Which statement best lists common risk factors for osteoporosis?

Which statement best lists common risk factors for osteoporosis?

• A. Family history; Female; White, Asian, or Hispanic; Slender builds; Smoking; Postmenopausal or hysterectomy; Inadequate calcium, vitamin D or protein intake; Inadequate exercise; Sex steroid deficiency
• B. Family history; Female; White or Asian; Slender builds; Smoking; Postmenopausal or hysterectomy
• C. Family history; Female; White, Asian, or Hispanic; Slender builds; Regular exercise; Adequate calcium intake
• D. Family history; Female; White, Asian, or Hispanic; Slender builds; Smoking; Postmenopausal or hysterectomy; Inadequate calcium, vitamin D or protein intake; Inadequate exercise; Sex steroid deficiency

Answer: (D)

Osteoporosis risk rises when genetic, hormonal, nutritional, and lifestyle factors all contribute to bone loss, so a comprehensive list should include all the major contributors. The statement that best reflects this includes family history; female sex; White, Asian, or Hispanic ancestry; slender body habitus; smoking; postmenopausal status or hysterectomy; inadequate intake of calcium, vitamin D, or protein; insufficient exercise; and sex steroid deficiency. Each piece fits a known risk factor: family history and being female relate to biology that reduces peak bone mass and accelerates loss; certain ethnicities have lower bone density on average; a slender build means less bone mass to begin with; smoking is associated with higher bone resorption and poorer calcium handling; postmenopausal status or hysterectomy lowers estrogen, a key protector of bone; inadequate calcium, vitamin D, or protein directly impairs bone maintenance; lack of exercise reduces the stimulus for bone formation; and sex steroid deficiency accelerates bone loss. The other options omit several of these risks or include factors that protect bone, such as regular exercise or adequate calcium, which would not be emphasized as risk factors.

Osteoporosis risk rises when genetic, hormonal, nutritional, and lifestyle factors all contribute to bone loss, so a comprehensive list should include all the major contributors. The statement that best reflects this includes family history; female sex; White, Asian, or Hispanic ancestry; slender body habitus; smoking; postmenopausal status or hysterectomy; inadequate intake of calcium, vitamin D, or protein; insufficient exercise; and sex steroid deficiency. Each piece fits a known risk factor: family history and being female relate to biology that reduces peak bone mass and accelerates loss; certain ethnicities have lower bone density on average; a slender build means less bone mass to begin with; smoking is associated with higher bone resorption and poorer calcium handling; postmenopausal status or hysterectomy lowers estrogen, a key protector of bone; inadequate calcium, vitamin D, or protein directly impairs bone maintenance; lack of exercise reduces the stimulus for bone formation; and sex steroid deficiency accelerates bone loss. The other options omit several of these risks or include factors that protect bone, such as regular exercise or adequate calcium, which would not be emphasized as risk factors.