You’ve finally bid adieu to the night sweats, hot flashes, and mood swings of the perimenopause (that lovely period when you’re body undergoes considerable biological, physical, and hormonal change), and you’re well into the next chapter of your life as a woman: the menopause. But don’t jump for joy just yet. You may be free from the shackles of menstrual cramps (hooray!), however you’ve still got the pressing matter of your bone health to tend to. You see, the perimenopause will have skewed your bone density, making your bones prone to weakening. In fact, women can lose up to 20% of their bone density in the five to seven years after the menopausei. Though this may sound alarming, don’t be disheartened by this statistic. With the correct tools, happy, healthy bones are well within reach.
How does menopause affect bone health?
Throughout the course of your life, oestrogen plays a critical role in regulating your bone production and turnover. Every day, your skeleton performs a process of formation and breakdown. During the menopause, however, your levels of oestrogen plummet in the body. Consequently, bone breakdown starts to exceed bone formation, resulting in porous, weak, and brittle bones. And while you can’t prevent bone loss entirely, there’s still plenty you can do to strengthen bones at this stage of your life.
Move more
The saying ‘move it or lose it’ couldn’t ring truer once you hit the menopause. At this point in your life, exercise needs to become a mainstay of your bone-supporting arsenal, quite simply because it maintains bone mass and muscle strength. In particular, you should focus on weight-bearing exercise since this activity stimulates extra calcium deposits and supports the production of osteoblasts – cells that promote bone growth. In one study on postmenopausal women, researchers found a 12-week weight-bearing exercise programme increased participants’ bone density, bones size, and bone strengthii. Confusingly, you don’t need ‘weights’ to perform weight-bearing exercise. Rather, you stay on your feet and work your bones and muscles against gravity. Brisk walking, jogging, aerobics, dancing are great examples.
A word of warning, though: don’t push yourself. Your bones won’t love it if you exercise intensely and excessively. Overall, you should aim for 150 minutes of moderate exercise every week. Be mindful that strength-bearing exercise and flexibility training will also support bones. In fact, the NHS recommends doing strength-based exercise – that is, activity that works your muscles against resistance – twice a week in addition to your weight-bearing workoutsiii. Why not grab some weights after you jump off the cross trainer, or start your day with a 10-minute yoga flow (you can find lots of free videos online!). Learn more about exercising for bone health here.
Cram in more calcium
Famous for its bone-loving credentials, your need for calcium skyrockets after the menopause. Not only is this mineral a major building block of your skeleton, but it’s also essential for muscle and nerve function. And if there’s a scarcity of calcium in your diet, it will be leached from your bones, rendering them more prone to fractures and breakages. Needless to say, calcium truly is the big daddy of the bone health world; failing to prioritise your intake after the menopause will severely compromise your bones. Yes – the TV ads were right when they told you dairy products are brilliant bone food. Besides chowing down on cheese (in moderation, of course) and pouring lashings of milk on your muesli, you can find calcium in a host of other nourishing food. Eating a range of canned fish (salmon, sardines, and mackerel), tofu, figs, nuts, seeds, and other fortified food and drinks will help you achieve your recommended daily allowance of 700mcg each day.
Vital vitamin D
When it comes to supporting bone health after the menopause, calcium is only half the story. You need its trusty steed, vitamin D, too. The bone-bolstering powerhouses are quite the duo: calcium builds and maintains bone density, while vitamin D supports the absorption of calcium. Ultimately, your intake of calcium and vitamin D needs to be adequate to properly realise the benefit of each nutrient on your skeletal system. Data on menopausal and postmenopausal women continuously informs us that those with poor vitamin D stores are more vulnerable bone loss and compromised bone densityiv. The best way to replenish your vitamin D stores is with 15 minutes of unprotected, direct sunlight every day. And when the sun isn’t so readily available in winter months (sigh), make a conscious effort to load up on foods rich in vitamin D, like oily fish (tuna, salmon, and mackerel), egg yolks, cheese, as well as fortified foods like bread, orange juice, and milk. Of course, the simplest means to plug any nutritional gaps is with a vitamin D supplement, which comes highly recommended by Public Health England. Always look for formulas that pack at least 10mcg.
