Fit to a T

That's right, T-score. If you had to think twice about what a T-score is - and no, it's not a golf term - chances are you probably don't know your bone mineral density (BMD) levels, or you haven't been tested. Don't worry, you're not alone.

Bones. Bone mineral density. T-score. Yes, you should add those to that list of health factors you need to be concerned about so that you can enjoy lifelong health and an active lifestyle.

If you want to shop 'til you drop, golf 'til your legs ache and line dance 'til you're 84 - knowing that your bones won't let you down - here's what you need to know.

Until a few years ago, many conditions - such as osteoporosis - were considered "old people's" diseases. Today we know differently. Steps to improve bone health start at an early age. Weak bones can affect individuals of all ages.

The T-score reveals whether bones are weak or strong, and what the chances are for breaking one of them. If you thought brittle bones are a natural part of aging, please think again.

Knowing what a T-score is and what "bone health" means are  important first steps. If you or your health care professional have concerns about your bone health, a T-score will help you learn how strong your bones are and whether you need to take action. How do you find out your T-score? A simple, painless BMD test - which takes less than 20 minutes - will provide the answer.

So let's get started. This booklet is part of an educational program, sponsored by the U.S. Bone and Joint Initiative, to help you learn more about your bone health and the early detection, diagnosis, treatment, and prevention of osteoporosis.

Why Should You Be Concerned?

We want you to be Fit to a T ™ so that you can enjoy good bone health.

Whether you are in your 20s, 40s or 70s, it's not too early or too late to make changes in your diet, exercise program and lifestyle to strengthen your bones.

If Americans don't take action, by the year 2020, half of all persons older than age 50 will be at risk for fractures related to osteoporosis and low-bone mass, according to the U.S. Surgeon General's Report on Bone Health and Osteoporosis.

One common myth is that osteoporosis only happens in Caucasian women. The fact is that it affects men and women of all races and ages. Another myth is that only seniors have brittle bones that break. Although weaker bones are more common in older people, certain factors that lead to weaker bones are important at all ages. And even younger people can suffer from broken bones related to osteoporosis.

The truth is that osteoporosis and other bone diseases can lead to a poor quality of life - causing pain, loss of mobility and independence, and even death.

Here is the Good News.

By learning more about osteoporosis, focusing on prevention and taking action, you can alter the course of the disease. Three things that you can do to improve your bone health and make your bones stronger are to take in enough calcium and vitamin D and get enough physical activity every day.

With that in mind, Americans can have strong bones and live healthy, independent and fulfilling lives - and be Fit to a T.

Warning Signs

A Broken Bone: A broken bone (fracture) as an adult does not always mean you have osteoporosis - but it could be a warning sign that your bones are weak, especially if the break is from normal activities or during a minor fall.

Back Pain or Spinal Deformities: Back pain that will not quit could be a sign that you have a spinal fracture. This occurs when bones in your back become so weak that they fracture and collapse.

Loss of Height: A fractured bone in your spine could collapse onto itself causing you to shrink. Multiple fractures can cause the spine to form a curve causing the disfigurement known as a "dowager's hump."

How Do You Build Strong Bones?

Daily physical activity and a diet with enough calcium and vitamin D can help prevent osteoporosis, according to the U.S. Surgeon General's Report.

Let's Get Physical

Building strong bones begins with daily exercise of at least 60 minutes for children and 30 minutes for adults. Children should know that building bone density in youth is an investment in the future. The best types of exercises for healthy bones are weight-bearing and strength-building activities. Jogging, tennis and walking are types of weight-bearing activities. They are important because they force muscles and bones to work against gravity and they put stress on the limbs. Strength-building exercises - which lead to stronger muscles and bone - include weight-lifting, calisthenics and resistance machines. Exercises, such as Tai Chi, are good because they can help improve your balance, and decrease your risk of falling.

