In Europe, vertebral fracture incidence has increased 300–400% for women and more than 400% for men during the last 30 years. These data are age-adjusted and therefore highlight that there is a decrease in bone mass or bone quality from generation to generation. To arrest or reverse the increases in osteoporotic fractures, effective general preventive regimens must be established. However, in order to do so, basic understanding of age-related changes in the material quality, 3D cancellous bone architecture, macrostructure (shape and size), and strength of human bone is crucial.