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Abstract

Osteoporosis and subclinical low bone mass are common conditions characterized by a decrease in bone micro-architecture which heightens one’s risk for fractures, disability, and chronic pain. Although men and women are both susceptible, particularly with advancing age, women have an accelerated rate of bone loss as they approach midlife. Many measures exist to assess bone health, but most people are not aware they have low bone density until they experience a fracture, as few visible signs manifest until later stages of the disorder. This chapter explores these measures of bone density including DEXA and ultrasonometry, and biomedical markers such as serum 25(OH)D levels. The case study of serum 25(OH)D levels in Qatar is offered as an example of how self-reported vitamin D deficiency can be compared with measured serum 25(OH)D. This study asked 523 midlife women whether they suffered from vitamin D deficiency and compared their responses to their actual 25(OH)D levels. Agreement between self-reported vitamin D deficiency and measured levels <20 ng/ml was very poor. Most women believed they were vitamin D deficient and even among women with levels ≥20 ng/ml, 82% believed they were vitamin D deficient. Among women with levels <20 ng/ml, 13% did not report deficiency. This study highlights that it may be informative to not only document quantitative results, but also to consider an individual’s perception of their own health. Furthermore, the study underscores the challenges that health care providers face in translating an “invisible condition” into something “visible,” or meaningful, to the individual.

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References

  • Affinito, P., Tommaselli, G. A., di Carlo, C., Guida, F., & Nappi, C. (1996). Changes in bone mineral density and calcium metabolism in women: A one year follow-up study. Journal of Clinical Endocrinology and Metabolism, 81, 2314–2318.

    Google Scholar 

  • Agarwal, S. C., & Stuart-Macadam, P. (2003). An evolutionary and biocultural approach to understanding the effects of reproductive factors on the female skeleton. In S. C. Agarwal & S. D. Stout (Eds.), Bone loss and osteoporosis: An anthropological perspective (pp. 105–119). New York: Plenum Press.

    Chapter  Google Scholar 

  • Alhamad, H. K., Nadukkandiyil, N., El-Menyar, A., Abdel Wahab, L., Sankaranarayanan, A., & Al Sulaiti, E. M. (2014). Vitamin D deficiency among the elderly: Insights from Qatar. Current Medical Research and Opinion, 30(6), 1189–1196.

    Article  Google Scholar 

  • Anderson, J. B., Switzer, B. R., Stewart, P., & Symons, M. (2004). Analysis of relations between nutrient factors and bone health. In M. Holick & B. Dawson-Hughes (Eds.), Nutrition and bone health (pp. 113–128). New Jersey: Humana Press.

    Chapter  Google Scholar 

  • Ardawi, M. S., Qari, M. H., Rouzi, A. A., Maimani, A. A., & Raddadi, R. M. (2011). Vitamin D status in relation to obesity, bone mineral density, bone turnover markers and vitamin D receptor genotypes in healthy Saudi pre- and postmenopausal women. Osteoporosis International, 22(2), 463–475.

    Article  Google Scholar 

  • Badawi, A., Arora, P., Sadoun, E., Al-Thani, A. A., & Thani, M. H. (2012). Prevalence of vitamin D insufficiency in Qatar: A systematic review. Journal of Public Health Research, 1(3), 229–235.

    Article  Google Scholar 

  • Barkmann, R., Kantorovich, E., Singal, C., Hans, D., Genant, H. K., Heller, M., et al. (2000). New method for quantitative ultrasound measurements at multiple skeletal sites. Journal of Clinical Densitometry, 3, 1–7.

    Article  Google Scholar 

  • Bartl, R., & Frisch, B. (2004). Osteoporosis: Diagnosis, prevention, therapy. Berlin: Springer.

    Book  Google Scholar 

  • Bener, A., Al-Ali, M., & Hoffmann, G. F. (2009). High prevalence of vitamin D deficiency in young children in a highly sunny humid country: A global health problem. Minerva Pediatrica, 61(1), 15–22.

    Google Scholar 

  • Bhan, I., Powe, C. E., Berg, A. H., Ankers, E., Wenger, J. B., Karumanchi, S. A., et al. (2012). Bioavailable vitamin D is more tightly linked to mineral metabolism than total vitamin D in incident hemodialysis patients. Kidney International, 82(1), 84–89.

