Bone Health in Menopause and Beyond

 Preventing osteoporosis should be a priority for all women. 

90% of your peak bone mass is acquired by 18 years of age in females and continues to increase until the age of 30. Women start to lose about 1% a year until menopause and after menopause which increases to around 2-3 % a year. This rapid increase in bone loss later in a woman’s life is due to the decreasing levels of estrogen.

This is one of the biggest risk factors for women who have had a medical menopause or an early menopause.

It is, therefore, easy to say that the better bone health you have in your earlier years, the easier it is to have good bone health as you age.

Bones are alive and bone cells are constantly renewing themselves, with your oldest bone cell being only 10 years old. It is possible to improve your bone health at any age in your life.

For the best bones possible, you need a combined approach of addressing your diet, supplements, and lifestyle.

Diet

The number one food you need for bone health is fat. Your bones have an outer fat layer, think of it as a fatty layer of mesh, this mesh allows your nutrients a place to attach to and this strengthens your bones. Without this mesh, your nutrients can’t help your bones, as they have nowhere to live. In your diet, you are looking at having 7-9 tablespoons of fat a day. Good food sources include coconut, olive, nuts, seeds, avocado, eggs, and seafood. I recommend taking an oil supplement to ensure an adequate amount. In contrast, bad fats, think anything deep fried, partially hydrogenated fats (like those found in supermarket bought cakes and other baked goods), cottonseed oil, corn oil, vegetable oil, soybean oil, canola oil, and trans fats destroy bone health.

The second most important is protein! In relation to your bones, it strengthens your bone mesh and helps with bone regeneration or turnover. To get adequate protein, you need a protein source in every meal and most snacks. Protein sources include fish, chicken, meat, eggs, nuts, and seeds.

Soft drinks. Research shows even one can a day increases your risk of bone fractures by 3-5 times by thinning and weakening your bones over time. 

Sugar! As sugar is highly acidic, it leaches calcium out of your bones to buffer the pH levels and this increases urinary excretion of calcium. This calcium is lost for good. 

Gluten in gluten-sensitive individuals have been found to thin bones and increase inflammation.

Key nutrients for bone building

Calcium. Bones are a storage house for calcium for the heart, muscles, blood, and nerves. If you do not have enough dissolved calcium in your blood, your body will take it from your bones. Having adequate calcium allows the body to redeposit the calcium in the bank (your bones). Consume non-dairy calcium sources. Dairy that has been pasteurised and homogenised has denatured the calcium in it, making it unabsorbable. Better calcium sources include seeds especially sesame seeds,  sardines, dark green leafy vegetables or nuts.

• Vitamin A - is a building block together with Vitamin D for the production of connective tissue and the collagen matrix of cartilage and bone. 
• Vitamin C- essential for bone repair and reduction of cortisol which is involved in bone breakdown.
• Vitamin D- activates alkaline phosphatase for bone remineralisation. It’s needed to absorb and lock calcium into your bones enhancing bone remineralisation.
• Vitamin K- is involved in bone metabolism and the prevention of osteoporosis by activating osteocalcin which is a building block for the bone matrix.  Food sources include spinach, silverbeet, broccoli, brussel sprouts, cabbage, lettuce. 
• Boron- is essential in combination with calcium and magnesium for good bone maintenance. It also has a role to play in Vitamin D activation.
• Calcium- best sources include citrate or malate. Avoid carbonate as it can increase your risk of kidney stones. High levels of calcium can cause bone spurs, kidney stones, bursitis, arteriosclerosis, glaucoma. It's no longer the solo golden supplement of bone health. Don’t take this on its own, having a combination product reduces your risk of complications.
• Magnesium- research is looking at the importance of magnesium over calcium for bone health. Magnesium helps keep calcium dissolved in the blood and stops it from being deposited elsewhere such as in the kidney, magnesium deficiency can contribute towards the development of kidney stones. Calcium on its own may be deposited in soft tissue rather than bone. Magnesium enhances bone building and remodeling
• Manganese - is needed for skeletal and cartilage formation
• Potassium - strengthens bones
• Resveratrol - prevents bone loss
• Silica - increases bone collagen and strengthens the connective tissue. It also increased the rate of bone mineralisation. 
• Zinc - essential for collagen formation

Lifestyle

• Exercise regularly with some kind of weight or resistance component. Ideally 3-4 times a week.
• See the sun, don’t burn but get outside and have some sunscreen-free exposure regularly. 
• Excessive alcohol consumption robs bones of their health by slowing down bone reformation and accelerating bone breakdown. 
• Cigarette smoking also accelerates bone breakdown. Stop smoking, if you are a smoker. Cigarettes contain cadmium which interferes with bone formation.
• Reduce stress due to the connection with cortisol and reduced bone mass
• Create a healthy home, to avoid toxic metals and chemicals from damaging your bone.
• Lead accumulates over a lifetime and can get stored in your bones, bones and teeth hold about 95% of the total body lead burden. As it's not stored in the blood, not test for it in the blood. Blood test for lead is only accurate during a recent lead exposure (usually within 28 days) as your exposure is more likely to have been decades ago this isn’t relevant. A hair test for lead is a better indication of stored lead levels. During your youth having lead locked into your bones and teeth was a safer place to it store away, but unfortunately, during menopause, when your bone mass is reducing, these stores can be mobilised. They leave their inert hiding place, recirculate the body and reenter the blood and soft tissue. High lead levels can cause an increase in blood pressure, an inability to sleep, concentration or memory issues, headaches, depression, etc. It's important to get the root cause of your symptoms so you can find a long term resolution. Thankfully for current generations, environmental lead levels are reducing these days but we grew up in the lead era. It was only removed from paint in 1978. But it is possible to still have lead-based paint and lead-based dust in older houses. It was removed from petrol in 2002.  

Certain medications weaken bones. Please speak to your doctor if you are on any of these and are worried about your bone density.

• corticosteroids (asthma, rheumatoid arthritis, and other inflammatory conditions)
• antacids
• certain cancer medications eg Tamoxifen
• some epilepsy medications
• antidepressants

Test: 

• Dexa scan - to assess bone density
• HTMA - to check for metal toxicity such as lead and cadmium
• Vitamin D