I’ve been relatively small my entire life. I have just the type of build to put me at risk for low bone density. I’ve never been a huge milk drinker and I don’t think I’ve always met the recommended calcium intake. After taking a course about exercise and osteoporosis I was concerned about my own risks. At my last annual physical I asked my physician to book a bone density scan. Knowing the risks I was scared to see the results. Fortunately I passed with flying colours. It seems I was doing a few things right after all.
Facts about osteoporosis and bone density
Bone is not solid. It has a porous internal structure and a solid external structure. The mineral structure of bone is constantly being remodeled with some bone cells responsible for resorption and some responsible for depositing new mineral structure. As we age less new mineral structure is formed and our bones generally become more porous.
Osteoporosis occurs when the bones become weak enough that they can fracture easily. Osteopenia is lower than normal bone density, but not yet considered to be osteoporosis. According to the International Osteoporosis Foundation, one in ten women worldwide over the age of 60 have osteoporosis. This number goes up with age. In fact one in three women will suffer a fracture caused by osteoporosis in their lifetime. Many women do not know they have osteoporosis until they suffer a fracture. Starting bone density scans at a young age can help to diagnose osteoporosis before a fracture occurs. If you are post menopausal, low body weight, or have other risk factors you should talk to your physician about getting a bone density scan.
Women are at a higher risk of osteoporosis because of our smaller size. We have smaller bones and our lower weight means less impact of the bones. We are generally protected by estrogen until after menopause. Then we often see rapid bone loss. Thyroid hormone levels also affect bone density. Young female athletes may also be at risk for osteoporosis if their menstrual periods have stopped.
Nutrition and supplements
You’ve probably heard that you need to drink milk for strong bones. Milk is a good source of calcium but it is not the only source of calcium. Many women cannot tolerate dairy so choose not to drink milk. This doesn’t necessarily mean your bones will be weaker. There are many other sources of calcium such as white beans and kale. Calcium does not work on its own. Other nutrients such as vitamin D, protein, phosphorous and vitamins K, C and E are also necessary for bone growth. Getting these nutrients from whole foods is better than from supplements. Vitamin D is an exception in that it is usually made in the body from sunshine on exposed skin. Many people in northern latitudes do not get enough vitamin D from sun exposure in the winter months and should consider supplementing. Even better, have your physician check your levels.
Our bones are constantly being broken down and rebuilt. As we age the breaking down takes over. Even if you have the proper nutrition for healthy bones, your bones still need a stimulus to rebuild. This stimulus comes in the form of exercise. Both weight bearing cardiovascular exercises and resistance training have been shown to have benefits.
Cardiovascular exercise has many benefits. If the exercise is weight bearing such as walking or running then it also helps to increase or maintain bone density. The impact of weight bearing activities stresses the bones and the bones respond by producing more bone. Exercises like cycling, swimming or water aerobics do not offer much benefit when it comes to bone density. We often hear that exercises like this are good because they are non impact, but when it comes to bone density the opposite is true.
Resistance training also has benefits when it comes to bone health. Bones respond to the stress of resistance training and bone mass can be increased. Being stronger also means you are less likely to fall. Another plus for resistance training is it allows smaller women to increase weight by adding muscle mass rather than fat mass.
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Body weight is an important component in the risk of getting osteoporosis. When your body weight is lower there is less stress on your bones and hence less bone growth. Female athletes can be at risk for osteoporosis if their body weight drops too low. They can develop what is known as the female athlete triad where low body weight and excessive stress on the body leads to the premature stopping of the menstrual cycle. With the cessation of menstrual periods the body no longer has the protection of estrogen which helps with bone growth.
Another risk factor for bone density is chronic dieting. If your body is not getting enough nutrients, then the nutrients it gets are likely to be converted to energy and used for other body functions rather than being used for bone growth. Bone mass can even be depleted along with fat mass, and muscle mass. Including exercise in a weight loss program can help diminish this effect. When trying to lose weight stick to a diet of whole foods and avoid ultra low calorie diets.
Some medication such as glucocorticoids, breast cancer drugs, and proton pump inhibitors can have a negative effect on bone density. If you are taking any medication ask your doctor about the effects on your bones and consider a bone density scan to see where you are at.
There are other lifestyle factors such as smoking and excessive alcohol use that affect bone density. If you eat whole foods, exercise and avoid other risk factors you are more likely to have healthy bones.
I am a certified osteoporosis exercise specialist (Bonefit certified) with Osteoporosis Canada. Book a free Menopause Reset session to find out how I can help.