    Article  Google Scholar 

  • Bhan, I. (2014). Vitamin D binding protein and bone health. International Journal of Endocrinology. doi:10.1155/2014/561214

    Google Scholar 

  • Bonnick, S. L. (2010). Bone densitometry in clinical practice: Application and interpretation. New Jersey: Humana Press.

    Book  Google Scholar 

  • Bunker, V. W. (1994). The role of nutrition in osteoporosis. British Journal of Biomedical Science, 51, 228–240.

    Google Scholar 

  • Carter, A. J., & Nguyen, A. Q. (2011). Antagonistic pleiotropy as a widespread mechanism for the maintenance of polymorphic disease alleles. BMC Medical Genetics. doi:10.1186/1471-2350-12-160

    Google Scholar 

  • Cauley, J. A. (2011). Defining ethnic and racial differences in osteoporosis and fragility factures. Clinical Orthopaedics and Related Research, 469(7), 1891–1899.

    Article  Google Scholar 

  • Chen, T. C. (1999). Photobiology of vitamin D. In M. F. Holick (Ed.), Vitamin D: Molecular biology, physiology, and clinical applications (pp. 17–37). New Jersey: Humana Press.

    Google Scholar 

  • Cheung, C. L., Chan, V., & Kung, A. W. (2008). A differential association of ALOX15 polymorphisms with bone mineral density in pre- and postmenopausal women. Human Heredity, 1, 1–8.

    Google Scholar 

  • Chun, R. F., Peercy, B. E., Orwoll, E. S., Nielson, C. M., Adams, J. S., & Hewison, M. (2014). Vitamin D and DBP: The free hormone hypothesis revisited. Journal of Steroid Biochemistry and Molecular Biology, 144, 132–137.

    Article  Google Scholar 

  • Dargeant-Molina, P., Favier, F., Grandjean, H., Baudoin, C., Schott, A. M., Hausherr, E., et al. (1996). Fall-related factors and risk of hip fracture: The EPIDOS prospective study. Lancet, 348, 145–149.

    Article  Google Scholar 

  • Dawodu, A., Absood, G., Patel, M., Agarwal, M., Ezimokhai, M., Abdulrazzaq, Y., et al. (1998). Biosocial factors affecting vitamin D status of women of childbearing age in the United Arab Emirates. Journal of Biosocial Science, 30, 431–437.

    Article  Google Scholar 

  • Dawson-Hughes, B. (2004). Calcium and vitamin D for bone health in adults. In M. Holick & B. Dawson-Hughes (Eds.), Nutrition and bone health (pp. 197–210). New Jersey: Humana Press.

    Chapter  Google Scholar 

  • Drinkwater, B. L., & Chestnut, C. H., 3rd. (1991). Bone density changes during pregnancy and lactation in active women: A longitudinal study. Bone and Mineral, 14, 153–160.

    Article  Google Scholar 

  • Eastell, R., & Hannon, R. A. (2008). Biomarkers of bone health and osteoporosis risk. The Proceedings of the Nutrition Society, 67(2), 157–162.

    Article  Google Scholar 

  • El-Hajj Fuleihan, G., & Deeb, M. (1999). Hypovitaminosis D in a sunny country. New England Journal of Medicine, 340, 1840–1841.

    Article  Google Scholar 

  • El-Sonbaty, M. R., & Abdul-Ghaffar, N. U. (1996). Vitamin D deficiency in veiled Kuwaiti women. European Journal of Clinical Nutrition, 50, 315–318.

    Google Scholar 

  • Elkum, N., Alkayal, F., Noronha, F., Ali, M. M., Melhem, M., Al-Arouj, M., et al. (2014). Vitamin D insufficiency in Arabs and South Asians positively associates with polymorphisms in GC and CYP2R1 genes. PLoS ONE, 9(11), e113102. doi:10.1371/journal.pone.0113102

    Article  Google Scholar 

  • Elshafie, D. E., Al-Khashan, H. I., & Mishriky, A. M. (2012). Comparison of vitamin D deficiency in Saudi married couples. European Journal of Clinical Nutrition, 66(6), 742–745.

    Article  Google Scholar 

  • Ensom, M. H., Liu, P. Y., & Stephenson, M. D. (2002). Effect of pregnancy on bone mineral density in healthy women. Obstetrical & Gynecological Survey, 57(2), 99–111.

