HERE’S WHAT YOU CAN DO ABOUT IT
Most of us spend a lot of time thinking about our heart, our weight, our blood pressure, and maybe our cholesterol.
But when was the last time you thought about your bones? Probably not this morning. That is part of the problem.
Your bones can slowly become weaker for years without causing any symptoms. They don’t hurt. They don’t send you a warning message. There isn’t a little red light on your dashboard that says:
CHECK SKELETON.
Then one day you trip over the edge of a rug, fall, and break a wrist. Or you develop persistent back pain and discover that one of the bones in your spine has compressed. Or, most seriously, you fall and break a hip.
Suddenly bone health becomes very important.
The good news is that losing bone as you age isn’t something you simply have to accept without a fight.
Let’s talk about what’s happening to your bones after 50—and what you can start doing about it.
Your Bones Are Alive
We tend to think of our skeleton as the frame of a house. Build it once, and there it sits.
But your bones aren’t like the lumber holding up your house. Bone is living tissue. Your body is constantly removing older bone and replacing it with new bone.
Think of it as a remodeling crew that works 24 hours a day.
When you’re young, the construction crew generally builds bone at least as quickly as the demolition crew removes it. We typically reach our greatest bone mass sometime in early adulthood.
Then things gradually begin to change.
As we get older, the demolition crew starts winning. More old bone may be removed than new bone is being built.
The result?
Your bones gradually become less dense and potentially more fragile.
For women, this process can accelerate around menopause because estrogen levels fall. Men lose bone too, although the process generally occurs more gradually.
And because you can’t feel bone loss happening, you may have no idea that it’s occurring.
Osteopenia Versus Osteoporosis
You’ve probably heard both of these words.
Here’s the simple version.
Osteopenia means your bone density is lower than normal but hasn’t reached the level we define as osteoporosis.
Osteoporosis means the bones have become significantly weaker, increasing the risk of fractures.
I sometimes think of it this way. Imagine the wooden beams supporting your house. Osteopenia is like discovering that those beams aren’t quite as strong as they used to be.
Osteoporosis means enough strength has been lost that something that normally wouldn’t cause a major problem could now cause the beam to break.
And that’s what we’re really trying to prevent.
Fractures.
Particularly fractures of the hip, spine, and wrist.
Why a Broken Bone After 50 Matters
A broken wrist is certainly inconvenient. A hip fracture can be life-changing.
Older adults who fracture a hip may require surgery, hospitalization, rehabilitation, and sometimes prolonged assistance with everyday activities.
Some never completely regain their previous level of independence.
That’s why I don’t want you thinking about bone health simply as preventing osteoporosis.
I want you thinking about it as protecting your independence.
Strong bones help keep you doing the things you enjoy—walking, traveling, gardening, playing with grandchildren, exercising, or simply getting up and down the stairs without worrying about a fall changing everything.
So what can you do?
Quite a bit.
1. Give Your Bones a Reason to Stay Strong
Your body is remarkably good at adapting to what you ask it to do. If you challenge your muscles, they respond by getting stronger.
Bones respond to physical stress too. Weight-bearing activity tells your skeleton: “We still need this structure. Keep it strong.”
Walking is a good start.
Depending on your abilities, other weight-bearing activities might include hiking, stair climbing, dancing, or similar activities where you’re supporting your body against gravity.
Swimming and cycling are excellent forms of cardiovascular exercise, but because your body weight is supported, they generally don’t provide the same bone-loading stimulus as weight-bearing exercise.
That doesn’t mean stop swimming or cycling.
It means they shouldn’t necessarily be your only exercise if maintaining bone strength is one of your goals.
Dr. Mike’s Prescription
Don’t just move. Give your bones something to respond to.
Include regular weight-bearing activity that is appropriate for your fitness level and medical situation.
2. Strength Training Isn’t Just About Muscle
If you’ve been reading The Exercise Doc for a while, you’ve heard me talk about strength training.
There’s a reason I keep coming back to it.
After 50, maintaining muscle is one of the most important things you can do to preserve your ability to function independently.
But here’s another benefit:
Strength training can help your bones too.
When muscles pull against bones during resistance exercise, the bones experience mechanical stress. That stimulus can help support bone strength.
You don’t have to become a bodybuilder. You don’t even necessarily need a gym. Weights, resistance bands, machines, and appropriate body-weight exercises can all be useful.
The important part is that you’re asking your muscles—and therefore your bones—to work against resistance.
