Why Does Osteoporosis Accelerate After Menopause And Other Bone Health Questions Answered

May 14, 2020
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Bone health isn’t something we think about often. Our bones that make up our skeleton seem to simply exist, keeping everything together, until one day, we trip or fall and realize just how necessary strong bones are to our daily lives. However, as women begin to lose estrogen and enter into menopause, osteoporosis becomes a major concern and rightfully so. Some low estrogen side effects include things like bone loss, which is a major risk factor for osteoporosis. The numbers show that nearly 1 out of 2 women over age 50 will break a bone because of osteoporosis.1 Thankfully, osteoporosis is not an inevitable part of aging. There are steps we can take throughout our lifetime to help support our overall bone health and help maintain healthy bones as we age.

WHY DOES OSTEOPOROSIS ACCELERATE AFTER MENOPAUSE?

Roughly 10 million Americans have osteoporosis and 80% of them are women.1 One of the main reasons for this is because of the steep decline of estrogen during menopause.1 Estrogen plays many vital roles in the body, including protecting our bone health. Menopause, however, introduces a stage of life in which estrogen supplies diminish, and that can cause bone loss.1

Most women experience the most rapid bone loss during the few years surrounding menopause.2 On average, women will lose about 2% of their overall bone mass during the year leading up to menopause and the 2 years following your last period.3 While this bone loss slows down during the postmenopausal years but doesn’t stop entirely.2 As we approach menopause and beyond, it’s helpful to recognize that decreased estrogen levels will increase our chances of developing osteoporosis.1 The good news is, we can take steps starting today to help protect our bone health, and one of those steps is to gain a deeper understanding of what factors are at play when dealing with bone health.

BONE HEALTH THROUGHOUT OUR LIVES

When we think of bones, many people imagine a sturdy, structural skeleton. But bones are actually living growing tissues.2 Bones are mostly made of collagen and calcium phosphate, which is a great combination for keeping our bones both flexible and strong.2

Throughout our lives, new bone is being added to our skeleton, and old bone is being removed.2 When we’re younger, this is a rather fast process. New bone is made before the old bone is discarded, which leads to denser, larger, and heavier bones.2 Around our late 20s, we hit what’s referred to as “peak bone mass.”2 After which point, the production of new bone slows down.2 Old bone is removed before new bone is produced to replace it, leaving us with smaller, less dense bones.2 Osteoporosis can develop either when bone loss occurs too quickly or when new bone formation happens too slowly.2

9 RISK FACTORS FOR DEVELOPING OSTEOPOROSIS DURING MENOPAUSE

Two overarching factors contribute to your risk of developing osteoporosis during the menopause transition: the amount of bone mass you have when you reach menopause, and how quickly you lose bone mass during menopause.1,2 Genetics, diet, lifestyle choices, other health complications can all play a role in both how much bone mass we have and how quickly we lose it during this transition.

Here are 9 other key risk factors for developing osteoporosis during menopause:4

  • A family history of osteoporosis or broken bones
  • Breaking a bone before age 50
  • Having your ovaries surgically removed before menopause
  • Undergoing early menopause
  • Not getting enough calcium or vitamin D throughout your life
  • Smokers may absorb fewer amounts of bone strengthening nutrients (such as calcium and vitamin D) throughout their lives
  • Taking certain medications, including those for arthritis, asthma, and some cancer drugs
  • Having a small body frame
  • Never reaching “peak bone mass” during your best bone-building years2

Other risk factors that cause you to lose bone can also increase your chances of developing osteoporosis during menopause.1 Some women lose up to 20% of their bone density within the first 5–7 after menopause.1 This is just another reason why it’s important to stay in touch with your doctor regarding your overall bone health, and they may have some tips that can help too.

WHAT ARE THE SIGNS OF OSTEOPOROSIS?

