How to Improve Your Bone Health Using DEXA Scans

Understanding how to maintain and improve your bone health is critical to enhancing your longevity and quality of life.

DEXA scans provide a clear picture of your bone density, allowing you and your healthcare provider to make informed decisions to strengthen your bones.

What is Bone Mineral Density (BMD)?

Bone Mineral Density refers to the amount of calcium and other minerals in your bone tissue.

It is calculated by dividing the weight of your bones (bone mineral content) by the area of the bone in squared centimeters.

BMD is a vital measure used to diagnose bone diseases like osteoporosis and assess the risk of fractures. The higher the density, the stronger the bones are, which decreases the risk of fractures.

Around 3.4% of people in Australia were estimated to be living with osteoporosis or osteopenia in 2022. The true prevalence, including undiagnosed cases, is likely to be higher than this.

BMD is usually measured at key sites prone to osteoporosis, such as the spine, hip, and forearm.

The Importance of DEXA Scans for Bone Health

DEXA scans are considered the gold standard for measuring BMD. They are quick, non-invasive, and provide detailed images of the bone and overall body composition. The process involves using low-dose X-rays at two different energy levels to calculate the bone density precisely.

Benefits of Regular DEXA Scans

• Early Detection: Regular DEXA scans can detect decreases in bone density before a fracture occurs.
• Monitoring Treatment Efficacy: DEXA scans can be a useful tool to monitor the efficacy of any interventions aiming to improve bone density.
• Preventative Care: By understanding the current state of your bone health, you can take proactive steps to strengthen them through lifestyle choices like diet, exercise, and supplements if necessary.

T-Score and Z-Score:

The BMD results are compared to a reference population to determine T-scores and Z-scores:

• T-Score: Compares the patient’s BMD to the average BMD of a healthy young adult of the same sex. It indicates how much higher or lower the patient’s BMD is compared to this reference.

• Z-Score: Compares the patient’s BMD to the average BMD of people of the same age, sex, and body size. Z-scores are typically more relevant for children, teenagers, premenopausal females, and males under the age of 50 years. The Z-score is used to identify whether other underlying conditions may contribute to bone loss rather than aging.

The T-score is used to diagnose osteoporosis and osteopenia:

• A T-score of -1.0 or above is considered ‘normal’ or not an increased risk of fractures.
• A T-score between -1.0 and -2.5 indicates osteopenia (low bone mass).
• A T-score of -2.5 or below indicates osteoporosis.

These scores are in the form of standard deviations. This mathematical term measures how close a number is to the average. The greater the number is away from 0, the further the individual is from the mean.

Who Are More At Risk?

• Women Aged 65 and Older: Women are more susceptible to osteoporosis, especially post-menopause. This susceptibility is largely due to reduced oestrogen levels, a hormone that helps maintain bone density.
• Men Aged 70 and Older: Men over 70 are at increased risk of bone loss and fractures. Factors contributing to this include lower levels of testosterone, reduced physical activity, and other age-related changes in bone metabolism.
• People with a Fracture History: Individuals who have had fractures with minimal trauma should consider a DEXA scan as this may be a sign of underlying weak bones.
• Individuals with Risk Factors: Those with risk factors such as rheumatoid arthritis, low body weight, a family history of osteoporosis, a history of low energy availability, or who use medications that affect bone tissue, like corticosteroids. These can all reduce bone mineral density.

Lifestyle Tips to Support Bone Health

Many nutrients can play a role, however below are some of the key lifestyle and dietary factors to consider.

Calcium

Calcium is the primary mineral found in bones, providing them with structure and strength. About 99% of the body’s calcium is stored in the bones and teeth, making it essential for their development and maintenance.

It also plays a vital role in bone remodeling, ensuring that the balance between old bone being broken down and new bone being formed is maintained.

The recommended daily intake varies depending on your age so it is important to be aware of this and to consume enough to support these functions.

Dairy products, fish with bones, and calcium-fortified are among some of the sources high in calcium.

Vitamin D

Vitamin D is also important as this helps the body absorb calcium effectively.

Although some foods like fatty fish, egg yolks, and fortified foods contain vitamin D, the best source is sunlight. For those receiving limited sun exposure, supplementing may be necessary to meet your needs. Your healthcare professional can advise how much may be appropriate for you.

High Impact Training

High-impact training, such as running and weight-bearing exercises are particularly beneficial for bone health. This type of exercise applies stress to the bones which encourages them to grow stronger.

Mobility and balance exercises may also be a good idea to implement as they can reduce the risk of falls that could lead to serious bone injuries.

Why Does This All Matter?

Hip fracture is the most serious consequence of falling in older people with osteoporosis.

The mortality rate after a hip fracture is notably high. Studies suggest that the one-year mortality rate after suffering a hip fracture can be as high as 20-30% and continue to rise over time.

Many of the deaths associated with hip fractures are due to complications from the fracture itself, such as infections, cardiovascular events, or pulmonary embolism.

In Australia specifically, 29% of fall burden in Australia is attributed to low bone mineral density and osteoporosis accounted for about 1.4% of all deaths.

Summary

Whether you are at risk for bone density loss or just committed to maintaining healthy bones, a DEXA scan can be an invaluable tool in your healthcare regimen. Book a scan today or contact us for more information.