Add more mag
Despite being a little more under-the-radar, magnesium plays a crucial role in nourishing your bones after the menopause. Why? Well, magnesium is fundamental for the proper utilisation of calcium and vitamin D. Without this mighty mineral, your calcium and vitamin D stores can’t deliver their full-spectrum of bone support. In one observational study on 73,684 postmenopausal women, researchers found participants with a lower magnesium intake had poorer bone mass density in the hip and whole of their bodyv. Conversely, those who received 400mg of magnesium each day had 2-3% higher bone density. To reap the bone-loving goodness, be sure to cram at least 300mg of magnesium into your diet each day. Legumes, whole grains, dark green leafy veggies, dark chocolate, nuts, and seeds are packed with this nutritional powerhouse.
Call on vitamin K2
After the menopause, you need to make vitamin K2 your friend, too. This nutrient is a potent weapon for bone health, playing a central role in bone formation, maintaining the balance of calcium in the body, and supporting against bone fractures. One study even proposed vitamin K2 could slow down the rate of bone loss in postmenopausal womenvi. When it comes to getting your recommended daily allowance of 90mcg, embrace a variety of fermented foods, yoghurt, ripe cheese, and natto – a Japanese fermented soy food.
Pack in protein
Never before has cramming more protein into your diet been so important. Not only does protein make up 50% of your bone structure, but it also supports the absorption of calcium and helps to maintain bone mass. Indeed, in one observational study on 144, 000 postmenopausal women, increased dietary protein was directly associated with improved bone density in the hip, spine, and total body areas, along with a reduced risk of forearm fracturevii. Generally speaking, women should aim for 45 grams of protein daily – that translates to two palm-sized servings of fish, meat, tofu, pulses, or nuts. To unlock the bone goodness, try to include protein with every meal. Oh, and did we mention protein is super satiating, too? Your bones and waistline will thank you. Find out more about protein and bone health here.
Maintain a healthy weight
Just like nutrition, weight is also something to keep your eagle eye on once you hit the menopause. While eating too much and piling on the pounds is never a good idea – for your bones and the rest of your body – it would seem that dropping into a calorie deficit will damage your bones the most. Besides causing muscle loss and slowing down your metabolism, it can severely compromise your bone health. A growing raft of data suggests diets delivering less than 1,000 calories a day can cause lower bone density in obese, overweight, and normal-weight individualsviii. After the menopause, make a conscious effort to eat a balanced and plentiful diet – one that’s brimming with the nutrients outlined above and packs at least 1,500 calories each day.
Cut back on caffeine
Many of us reach for a morning cup of java to energise our tired bodies and sleepy eyes. Though one or two mugs won’t do you much harm, experts have pointed to excessive caffeine intake (more than six cups a day) compromising bone health. In a study, researchers found that participants’ who guzzled coke cola excreted calcium in their urine, which conspired to hijack bone densityix. Why not swap your third cuppa joe with a herbal tea? Added bonus: herbal teas won’t only give your body a much-needed hydration boost, but you’ll skip the post-caffeine crash and side order of jitters, too.
Take it easy on the tipples
Sure – we all like to unwind with a glass of vino now and again, but going overboard on the tipples is never a wise idea. Beyond affecting your liver and heart, heavy drinking launches a two-pronged attack against bone health. Firstly, it tilts the delicate balance of calcium in the body; and secondly, it interferes with the production of vitamin D, affecting the absorption of calcium as a result. In one study, postmenopausal women who consumed more than six alcoholic drinks per day experienced a greater bone loss than their female counterparts who drank minimallyx. To keep the health risks of alcohol a bay, avoid drinking any more than 14 units of alcohol a week. Make sure you disperse your drinking over 3 or more days, too. Top tip: use smaller glasses for your beverages so you aren’t tempted to guzzle more. Want to learn more about alcohol and its effects on bone health, click here.
