Abstract
Musculoskeletal disorders are the most frequently reported long-standing illness or disability in Britain. Osteoporosis is a subheading of these disorders frequently first diagnosed following fracture. British research shows body mass index (BMI) to be the most statistically significant risk factor, showing an increase by a factor of 6.7 for hip fractures as BMI fell from 25 to under 20. Research in nine countries is introduced showing BMI is an accepted key risk factor for osteoporosis. Irregular menstruation is a risk factor for poor nutrition and later osteoporosis. Exercise on an adequate diet increases bone mineral density, but increases the risk of osteoporosis on an inadequate diet and low BMI. A minority of men and women live until their 80s with fully adequate bone density, suggesting that osteoporosis is wholly preventable. But the majority, and particularly women over 50, have a deteriorating bone density. Hormone replacement therapy is a valuable preventative for women at risk. Several studies show a correlation of low bone density and dietary intake of calories and protein, and one study of protein but not calories. Other studies show correlations with some individual vitamins and minerals. It is concluded that current recommendations for BMI need reconsideration, as the increase in osteoporosis risk as BMI falls below 25 is shared by other disorders.