoking, it’s a significant risk factor for osteoporosis - another good reason not to smoke.