Osteoporosis often occurs without any symptoms at all.2 You may not know your bone health is at risk until a sudden strain, bump, or fall causes a fracture or collapsed vertebrae.2 Unfortunately, there are no signs of early bone loss. But if you already have osteoporosis you may experience:5

  • Back pain caused by a fractured or collapsed vertebrae
  • Loss of height over time
  • A stooped posture
  • Bones that break much easier than expected

4 TIPS FOR STRENGTHENING BONE HEALTH

1. Boost these two bone strengthening nutrients

Calcium and vitamin D are partners in bone health. Together they comprise two of the most important nutrients for strong bones. Your body needs vitamin D in order to absorb calcium.3 Which means if you aren’t getting in your 15 minutes of sunshine every few days, you could be missing out on both of these critical bone nutrients.3

Calcium: Even though our bones are made of calcium, the body can’t produce this mineral on its own. Our body needs us to consume foods and drinks that contain this essential mineral. Women ages 18–50 need to consume about 1000mg of calcium per day.3 That goes up to 1200mg / day for women over 50.3

Being lactose intolerant, however, can complicate whether or not you get enough calcium throughout your life. In fact, roughly 70% of African-American women and 90% of Asian-American women in the United States are lactose intolerant—which makes it difficult to consume the right amounts of dairy-friendly, bone health nutrient.1

If you can’t get enough calcium from your food, doctors may recommend supplementing with calcium.3 Talk to your doctor first before beginning to take any new bone supplements, as too much calcium can cause other health concerns, such as kidney stones.3

Calcium can be found in:

  • Collard greens
  • Plain, non-fat yogurt
  • Milk
  • Broccoli
  • Kale
  • Kidney beans
  • Tofu

Vitamin D: Vitamin D not only helps your body absorb calcium, but it also supports the muscles needed to avoid falling.6 As we age, if we don’t get enough of this essential nutrient, we’re more likely to break bones.6 There are two types of vitamin D, one found in plant-based sources (D2) and the other in animal sources (D3). Both forms are effective, but overall the body prefers vitamin D3 which is mostly found in fatty fish and fortified foods. It’s recommended most adults under age 70 consume 600 IU/day of vitamin D. Adults over age 70 need slightly more, at 800 IU/day.3

Sunshine is the best source of vitamin D, but it can also be found in very few foods, including:

  • Mushrooms
  • Fortified dairy
  • Fortified juices
  • Salmon
  • Tuna

2. Look for ways to add these other key nutrients to your diet

Our bodies are sustained by the fuel we feed them with from our diets. Every bite we take determines whether or not we’re supporting our bone health with these critical life-giving nutrients. Here are a few nutrients that are especially important for women ages 40+:

Magnesium: Magnesium is another essential mineral that plays a key role in support bone and muscle health. Yet recent data shows that nearly 45% of Americans aren’t getting enough of this critical nutrient.7

Foods that contain magnesium include:

  • Spinach
  • Swiss chard
  • Avocados
  • Almonds
  • Peanuts
  • Lima Beans
  • Chickpeas

Omega-3s: Omega-3 fatty acids are the building blocks of our cell membranes. Their goal is to keep cells agile and flexible so that the nutrients we consume can flow into the cell and the waste created by it can flow easily out. They also help with communication between cells, which is vital to our general health. Certain amounts of omega-3s are even shown to support heart, eye, and mood health. As we age, all of those things become increasingly important.

Scientific organizations recommend 250–500mg of two key omega-3 fatty acids (DHA / EPA).8 That amounts to at least two servings of fatty fish per week.

Foods rich in EPA / DHA omega-3s include:

  • Wild salmon
  • Albacore tuna
  • Lake trout
  • Sardines

ALA is another type of omega-3 found in flaxseed, walnuts, and chia seeds—but it’s found in lesser amounts and isn’t nearly as efficient at DHA or EPA.

Vitamin B12: This vitamin is important for women of all ages, but especially for women in postmenopause. As we age, we don’t absorb vitamin B12 as well from its usual protein sources. But vitamin B12 is critical to supporting the nervous system and how we turn food into cellular energy. It’s especially important if you ascribe to a vegetarian or vegan diet, as you’ll need to find sources for this critical nutrient outside of its most common sources such as animal products such as meat, poultry, and fish.

