How to Boost Bone Health Before and After Menopause
Time isn’t your friend when it comes to bone density. But no matter what your age, you can improve the health of your bones with these tips.
By Beth W. Orenstein
Medically Reviewed by Meeta Shah, MD
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Part of being a woman means paying attention to bone health throughout your life. There's good reason for this: Your bones are likely smaller and thinner than a man’s, and as you approach menopause, your ovaries produce less and less estrogen, which causes your bone cells to break down, possibly leading to osteoporosis.
According to the Arthritis Foundation, women lose about half of their trabecular bone — the spongy tissue that fills your long bones — over a lifetime. Women also lose 30 percent of the denser tissue that covers bones. Most of the loss occurs within the first decade after menopause, but both men and women lose 0.5 percent of bone density every year after age 50.
But you don’t have to take this news lying down. Just the opposite, in fact — you want to get up, get moving, and create a plan to help keep your bones as strong as possible.
Your Pre-menopause Plan to Boost Bone Health
The stronger your bones are in your twenties and thirties, the better off you’ll be when you reach the age at which bone density begins to decline. Here’s what you need to do to improve your bone health.
Start young. Make bone health a priority at as young an age as possible, long before menopause. “We are seeing women (and men) in their thirties with problems with their bones because of unhealthy habits they started as teenagers,” says orthopedic surgeon Lisa Kaye Cannada, MD, an associate professor of orthopedic traumatology at the Saint Louis University School of Medicine and a spokeswoman for the American Academy of Orthopaedic Surgeons.
It’s important to eat a well-balanced, healthy diet and maintain a healthy weight throughout your life. Focus on fruits, vegetables, whole grains, lean protein, nuts, legumes, and low-fat dairy and cut back on sugar, fat, and highly processed foods to improve bone health, according to research published inAdvances in Nutritionin January 2019.
Build strong bones. Your bones are in a constant state of turnover, breaking down old bone cells and building new ones, Dr. Cannada explains. Weight-bearing exercises such as weight lifting (also called resistance training) and activities you do standing up — like walking, running, jogging, dancing, step aerobics, and tennis — are excellent ways to build bone density. A minimum of 30 minutes of activity on most days of the week helps result in stronger, denser bones. Resistance training in particular helps build strong bones because the mechanical force of these exercises encourages the growth of new bone cells, according to a study published inClinical Calciumin 2019.
Your Post-Menopause Plan to Preserve Bone Health
It’s never too late to implement a bone health action plan. Start with these strategies.
Exercise. Participating in a regular weight-bearing exercise program becomes even more important as you age. You’ll get the most benefit if you vary the types of activities you do — which will make it more interesting, too. Weight-bearing and muscle-strengthening exercise are important for building bones in every stage of life, according to another study published in 2019 inClinical Calcium.
Increase calcium intake… Calcium builds strong bones, and the best source is your diet. Good sources of calcium are dairy products, like low-fat milk, and fish such as sardines and salmon. Green leafy vegetables also have calcium, so fill up on kale, collard greens, Brussels sprouts, broccoli, Chinese cabbage, and turnip greens.
… as well as vitamin D... You also need vitamin D to help absorb calcium. Food sources for vitamin D include some fatty fish, beef liver, eggs, and packaged foods that have been fortified, such as cereal. “Don’t forget the sun can also be a source of vitamin D," Cannada says. But she cautions that vitamin D levels may be lower in the winter for those who live in colder climates and get less exposure to the sun for several months.
… and supplement as needed. Women ages 19 to 50 years old need about 1,000 milligrams of calcium a day. After menopause or age 50, the National Osteoporosis Foundation (NOF) recommends boosting that number to 1,200 milligrams of calcium a day. The NOF also recommends that women younger than 50 get 600 international units (IUs) of vitamin D daily; those older than 70 need 800 IUs. It’s hard to get all the calcium and vitamin D you need, so you should talk to your doctor about using supplements to maintain bone health. If you already take a calcium supplement, ask whether it's appropriate for you to get a formula that includes vitamin D.
Cut back on caffeine. Caffeine causes your body to excrete calcium more quickly. So drink less regular coffee, tea, and caffeinated soft drinks — and avoid high-caffeine energy drinks, Cannada says.
Drink only in moderation. Alcohol can lower your body’s ability to absorb calcium. If you do drink, strive for moderation — which is no more than 2 to 3 glasses a day, according to the NOF.
Cut down on salt. Like caffeine and alcohol, salty foods can cause you to lose calcium and increase bone loss. In fact, postmenopausal women who consume a lot of salt are at greater risk for osteoporosis, the bone-thinning disease, according to research published in the journalOsteoporosis Internationalin January 2019. Processed and canned foods tend to be high in salt, so limit your intake. Whenever you eat packaged foods, look for low-sodium or no-salt-added varieties.
Consider osteoporosis treatment. There are several medications on the market that can help increase your bone strength. One option is hormone replacement therapy (HRT), which replaces the estrogen lost after menopause. However, HRT can have side effects, including an increased risk for endometrial and breast cancer.
Bisphosphonates are another option. These medications slow your bone’s reabsorption rate so you lose less bone. It is unclear, however, whether the benefits last beyond a few years.
It’s important to discuss treatment options with your doctor. “Some may be better for you based on your health history than others," Cannada says. “There are differences in dosing schedules — weekly to annually, and method given — oral versus IV. The most important thing is to start the medications within five years of menopause.”
Reduce your chance of falls. Taking steps to reduce falls can help you reduce your risk for bone fracture. Start by clearing your home of clutter so you’re not tripping over shoes left in the hallway or a wire running between your desk and the door. Make sure areas where you need to walk at night are well-lit. And try strengthening and balance exercises such as tai chi to help you improve your balance.
Video: Osteoporosis Exercises for Spine Strength and Posture
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