Osteoporosis Risks After Menopause
Osteoporosis is the most common bone disease. Menopause increases the risk of osteoporosis for women. Estrogen, known for its bone-protective properties, decreases during the menopause transition and post-menopause, leading to bone loss. Inadequate calcium intake exacerbates this condition, as the body relies on stored calcium in bones when intake is insufficient. This weakens bones and increases susceptibility to fractures. In addition, low levels of vitamin D, vital for calcium absorption, further compound the issue. Many individuals lack adequate vitamin D intake and do not get adequate sun exposure for the body to make the needed vitamin D. Initially asymptomatic, bone loss progresses silently, often unnoticed until a fracture occurs. A fracture can result from routine activities like climbing stairs, causing vertebrae to collapse. Fortunately, interventions can mitigate bone density loss and reduce fracture risk.
Consume Adequate Dietary Calcium
Calcium is a mineral needed for strong bones. Most of the calcium in our body is stored in the bones, and that calcium moves in and out of bones as it is utilized by the body. As we age, the bones are broken down at a faster rate than they are being built. When calcium intake is too low it can contribute to weakened bones and eventually osteoporosis. Consume calcium-rich foods such as dairy products, leafy greens, tofu, sardines, and salmon.
Increase Protein Intake
Diets that are higher in protein are associated with higher bone mineral density and fewer fractures as long as there is an adequate calcium intake. Try to consume 25 grams of protein at each meal. Aim for healthy high protein foods such as lean meats, Greek yogurt, nuts, seeds, and legumes.
Eat More Fruits and Vegetables
Fruits and vegetables are good sources of essential vitamins and minerals which are important for bone health. Magnesium, zinc, potassium, and copper are positively associated with better bone health.
Incorporate Foods with Vitamin K
Vitamin K is important for bone health. Eat more leafy greens, egg yolks, natto, and organ meats to increase dietary vitamin K consumption. Supplemental vitamin K has not been shown to be as effective as dietary vitamin K.
Manage Caffeine Intake
Caffeine can decrease calcium absorption. This is only a problem for bones if there is inadequate calcium in the diet. As a precaution, limit coffee or caffeine intake to three cups per day and make sure to get adequate amounts of calcium and vitamin D.
Increase Vitamin D
Vitamin D is not naturally present in many foods and much of our dietary intake comes from fortified foods. Fatty fish such as salmon, sardines, and mackerel are good sources. Egg yolks and mushrooms that have been exposed to UV light can also be good dietary sources. Moderate sun exposure is a very effective way for the body to produce this essential vitamin.
Limit Sodium Intake
High sodium consumption can increase calcium excretion through urine. Reduce or eliminate processed foods from the diet to avoid excess dietary sodium.
Exercise
Weight-bearing exercises slow bone loss, enhance muscle strength, and improve balance. Adequate exercise can help reduce the risk of falls and fractures. Consider participating in strength training exercises if possible to keep bones strong and mitigate the loss of lean muscle mass that can accompany aging.
Maintain a Healthy Body Weight
Being underweight can increase the risk of bone fractures due to a lower bone mineral density and less protective subcutaneous fat.
Avoid Smoking
Smoking can impact the ability of the body to absorb dietary calcium.
Consider Supplements
Sometimes it is difficult to get adequate vitamins and minerals through the diet. This can be especially difficult as we age and digestion isn't optimal. Vitamin D is important for calcium absorption in the small intestine and colon and is recommended along with calcium supplementation. The bones require specific nutrients to stay strong and healthy. It’s important to discuss supplement use with your doctor.
Calcium - 1200 milligrams/day (Calcium citrate is better for absorption because stomach acid decreases as we age. Take calcium with vitamin D and do not take antacids at the same time.)
Vitamin D - 800-1000 IU/daily
Sources:
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Menopause and Osteoporosis: What’s the Connection? Women’s Health Blog. Penn Medicine. Available at: https://www.pennmedicine.org/updates/blogs/womens-health/2016/march/menopause-and-osteoporosis. Written March 18, 2016. Accessed May 8, 2024.
What Women Should Know About Osteoporosis and Menopause. Weill Cornell Medicine. Available at: https://weillcornell.org/news/what-women-should-know-about-osteoporosis-and-menopause. Written October 26, 2021. Accessed May 8, 2024.
Brown, Judith. Nutrition Through the Life Cycle. Seventh Edition. Boston, MA: Cengage; 2020.
Higdon, Jane. An Evidence-Based Approach to Vitamins and Minerals. New York, NY: Thieme; 2003.
Stránský M, Ryšavá L. Nutrition as prevention and treatment of osteoporosis. Physiol Res. 2009;58 Suppl 1:S7-S11. doi: 10.33549/physiol res.931858. PMID: 19857038. Accessed May 8, 2024.
