Osteoporosis: Rule of the bone

I am 47 and approaching the menopause. I have not had any dairy products for 10 years as they give me diarrhoea. Should I have a bone density scan to check for osteoporosis? I am 5ft 7in, 10st, size 12 (so the correct weight for my height) and I am healthy. I do a desk job but try to get to the gym once a week for a hour; I do a Pilates class every week and I cycle to work, but I'm aware that cycling is not a weight-bearing exercise. I feel that exercise is more important for bone density than calcium, but I know not everyone agrees.

Dr Fred Kavalier answers your health question:

There are quite a few important risk factors for osteoporosis. Age is the most important, because our bones get thinner as we get older. Being a woman is another, because women's bones are smaller and they deteriorate more quickly after the menopause though osteoporosis can affect men too. White and Asian women are at higher risk than Afro-Caribbean women, as are women who are small and thin (under 9st), and women who have had anorexia or bulimia. An early menopause also makes osteoporosis more likely.The final two factors are diet and exercise. Dairy products are an important source of calcium, but so are leafy green vegetables, nuts, tofu and dried fruit. So the fact that you have avoided dairy products does not necessarily mean that you have been short of calcium in your diet. As for exercise, although cycling is not strictly a weight-bearing exercise, it does help to strengthen the bones by the muscular stress that it exerts on them. Weight-bearing exercise is particularly important when you are young and still building up bone mass.I have put your details into several osteoporosis risk-scoring systems, and they all say that you do not need a bone scan. I think you would be wise to increase your dietary intake of calcium, and get enough vitamin D by going out in the sun regularly. You can score your osteoporosis risk yourself at www.osteoed.org.

Please mail your questions for Dr Fred to health@independent.co.uk. He regrets that he is unable to respond personally to questions.