Bone health is a major priority and health concern of mine now that I am almost 50. I remember a lady who was in her 60’s came to speak to us in a post-natal class after I had had my 2nd child. She spoke very passionately about bone health and urging us to think seriously about osteoporosis risks, diet and lifestyle habits for our future bone health. If I am honest, it went a little over my head. During my late 20’s, menopause, osteoporosis and bone health felt like a lifetime away and quite frankly, my attention was being taken with raising 2 babies being born just 15 months apart – my hands were full and my mind could only handle one sleepless night at a time! Little did I know that only 3 years later, I would go through the life-changing event of an emergency hysterectomy which would catapult me into an early menopause at only age 34 years old. Low oestrogen, it’s impact on my bone health and perimenopause were much closer than I could ever have envisaged.
I have had various blood tests over the years to ensure my levels of minerals that are essential for bone health were all within a healthy range. The first test, several years ago, showed my vitamin D levels were critically low. Living in the UK and not have lots of sun exposure, this was not too much of a surprise as it is reported that many people living in the Northern hemisphere also report to having low Vitamin D. I have taken a vitamin D supplement ever since and my levels have maintained in the normal range.
Recently, I underwent a DXA Scan to get a clearer picture of my bone health. This was in 2024, my age was 47 years old and it was 15 years post hysterectomy. Unfortunately, it showed the start of osteopenia in my right hip with a Hip DXA scan T score: -1.5
These are the ranges for the DXA scan for bone density;
- T-score +1 to -1: Normal bone density.
- T-score -1 to -2.5: Osteopenia (slightly below normal).
- T-score -2.5 and below: Osteoporosis (severe bone loss).
Based on the T-scores from the NHS Website, my score of -1.5 in my hip, shows that I have osteopenia.
This news was not a shock as I suspected after everything I had been through must have had an impact on my bones, but it was still difficult to see it in black and white.
However, all clouds have a silver lining and this result has supercharged me with the ambition to try and have as much power over future bone health as possible. I know that my diet and lifestyle habits can have a huge effect on how this situation progresses. Understanding how food impacts my bones and committing to lifestyle habits such as regular exercise, I know I will give my body the tools it needs to do what it so naturally wants to do – build new strong bones to help me live into my old age without the threat of falls or fractures.
This blog post is really written for me. I wanted to create a piece of useful information that I could refer to and learn from. My hope is that you will use this too and learn something about your bones and how much impact you have over their health and longevity as you progress through your life. I hope you don’t have to go through the trauma that I have of a hysterectomy at age 32 years old, an early menopause at age 34, declining oestrogen and its impact on your bone density – but even without this – women are highly susceptible to osteoporosis as they age and go through the menopause. We should all be aiming to preserve our bone health and give it as much attention as we give other areas of health.
THE IMPORTANCE OF BONE HEALTH
Most people do not give the health status of their bones much thought unless they break a bone or get to an age during mid-life when they are forced to think about it. This is an understandable but sad fact of life and I am guilty of it too! The good news is that it’s never too late to make a difference. Changes to diet and lifestyle habits at any stage can have a profound impact on bone health and it is this knowledge which spurs me on to take immediate action.
A scary fact is that we reach our peak bone mass in our early 20’s. Peak Bone Mass (PBM) is defined as the highest level of bone mass achieved through normal growth. This PBM is usually stable until we reach 45-50yrs old and then starts to decline due to decreasing female sex hormones such as oestrogen. It is very beneficial to build as much bones mass as possible during our childhood and teenage years.
WHAT ARE THE MOST IMPORTANT NUTRIENTS FOR BONE HEALTH?
We all know that calcium is needed to build strong bones but there are other key nutrients which play a part too and they all work in synergy together;
Calcium is the most abundant mineral in our bones, but it needs the other minerals and vitamins to enable it to be absorbed and utilised efficiently.
Vitamin D is best obtained from sun exposure, but this can prove difficult if you live in a climate that does not offer much sunshine during long Winter months. You may be advised to take a vitamin D supplement like I was after I had my vitamin D levels checked and they were very low. Taking a Vitamin D supplement with K2 has brought my levels to a normal and healthy level.
Magnesium can be obtained from green leafy vegetables, good quality dark chocolate, some nuts, seeds and wholegrains and bananas.
Vitamin K is obtained from fermented foods such as sauerkraut and fermented cheese.
Zinc is acquired from red meat, poultry, hemp seeds, wholegrains and pulses. The most abundant source is from oysters so I always have a few of these on the rare occasion I can get hold of them!
