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Why Bone Health Is Vital As We Age

Bones are composed of a matrix of collagen and minerals, predominantly calcium, which gives them rigidity. They grow, harden and reach peak density around the age of 20. After that, it’s downhill all the way, I’m afraid.

Bone breakdown exceeds the rate of new bone formation, calcium is lost and they can become brittle (osteoporotic) and prone to fracture. For women, the rate of thinning increases further after menopause. So whilst at age 50, only 2% of women in the UK are osteoporotic, by age 80, this figure approaches 50%.

In 2021 there were two million women in England and Wales living with osteoporosis, according to the National Institute of Clinical Excellence (NICE). Additional risk factors include diabetes, hypothyroidism, inflammatory bowel disease (Crohns and Ulcerative Colitis) and chronic diseases of the lungs, kidneys and liver.

Medications, such as steroids, and those used to treat depression, epilepsy and to reduce stomach acid can also contribute.

What are the risks of Osteoporosis?

One third of women and a fifth of men will sustain an osteoporotic fracture in their lifetime, many of which will be undiagnosed of the vertebra (spine) leading to chronic back pain, loss of height and kyphosis (stooped posture). Hip fracture is a particular concern since it leaves the person immobile and hospitalised; 50% suffer permanent disability and 20% will die.

Is there any good news?

Encouraging good bone health from a young age can help make bones robust in early life so that the later decline has less impact. For those of us who are “over the hill”, as it were, it’s possible to flatten the trajectory of that downhill slope – and we really should try to do so if we want to avoid becoming one of the aforementioned sobering statistics.

Good Habits for Bone Health

  • Eat your greens: Your grandmother was right – they help make children’s bones grow and stay strong. Green vegetables, especially cruciferous plants such as broccoli, kale, rocket, cabbage and Brussels sprouts are rich in calcium and the vitamin C and other micronutrients essential for our bodies’ production of collagen.

  • Eat Protein: Too little can reduce calcium absorption from the diet but don’t overdo it. Too much creates an acidic environment which encourages release of calcium from bones to restore the body’s acid/base balance.

  • Get your vitamins: Vitamin D is especially important for calcium absorption and is best produced naturally by the skin in response to natural UV light. This is one of the many reasons it is important to get some outdoor activity in each day, if at all possible.

  • Work your body: Resistance training, using weights or practices where the resistance comes from using the weight of our own bodies, such as yoga or Pilates, have been shown to help reverse bone loss.

  • Eat enough: Calorie restriction forces the body to use calories more efficiently, putting on hold vital but non-urgent tasks, including bone maintenance. Athletes who maintain a low weight to gain advantage in their sports, such as elite cyclists, have been shown to develop osteopenia (the precursor to osteoporosis) despite their heavy training schedules.

  • Don’t overindulge: Being overweight can also be a risk factor so try to maintain a healthy weight, long term. Keeping your alcohol and caffeine consumption to under three units or three coffees per day is also recommended.

  • Don’t smoke: It accelerates bone loss. Simple.

  • Consider HRT: If you are peri- or post-menopausal, speak to your GP or a menopause specialist, particularly if yours arrived early.

The good news is that these habits are very achievable and you can start putting them into practice today. Not only will you notice an improvement in your general sense of wellbeing in the short term, but these measures will also help maintain your strength, general health and fitness, allowing you to maintain physical independence for the rest of your life.


You can read more about the effects of HRT and menopause on your bone health in my blog post here.


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