Let’s talk about how to eat for bone health — without diets, deprivation, or confusion.
Most women in their forties and up know that declining levels of oestrogen through the perimenopause years has a huge range of impacts on the body. Whilst everyone is talking about the hot flushes and night sweats they experience, or expanding waistlines and how clothes don’t fit as they used to, one of the most physically damaging results of low oestrogen levels doesn’t usually get more than a passing mention, if that. And this is the one I’m focusing on today: osteoporosis and increased risk of bone fractures.
Going through perimenopause, most of us carry on with our usual activities. Many of us, myself included, have mothers who have experienced fractures or who are beginning to develop the ‘dowager’s hump’ bent posture, but that’s not something that happens to us, right? Or is it?
Well, maybe not right now, but looking at the older women in your family will give you some clues about a possible future.
Let’s take a step back and look at how oestrogen acts on bones.
Bones may seem like something solid and structural, but in fact they are part of our organism, and as such undergo a process of constant repair and renewal. In fact, every single cell in our the collection of bones that we call our skeleton is replaced on average every seven years. Between the end of puberty (which is actually in our mid-twenties) and the beginning of perimenopause, the rate of bone formation (osteogenesis, to give it its scientific name) and the break down of old or damaged cells (resorption) balance each other.
A number of factors trigger osteogenesis, including weight bearing exercise, adequate nutrition, and hormonal stimulation. The most important stimulatory hormone in women is oestrogen.
As oestrogen declines through the perimenopause years, the level of bone formation decreases. In parallel to this, as we age, cells are damaged more easily and more frequently. When the rate of bone cell loss exceeds the rate of growth of new cells, then our bones become less strong. If this is in tandem with a diet that does not provide enough of the vitamins and minerals needed for bone formation, then the problem is exacerbated. Some lifestyle habits such as smoking and drinking alcohol are also known to contribute to bone loss (and less face, alcohol consumption can increase the risk of falls!).
To put some numbers on this, in the UK alone, upwards of 3.5 million people live with osteoporosis. 80% of those are women. Half of all women over the age of 50 experience at least one fracture. That’s frankly a depressing picture.
But it is not all doom and gloom. There are preventative steps that every woman can take to reduce her long term fracture risk. Some of these are things that might actually surprise you.
Eat sufficiently to meet your energy needs.
I’m dipping into the realms of sports nutrition for a moment here. In sports circle, the concept of the Female Athlete Triad is accepted knowledge, and has been expanded into the concept of Relative Energy Deficiency in Sport (RED-S). Essentially it is well know that female athletes who do not consume sufficient calories (we’re talking about energy here, not the nutritional content of those calories) over an extended period of time develop dysregulated menstrual cycles and weakened bones culminating in osteoporosis.
Bearing in mind the diet culture we live in, many perimenopausal routinely reduce the amount that they eat to beat the perimeno belly and expanding waistline. It’s questionable how effective this is anyway, but it certainly has the long term potential to weaken your bones.
Get your vitamin K
Hands up who has heard of vitamin K? It’s not one that is often spoken about, so it was heartening to hear Jamie Oliver mention in his cookery programme recently! Vitamin K is vital to bone health – it acts in conjunction with vitamin D to form the cement that locks calcium into bones. Now some of the research around vitamin K is controversial. However, the research that looks at fracture incidence as opposed to just bone mineralisation on its own is very promising. Where do you find vitamin K?
- Leafy greens, especially broccoli,
- full fat dairy produce especially the fermented variety: yoghurt and hard cheese. The longer the cheese has aged, the better from a vitamin K point of view. Why full fat? Vitamin K is fat soluble. Remove the fat, and you remove the vitamin. Some cheese makers have actually tested their cheese for it’s vitamin K content!
- Fermented foods: sauerkraut and kimchi (the ‘live’ variety from the fridge section in the supermarket, not the bottled variety. Fermented soy products such as miso and natto (warning: natto is very much an acquired taste!)
Resistance Training
Any weight bearing exercise is great for your bones, but resistance training (weights or resistance bands) is an essential part of the bone strength picture. There are two reasons for this: firstly bones contains sensors that detect pressure, and respond to it by stimulating the growth of new cells. Secondly, resistance training builds muscle, bigger muscles put more pressure on bones, and stimulate bone growth. Win-win. Just one caveat: if you’ve never used weights before, get some instruction from a PT before you launch in lifting stuff.
Lifestyle
If your little treat to yourself is a cigarette, vape, a G&T or a cheeky Prosecco or several, it’s time to reconsider. I like a G&T as much as the next woman, but I keep it to the occasional treat, not an every day pleasure. And if you inhale hot chemicals of any kind for fun or relaxation, you’re doing your lungs no favour anyway. Consider swapping them out for breathing exercises instead?
This is a quick glance at how you can support your bones through perimenopause to remain as strong and straight-backed as possible through your elder years. If you would like to find out more, I’m hosting a webinar on this subject on Monday 20th October, in honour of World Osteoporosis Awareness Day.
For an investment of £15, you can join me as I guide you through my top tips for keeping your bones strong for the future. Sign up for Eat Well, Stay Strong here.