B Vitamins are important for converting foods into useable energy. Vitamins B6 (pyridoxine), B9 (folic acid) and B12 (cyanocobalamin) help strengthen your bones and prevent breaks. B vitamins are high in animal derived foods such as meat and dairy, wholegrains, nuts, and legumes.
Personally, I concentrate on eating dietary calcium such as that from dairy from kefir, cottage cheese, hard and soft cheeses like feta and parmesan, chia seeds, walnuts, almonds, tahini, dark leafy greens which have been blanched to reduce oxalates and oily fish with small bones such as sardines. I take a supplement for vitamin D & K2 especially during Winter months and I eat egg yolk, sauerkraut and aged hard cheese like parmesan or Parmigiano Reggiano cheese for Vitamin K2. Zinc I obtain from beef, chicken, hemp seeds, wholegrains and pulses. Vitamin C I get from foods such as salads, fruits and vegetables. I also supplement with Magnesium Glycinate to ensue I am getting adequate magnesium as it’s such an important mineral for bone health and many other health benefits and magnesium is depleted in soil used to grow produce today. I try an incorporate as many of these foods into my diet on a daily basis and hope they provide the adequate materials to make my bones strong!
LIFESTYLE FACTORS FOR GOOD BONE HEALTH
Diet is important for good bone health but lifestyle factors play an incredibly important role too.
EXERCISE
Weight-bearing exercise – lifting heavy weights 3-4x per week to maintain muscle mass but also improve skeletal mass is a topic that is receiving more and more attention due to it’s important links to maintaining bone health. A great source of information on this topic comes from Dr. Gabrielle Lyon | Muscle Health for High Performers | Board-Certified Physician who is dedicated to getting this important information out into the wellness space. Being sedentary and not loading your bones with impact is not sending any signals that it needs to repair or rebuild so sitting still for long periods of time will impact on bone density as you age.
Weight-lifting, running, rebounding on a trampoline, weighted vest walking – these are all ways you can create impact on your bones which sends the biological messenger that they need to be strong!
SUN EXPOSURE
We need exposure to the sun to create the hormonal reaction on our skin to produce vitamin D. Known as the sunshine vitamin, it’s actually a hormone and our body makes it when our skin is exposed to the sun. Getting out in early morning or late afternoon sunshine, exposing our skin to it’s rays is a great way to boost out vitamin D which is essential for making strong bones. You can get some vitamin D from foods but not enough and it is usually advised that you take a supplement that contains both vitamin D and vitamin K2 which helps your bones to absorb the calcium you eat in your diet.
OTHER THINGS TO CONSIDER
HORMONE REPLACEMENT THERAPY – HRT
HRT is a topic to discuss with your GP or hormone specialist. You need to have a blood test or do a Dutch Test to really get a good understanding if what is happening on a biological level with your hormones. Declining oestrogen can impact bone health so it is important to check your hormone levels and discuss this with a professional.
DEXA Scan – this is a Dual Energy X-ray Absorptiometry which is an imaging test to measure bone density to diagnose osteopenia or osteoporosis and gives real date in understanding the state of your bone density – information which is important especially during menopause.
WHAT HINDERS BONE HEALTH?
BEING SEDENTARY
It is a sad fact that many people spend so many hours sat down either at a desk, driving a car or on the sofa watching tv. Lack of exercise means that your bones are not receiving the impact they need to stimulate new bone growth. Weight bearing exercise such as weightlifting or high-impact exercise such as running, weighted vest walking, rebounding or skipping all help the skeletal bones structure to maintain density and strength throughout life. This knowledge alone is what gets me up and moving my body every day. Knowing how crucial exercise is for bone health is a huge motivation to keep going to the gym, following a YouTube exercise workout, getting outside for a run or a long walk with the dog. Even walking to the supermarket and carrying heavy bags of shopping home all helps to give my bones that stimulation they need to send the signals for calcium and other minerals needed to where they need to be to build my bones.
CAFFEINE
I love my morning ritual of brewing coffee when I wake so it would take a lot to make me give up that habit! However, I am interested in how it affects my health so I limit it to 1 a day and a maximum of 2 if I fancy it but always before 10am because I know it is still in my system for up to 12 hours later and I don’t want it to affect my sleep.
HOW DOES CAFFEINE INTERFERE WITH CALCIUM ABSORPTION?
Caffeine can increase calcium excretion in the urine, which might lead to a slight reduction in calcium levels in the body over time. This is especially true in large amounts of caffeine intake. The effect is usually mild, but if you’re not getting enough calcium through your diet or have a risk for osteoporosis, it could be a concern.
