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  • Hayley Oxley


Osteoporosis is a health condition that weakens bones, making them fragile and more likely to break. It is characterised by low bone mineral density (BMD) and generally occurs in women 10 to 15 years after the menopause. The stage before osteoporosis is called osteopenia. This is when a bone density scan shows you have lower bone density than the average for your age, but not low enough to be classed as osteoporosis.

The rate of post-menopausal bone loss is typically 1-3% per year. Loss of ovarian function in menopause and the increase in follicle-stimulating hormone (FSH) from the pituitary has been shown to increase osteoclast (responsible for aged bone resorption) formation by stimulating osteoclast generation. Increased FSH has also been associated with increased weight diabetes and high blood pressure in postmenopausal women.

Chronic inflammatory diseases of almost any cause are associated with bone loss. In people with rheumatoid arthritis (RA), the fracture risk is roughly twice that of people without RA.

Taking care of your bones should be a priority for all women after they hit the menopause and it's more than ensuring you're getting enough calcium through your diet. Other factors such as taking vitamin D, vitamin K2, and magnesium, starting weight-bearing exercises, and ensuring your gut is healthy are also key.

What are the key risk factors of contracting osteoporosis?

  • Age - post menopausal

  • Gender – white and asian women are at more risk due to loss of estrogen

  • Early menopause

  • Low body weight or previous history of eating disorders

  • Gut dysbiosis, problems such as IBS (medication for IBS has been shown to increase levels of cytokines increasing osteoclasts and causing osteocyte apoptosis ref) Crohn's disease, coeliac disease

  • Genetics – family history of osteoporosis

  • Cigarette smoking and excessive alcohol intake

  • Lack of exercise especially weight-bearing exercise is linked to lower BMD as sarcopenia accompanies osteoporosis

  • Hyperparathyroidism, thyroid disease or thyroxine medication, drugs for breast cancer treatments, glucocorticoid steroid treatments, rheumatoid arthritis, patients on PPIs and SSRIs and high dose statins

  • Diet lacking in adequate protein, vegan or vegetarian diets

  • Inadequate calcium/magnesium

  • Lack of vitamin D

  • An acidic diet, fizzy drinks, high sodium intake

  • Stress – cortisol inhibits osteoblasts

  • Obesity. Insulin stimulates osteoblast activity however insulin resistance can cause a reduction in bone strength and higher incident of bone fractures ref Type 2 diabetes and hyperglycemia reduces osteoblast function and impairs response to vitamin D.

  • Lactose intolerance

How can you improve bone quality?

Healthy lifestyle and a diet that includes a range of nutrients can improve and influence bone quality.

Nutrients and their bone effects (Nutrients and Dietary patterns related to osteoporosis)

Incidence of osteoporosis is found to be lower in countries that predominantly follow the Mediterranean diet. This is a diet that is composed of healthy foods that have anti-inflammatory and antioxidant properties. Data from the Framingham research suggest that subjects that consumed the most fruits, vegetables, grains and protein had the greatest BMD.

Here's a list of foods that will help to promote and maintain bone health:


Weight-bearing exercise which strengthens bone from mechanical stress and the effect of gravity should be incorporated into the postmenopausal lifestyle. It should include four components, weight-bearing, muscle strengthening using weights or resistance, vestibular balance exercises, and flexibility.

Source: Article written by Hayley Oxley

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