    Article  Google Scholar 

  • Ferrari, S., Rizzoli, R., Slosman, D., & Bonjour, J. P. (1998). Familial resemblance for bone mineral mass is expressed before puberty. Journal of Clinical Endocrinology and Metabolism, 83, 358–361.

    Google Scholar 

  • Fields, J., Trivedi, N. J., Horton, E., & Mechanick, J. I. (2011). Vitamin D in the Persian Gulf: Integrative physiology and socioeconomic factors. Current Osteoporosis Reports, 9(4), 243–250.

    Article  Google Scholar 

  • Frost, H. M. (2003). On changing views about age-related bone loss. In S. C. Agarwal & S. D. Stout (Eds.), Bone loss and osteoporosis: An anthropological perspective (pp. 19–32). New York: Springer.

    Chapter  Google Scholar 

  • Frost, M. L., Blake, G. M., & Fogelman, I. (2000). Can the WHO criteria for diagnosing osteoporosis be applied to calcaneal quantitative ultrasound? Osteoporosis International, 11, 321–330.

    Article  Google Scholar 

  • Gannagé-Yared, M. H., Chemali, R., Yaacoub, N., & Halaby, G. (2000). Hypovitaminosis D in a sunny country: Relation to lifestyle and bone markers. Journal of Bone and Mineral Research, 15, 1856–1862.

    Article  Google Scholar 

  • Galloway, A. (1997). The cost of reproduction and the evolution of postmenopausal osteoporosis. In M. E. Morbeck, A. Galloway, & A. Zihlman (Eds.), The evolving female: A life history perspective (pp. 132–146). New Jersey: Princeton University Press.

    Google Scholar 

  • Gerber, L. M., Giambrone, A. E., Al-Ali, H. M., & Verjee, M. A. (2016). Validity of self-reported vitamin D deficiency among midlife Arab women in Qatar. American Journal of Human Biology, 28(2), 181–185.

    Google Scholar 

  • Gerber, L. M., Bener, A., Al-Ali, H. M., Hammoudeh, M., Liu, L. Q., & Verjee, M. (2015). Bone mineral density in midlife women: The Study of Women’s Health in Qatar. Climacteric, 18(2), 316–322.

    Article  Google Scholar 

  • Gerber, L. M., Mamtani, R., Chiu, Y. L., Bener, A., Murphy, M., Cheema, S., et al. (2014). Use of complementary and alternative medicine among midlife Arab women living in Qatar. Eastern Mediterranean Health Journal, 20(9), 554–560.

    Google Scholar 

  • Gerdhem, P., Dencker, M., Ringsberg, K., & Akesson, K. (2008). Accelerometer-measured daily physical activity among octogenerians: Results and associations to other indices of physical performance and bone density. European Journal of Applied Physiology, 102, 173–180.

    Article  Google Scholar 

  • Ghannam, N. N., Hammami, M. M., Bakheet, S. M., & Khan, B. A. (1999). Bone mineral density of the spine and femur in healthy Saudi females: Relation to vitamin D status, pregnancy and lactation. Calcified Tissue International, 65, 23–28.

    Article  Google Scholar 

  • Gloth, F. M. (1999). Vitamin-D. In C. Rosen, J. Glowacki, & J. P. Bilezikian (Eds.), The Aging Skeleton (pp. 185–194). San Diego: Academic Press.

    Chapter  Google Scholar 

  • Guyton, A. C., & Hall, J. E. (2011). Pregnancy and lactation. In A. C. Guyton & J. E. Hall (Eds.), Textbook of medical physiology (12th ed., pp. 1027–1041). Philadelphia: WB Saunders Company.

    Google Scholar 

  • Hans, D. B., Kanis, J. A., Baim, S., Bilezikian, J. P., Binkley, N., Cauley, J. A., et al. (2011). Joint official positions of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®. Journal of Clinical Densitometry, 14(3), 171–180.

    Article  Google Scholar 

  • Hamdy, R. C., & Lewiecki, E. M. (2013). Osteoporosis. New York: Oxford University Press.

    Google Scholar 

  • Hawkes, K., O’Connell, J. F., Blurton Jones, N. G., Alvarez, H., & Charnov, E. L. (1998). Grandmothering, menopause, and the evolution of human life histories. Proceedings of the National Academy of Sciences, 95, 1336–1339.

    Article  Google Scholar 

  • Hernández-Avila, M., Stampfer, M. J., Ravnikar, V. A., Willett, W. C., Schiff, I., Francis, M., et al. (1993). Caffeine and other predictors of bone density among pre-and perimenopausal women. Epidemiology, 4, 128–134.