Before you start an exercise program, or if you have osteoporosis, check in first with your physician or other healthcare professional. Individuals with low bone mass may need to skip certain exercises to avoid medical problems, such as breaking a bone.

Your Body Needs Calcium

Calcium is a building block of bone and is key to having strong bones. Based upon your age, your body needs different amounts of calcium.

Children and young adults generally need more calcium because their bodies are developing. Young adults between ages 9 and 18 need more calcium than any other age group - 1,300 milligrams per day.

Men and women over age 50 and postmenopausal women also need a higher intake of calcium. They need about 1,200 to 1,500 mg of calcium daily. Dairy products and milk are high in calcium; non-dairy foods such as leafy green vegetables, soybeans and salmon also contain calcium but in a lesser amount. If you have problems digesting lactose, which is in dairy products, you may need to take a calcium supplement. Talk with your physician or other healthcare professional before starting a supplement, and about the appropriate amount for you.

Vitamin D and Your Bone Health

Individuals need vitamin D to help their bodies absorb calcium from the gastrointestinal tract and to keep bones strong and healthy. The older you become, the more of this vitamin you need. Where does vitamin D come from? The vitamin can be synthesized in skin from exposure to the sun or ingested in foods such as fortified dairy products, egg yolks, fish (i.e., salmon, mackerel and tuna), liver or in supplements. Consult your physician or other healthcare professional for the appropriate dosage for you. Click here for more information about Vitamin D and Your Bone Health.

How Do You Treat Osteoporosis?

If you have low bone mass but no fractures, you and your healthcare professional will put together a treatment plan to stop further bone loss and prevent fractures. If you have had one or more fractures due to osteoporosis, your physician or healthcare professional will work with you to prevent further breaks, reduce pain, improve your bone health, keep you active and enhance your quality of life.

What is Osteoporosis?

Osteoporosis - which means "porous bone" - is a progressive medical condition in which the bone becomes thinner than normal, and weakens. As a result, bones break easily even with something as simple as a fall - causing fractures most commonly of the hip, spine and wrist. Men and women at any age may suffer from osteoporosis.

One out of four persons with a hip fracture due to osteoporosis ends up in a nursing home for long-term care. Out of that group, another one in four is at greater risk of dying within the first year after the fracture. The risk for death is even greater among men.

The Risk Factors

Gender: Women develop osteoporosis more often than men. Women have less bone tissue to start with and lose bone more rapidly than men as a result of menopause. But men are not immune to this condition, and are often under-diagnosed and inadequately researched.

Age: Bones become less dense and weaker as you age, increasing risk of osteoporosis.

Body Size: Low body weight (under 127 pounds) is an important risk factor for osteoporosis and increased risk of fractures. Being too thin means less padding of muscle and fat to protect your bones from injury, and may indicate you don't have adequate nutrition to maintain your bone.

Ethnicity: In the United States, Hispanic women are at highest risk - 13 to 16 percent have osteoporosis. Caucasian and Asian women are also at high risk. African-American women have a lower, but significant risk, with 10 percent over age 50 having the disease.

Family History: Individuals whose family members have a history of fractures or osteoporosis seem to have an increased risk for both. If someone in your family has osteoporosis, you have a 60 to 80 percent chance of getting the condition, too.

Medications: Long-term use of certain drugs - such as oral glucocorticoids (steroid pills such as prednisone) or anti-seizure medications - can put you at risk for osteoporosis. Certain chronic medical conditions can also lead to weaker bone.

Other Medical Problems: Your chances of osteoporosis increase if you have conditions such as rheumatoid arthritis, hyperthyroidism (excessive production of thyroid hormones or taking too much thyroid replacement medication), hyperparathyroidism (a condition caused by excessive amounts of parathyroid hormone), type I diabetes, kidney disease, liver disease, inflammatory bowel disease, chronic obstructive pulmonary disease (COPD), anorexia or other eating disorders.

