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Other risk factors include:

• A family history of osteoporosis
• Osteopenia â€� or low bone mineral density
• Low body weight
• A diet low in calcium
• Low levels of physical activity
• Ovaries removed or early menopause (before the age of 45), without hormone replacement
• Being past menopause
• Vitamin D deficiency
• Smoking
• Excessive caffeine intake (more than four cups a day of coffee, tea or cola) or excessive alcohol intake (more than two drinks a day)
• Long-term oral use of some medications such as cortisone, prednisone or anticonvulsants

If you are at risk, talk to your doctor about getting a bone density test and take preventive action to reduce the risk. And no matter what your risk level, follow these tips for better bone health:

• Eat well. A diet rich in lean protein, low-fat dairy, fruits and vegetables has been shown to reduce their risk of chronic diseases such as osteoporosis. Ask your doctor if you should be taking a calcium supplement.
• Be active every day. Bones become stronger with increased activity. Include regular weight-bearing exercise such as dancing, walking, hiking or tennis in your daily routine. Exercise that improves balance and coordination such as yoga, tai chi swimming and flexibility exercises will help reduce falls and prevent fractures.
• Avoid smoking. Smokers have faster rates of bone loss and a higher risk of fractures than non-smokers. Women who smoke also tend to enter menopause at an earlier age than non-smokers. This means more rapid bone loss - and at an earlier age.
• Prevent falls. If you have been diagnosed with osteoporosis or have some of the risk factors, preventing falls is particularly important. An exercise program geared to your abilities will help. Wear comfortable shoes that give good support. Watch for uneven ground, sidewalks and floors. Don't rush to catch a bus, answer the phone or a doorbell. Make your house safe to reduce the risk of accidents.

If you have already been diagnosed with osteoporosis or osteopenia, talk to your doctor about medication that may help with your condition.

This article first appeared in the January 2014 edition of the HealthPerks newsletter.