Skip to main content
SpringerLink
Log in

Prevention of Osteoporosis and Fragility Fractures

  • Chapter
  • First Online:
Book cover Pocket Reference to Osteoporosis

  • 840 Accesses

Abstract

A fracture represents a structural failure of the bone whereby the forces applied to the bone exceed its load-bearing capacity. Therefore, besides bone geometry, mass, density, microstructure, and material level properties, the direction and magnitude of the applied load also determine whether a bone will fracture. Almost all fractures, even those qualified as “low-trauma” fractures, occur as the result of some injury, for instance, a fall from standing height or bending forward to lift heavy objects for vertebral fracture. While available pharmacological intervention is primarily aimed at restoring bone strength (i.e., reducing bone fragility) by altering bone turnover and/or material level properties, a variety of preventive measures for osteoporotic fractures are capable of influencing both components of fracture risk: mechanical overload, for example, falls, and mechanical incompetence, such as osteoporosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 49.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Vico L, Collet P, Guignandon A, et al. Effects of long-term microgravity exposure on cancellous and cortical weight-bearing bones of cosmonauts. Lancet. 2000;355:1607–11.

    Article  CAS  Google Scholar 

  2. Bonaiuti D, Shea B, Iovine R, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2002:CD000333.

    Google Scholar 

  3. Howe TE, Shea B, Dawson LJ, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2002:CD000333.

    Google Scholar 

  4. Auais MA, Eilayyan O, Mayo NE. Extended exercise rehabilitation after hip fracture improves patients' physical function: a systematic review and meta-analysis. Phys Ther. 2012;92:1437–51.

    Article  Google Scholar 

  5. Girgis CM. Integrated therapies for osteoporosis and sarcopenia: from signaling pathways to clinical trials. Calcif Tissue Int. 2015;96:243–55.

    Article  CAS  Google Scholar 

  6. Martyn-St James M, Carroll S. Meta-analysis of walking for preservation of bone mineral density in postmenopausal women. Bone. 2008;43:521–31.

    Article  Google Scholar 

  7. Martyn-St James M, Carroll S. A meta-analysis of impact exercise on postmenopausal bone loss: the case for mixed loading exercise programmes. Br J Sports Med. 2009;43:898–908.

    Article  CAS  Google Scholar 

  8. Kelley GA, Kelley KS, Kohrt WM. Effects of ground and joint reaction force exercise on lumbar spine and femoral neck bone mineral density in postmenopausal women: a meta-analysis of randomized controlled trials. BMC Musculoskeletal Disord. 2012;13:177.

    Article  Google Scholar 

  9. Kelley GA, Kelley KS, Kohrt WM. Exercise and bone mineral density in men: a meta-analysis of randomized controlled trials. Bone. 2013;53:103–11.

    Article  CAS  Google Scholar 

  10. Karlsson MK, Nordqvist A, Karlsson C. Physical activity, muscle function, falls and fractures. Food Nutr Res. 2008;52:1920.

    Article  Google Scholar 

  11. Chilibeck PD, Vatanparast H, Cornish SM, Abeysekara S, Charlesworth S. Evidence-based risk assessment and recommendations for physical activity: arthritis, osteoporosis, and low back pain. Appl Physiol Nutr Metab. 2011;36(Suppl 1):S49–79.

    Article  Google Scholar 

  12. Cermak NM, Res PT, de Groot LC, Saris WH, van Loon LJ. Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis. Am J Clin Nutr. 2012;96:1454–64.

    Article  CAS  Google Scholar 

  13. Finger D, Goltz FR, Umpierre D, Meyer E, Rosa LH, Schneider CD. Effects of protein supplementation in older adults undergoing resistance training: a systematic review and meta-analysis. Sports Med. 2015;45:245–55.

    Article  Google Scholar 

  14. Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1435–45.

    Article  Google Scholar 

  15. Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society. Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011;59:148–57.

    Article  Google Scholar 

  16. Woolcott JC, Richardson KJ, Wiens MO, et al. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med. 2009;169:1952–60.

    Article  Google Scholar 

  17. Harwood RH, Foss AJ, Osborn F, Gregson RM, Zaman A, Masud T. Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial. Br J Opthalmol. 2005;89:53–9.

    Article  CAS  Google Scholar 

  18. Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9:CD007146.

    Google Scholar 

  19. Sherrington C, Tiedemann A. Physiotherapy in the prevention of falls in older people. J Physiother. 2015;61:54–60.

    Article  Google Scholar 

  20. Trombetti A, Hars M, Herrmann FR, Kressig RW, Ferrari S, Rizzoli R. Effect of music-based multitask training on gait, balance, and fall risk in elderly people: a randomized controlled trial. Arch Intern Med. 2011;171:525–33.

    Article  Google Scholar 

  21. Hars M, Herrmann FR, Fielding RA, Reid KF, Rizzoli R, Trombetti A. Long-term exercise in older adults: 4-year outcomes of music-based multitask training. Calcif Tissue Int. 2014;95:393–404.

    Article  CAS  Google Scholar 

  22. Low S, Ang LW, Goh KS, Chew SK. A systematic review of the effectiveness of Tai Chi on fall reduction among the elderly. Arch Gerontol Geriatr. 2009;48:325–31.