Hormone Levels: Men and women have lower sex hormone levels (such as testosterone and estrogen) as they age. This loss may be accelerated by some medical treatments. Loss of estrogen, especially after menopause, is the most common cause of osteoporosis in women. Sex hormones in both men and women are necessary to achieve and maintain an adequate amount of bone.

Low Calcium or Vitamin D: People need calcium and vitamin D throughout their lives to build bone. Milk and other fortified dairy products, and certain other foods, can provide a major boost of these nutrients.

Inactive Lifestyle: Your bones need weight-bearing exercise, about 30 minutes a day, to remain healthy.

Smoking, or Drinking Excessive Amounts of Alcohol: Smoking increases your risk of having osteoporosis as it damages bone cells and prevents new bone growth. More than 2 to 3 ounces a day of alcohol may damage your bones - putting those who consume larger amounts of alcohol at risk.

Talking with Your Healthcare Provider

A dialogue with your physician or healthcare professional is essential in preventing, detecting and treating osteoporosis. Here are some key issues to discuss during your visit:

Symptoms: Let your physician or healthcare professional know if you are experiencing any warning signs of osteoporosis.  Remember, osteoporosis doesn't hurt until you break a bone.

Family Medical History: If someone in your family has osteoporosis or had a fragility fracture, you may also be at risk.

Bone Mineral Density (BMD) Scan: Women over age 65 should be screened with this simple test to determine bone strength. If you have one or more of the risk factors described in this booklet, you should consider getting a BMD scan, regardless of your age. Other common situations that suggest a test may be required:

  • Post-menopausal women under age 65
  • Men over age 50 with risk factors
  • Any person with a fragility fracture

Even if you don't fit into one of these categories and don't need to be tested now, it is still important to work on improving your bone health.

Diagnosis and Treatment: If diagnosed with osteoporosis, discuss treatment options, and how to prevent further bone loss, disability, pain and fractures. If you don't have osteoporosis, ask if there are changes you need to make to keep your bones in good shape.

Diet: Know your daily Calcium and vitamin D intake, and talk about appropriate nutritional requirements.

Physical Activity: Discuss how much exercise is needed, what type of exercise, and how can it help to build strong bones.

Medications: Make a list of the medications you take and find out whether they can contribute to bone loss.

Vision and Balance: Check your vision regularly. Poor vision can lead to falls and broken bones. If you have vision or balance problems, or difficulties walking - you may need further testing to rule out any problems.  You may also need to make some changes at home to lessen your risk of tripping and falling.

Four Stories of How Osteoporosis Impacts Lives

When Osteopororis Strikes at an Early Age

Susan's Story

Diagnosed: At age 46

Condition: Susan has osteoporosis of the spine, right and left hip.

Advice: "The bone density test is the easiest test you'll ever have. You lie down and it can be done in minutes. It should be done by everyone."

What She Says: "People are surprised that I have osteoporosis. Everyone thinks it is a little old lady's disease."

A Look at Susan - "I never smoked, my drinking is limited and overall I am healthy," said Susan, referring to some risk factors for the disease. However, from about age 24, Susan experienced problems with dairy products and couldn't tolerate them. She was at risk because of her low-calcium diet. Her mother also has osteoporosis, so that made Susan even more prone.

Susan knows the importance of talking about osteoporosis with friends and family members, and she knows how a good fitness program can help rebuild bones and she exercises regularly. "These are the cards you're dealt," said Susan, who has a positive attitude. "I feel lucky to live in this day and that there are medicines to help improve osteoporosis. Ten years ago they didn't have some of these medicines."

Early Menopause and the Link to Osteoporosis

Pam's Story

Diagnosed: At age 44

Current Condition: Pam has osteoporosis, diagnosed after she had broken several bones with minimal trauma. She knows about trauma: she was in severe automoblile collision 30 years ago, sustaining significant injuries. She has been living with osteoporosis for about 20 years.

