One topic that comes up frequently in my women’s total health practice is how to preserve bone health and prevent or decrease the incidence of osteopenia and osteoporosis. Osteoporosis is a gradual thinning of the bones that increases the risk of bone fracture. This is a very important topic for senior women’s health care. According to a 2024 article published on John Hopkins University website and reviewed by Kendall Moseley MD, 54 million Americans have osteoporosis and up to 50 % of women over 50 have a bone fracture. Women already have naturally lower bone density than men, and the lack of estrogen with menopause causes more bone density loss and increases the risk of osteoporosis. Thankfully, there are things that we can do to prevent or slow down bone density loss and osteoporosis, and the earlier in life women start working on it, the better their bones can be after 50.
Lifestyle can play a huge role in bone strength and bone loss prevention.
Some lifestyle modifications that can help keep you bones healthier include:
Don’t smoke! Smoking is bad for you in just about every way possible and it can contribute to bone loss as well. Nicotine can damage bone- making cells and decreases the body’s ability to absorb calcium.
Limit alcohol consumption. Alcohol can make it difficult for your body to absorb calcium and vitamin D which are needed to create new bone cells. It can also cause the body to produce less estrogen and testosterone, which causes a decrease in the body’s ability to remodel bone and increases bone resorption (when the bones release calcium in the bloodstream).
Eat a well-balanced diet. Getting enough protein is very important, about 60 grams a day for 140-pound women is good. Adequate protein has been found to increase bone mineral density in women. Getting enough calcium is also essential for healthy bones. The recommended daily requirement of calcium for women over 50 is 1200 mg. Calcium can be found in many foods such as certain kinds of fish, fortified juice, milk and cereals, and is very important for bone health. Sometimes women cannot get enough calcium through diet alone and may require a calcium supplement. This should always be discussed with your own healthcare provider.
Exercise and stay active. Certain kinds of exercise stimulate the cells that are responsible for building bones. Weight bearing exercise carries the weight of your body against gravity. Some examples of weight bearing exercise are walking, running, aerobics, tennis and hiking. Resistance exercise uses an opposing force such as weights, bands or water to strengthen your muscles and build bone.
Adequate vitamin D is one of the most important players in maintaining strong bones when you are young and as you age. Your body can only absorb calcium (the primary component of bone) when there is vitamin D present. Vitamin D can be found in some foods, although it isn’t naturally present in very many foods. In addition, sunlight converts a chemical in our skin to an active form of vitamin D. Because it is difficult to get enough vitamin D from food, our ability to absorb vitamin D declines as we age, and because many older adults have less sun exposure, often vitamin D supplements are recommended for bone health in people over 50. This is something that should be discussed with your own health provider. The normal recommended daily amount of vitamin D is 600 IU for people from 1-70 years old and 800 IU for people 71 and older. You may see varying recommendations depending on the source. It is not normally recommended to take over 4000 IU per day, taking too much can be harmful. In looking at supplements for vitamin D, you may see both vitamin D2 and D3 and this can be confusing to people. Vitamin D2 is derived from plants, and vitamin D3 is derived from animal sources and sunlight. There are some studies that suggest that D3 is absorbed better than D2, but this is controversial. Sometimes calcium and vitamin D are given together and sometimes it is recommended with vitamin K2, which is supposed to improve absorption.
In addition to being vital for bone health, vitamin D has been extensively studied and may play roles in preventing some forms of cancer and cognitive decline among other benefits. Women should talk to their health care provider about possibly testing vitamin D levels and whether a supplement is appropriate for them.
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