{'fraction_non_alphanumeric': 0.02186761229314421, 'fraction_numerical': 0.002364066193853428, 'mean_word_length': 5.134057971014493, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Osteoporosis: is primary prevention possible?

Osteoporosis is a major and increasing cause of morbidity and mortality in developed countries, and set to become so worldwide in the next few decades. Health-care costs are high, principally due to associated hip fractures which often result in loss of independence. An individual’s risk of developing osteoporosis is determined by the peak bone mass reached at skeletal maturity, and the rate of bone loss later in adult life. Historically, strategies to prevent osteoporosis concentrated on reducing bone loss, particularly after the menopause in women. However, over the past decade there has been a greater focus on maximizing peak bone mass as an alternative or additional potential strategy. Although peak bone mass is to a great extent (70–80%) genetically determined, it is clear that events during fetal life, infancy and childhood are also important. This chapter will discuss the evidence that osteoporosis may be a disease that is amenable to primary prevention during early life, and the potential role of nutritional interventions. It is important to appreciate that a number of factors have been shown to result in increased bone mass in the short-term, during the period of intervention. This may in itself have immediate outcome benefits for the individual, for example reducing short-term fracture risk. However, to represent a potential preventative strategy against osteoporosis, any such effect must be shown to persist after the intervention has stopped, resulting in higher peak bone mass and/or favorable effects on bone structure or bone turnover. This has received much less attention, and is the principle focus here.