Advice: "I'm not sure what caused my osteoporosis - there are probably a lot of factors. My mother had been diagnosed with the condition. Also, I was limited in how much weight bearing activity I could do for quite a while after my motor vehicle collision; my diet when I was younger was also not very good. There are some things out of your control regarding the development of osteoporosis; however, I know you can do things to keep it in check, and I am doing everything I possibly can so I can continue to do things in life I want to."

What She Says: "It was devastating to learn that a woman of my age would have such a low bone density. I started working with a trainer twice a week using weights to increase my bone density. To this day I continue to exercise, lift the weights, watch my diet, and stay informed about the advancements and treatments for osteoporosis."

A Look at Pam - Thirty years ago Pam was in a serious automobile accident, Nearly every bone had been broken, including both legs and spine. After several surgeries and months of intensive physical therapy, she was able to walk again and slowly return to her job as a Flight Attendant for a major airline. Over the last several years she has had numerous subsequent surgeries due to the damage from the accident and joint deterioration from posttraumatic arthritis.

The Fight Against Fragility Fractures

Ellen's Story

Diagnosed: At age 52

Current Condition: Ellen has osteoporosis of the hip and spine and arthritis. She has suffered multiple fractures of the neck, hip and shoulder.

Treatment: She has taken medication for osteoporosis for more than 15 years to slow down bone loss, calcium supplements for more than 40 years, and a vitamin D supplement. She exercises on a regular basis.

Advice: "If I was working as a physical therapist now, I would tell people different things. One didn't know (back then) that exercise had to be weight-bearing. Younger people should lift weights."

What She Says: "My bone density is so poor, I have a lifelong danger of non-traumatic fractures."

A Look at Ellen - For 45 years, Ellen has lived with osteoporosis. At age 52, she was a hospital physical therapist and was having severe back pain. An X-ray revealed she had arthritis and osteoporosis. "Osteoporosis has affected my life quite a bit," said Ellen, who retired at age 59 because of arthritis of the back and knees. "Until the first two fractures - I always was quite active."  About 30 years ago, Ellen suffered a compression fracture of a neck vertebrae while sleeping. About 23 years ago, she slipped on a wet kitchen floor and had a spinal compression fracture. Six weeks after that, she suffered yet another compression fracture while walking. Other breaks have included hip and shoulder fractures from falls. She admits she has fallen many times. But unlike other people, her falls often result in a fracture, which take weeks to heal. Ellen had several risk factors for developing osteoporosis. She has a small build and the disease has affected other family members. Also, Ellen never drank much milk as an adult, but she did consume other dairy products.

When Men Have Poor Bone Health

Steve's Story

Diagnosed: At age 42

Current Condition: Steve has osteoporosis of the spine.

Treatment: Steve was placed on therapy with oral bisphosphonate. His Vitamin D was repleted with high dose Ergocalcifeorol and then switched over to Cholecalciferol for maintenance. He was also placed on Calcium supplement, and the doctor recommended he start a more regular weight-bearing exercise program. He stayed on the bisphosphonate for 4 years until his DXA showed stabilization and he now just takes Calcium and Vitamin D supplements daily. Weight bearing exercise continue to be part of his regular routine.

Advice: "Because I maintained a healthy and active lifestyle which was required of my occupation as a Police Officer, it was distressing to me to find out I could easily fracture a bone with just a minor injury especially in my line of work. I had always connected fragile bone disease with elderly women."

A Look at Steve - Steve's wife is a Nurse Practitioner in an Osteoporosis Center and both of them were taken by surprise when the results of a DXA scan he took one day, purely out of interest in the DXA michine in the center where his wife works, demonstrated osteoporosis. His internist was also surprised. Steve had never had a fracture. At that time Steve was working in law enforcement as a police sergeant. He was physically active and there was no reason to suspect he had osteoporosis.