    Article  Google Scholar 

  23. Oliver D, Connelly JB, Victor CR, et al. Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analyses. BMJ. 2007;334:82.

    Article  Google Scholar 

  24. El-Khoury F, Cassou B, Charles MA, Dargent-Molina P. The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f6234.

    PubMed  PubMed Central  Google Scholar 

  25. Rizzoli R. Nutritional aspects of bone health. Best Pract Res Clin Endocrinol Metab. 2014;28:795–808.

    Article  CAS  Google Scholar 

  26. Bischoff-Ferrari HA, Kiel DP, Dawson-Hughes B, et al. Dietary calcium and serum 25-hydroxyvitamin D status in relation to BMD among U.S. adults. J Bone Miner Res. 2009;24:935–42.

    Article  CAS  Google Scholar 

  27. Ross AC, Manson JE, Abrams SA, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96:53–8.

    Article  CAS  Google Scholar 

  28. Mithal A, Wahl DA, Bonjour JP, et al. Global vitamin D status and determinants of hypovitaminosis D. Osteoporosis Int. 2009;20:1807–20.

    Article  CAS  Google Scholar 

  29. Rizzoli R, Stevenson JC, Bauer JM, et al. The role of dietary protein and vitamin D in maintaining musculoskeletal health in postmenopausal women: a consensus statement from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Maturitas. 2014;79:122–32.

    Article  CAS  Google Scholar 

  30. Bischoff-Ferrari HA, Willett WC, Orav EJ, et al. A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med. 2012;367:40–9.

    Article  CAS  Google Scholar 

  31. Gaffney-Stomberg E, Insogna KL, Rodriguez NR, Kerstetter JE. Increasing dietary protein requirements in elderly people for optimal muscle and bone health. J Am Geriatr Soc. 2009;57:1073–9.

    Article  Google Scholar 

  32. Castaneda C, Gordon PL, Fielding RA, Evans WJ, Crim MC. Marginal protein intake results in reduced plasma IGF-I levels and skeletal muscle fiber atrophy in elderly women. J Nutr Health Aging. 2000;4:85–90.

    CAS  PubMed  Google Scholar 

  33. Kerstetter JE, O'Brien KO, Caseria DM, Wall DE, Insogna KL. The impact of dietary protein on calcium absorption and kinetic measures of bone turnover in women. J Clin Endocrinol Metab. 2005;90:26–31.

    Article  CAS  Google Scholar 

  34. Darling AL, Millward DJ, Torgerson DJ, Hewitt CE, Lanham-New SA. Dietary protein and bone health: a systematic review and meta-analysis. Am J Clin Nutr. 2009;90:1674–92.

    Article  CAS  Google Scholar 

  35. 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.

    Article  CAS  Google Scholar 

  36. Bauer J, Biolo G, Cederholm T, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013;14:542–59.

    Article  Google Scholar 

  37. Rizzoli R, Branco J, Brandi ML, et al. Management of osteoporosis of the oldest old. Osteoporosis Int. 2014;25:2507–29.

    Article  CAS  Google Scholar 

  38. Feldblum I, German L, Castel H, Harman-Boehm I, Shahar DR. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc. 2011;59:10–7.

    Article  Google Scholar 

  39. Schurch MA, Rizzoli R, Slosman D, Vadas L, Vergnaud P, Bonjour JP. 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.

    Article  CAS  Google Scholar 

  40. Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet. 2007;370:657–66.

    Article  CAS  Google Scholar 

  41. Rizzoli R. Dairy products, yogurts, and bone health. Am J Clin Nutr. 2014;99:1256S–62S.

    Article  CAS  Google Scholar 

  42. Kanis JA, McCloskey EV, Johansson H, et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis Int. 2013;24:23–57.

    Article  CAS  Google Scholar 

  43. Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ. 2013;c3691:341.

    Google Scholar 

  44. Prentice RL, Pettinger MB, Jackson RD, et al. Health risks and benefits from calcium and vitamin D supplementation: Women's Health Initiative clinical trial and cohort study. Osteoporosis Int. 2013;24:567–80.

    Article  CAS  Google Scholar 

  45. Paik JM, Curhan GC, Sun Q, et al. Calcium supplement intake and risk of cardiovascular disease in women. Osteoporosis Int. 2014;25:2047–56.

    Article  CAS  Google Scholar 

  46. Sanders KM, Stuart AL, Williamson EJ, et al. Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA. 2010;303:1815–22.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland

    René Rizzoli

Authors
  1. René Rizzoli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to René Rizzoli .

Editor information

Editors and Affiliations

  1. Division of Bone Diseases, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland

    Serge Livio Ferrari

  2. Department of Rheumatology, Paris Descartes University Cochin Hospital, Paris, France

    Christian Roux

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Rizzoli, R. (2019). Prevention of Osteoporosis and Fragility Fractures. In: Ferrari, S., Roux, C. (eds) Pocket Reference to Osteoporosis. Springer, Cham. https://doi.org/10.1007/978-3-319-26757-9_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-26757-9_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26755-5

  • Online ISBN: 978-3-319-26757-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation