Abstract

Introduction

Dietary Agents

Pharmacologic Agents

Selected References

Discussion
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The maintenance of skeletal mass throughout adult life has been the subject of numerous investigations. Genetic factors have clearly been shown to play an important role as determinants of peak bone mass status and susceptibility to fracture. The regulation of bone mass, and in particular the decline in BMD that occurs both as a function of aging or specifically as a consequence of hormone deficiency, provide the most practical targets for currently available interventions aimed at maintaining skeletal mass over the lifetime of an individual, and thus reducing the risk for fracture. Measures aimed at optimizing lifestyle factors, specifically diet and exercise, appear to be more effective in maximizing peak bone mass attainment if instituted early in growth and development (i.e. pre and during adolescence). Interventions using the current armamentarium of pharmacologic agents (such as hormone replacement or bone specific agents e.g. bisphosphonates) are effective not only during periods of rapid bone turnover (e.g. postmenopausally), but during the entire period of significant age related bone loss. In addition, these drugs demonstrate efficacy in the treatment of clinical conditions or modifying the deliterios effects of certain drugs (e.g. corticosteroid) that may secondarily result in reduced bone mass. In the future, a more comprehensive understanding of the complex nature of gene-environmental interactions and the resultant impact on bone mass during the critical periods of rapid accumulation, maintenance, and loss with aging will undoubtedly lead to more appropriate interventions, targeted at those at greatest risk, with the attendant economic and societal benefits.

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Presentation Number SArubin0527
Keywords: exercise, diet, hormones, bisphophonates, bone