It was not clear what his risks were as he had always been healthy, didn't smoke, ate a good diet and neither of his parents had osteoporosis. The internist was unsure of why Steve had osteoporosis so made the decision to send him to an osteoporosis specialist.

The doctor reviewed his history and ordered a battery of laboratory tests to find other contributing causes. While reviewing his history she discovered that approximately 2 years earlier he was diagnosed with thyroiditis. His laboratory results also demonstrated a low Vitamin D level. The doctor concluded that these two conditions caused enough bone loss to develop osteoporosis.

Steve retired from law enforcement in 2002 and now works as a Transportation Security Manager with the U.S. Department of Homeland Security

Getting Your T-score

One of the most common ways to estimate the strength of your bone is to measure your bone mineral density (BMD) with a DXA scan, also known as dual X-ray absorptiometry. The test takes 20 minutes or less. It is non-invasive (doesn't penetrate the body's skin), causes no pain and is performed with low levels of radiation - less than from a typical chest X-ray. The DXA measures your BMD at the spine and hip, and occasionally in other locations, and provide the T-score.

The test will help predit your chances of breaking a bone and confirm that you have osteoporosis after a fracture. Over time, the test will analyze your rate of bone loss and evaluate wheater treatment for osteporosis has been effective. 

Knowing the T-score Once you have a scan, what does the result mean?  With the DXA scan, the amount of bone you have (your "bone density") is compared to the bone density of a healthy young adult, who should have the most optimal amount of bone or ³peak bone mass." Your healthcare professional will give you your test results in a T-score. The T-score is a very important measurement because it helps identify people at highest risk before they get a facture. As defined by the World Health Organization, a normal T-score ranges from +1 to -1. Low bone mass is -1 to -2.5. Osteoporosis is defined as -2.5 or lower. The lower your T-score, the higher your risk for a fracture. However, you can still have a score not low enough to be defined as "osteoporosis" and still be at risk of having a broken bone because of other factors.

The Benefits of Exercising

    • Decreased risk of falling
    • Improved bone mass and strength
    • Enhanced muscle strength
    • Improved balance, better posture
    • Increased flexibility of soft tissues
    • Improved cardiovascular fitness

Vitamin D and Your Bone Health

Why is vitamin D important?
Vitamin D is necessary to form and maintain strong bones. Among other roles, vitamin D helps your body absorb the calcium you take in from food or supplements. Once absorbed, calcium, along with other minerals, provides the strength needed for bones to withstand the stresses of daily activities. Low levels of vitamin D or calcium intake can lead to bone loss, making bones weaker. An adequate diet, especially in terms of calcium and vitamin D, and exercise are the cornerstones of achieving and maintaining optimal bone health and helping to prevent broken bones.

Why Don’t Some People Get Enough Vitamin D?
Everyone needs vitamin D. However, people are different in their ability to get enough of this vitamin. Vitamin D can be produced in the skin as a result of sun exposure, typically 10-15 minutes per day, with arms and legs exposed. The amount of vitamin D made this way is variable, depending on where you live and the time of year: the farther north you live and during winter months, less vitamin D is made. Also, adults over the age of 50, due to changes in chemical reactions in the skin, may be limited in their ability to make vitamin D with sun exposure. In addition, people with darker complexions and people of any race who use sunscreen make less vitamin D, due to lower sunlight absorption. People make almost no vitamin D with the use of sunscreen with an SPF of 15 or higher. People with less exposure to the sun, including those living in more northern regions, those with jobs indoors, the elderly and those who are chronically ill, also have limited ability to make vitamin D. Once produced in the skin, this initial form of vitamin D is further processed in the liver and kidney, producing its active form. This makes people with chronic liver and kidney diseases at risk of low levels of active vitamin D.

Vitamin D can also be obtained in the diet. However, vitamin D occurs naturally in only a few foods, including salmon and other fatty fish, liver and egg yolks. Vitamin D is frequently added to dairy products, especially milk, as well as some fruit juices and cereals. However, since it does not naturally occur in these products, you need to be careful in reading the label, as different products contain different amounts of vitamin D. Some people are lactose intolerant or are otherwise unable to consume dairy products. These people are at risk of not getting enough vitamin D to develop or maintain optimal bone strength. Even those products with vitamin D contain only a portion of the amount that you need every day. So, even if vitamin D-supplemented products are a regular part of your diet, it may be difficult to take in enough vitamin D only through your diet. Check product labels for the amount of vitamin D contained in individual servings.

Vitamin D is necessary to develop and maintain bone health. Vitamin D, along with calcium and exercise, can help prevent broken bones. It is important for you to talk with your health care provider to find out how much vitamin D you need and the best way to make sure you are getting enough every day.

How Much Vitamin D Do I Need?
The biology of vitamin D is complex and impacted by many factors. Recommendations for daily intake are made assuming you make minimal amounts from sun exposure. Adults should consume 600 IU (International Units) of vitamin D, and those over the age of 70 may need up to 800 IU per day, from food and, if needed, supplements. More may not be better: taking in more than 4,000 IU per day in adults (and even less in children) may be dangerous. If you are obese or have undergone weight loss surgery, you may need higher doses of vitamin D. Also, prescription and over-the-counter medications to help you lose weight or lower your cholesterol may keep you from absorbing vitamin D from your diet or supplements, meaning you may need to take in more. 

Discuss with your health care provider how much vitamin D is right for you and your bones and how best to take in enough vitamin D. Your health care provider may recommend that you get a blood test to see how much vitamin D is in your body. Medications to treat osteoporosis work better if you are taking in enough vitamin D and calcium to help build bone. If you are already on one of these medications, talk with your health care provider to ensure that you are getting enough vitamin D. If you and your health care provider decide that you aren’t getting enough vitamin D from your diet and that you need vitamin D supplements, discuss the supplements that are best for you because different supplements contain different forms and amounts of vitamin D.

While vitamin D is necessary for strong bones, it cannot do it alone. You also need calcium and weight-bearing exercise for strengthening bones and preventing falls that can lead to bone fracture.

For More Women's Health Information Visit:
American Medical Women's Association -
HealthyWomen - 

Vitamin D and Your Bone Health - Downloadable PDF


Bibliography and Links on Good Bone Health And To Prevent Osteoporosis

 General Information

  • MedlinePlus
    MedlinePlus includes links to carefully researched websites, interactive slideshows, drug information, a medical encyclopedia, and the latest news on osteoporosis, from the National Library of Medicine (NIH) (in English and Spanish).

  • Healthfinder
    healthfinder® links to carefully selected information and Web sites from over 1,500 health-related organizations (in English and Spanish)

  • NOAH (New York Online Access to Health)
    NOAH provides access to high quality full-text consumer health information in English and Spanish that is accurate, timely, relevant and unbiased (in English and Spanish).

U.S. Government Resources
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIH)
    NIAMS is the primary NIH organization for research on osteoporosis and other musculoskeletal health issues.  The section called "Health Information" provides consumer and patient information.

  • Osteoporosis and Related Bone Diseases—National Resource Center (NIH)
    The National Resource Center is dedicated to increasing awareness, knowledge and understanding about the prevention, early detection and treatment of osteoporosis and related bone diseases.

  • Bone Health and Osteoporosis: A Report of the Surgeon General
    The Surgeon General issues the first-ever report on the nation's bone health.

  • Centers for Disease Control and Prevention: Bone Health
    Information for both adults and children about bone health and osteoporosis from the Centers for Disease Control and Prevention.

  • National Institute on Aging
    The National Institute on Aging leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life.

  • provides regularly updated information about federally and privately supported clinical research in human volunteers. gives you information about a trial's purpose, who may participate, locations, and phone numbers for more details.
  • United States Bone and Joint Initiative
    A multi-disciplinary initiative targeting the care of people with musculoskeletal conditions--bone and joint disorders. Its focus is on improving your quality of life as well as advancing the understanding and treatment of those conditions through research, prevention and education.

