10 million Americans have osteoporosis, and another 18 million have low bone mass

According to the National Osteoporosis Foundation, 10 million Americans have osteoporosis, and another 18 million have low bone mass, making them at risk for osteoporosis. Often referred to as the silent disease because it develops slowly over a number of years without symptoms, osteoporosis is characterized by a gradual weakening of the bones due to bone loss, which can lead to fractures.

Eighty percent of those affected by osteoporosis are women. In fact, by the time women go through menopause, approximately one out of three has developed osteoporosis. At greatest risk for osteoporosis are petite or underweight Caucasian and Asian women who experience early menopause. However, all older men and women, regardless of race or ethnicity, are at significant risk.

Currently there is no cure for osteoporosis, so prevention is key. While the most important years for building bone mass are in the first 20 to 35 years of life, there are measures that middle-aged and older adults can take to improve or at least slow down the deterioration of bone health. The National Osteoporosis Foundation recommends a combination of the following steps:

Get your daily recommended amounts of calcium and vitamin D. National nutrition surveys demonstrate that most women and young girls consume less than half the amount of calcium needed to build and maintain healthy bones. Depending on your age, you need 800 to 1,300 milligrams of calcium daily. You can increase your dietary intake of calcium by eating more dairy products; fish such as canned salmon and sardines with tiny edible bones; legumes; tofu made with calcium sulfate; dark green, leafy vegetables such as broccoli, kale and collard greens; and calcium-fortified orange juice. If you have difficulty getting enough calcium from food, a calcium supplement may be needed. Talk with your doctor about how much calcium you're already getting and which type of supplement may be best for you.

Vitamin D, which is needed by the body to absorb calcium, comes from two sources: through the skin following direct exposure to sunlight and from the diet. Experts recommend a daily intake of 400 and 800 International Units, which can be obtained from fortified dairy products, egg yolks, saltwater fish, liver and sunlight exposure.

Engage in regular weight-bearing exercise. Research has shown that a sedentary lifestyle is conducive to bone loss and that regular weight-bearing exercise, such as walking or jogging, for at least 30 minutes most days of the week helps strengthen bones. As with any exercise program, it's important to start slowly, build gradually and stay within your limits.

Avoid smoking and excessive alcohol: Both smoking and high intake of alcohol have been associated with an increased risk of osteoporotic fracture.

Have a bone density test and consider treatment if appropriate. A Bone Mineral Density test is used to diagnose osteoporosis and determine risk for future fracture. The test is an accurate, painless and noninvasive method for measuring the density of your bones and to help determine if treatment is necessary to help maintain bone mass, prevent further bone loss and reduce fracture risk.