It is often suggested that the major causes of osteoporosis are low calcium intake and lower estrogen levels at menopause. Looking from a cross-cultural perspective, however, we find that this is not always true. For example, many countries have lower calcium intakes than the US, yet osteoporosis is less prevalent in these cultures. As an example, the Japanese calcium intake averages only 540 mgs, yet the US hip fracture rate is twice that of Japan. Also, many nutrients, not just calcium, are essential to bone health.

The same holds true for estrogen. Women all over the world experience a lowering of estrogen at menopause, but not all women experience osteoporosis. Attributing the causes of osteoporosis to the natural lowering of estrogen at menopause is too simplistic. The fact is that Mayan Indian women, Bantu women of Africa, and the Japanese all have lower estrogen levels than US women, but they all experience many fewer fractures than US women.

A more realistic conception of the cause of osteoporosis is that of varied bone-depleting factors, each building one upon the other. Each bone-depleting factor adds to the others until the total load is more than our bone can bear, so to speak. The picture to the right depicts many of the factors that can contribute to poor health and osteoporotic fractures.

My book Better Bones, Better Body offers a thorough discussion of the causes of osteoporosis. In my private consultations with individuals, I take great care to uncover all the varied factors that might contribute to each individual's osteoporosis or osteopenia diagnosis. It is surprising how different the causes of osteoporosis or osteopenia can be.

Next: Rethinking the Best Prevention & Treatment of Osteoporosis