  • Bone Health and Osteoporosis Foundation
    The goals of this organization are to prevent osteoporosis, to promote lifelong bone health, to help improve the lives of those affected by osteoporosis and related fractures, and to find a cure. 

  • American Academy of Orthopedic Surgeons
    AAOS will serve the profession, champion the interests of patients, and advance the highest quality musculoskeletal health.

  • Arthritis Foundation
    The Arthritis Foundation supports the more than 100 types of arthritis and related conditions with advocacy, programs, services and research (in English and Spanish).

  • International Osteoporosis Foundation
    The International Osteoporosis Foundation is an international non-governmental organization whose mission is to advance the understanding of osteoporosis and to promote prevention, diagnosis and treatment of the disease worldwide.

  • American College of Rheumatology
    The American College of Rheumatology is the professional organization of rheumatologists and associated health professionals.  The "patients and public" section of the website has consumer-friendly information.


EXERCISES FOR OSTEOPOROSIS: More Than 100 Exercises To Build Bone Density And Muscle Strength

Dianne Daniels, 2004


BEAUTIFUL BONES WITHOUT HORMONES : The Revolutionary New Diet And Exercise Program to Reduce The Risk of Osteoporosis And Keep Your Bones Healthy And Strong

Leon Root, 2004



Linda Sparrowe , 2004


OSTEOPILATES: Increase Bone Density Reduce Fracture Risk Look And Feel Great!

Karena Thek, Lineback,  2003

OUTWITTING OSTEOPOROSIS: The Smart Woman's Guide to Bone Health

Ronda Gates,   2003


WHAT YOUR DOCTOR MAY NOT TELL YOU ABOUT OSTEOPOROSIS: Help Prevent And Even Reverse The Disease That Burdens Millions Of Women

Felicia Cosman,  2003



Fiona Hunter,  2003



616.716 MAYO

I'M NOT SLOWING DOWN: Winning My Battle With Osteoporosis

Ann Richards,   2003



E. Joan Bassey,  2002

ESPANOL 616.716


Mia Schmidt,   2002

ESPANOL 616.716

VENCER LA OSTEOPOROSIS: El Colágeno, Clave de La Descalcificación Y La Artrosis

Ana María Lajusticia Bergasa,   2000

ESPANOL 616.716

PERFECT BONES: A Six-Point Plan For Healthy Bones

Pamela Levin,   2002




THE SILENT THIEF: OSTEOPOROSIS, Exercises And Strategies For Prevention And Treatment

Karine Bohme,  2001


BETTER BONES, BETTER BODY: Beyond Estrogen And Calcium: A Comprehensive Self -Help Program For Preventing, Halting, And Overcoming Osteoporosis

Susan Brown, Ph.D.    2000


Do you know your… Blood pressure? Cholesterol level? Weight? T-score?

That’s right, T-score. If you had to think twice about what a T-score is — and no, it’s not a golf term — chances are you are not alone.“Fit to a T” is the USBJI’s response to the Surgeon General’s first-ever report on bone health and osteoporosis. In partnership with the Public Library Association and the National Network of Libraries of Medicine this education program is called "Fit to a T" because the T-score is the measure of a person's bone density and susceptibility to fragility fracture.Osteoporosis is the most prevalent bone condition among Americans with nearly one in two women, and one in four men, likely to suffer from it in their lifetime. Osteoporosis is debilitating, reducing a person's freedom of movement, and leads to high incidences of hip and spine fractures. Prevention education is essential to lowering the burden of disease.Although relevant and applicable to people of all ages, the program is especially aimed at men and women in the mid-40s to late 60s, as well as people who are highly susceptible to osteoporotic fractures or have experienced a break.  The goal is to reach people before they have a fracture, so they can take necessary steps to prevent bone disease and make changes in their lives to alter the course of the condition.Education sessions are conducted at local public libraries, community centers, health/fitness clubs, senior centers, or at local corporations.  The one-hour program - aimed at the general public - focuses on bone health, osteoporosis, how to avoid fragility fractures, and provides information needed to make informed decisions on bone health.At each session, a healthcare professional and occasionally a patient will team up to present the program.  The session features a PowerPoint presentation, collateral materials, discussion, and a question/ answer period.  The Fit to a T booklet, a risk assessment sheet, the Surgeon's General's "What it Means to You," plus resource materials are distributed to participants.