    Article  Google Scholar 

  • Holick, M. F. (2006). High prevalence of vitamin D inadequacy and implications for health. Mayo Clinic Proceedings, 81(3), 353–373.

    Article  Google Scholar 

  • Holick, M. F., Binkley, N. C., Bischoff-Ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P., et al. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 96, 1911–1930.

    Article  Google Scholar 

  • Holick, M. F., & Chen, T. C. (2008). Vitamin D deficiency: A worldwide problem with health consequences. American Journal of Clinical Nutrition, 87(4), 1080S–1086S.

    Google Scholar 

  • Hreschchyshyn, M. M., Hopkins, A., & Zulstra, S. (1988). Associations of parity, breastfeeding, and birth control pills with lumbar spine and femoral neck bone densities. American Journal of Obstetrics and Gynecology, 159, 318–322.

    Article  Google Scholar 

  • Institute of Medicine (IOM). (2011). Dietary reference intakes for calcium and vitamin D. Washington, DC: The National Academies Press.

    Google Scholar 

  • International Osteoporosis Foundation (IOF). (2010). Facts and statistics about osteoporosis and its impact. Accessed Nov 21, 2014. http://www.iofbonehealth.org/facts-and-statistics.html

  • International Society of Clinical Densitometry (ISCD). (2013). 5th ISCD Position Development Conference (Adult). Accessed Dec 27, 2014. http://www.iscd.org/official-positions/5th-iscd-position-development-conference-adult/

  • Kanis, J. A., Hans, D., Cooper, C., Baim, S., Bilezikian, J. P., Binkley, N., et al. (2011). Task force of the FRAX initiative: Interpretation and use of FRAX in clinical practice. Osteoporosis International, 22(9), 2395–2411.

    Article  Google Scholar 

  • Kazmi, A. (2005, May 17). Vitamin D deficiency hits Arab women and children. Gulf News. Accessed Nov 30, 2014. http://www.gulfnews.com/news/gulf/uae.health/vitaminD-deficiency-hits-arab-women-and-children-1.287946

  • Kemper, H., Twisk, J., van Mechelen, W., Post, G. B., Roos, J. C., & Lips, P. (2000). A fifteen-year longitudinal study in young adults on the relation of physical activity and fitness with the development of the bone mass: The Amsterdam growth and health longitudinal study. Bone, 27, 847–853.

    Article  Google Scholar 

  • Kent, G. N., Price, R. I., Gutteridge, D. H., Allen, J. R., Rosman, K. J., Smith, M., et al. (1993). Effect of pregnancy and lactation on maternal bone mass and calcium metabolism. Osteoporosis International, 3(Suppl 1), 44–47.

    Article  Google Scholar 

  • Kirkwood, T. B. (2005). Understanding the odd science of aging. Cell, 120(4), 437–447.

    Article  Google Scholar 

  • Kirkwood, T. B., & Rose, M. R. (1991). Evolution of senescence: Late survival sacrificed for reproduction. Philosophical Transactions of the Royal Society B: Biological Sciences, 332(1262), 15–24.

    Article  Google Scholar 

  • Kushida, K., Takahashi, M., Kawana, K., & Inoue, T. (1995). Comparison of markers for bone formation and resorption in pre-menopausal and postmenopausal subjects, and osteoporosis patients. Journal of Clinical Endocrinology and Metabolism, 80, 2447–2450.

    Google Scholar 

  • Lamke, B., Brundin, J., & Moberg, P. (1977). Changes of bone mineral content during pregnancy and lactation. Acta Obstetricia et Gynecologica Scandinavica, 56, 217–219.

    Article  Google Scholar 

  • Langton, C. M., & Langton, D. K. (2000). Comparison of bone mineral density and quantitative ultrasound of the calcaneus: Site-matched correlation and discrimination of axial BMD status. British Journal of Radiology, 73(865), 31–35.

    Article  Google Scholar 

  • Lazenby, R. (1997). Bone loss, traditional diet, and cold adaptation in Arctic populations. American Journal of Human Biology, 9, 329–341.

    Article  Google Scholar 

  • Lees, C. J., Jerome, C. P., Register, T. C., & Carlson, C. S. (1998). Changes in bone mass and bone biomarkers of cynomolgus monkeys during pregnancy and lactation. Journal of Clinical Endocrinology and Metabolism, 83, 4298–4302.

