Imagine you are a 19-year-old runner on the USF cross country team. Or a 23-year-old fitness nut who eats a macrobiotic diet and works out three hours a day. Maybe you’re a 35-year-old mother returning to school and living on cigarettes and coffee. Perhaps you’re a 55-year-old male professor who can’t understand why his back always aches. None of these people have to worry about bone loss, do they? After all, osteoporosis is for 80-year-old ladies, right? Wrong.

After five years as a competitive triathlete and cross country runner, I had everything going for me. I trained several hours a day and ate an extremely healthy diet. I had even been admitted to the U.S. Air Force, Naval and Military academies and had settled on West Point.

My senior year of high school, I broke my finger after catching a football and developed stress fractures in my foot that prevented me from finishing the cross country season. During my first year at West Point, I suffered two painful back fractures. Medical tests determined that I had low bone density, or osteopenia. This had probably been caused by years of overtraining and dieting. In order to recover properly, I had to leave West Point and give up both my military and athletic careers.

So, how do you prevent bone loss? Dr. Harris McIlwain, a rheumatologist and founder of the Tampa Medical Group, published author and winner of Town and Country’s Best Doctors in America award, has answers.

Risk Factors

Dr. McIlwain identifies several risk factors for bone loss. Many of them appear in young college women in their peak bone building years.

Your bone-density peaks at about age 25. If you have two or more of the following risk factors, talk to your doctor. Although many of these factors are specific to women, men need to be aware that 30 percent of all osteoporosis cases occur in men. Talk to your doctor about bone loss, and ask about a bone-density test (also called a DEXA scan) if you fall into one of these nine risk factors:

1. Low body weight. This means being petite underweight for your height, especially if you diet excessively to maintain this low weight.

2. Genetics. If your mother or grandmother has or has had osteoporosis, it may increase your chances of bone loss.

3. Age. The risk of bone loss increases with age.

4. Premature menopause or irregular menstrual periods.

5. Previous fractures. If you have had a fracture as an adult, your chance of having another fracture can double.

6. Smoking and drinking. Smoking is just plain bad for your health. It has an anti-estrogenic effect on the bones. Drinking excessively prevents the bones from absorbing calcium.

7. Avoidance of dairy products. Dairy products have calcium. Bones are made of calcium. Need I say more?

8. Certain medications. Prednisone or other cortisone medications taken for conditions such as asthma can lead to premature bone loss, as can medications for cancer and for seizures.

9. A history of eating disorders or chronic dieting.

How to increase and maintain your bone density

There are several things that Dr. McIlwain recommends to strengthen your bones. Young college women need to remember that they are in their prime bone-building years. Even though it can be difficult to maintain healthy habits while in school, it is very important to do so.

Exercise: Choose weight-bearing exercises, such as aerobics, jogging, rollerblading, tennis and soccer. Also, do strength-training exercises at least three times per week. Exercise moderately, since overtraining can also increase your risk of osteopoenia.

Depending on your current eating habits, you may be able to add just a few more calcium-rich foods to your diet, or you may need to completely change your eating habits. You need to be eating enough calories to keep your body healthy, and you need to be eating the right foods. Three thousand calories a day of beer, chips and candy does not cut it, but neither does 1000 calories of yogurt and lettuce. You need a diet that balances your favorite foods with foods that make your body healthy and strong. If you feel that you may have an eating disorder or if you have no idea how to eat a healthy diet, talk to a nutritionist.

Prevent fractures. If you smoke, quit. If you drink excessively, cut back. You may also have to take measures to prevent falling.

If your bone density is low, talk to your doctor about medical treatments. This could include estrogen, bone-building medications and/or calcium supplements. Even if you have normal bone density, select a multivitamin with calcium.

Low bone density is not just something you can brush off. Even at a young age, fractures can cause a lot of physical pain and derail your life. Fortunately, the steps to prevent bone loss are very simple. To learn more, read Dr. McIlwain’s book Reversing Osteopoenia.

Tereza Zambrano is a junior majoring in international studies and is a triathlete.

You can ask her questions at tmzambrano@triathlete.com .