Program Goals

The USBJI through this public education program is working with communities to generate awareness and understanding of these important issues and to help reduce the approximately 2 million fractures that occur each year in this country as a result of low bone mass.Specifically, we want session participants to:
  • Learn to assess their living environment and fracture risk.
  • Understand the basics of lifelong bone health.
  • Be able to discuss bone health issues with their healthcare professional.
  • Learn to identify quality consumer health information.
  • Be encouraged to discuss these issues with family, friends and colleagues of all ages.

Key Messages

  • Osteoporosis and other bone diseases are debilitating. They can cause pain, loss of mobility and independence, deformity and mortality (contributing to a poor quality of life)
  • The disorder affects men and women of all races and ages (it doesn’t just affect women)
  • Information-gathering skills and prevention can help alter the course of the disease (it’s never too early or too late to make changes)
  • Americans can have strong bones and live healthy, independent and productive lives (through better awareness and education)

Background on Osteoporosis

Osteoporosis is the most prevalent bone condition among Americans. Nearly one in two women, and one in four men, likely to suffer from it. Osteoporosis doesn't hurt but can be debilitating or disabling due to the high incidence of broken bones in people with low bone mass. Prevention education is essential to lowering the number of people with low bone mass and broken bones.

The Surgeon General’s Report on bone health and osteoporosis, released in 2004, is the first-ever such Report on this topic. Reports by the Surgeon General, America's chief health educator, have always played a critical role in promoting good health and safety. These reports identify relevant scientific data, rigorously evaluate and summarize the evidence, then determine conclusions. The Report serves as a starting point for concentrated national action to understand, prevent, diagnose, and treat bone diseases. Osteoporosis and low bone mass are the most common diseases of bone. Ten million Americans over the age of 50 have osteoporosis, and another 34 million are at risk for developing it.  Each year, roughly 2 million people suffer a broken bone related to osteoporosis, frequently after minimal trauma.  By 2020, half or all American citizens older than 50 will be at risk for fractures from osteoporosis and low bone mass if no immediate action is taken be everyone, including the general public, healthcare professionals, health systems, and policymakers.

How to Schedule a Session

What the USBJI will do

  • Provide guidelines on organizing a session (see link below).
  • Confirm the lead healthcare presenter and other presenters; supply PowerPoint presentation; and program materials.
  • Can supply artwork for flyers and posters to promote sessions. (Sample Flyer)
  • Work with you to coordinate the session, requirements, and program schedule. The session is designed to take 45–60 minutes.
  • Provide hand-out materials for participants.
  • Supply evaluation forms.

What you need to do

  • Read the Guidelines for Organizers.
  • Decide on a date and place to hold a session.
  • Provide the USBJI with your full contact details and whom you represent, tell us when and where you plan to hold a session, who the audience is, and how many people you expect, by emailing [email protected].
  • Confirm healthcare professional to lead the session, or request USBJI find presenter.
  • Promote the session.
  • Supply a laptop/computer, LCD projector, screen, table for hand-out materials, and chairs for participants. Consider a microphone/speaker system if a large audience is expected. Consider offering healthy refreshments.
  • Take photos of the session and supply a brief report to the Initiative; this would be greatly appreciated.

Thank you for your interest in organizing a Fit to a T session!