We’ll talk much more about exactly what kinds of exercise are best for building stronger bones later this week.
For now, remember this:
Your skeleton likes resistance.
3. Don’t Forget About Calcium
When most people hear “bone health,” they immediately think calcium.
And calcium is important. About 99% of the calcium in your body is stored in your bones and teeth.
But here’s where people sometimes get confused. More isn’t automatically better.
I generally prefer getting nutrients from food whenever practical.
Good calcium sources include dairy products such as milk and yogurt, as well as certain fortified foods, leafy greens, tofu, and some fish.
Your individual calcium needs can depend on your age, sex, diet, and medical history.
Before automatically reaching for a large calcium supplement, take a look at how much you’re already getting from food and discuss supplementation with your healthcare professional if you’re unsure.
A supplement should supplement something you’re missing.
That’s why they call it a supplement.
4. Vitamin D Helps You Use That Calcium
Calcium and vitamin D are partners. Vitamin D helps your body absorb calcium from your digestive tract.
You can get vitamin D through sunlight, certain foods, and supplements when needed.
But vitamin D is another area where I’ve seen the pendulum swing too far. If some vitamin D is important, people sometimes assume enormous doses must be even better.
They aren’t.
Vitamin D deficiency should certainly be addressed, but taking excessive amounts doesn’t magically create indestructible bones.
Your healthcare professional can help determine whether you are at risk for deficiency and whether testing or supplementation makes sense for you.
Research Snapshot
Bone health isn’t determined by one nutrient or one exercise.
The research supports a broader approach that includes appropriate weight-bearing and resistance exercise, adequate nutrition, sufficient calcium and vitamin D, avoiding smoking, limiting excessive alcohol, and identifying people at increased fracture risk.
There isn’t one magic pill.
Unfortunately, the human body rarely works that way.
5. Protein Matters More Than You Might Think
People don’t always associate protein with their skeleton.
They think:
Protein = muscle.
Calcium = bone.
It’s not quite that simple.
Bone contains a protein framework that helps give it structure, and adequate protein is also important for maintaining muscle.
Why does muscle matter to your bones?
Because stronger muscles help you move better. Better strength can improve your ability to recover when you stumble.
And avoiding the fall in the first place is a pretty effective way to avoid breaking a hip.
We’ll come back to that connection between bones, muscles, balance, and falls later this week.
6. Know Whether You Should Be Screened
Because bone loss is usually silent, we sometimes need to look for it before a fracture occurs.
That’s where a DEXA scan comes in.
A DEXA scan is a quick, low-radiation test that measures bone mineral density, commonly at the hip and spine.
Screening recommendations depend on age, sex, and individual risk factors.
Certain medications and medical conditions can also increase the risk of osteoporosis.
So can a previous fracture that occurred from relatively minor trauma.
If you’ve never discussed your bone health or fracture risk with your healthcare professional, particularly as you’ve gotten older, it’s worth asking.
Don’t wait until after the fracture to discover that your bones were weak.
Did You Know?
Osteoporosis is often called a “silent disease.”
You generally can’t feel your bones getting weaker.
For some people, the first obvious sign is a fracture.
That’s why prevention and appropriate screening matter.
Your Bones Are Part of the Bigger Picture
Here’s what I really want you to take away from this.
Healthy aging isn’t just about living longer. It’s about remaining capable. Your muscles help you get out of the chair. Your heart and lungs help you walk up the stairs. Your balance helps keep you from falling. And your bones need to be strong enough to tolerate the occasional bump when life doesn’t go according to plan.
All of these systems work together.
And while we can’t stop aging, we can influence how we age.
That’s an important distinction.
Maybe you haven’t exercised regularly in years. Maybe your diet isn’t perfect. Maybe nobody has ever talked to you about osteoporosis.
That’s okay.
Start where you are. Walk. Lift something. Eat enough protein. Make sure you’re getting adequate calcium and vitamin D. Don’t smoke.
And ask your healthcare professional whether you should have your bone density checked.
Small decisions made consistently can become very important over the next 10, 20, or 30 years.
Bottom Line
Your bones may gradually become weaker after 50, but that doesn’t mean you’re powerless to do anything about it.
Give your bones a reason to stay strong.
Exercise.
Use your muscles.
Eat well.
Know your risks.
Get screened when appropriate.
Because the goal isn’t simply to have a good number on a bone-density test.
The goal is to keep you standing, moving, traveling, playing, and living independently for as long as possible.
And that’s worth protecting.