Bone Health Quiz

Know Your Risk Factors for Weakened Bones and Fractures

Bone health facts appear below along with your responses as you take the Bone Health Quiz. If a message appears in red type, that indicates a risk factor for weakened bones and fractures. If you have risk factors, you should discuss them with your health care provider.

Download our publication “Talking with Your Health Care Provider about Bone Health.”

If you are 45 or older, click here to take the Fracture Risk Calculator

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What was your sex at birth?*

Male

Female

Women are more at risk of fractures due to weakened bones than men. In the United States, 1-in-2 women and 1-in-4 men will break a bone due to osteoporosis after age 50. During menopause, women lose estrogen, which is essential for building bone. The changes in women’s hormones can lead to osteoporosis and increased risk of broken bones. Women’s bones also tend to be smaller and less dense than men’s bones. Women also live longer than men, on average, and risk of fractures increases with age.

What is your age?*

Your bones change constantly, with new bone being built and old bone being removed throughout your lifespan. Approximately every 7 years, you will have new bones! Ages 9-14 are the most important for developing your skeleton. During the teen years, you will build more bone than you will lose during your entire lifetime. You will continue to build bone in your 20s until you achieve peak bone mass around ages 30-35. Around age 35, you will slowly begin to lose more bone than you build, so it’s important to focus on healthy habits to maintain your peak bone mass. This is also a good time to be aware of risk factors, such as lifestyle habits, medical conditions and medicines, in addition to age, that can cause bone loss and increase risk of fractures. Around age 50, most women will begin menopause. Women lose up to 25% of their bone mass as their estrogen levels drop during menopause. Their risk of fractures increases in the decades following menopause. Men begin losing testosterone around age 70, which also causes a loss of bone mass, and their risk of fractures increases at the same rate as women that age.

Getting older is a major risk factor for developing osteoporosis and having broken bones. After age 50, 1-in-2 women and 1-in-4 men in the U.S. will have a fracture related to osteoporosis.

How much calcium do you consume each day, including supplements?*

A serving of a calcium-rich food contains about 300 mg of calcium. A typical serving might be 1 cup of milk or fortified orange juice, 1½ slices of cheese, or a small can of salmon.

Less than 1,000 mg (3 or fewer servings)

More than 1,000 mg (more than 3 servings)

Don’t know

Calcium is essential for healthy bones If you don’t consume enough calcium, your body will take what it needs from your bones for other body systems to function. The U.S. National Institutes of Health recommends adults consume 1,000 mg per day of calcium from all sources. Some groups should get more, such as preteens and teens (1,300 mg), women 50 years or older and adults 71 years and older (1,200 mg). You should try to get the recommended daily amount from your diet. Good sources include dairy products, such as milk, yogurt and cheese; green vegetables, including broccoli, kale and bok choy; canned fish such as salmon and sardines; and fortified products, including orange juice and milk substitutes such as almond and soy beverages. Use calcium supplements only to bridge the gap in your daily intake. Large doses of calcium supplements may be harmful.

Do you consume at least 600 IU per day of vitamin D?*

Yes

Don’t know

Vitamin D is necessary for your body to absorb calcium. Vitamin D deficiency is very common in the United States. Vitamin D deficiency is defined as 25-hydroxyvitamin D below 20 ng/ml. Vitamin D insufficiency is defined as 25-hydroxyvitamin D between 21-29ng/ml. There are not many food sources of vitamin D. Sunlight can provide vitamin D, but prolonged exposure can increase risk of skin cancer. Therefore, you should ask your health care provider about taking a vitamin D supplement. The U.S. recommended daily allowance of vitamin D is 600 IU; for adults who are pregnant or nursing or older than 70, the recommendation is 800 IU.

Do you engage in moderate exercise at least 150 minutes (2½ hours) every week?*

Yes

Lack of physical activity is a risk factor for weakened bones, osteoporosis, and fractures. Weight-bearing and resistance activities are best for bone health. These include walking, yoga and tai chi, calisthenics, jumping rope, racquet sports, and dancing. Weight-bearing activities put a load on the bones that stimulates bone growth. Swimming and bicycling, while good for cardiovascular health, do not put a load on the bones and so are not considered good for bone health.

Do you currently smoke cigarettes?*

Yes

Smoking is a known risk factor for bone loss and increased risk of fractures. Quitting may reduce the risk; even cutting down may help.