Stub out smoking
Want another reason to stub this unhealthy habit out for good? Listen up? Tobacco use has long been associated with an increased risk of bone health conditions, a higher risk of bone fractures, a decrease in new bone formation, and compromised bone mass. Simply put, it really is one of the worst habits for your bone health. In one study, researchers revealed that among postmenopausal women, smokers lost their cortical bone approximately 50 per cent faster than non-smokersxi. That – in combination with the myriad other health implications – is a good enough excuse to quit the smokes.
References:
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nhs.uk. (2019). Menopause and your bone health. Available online: https://www.nhs.uk/live-well/healthy-body/menopause-and-your-bone-health. [Accessed 11 Apr. 2019].
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Klentrou,. P., Slack. J., Roy. B. & Ladouceur. M. (2007). Effects of Exercise Training with Weighted Vests on Bone Turnover and Isokinetic Strength in Postmenopausal Women. Journal of Aging and Physical Activity. 15(3), pp.287-299.
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nhs.uk. (2019). Menopause and your bone health. Available online: https://www.nhs.uk/live-well/healthy-body/menopause-and-your-bone-health. [Accessed 11 Apr. 2019].
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Bener. A. & Saleh. N. (2015). Low vitamin D, and bone mineral density with depressive symptoms burden in menopausal and postmenopausal women. Journal of Mid-life Health. 6(3), 108.
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Orchard. T., Larson. J., Alghothani. N., Bout-Tabaku. S., Cauley. J., Chen. Z., LaCroix. A., Wactawski-Wende. J. & Jackson. R. (2014). Magnesium intake, bone mineral density, and fractures: results from the Women’s Health Initiative Observational Study. The American Journal of Clinical Nutrition. 99(4), 926-933.
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Iwamoto. J. (2014). Vitamin K therapy for postmenopausal osteoporosis. Nutrients. 6(5), 1971–1980.
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Promislow. J. (2002). Protein Consumption and Bone Mineral Density in the Elderly : The Rancho Bernardo Study. American Journal of Epidemiology. 155(7), 636-644.
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Redman. L. (2008). Calorie Restriction and Bone Health in Young, Overweight Individuals. Archives of Internal Medicine. 168(17), 1859.
Villareal. D., Fontana. L., Das. S., Redman. L., Smith. S., Saltzman. E., Bales. C., Rochon. J., Pieper. C., Huang. M., Lewis. M. & Schwartz. A. (2015). Effect of Two-Year Caloric Restriction on Bone Metabolism and Bone Mineral Density in Non-Obese Younger Adults: A Randomized Clinical Trial. Journal of Bone and Mineral Research. 31(1), 40-51. -
Tucker. K., Morita. K., Qiao. N., Hannan. M., Cupples. L. & Kiel. D. (2006). Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study. The American Journal of Clinical Nutrition. 84(4), 936-942.
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Hannan. M., Felson. D., Dawson-Hughes. B., Tucker. K., Cupples. L., Wilson. P. & Kiel. D. (2010). Risk Factors for Longitudinal Bone Loss in Elderly Men and Women: The Framingham Osteoporosis Study. Journal of Bone and Mineral Research. 15(4), 710-720.
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Pubs.niaaa.nih.gov. (2019). Alcohol and Other Factors Affecting Osteoporosis Risk in Women. Available online: https://pubs.niaaa.nih.gov/publications/arh26-4/292-298.htm [Accessed 11 Apr. 2019].
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Olivia
Olivia Salter has always been an avid health nut. After graduating from the University of Bristol, she began working for a nutritional consultancy where she discovered her passion for all things wellness-related. There, she executed much of the company’s content marketing strategy and found her niche in health writing, publishing articles in Women’s Health, Mind Body Green, Thrive and Psychologies.
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