    Google Scholar 

  • Levis, S., & Altman, R. (1998). Bone densitometry: Clinical considerations. Arthritis and Rheumatology, 41, 577–587.

    Article  Google Scholar 

  • Lewiecki, E. M., & Watts, N. B. (2009). New guidelines for the prevention and treatment of osteoporosis. Southern Medical Journal, 102(2), 175–179.

    Article  Google Scholar 

  • Lips, P. (2007). Vitamin D status and nutrition in Europe and Asia. Journal of Steroid Biochemistry and Molecular Biology, 103(3–5), 620–625.

    Article  Google Scholar 

  • Lips, P., Duong, T., Oleksik, A., Black, D., Cummings, S., Cox, D., et al. (2001). A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: Baseline data from the multiple outcomes of raloxifene evaluation clinical trial. Journal of Clinical Endocrinology and Metabolism, 86, 1212–1221.

    Article  Google Scholar 

  • Looker, A. C., Johnston, C. C., Wahner, H. W., Dunn, W. L., Calvo, M. S., Harris, T. B., et al. (1995). Prevalence of low femoral density in older US women from NHANES III. Journal of Bone and Mineral Research, 10, 796–802.

    Article  Google Scholar 

  • Madimenos, F. C., Liebert, M. A., Cepon-Robins, T. J., Snodgrass, J. J., & Sugiyama, L. S. (2014). Determining osteoporosis risk in older Colono adults from rural Amazonian Ecuador using calcaneal ultrasonometry. American Journal of Human Biology, 27(1), 139–142.

    Article  Google Scholar 

  • Madimenos, F. C., Snodgrass, J. J., Liebert, M. A., Cepon, T. J., & Sugiyama, L. S. (2012). Reproductive effects on skeletal health in Shuar women of Amazonian Ecuador: A life history perspective. American Journal of Human Biology, 24(6), 841–852.

    Article  Google Scholar 

  • Malabanan, A. O., & Holick, M. F. (2003). Vitamin D and bone health in postmenopausal women. Journal of Women’s Health, 12(2), 151–156.

    Article  Google Scholar 

  • McClung, M. R. (2012). To FRAX or not to FRAX. Journal of Bone and Mineral Research, 27(6), 1240–1242.

    Article  Google Scholar 

  • Musaiger, A. O., Hassan, A. S., & Obeid, O. (2011). The paradox of nutrition-related diseases in the Arab countries: The need for action. International Journal of Environmental Research and Public Health, 8(9), 3637–3671.

    Article  Google Scholar 

  • National Osteoporosis Foundation (NOF). (2010). Clinician’s guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation. Accessed Dec 18, 2014. http://nof.org/files/nof/public/content/file/344/upload/159.pdf

  • National Osteoporosis Foundation (NOF). (2014). Statement on calcium and vitamin D. Accessed Dec 18, 2014. http://www.nof.org/prevention/calcium/html

  • Nayak, S., Olkin, I., Liu, H., Grabe, M., Gould, M. K., Allen, I. E., et al. (2006). Meta-analysis: Accuracy of quantitative ultrasound for identifying patients with osteoporosis. Annals of Internal Medicine, 144, 832–841.

    Article  Google Scholar 

  • Nelson, D. A., & Villa, M. L. (1999). Racial/ethnic influences on risk of osteoporosis. In C. Rosen, J. Glowacki, & J. P. Bilezikian (Eds.), The aging skeleton (pp. 237–249). San Diego: Academic Press.

    Chapter  Google Scholar 

  • Nguyen, T. V., Jones, G., Sambrook, P. N., White, C. P., Kelly, P. J., & Eisman, J. A. (1995). Effects of estrogen exposure and reproductive factors on bone mineral density and osteoporotic fractures. Journal of Clinical Endocrinology and Metabolism, 80, 2709–2714.

    Google Scholar 

  • North American Menopause Society (NAMS). (2010). Management of osteoporosis in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause, 17(1), 25–54.

    Article  Google Scholar 

  • Office of the Surgeon General (2004). Bone health and osteoporosis: A report of the Surgeon General. Office of the Surgeon General (US). Accessed Dec 27, 2014. http://www.surgeongeneral.gov/library/bonehealth/content.html

  • Pearce, K. L. (2006). Breastfeeding and bone density change. Dissertation, University of Massachusetts, Amherst.