You can find vitamin B12 in a few foods, including:

  • Clams
  • Salmon
  • Beef
  • Milk
  • Yogurt
  • Some fortified foods

3. Include weight-bearing exercises into your routine

Weight-bearing exercises are important for building and maintaining bone density.9

Thankfully, there are lots of ways to do them. There’s high and low impact, both of which are good options.

Choose a high-impact weight-bearing exercise like:

  • Dancing
  • Hiking
  • Jogging
  • Jump roping
  • Stair climbing
  • Tennis

Low-impact weight-bearing exercises can be helpful as well in supporting your overall bone health. Some options include:

  • Elliptical training machines
  • Low-impact aerobics
  • Stair-step machines
  • Fast walking outside or on a treadmill

Some weight-bearing exercises may be too high-impact or involve bending and twisting in a way that is neither comfortable nor safe.10 If you have any concerns about weight-bearing exercises—and if you already have osteoporosis—consult your healthcare practitioner before beginning a new exercise regimen about which workouts are best for you.

4. Avoid alcohol and cigarette smoke

These two pieces of advice seem to make it onto every list about not just bone health but overall health in general. But for women who are concerned about bone health during menopause, they’re especially relevant.

Regularly consuming 2–3 ounces of alcohol each day may damage the skeleton, even in young women.2 Plus, people who drink are more likely to experience bone loss and fractures—both because of poor nutrition and because being tipsy makes you a little tipsy and at greater risk of falling.2

Women who smoke may not only absorb less calcium (a critical bone supporting nutrient), but they also have lower levels of estrogen when compared to nonsmokers and often go through menopause earlier.2

WHEN IT COMES TO BONE HEALTH, PLAY TO YOUR STRENGTHS

Even if your best bone-building days are behind you as you navigate ‘The Change,’ there are still choices you can make every day to help maintain your bone health as you age. Try increasing your calcium and vitamin D intake either through diet or supplements. Explore some weight-bearing exercises to find one you actually enjoy and try to avoid substances that inhibit how your body absorbs those critical bone strengthening nutrients. All of these small daily choices will help keep you going strong for years to come.

References

  1. National Osteoporosis Foundation. “What Women Need to Know.” 2020. Accessed on: May 13, 2020. https://www.nof.org/preventing-fractures/general-facts/what-women-need-to-know/
  2. National Institutes of Health. “Osteoporosis Overview.” 2018. Osteoporosis and Related Bone Diseases National Resource Center. Accessed on: May 13, 2020. https://www.bones.nih.gov/health-info/bone/osteoporosis/overview
  3. Mayo Clinic. “Mayo Clinic Q and A: Bone Health as You Age.” 2016. Accessed on: May 13, 2020. https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-bone-health-as-you-age/
  4. National Institutes of Health. “Osteoporosis.” 2017. National Institute on Aging. Accessed on: May 13, 2020. https://www.nia.nih.gov/health/osteoporosis
  5. Mayo Clinic. “Osteoporosis.” Accessed on: May 13, 2020. https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968
  6. National Osteoporosis Foundation. “Calcium and Vitamin D.” 2018. Accessed on: May 13, 2020. https://www.nof.org/patients/treatment/calciumvitamin-d/
  7. Fulgoni VL, 3rd et al. Foods, fortificants, and supplements: Where do Americans get their nutrients? J Nutr. 2011; 141 (10): 1847-1854. https://www.ncbi.nlm.nih.gov/pubmed/21865568
  8. Department of Health and Human Services. “2015­–2020 Dietary Guidelines for Americans.” 2015. 8thS. Department of Agriculture. Accessed on: May 13, 2020. https://health.gov/dietaryguidelines/2015/
  9. National Osteoporosis Foundation. “Exercise/Safe Movement.” Accessed on: May 13, 2020. https://www.nof.org/patients/treatment/exercisesafe-movement/
  10. Mayo Clinic. “Exercising with osteoporosis: Stay active the safe way.” 2019. Accessed on: May 13, 2020. https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis/art-20044989
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