Osteopenia refers to bone mineral density (BMD) that is lower than normal but not low enough to be classified as osteoporosis. BMD is a measurement of the level of minerals in the bones, which shows how dense and strong they are. If your BMD is low compared to normal peak BMD, you are said to have Osteopenia. WHAT CAUSES IT? Bones naturally become thinner as people grow older. Everyone begins to lose bone mass after they reach peak BMD at about 30 years of age. The thicker your bones are at about age 30, the longer it takes to develop osteopenia or osteoporosis. Some people, who have osteopenia, may not have bone loss. They may just naturally have a lower bone density. Osteopenia may also be the result of a wide variety of other conditions, diseases or treatments. Women are far more likely to develop osteopenia and osteoporosis than men. In both men and women, the following things can contribute to osteopenia: ? Eating disorders or metabolic problems that do not allow the body to take in and use enough vitamins and minerals. ? Chemotherapy, or medicines such as steroids used to treat a number of conditions. ? Exposure to radiation WHAT ARE THE SYMPTOMS? Osteopenia has no symptoms. You notice no pain or change as the bone becomes thinner, although the risk of breaking/fracturing a bone increases as the bone becomes less dense. HOW IS OSTEOPENIA DIAGNOSED? Osteopenia is diagnosed with a bone mineral density (BMD) test, usually done to see whether you have osteoporosis. The most accurate test of BMD is dualenergy x-ray absorptiometry (DEXA) scan, although there are other methods. A standard x-ray is not useful in diagnosing osteopenia because it is not sensitive enough to detect small amounts of bone loss or minor changes in bone density. HOW IS IT TREATED? Lifestyle changes can help reduce the bone loss that leads to osteopenia and osteoporosis. Calcium is the most critical mineral for bone mass. Your best sources of calcium are milk and other dairy products, green vegetables, and calcium-enriched products. Your doctor may also want you to take a calcium supplement, often combined with vitamin D, which helps your body absorb calcium and other minerals. In addition to what you take in from food, your body makes vitamin D in response to sunlight. Weight-bearing exercises such as walking, hiking, and dancing are all good choices. Talk to your doctor or a physical therapist about starting an exercise programme. In addition to diet and exercise, quitting smoking and avoiding excessive use of alcohol and cola will also reduce your risk of bone loss. There are medicines for treating bone thinning. But these are more commonly used if you have progressed past osteopenia to the more serious condition of osteoporosis. HOW CAN OSTEOPENIA BE PREVENTED? If you are a young adult or if you are raising children, there are things you can do to help develop strong bones and help slow down osteopenia and prevent osteoporosis. Your bones don't reach their greatest density until you are about 30 years old, so for children and people younger than 30, anything that helps increase bone density will have long-term benefits. To maximize bone density, make sure you get plenty of calcium and vitamin D through your diet and by spending a little time in the sun, getting weight-bearing exercise on a regular basis, not smoking, and avoiding cola and excessive alcohol. If you have children, teach them to eat healthy, get regular exercise, and avoid smoking and alcohol. Also, get them to play a little in the sunshine to help their bodies make more vitamin D. If you're older than 30, it's still not too late to make these lifestyle changes. A balanced diet and regular exercise will help slow the loss of bone density, delay osteopenia, and delay or prevent osteoporosis.