Managing Bone Health

Written By: Tracy Pritchard (MS, CNS, LDN)

There are many important health topics that impact women, and one of these is bone health. Women are at a higher risk than men for bone health issues, especially after menopause.  Many of us aren’t really thinking about bone health until we are older and joint aches and pains start to occur. Bone loss is a natural part of aging and starts to decline after it’s peak (around age thirty.)

Two conditions associated with bone health are osteopenia and osteoporosis. Osteopenia is a lower-than-normal bone density but not severe enough to be diagnosed as osteoporosis. Osteoporosis is a disease that weakens bones, making them more prone to fractures. It has been called a “silent disease” because there may be no symptoms prior to breaking a bone. The common areas for fractures include the hip, wrist, or spine, and these may result from even a minor fall or bump.  

The first time we think about evaluating bone health may be at a dual-energy X-ray absorptiometry (DXA) scan. When evaluating the results, a t-score is used to compare bone density to the average bone density of a young healthy adult. A t-score of -1 or higher  (including 0 and positive numbers) is considered normal bone density. A score between -1 and -2.5 shows osteopenia while a score of -2.5 or less indicates osteoporosis. Another biomarker to consider is 25-OH Vitamin D levels. While labs will show a wide range, optimal levels are between 40ng/mL to 80ng/mL. The earlier osteopenia/osteoporosis is diagnosed and treated, the better chance of slowing down the progression and reducing further complications.

It is important to understand the risk factors that affect bone health. There are several factors that we can’t control as well as several modifiable factors. As previously mentioned, bone density decreases with age and is influenced by hormonal changes in women. For those with a family history of osteoporosis, genetics may increase the likelihood of developing this condition. Ethnicity also plays a role – white women have the highest rate of hip fractures followed by Hispanics, Asians, and African Americans. 

Some controllable lifestyle factors that may worsen bone health include smoking, excessive alcohol intake, and a sedentary lifestyle. Most people know that physical activity is good for overall well-being and disease prevention. It is also one of the best ways to preserve bone mass. We often think of building and strengthening our muscles, but our bones also need physical activity to maintain strength, density, and resilience. Both strength training and low impact activities such as walking are helpful. Walking? Yes – walking puts weight on the bones and promotes balance which help reduce the risks of falls and bone injuries. Being underweight or overweight/obese may also lead to impaired bone quality.

There are also numerous medical conditions and medications that may increase the risk of bone loss. If you are dealing with any medical conditions consider talking to your provider about how they may impact your bone health. A variety of medications can compromise bone health, a couple examples include oral and inhaled steroids, some birth control pills, anti-depressants, acid blockers, and anti-seizure or anti-convulsant medications. 

Tips to make your bones healthier:

*Diet: Incorporate calcium and vit D into a well-balanced diet. Some people may need supplementation to get enough calcium and Vit D. Men and women 19-50 years old should aim for 1,000mg of calcium per day, while women 51-70 need 1,200mg per day. Men and women over 71 years of age should also aim for 1,200mg per day. Sources of calcium include dairy products, canned sardines and salmon, leafy greens and broccoli, and some fortified foods. Food sources of vit D include fatty fish, liver, egg yolks, some mushrooms, and fortified foods. Adequate protein intake is important for building bone tissue. Protein is found in meats, fish, poultry, dairy, and legumes. Other important bone nutrients include magnesium, phosphorous, potassium, and Vitamin C. Check out these bone-supporting meal plans created with these nutrients in mind:

Bone Health Support Meal Plan

Plant-Based Bone Health Support Meal Plan

*Lifestyle: If you are a smoker, find support to help you quit. If you are a heavy drinker, find ways to reduce intake.  

*Physical Activity: incorporate a variety of strength building and weight-bearing activities for at least 30 minutes per day. These may include walking, lifting weights, or even dancing. Find an activity you like to do and put it on the schedule! Planning is key – put your workout on your schedule just like other appointments and consider the details of where, when, and how so it is easier to follow through. Be sure to be adjust exercises to accommodate any health conditions, physical limitations, or personal preferences to make it more likely you will stick with your plan. Most workouts can be adjusted in intensity or duration to match your fitness level and long-term goals.