Is Getting a Bone Density Scan Enough? Bone Density Versus Bone Quality

 Why are there some people with extremely low bone density who never sustain a fracture and others with dense bones who experience bone fractures? There are many reasons that can put one at risk for a fracture, and relying only on the scores of a bone density scan can be a false security – mainly because having osteoporosis may or may not lead to breaking a bone. Denser bone is not always stronger bone.
Bone health is an involved system, and bone strength or resistant to fracture is not easily measured by routine bone density tests. The quality of the bone is as important as bone quantity (density) when considering a person’s risk for a fracture. Nutrition and lifestyle can have a huge effect on bone quality and quantity by impacting the remodeling system, mineralization, and flexibility of the bone.
The body is always trying to remodel, repair, and renew the skeletal bone. Inside the skeleton there are special bone cells with the job to break down worn and weakened bone, while other special bone cells replace and build new bone. Bone density is the interaction between these two bone cells. The system fails when the breakdown activity is ramped up during a time when build up activity goes down, specifically with age and times of inflammation. In other words, breaking down bone is occurring faster or at a higher rate than bone is building up.
Mineralization is the process of laying down minerals into the bone and is essential for giving bone its hardness and strength. Bones serve as a storage place of important minerals for the body such as dissolved calcium, phosphorus, and magnesium. When the body needs these minerals, it will draw the mineral from the bone. If this process is not regulated in such as too much or too little of minerals, then bone health is compromised resulting in the bone being too soft or too brittle.
The protein structure called the collagen matrix gives bones flexibility. About 90 percent of the bone matrix proteins are collagen structures to provide the flexibility.