Drinking coffee, tea, or other caffeinated beverages in moderation is unlikely to cause a significant loss of calcium for most people, but if you’re concerned about calcium balance, it’s a good idea to ensure you’re consuming enough calcium-rich foods
The amount of caffeine that may start to affect calcium balance tends to vary depending on factors like individual sensitivity, diet, and overall calcium intake. However, research suggests that consuming more than 300–400 mg of caffeine per day (roughly equivalent to about 3–4 cups of coffee) could lead to a noticeable increase in calcium excretion through urine.
For reference:
- A single cup of brewed coffee typically contains about 95 mg of caffeine.
- A cup of tea generally has about 30-50 mg of caffeine.
- Some energy drinks or sodas can have more caffeine, up to 200 mg or more per serving.
While moderate caffeine consumption is usually ok for most people, if you’re at risk for bone issues or don’t get enough calcium, it’s wise to limit caffeine intake or offset its effects by ensuring you’re getting enough calcium from food.
INADEQUATE NUTRIENT INTAKE
Not eating enough food, being in a constant calorie deficit, not eating adequate protein or foods high in the minerals needed for bone health all leads to our health declining. Your body cannot make new cells and tissues without the right materials. You get these from the foods you eat and your miraculous body is able to transfer these dietary food molecules into building blocks of new cells which become your hair, skin, tissue and many other things including bone tissue. It is very clever at adapting what material you give it, and if it does not receive adequate nutrient supplies, it breaks down tissue already present in the body from other areas if it needs to in the name of survival and does the best it can with the resources it has. By eating well and giving your body the right materials it needs to renew and rebuild itself every day, you will maintain and preserve your body and health which will enable you to thrive into old age.
ALCOHOL
Alcohol in any form does not contain any health benefits and it is very damaging to the liver. It contains empty calories, causes inflammation and disrupts sleep. If these aren’t enough reasons to ditch the alcohol, do it for the bones because it’s not good for bone health either. I’m a kill joy, yes, I know but waking up with a clear head every morning and having the energy get moving, far outweighs the enjoyment of sinking a few glasses of whatever you choose. Lots of people are waking up to the harmful effects of alcohol and are choosing to replace it with things like kombucha – a fermented tea drink or a botanical mix of relaxing herbs you can make into a healthy mocktail. There are some good CBD containing drinks too so you’re getting your fix of relaxation, fizz and bubbles without the headache. Win Win.
DECLINING OESTROGEN AND BONE HEALTH
Declining oestrogen levels, especially during perimenopause and menopause, can have a significant impact on bone density and overall bone health. Oestrogen is a hormone that plays a key role in maintaining bone density by promoting bone formation and regulating bone resorption (the process by which bone tissue is broken down and minerals like calcium are released into the bloodstream).
How declining oestrogen levels affect bone density:
- INCREASED BONE RESORPTION
Bone resorption is essentially the breaking down of bone tissue to release important minerals into the body. Osteoclasts break down the bone matrix, releasing calcium and other minerals into the bloodstream.
It’s a natural part of the bone remodelling cycle, which is the ongoing process where old bone tissue is removed (resorption) and replaced with new bone tissue. Bone formation is were osteoblasts, another type of bone cell, build new bone tissue.
In a healthy individual, bone resorption and formation are balanced. However, when there’s an imbalance (such as with reduced oestrogen levels or certain diseases), bone resorption may outpace formation, leading to conditions like osteoporosis (weakened bones).
Why It Matters:
Bone resorption helps maintain calcium balance in the blood. When calcium levels are low, the body may break down bone to release calcium.
However, excessive or unchecked bone resorption can lead to bone loss and fragility, increasing the risk of fractures.
MANAGING BONE HEALTH IN MENOPAUSE
While the decline in oestrogen during menopause is inevitable, there are several ways to maintain or improve bone health and minimize the impact of declining oestrogen:
- Eating a diet rich in all the nutrients required for good bone health.
- Weight-Bearing Exercise: Activities like walking, running, and strength training help stimulate bone formation and slow down bone loss.
- Hormone Replacement Therapy (HRT): For some women, HRT can help manage menopausal symptoms and maintain oestrogen levels, which in turn can help protect bone density. This should be discussed with a healthcare provider such as your GP or a hormone specialist.
- Lifestyle Factors: Avoiding smoking (which accelerates bone loss) limiting alcohol and caffeine consumption can further help protect bone health.
For more information on bone health and osteoporosis, visit;
Royal Osteoporosis Society – Better Bone Health for Everybody
Osteoporosis symptoms and treatment | Looking after your bones | Age UK
DISCLAIMER: This information is for guidance only and is not intended to give professional health advice. Please consult your doctor for specific health concerns.