    Google Scholar 

  • Powe, C. E., Evans, M. K., Wenger, J., Zonderman, A. B., Berg, A. H., Nalls, M., et al. (2013). Vitamin D binding protein and vitamin D status of black Americans and white Americans. New England Journal of Medicine, 369, 1991–2000.

    Article  Google Scholar 

  • Prior, J. C. (1990). Progesterone as a bone-trophic hormone. Endocrine Reviews, 11(2), 386–398.

    Article  Google Scholar 

  • Proctor, D. N., Melton, L. J., III, Khosla, S., Crowson, C. S., O’Connor, M. K., & Riggs, B. L. (2000). Relative influence of physical activity, muscle mass and strength on bone density. Osteoporosis International, 11, 944–952.

    Article  Google Scholar 

  • Ross, P., Huang, C., Davis, J., Imose, K., Yates, J., Vogel, J., et al. (1995). Predicting vertebral deformity using bone densitometry at various skeletal sites and calcaneus ultrasound. Bone, 16, 325–332.

    Article  Google Scholar 

  • Sampson, H. (2002). Alcohol and other factors affecting osteoporosis risk in women. Alcohol Research and Health, 264, 292–296.

    Google Scholar 

  • Schousboe, J. T., Shepherd, J. A., Bilezikian, J. P., & Baim, S. (2013). Executive summary of the International Society for Clinical Densitometry Position Development Conference on bone densitometry. Journal of Clinical Densitometry, 16(4), 455–466.

    Article  Google Scholar 

  • Silverman, S. L., & Calderon, A. D. (2010). The utility and limitations of FRAX: A US perspective. Current Osteoporosis Reports, 8(4), 192–197.

    Article  Google Scholar 

  • Snyder, P. J., Peachey, H., Hannoush, P., Berlin, J. A., Loh, L., Holmes, J. H., et al. (1999). Effect of testosterone treatment on bone mineral density in men over 65 years of age. Journal of Clinical Endocrinology and Metabolism, 84(6), 1966–1972.

    Google Scholar 

  • Sowers, M. F., Corton, G., Shapiro, B., Jannausch, M. L., Crutchfield, M., Smith, M. L., et al. (1993). Changes in bone density with lactation. Journal of the American Medical Association, 269(24), 3130–3135.

    Article  Google Scholar 

  • Sowers, M. F. (1996). Pregnancy and lactation as risk factors for subsequent bone loss and osteoporosis. Journal of Bone and Mineral Research, 11, 1052–1060.

    Article  Google Scholar 

  • Stieglitz, J., Beheim, B. A., Trumble, B. C., Madimenos, F. C., Kaplan, H., & Gurven, M. (2015). Low mineral density of a weight-bearing bone among adult women in a high fertility population. American Journal of Physical Anthropology, 156, 637–648.

    Article  Google Scholar 

  • Streeten, E. A., Ryan, K. A., McBride, D. J., Pollin, T. I., Shuldiner, A. R., & Mitchell, B. D. (2005). The relationship between parity and bone mineral density in women characterized by a homogenous lifestyle and high parity. Journal of Clinical Endocrinology and Metabolism, 90, 4536–4541.

    Article  Google Scholar 

  • U.S. Preventive Services Task Force. (2011). Screening for Osteoporosis: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 154, 356–364.

    Article  Google Scholar 

  • van Schoor, N. M., & Lips, P. (2011). Worldwide vitamin D status. Best Practice & Research. Clinical Endocrinology & Metabolism, 25(4), 671–680.

    Article  Google Scholar 

  • Webb, A. R., Kline, L., & Holick, M. F. (1988). Influence of season and latitude on the cutaneous synthesis of vitamin D3: Exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. Journal of Clinical Endocrinology and Metabolism, 67, 373–378.

    Article  Google Scholar 

  • Weston, J. M., Norris, E. V., & Clark, E. M. (2011). The invisible disease: Making sense of an osteoporosis diagnosis in older age. Qualitative Health Research, 21(12), 1692–1704.

    Article  Google Scholar 

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Gerber, L.M., Madimenos, F.C. (2016). Bone Health in Midlife Women. In: Sievert, L., Brown, D. (eds) Biological Measures of Human Experience across the Lifespan. Springer, Cham. https://doi.org/10.1007/978-3-319-44103-0_12

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