How many alcoholic beverages do you consume each day, on average?*

2 or fewer

3 or more

How many alcoholic beverages do you consume each day, on average?*

1 or none

2 or more

Drinking alcohol in excess can affect bone structure and bone density. Men should limit alcohol to no more than two drinks per day, women to no more than one per day. Consuming three or more alcoholic beverages appears to affect calcium and vitamin D metabolism and can increase risk of falling.

Have you lost 1 inch or more of height in the past year, as measured on visits to your health care provider?*

Yes

Losing 1 inch or more of height in a year could be a sign of fractures in your spine bones. Ask for a height measurement at every visit to your health care provider. Keep track of your height from year to year.

Has your mother, father or another first-degree relative been diagnosed with osteoporosis?*

Yes

More than 60% of your bone health risk is inherited. If your mother or another family member had a hip fracture, you are at increased risk of also having one. Having a family history of osteoporosis also places you at increased risk of developing osteoporosis.

Has your mother, father or another first-degree relative had a hip fracture?*

Yes

Have you broken a bone from a low-trauma event, such as a simple fall from standing height or bumping into something?*

(Do not include broken bones in the fingers, toes, skull, or face.)

Yes

If you have broken a bone due to a low-impact event, such as a fall from standing height or bumping into something, you are at risk of having more fractures. Even a hard cough or sneeze can cause a fracture in a person with weakened bones. The Endocrine Society recommends that women who have had a low-impact fracture get a bone density test to see if they have osteoporosis.

Have you ever taken any of these medicines?

(Select all that apply.)

Corticosteroids (like prednisone) for extended periods of time

Thyroid medicines

Medicines that reduce levels of sex hormones (such as androgen deprivation therapy for prostate cancer or aromatase inhibitors for breast cancer)

Proton pump inhibitors or antacids that contain aluminum

Thiazolidinediones (TZD) for diabetes

Mood stabilizers containing lithium

Blood thinners or anticoagulants containing heparin or coumadin

Loop diuretics

Anticonvulsants containing phenytoin, phenobarbital or sodium valproate

Antiretroviral therapies to treat HIV, such as regimens containing TDF

Tramadol

None of the above

Some medicines can cause bone loss, some may increase your risk of a fall, and some may increase the chance of breaking a bone. If you have certain diseases, you may not have a choice but to take one of these medicines. If you do take certain medicines that can cause bone loss or increase your risk of breaking a bone, it is very important to take steps to protect your bones. Talk to your health care provider about whether a medicine you are taking could harm your bones. For more ways to reduce the harm to your bones, read our article on "Medicines That Can Be Bad for Your Bones."

Have you had any of these medical conditions?

(Select all that apply.)

Rheumatoid arthritis

Inflammatory bowel disease (Crohn’s disease, ulcerative colitis)

Celiac disease

Lupus

Sjögren’s syndrom

Disordered eating (for example bulimia or anorexia nervosa)

HIV

Diabetes (Type 1 or Type 2)

Primary hyperthyroidism or hyperparathyroidism

Leukemia/lymphoma/multiple myeloma

Breast cancer

Prostate cancer

Weight loss surgery

Early menopause, had periods stop (outside of pregnancy), or ovaries removed

Low testosterone (hypogonadism)

Chronic kidney disease

None of the above

Many medical conditions can cause weakened bones and increase risk of fractures. Medicines prescribed to treat certain medical conditions also can cause bone loss. Talk with your health care provider about how certain diseases and treatments can affect your bones.

Do you fall often? Have you fallen in the past year?*

Yes

According to the Centers for Disease Control and Prevention, one out of five falls causes a serious injury such as a broken bone or a head injury. Falls are the leading cause of hip fractures. Falling once doubles your chances of falling again.

Have you ever been diagnosed with a vertebral fracture, a fractured spine, or a broken back?*

Yes

Fractures to the bones in the spine are the most common injury caused by osteoporosis. Having one vertebral fracture increases your risk of having more vertebral and other fractures.

My Results

You can see your results on the next page by hitting the submit button below. Please discuss your bone health and any risk factors you have with your health care provider. By providing your name and email address you are opting in to receive emails that will include your Bone Health Quiz results and information from American Bone Health. You will be able to opt out of these messages at any time.

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