Osteoporosis is a terrifying disease: bones are so porous and brittle that a fall or even an exuberant hug could cause a fracture. We associate osteoporosis with old age, with stooped-over little old ladies. But just last month a dear friend, who's only 44, learned she has lost a significant amount of bone, apparently a consequence of early menopause. She knows she's at risk for osteoporosis, and she asked me for suggestions. I reminded her that I'm not a MD, and I urged her to follow her doctor's advice. But I gave her these suggestions:

Talk to your doctor about medications - there are some wonderful new drugs for osteoporosis. One, Evista, seems to protect against heart disease and breast cancer too.

Make sure you're getting enough vitamin D (600 to 800 IU/day). Calcium is important, but it doesn't work without vitamin D!

Consider joining a gym so that yoou can do strength training on machines. Because your body is positioned correctly by the machine, you can safely lift heavier weights that way.

Start a walking program, because that may help your bones too.

Work on your balance - it's imporrtant to prevent falls if you bones are weak. Tai Chi or yoga could be helpful.

All women need to be aware of osteoporosis, since it will affect about half of us after age 50. But there's a lot we can do to protect our bones, especially if we get an early start. The good news, as I told my worried friend, is that medical experts now consider osteoporosis a preventable disease.