by Cord Prettyman
Master Personal Trainer


Bigfork, Montana 59911


By Appointment Only


Mention the word osteoporosis in just about any social situation and you’d be hard pressed to find someone who didn’t have at least a basic understanding of what the word meant. But, utter the word osteopenia and you’re likely to be greeted with a blank stare.

What’s the difference? According to the Foundation for Osteoporosis Research and Education, osteoporosis is a disease that breaks down the tissue in our bones making them fragile and more likely to break. Osteopenia is not a disease but rather a term that describes low bone density that may or may not put you at risk for a fracture.

Osteopenia is a relatively new medical term defined in June of 1992 by the World Health Organization. A group of experts decided that having a bone density that was one standard deviation below that of an average 30-year-old white woman would classify one as having osteopenia. The group also defined osteoporosis as a bone density of greater than 2.5 standard deviations below that arbitrary 30-year-old.

What the experts were referring to is a person’s bone mineral density (BMD), which is measured today by a low-energy x-ray known as a DEXA scan. A patient’s BMD is expressed as a T-score, which is derived by comparing it to the arbitrary 30-year-old woman.

Patients with T-scores between -1 and -2.5 are diagnosed with osteopenia. Those with T-scores greater than -2.5 are diagnosed with osteoporosis.

From the start, the new definitions were controversial. One of the experts from the Mayo Clinic who participated in setting the criteria in 1992 said, “It was just meant to indicate the emergence of a problem. It didn’t have any particular diagnostic or therapeutic significance.”

Dr. Steven R. Cummings of the University of California at San Francisco took issue with the establishment of the osteopenia classification saying, “There is no basis, no biological, social, economic or treatment basis, no basis whatsoever, for using minus one.” “As a consequence, though,” he continued, “more than half of the population is told arbitrarily that they have a condition they need to worry about.”

There are critics who claim that osteopenia is a creation of the pharmaceutical industry who fund most of the studies on osteoporosis and osteopenia and reap huge profits from the drugs that prevent or reverse bone loss. A recent article – not funded by the industry – in the British Medical Journal claims that marketers have overstated the benefits and underplayed the risks of their drugs.

There are, in fact, few studies that demonstrate that the drugs actually prevent fractures in women who don’t already have osteoporosis.

Here’s the skinny. Bone is a living, growing tissue constantly being formed and broken down. Early in life, more bone tissue is formed than is lost, allowing the skeleton to grow.

By about age 30, your bones are at your lifetime best or your “peak bone mass.” After this peak, bone maintains equilibrium until about age 50 in women and age 60 in men.

Then – in most people – bone breaks down faster than it is formed. This bone loss is a natural part of the aging process.

If you’ve been diagnosed with osteopenia, you may want to log on to the Foundation for Osteoporosis Research and Education’s online calculator at By filling in your age, height, weight, smoking history and other factors – including your T-score – you can calculate your risk of a bone fracture over the next 10 years.

Keep in mind, not everyone who has osteopenia progresses to osteoporosis.

Cord Prettyman is a certified Master Personal Trainer and owner of Absolute Workout Fitness and Post-Re-hab Studio in Woodland Park. He can be reached at 687-7437 or by email at