Make no bones about it — not minding them bones is a health risk

By the time we reach middle age, the body’s bone-building capacity declines, with old cells breaking down faster than new ones are formed. Here's what you can do to keep them strong 

In early adulthood, bones are kept strong and healthy by the continual turnover of new cells and removal of old ones, but once we hit peak bone health, at 30, strength starts to decline.

Osteoporosis affects 300,000 people in Ireland, but only about 20% of cases are diagnosed. The bone-thinning condition increases the risk of fractures.

In early adulthood, bones are kept strong and healthy by the continual turnover of new cells and removal of old ones, but once we hit peak bone health, at 30, strength starts to decline. 

This is especially true for women around the age of menopause, when levels of the bone-protective hormone oestrogen are lost. However, Michele O’Brien, CEO of the Irish Osteoporosis Society (IOS), says that it is not just a disease of later life.

“Anyone is at risk of bone loss at any age,” she says. “Risk factors include eating disorders and over-exercising, extreme dieting, stress, and a lack of vitamin D, all of which can lead to bone loss.”

So what can be done to protect our bones? Here’s the latest advice:

Run for just one minute every day

Brief bursts of one to two minutes of high-impact, weight-bearing activity, such as running, boost bone health in women, according to a study by researchers at the Universities of Exeter and Leicester.

In their study of 2,500 women, published in the International Journal of Epidemiology, the team found that those who managed 60-120 seconds of daily running had 4% stronger bones than those who did less than 60 seconds.

It doesn’t need to be flat-out sprinting, as the intensity required to make a difference was equivalent to a medium-paced run for pre-menopausal women and a slow jog for post-menopausal women.

Invest in exercise bands

Strength training is hugely beneficial for bones, but if you are new to it, it is worth investing in elastic exercise bands. 

The bands stretch and strengthen muscles as they work against the tension of the fabric, and are available as rubber tubes with handles, mini-band loops, luxury fabric bands, or basic stretches of cheap latex cut to different lengths. 

They are colour-coded: Yellow is the weakest or easiest resistance, red and green are middle strength, and blue, grey, and black are the most challenging, meaning you can progress as you get stronger. 

In July, a review involving 108 older women, published in the Journal of Orthopaedics, found that training with bands on three or more days a week produced “notable improvements in bone density” after 12 weeks.

Move onto weights when you are strong enough

When you have progressed to your strength limit with exercise bands, it is time to pick up dumbbells or a kettlebell. 

In a paper published in the British Journal of Sports Medicine two years ago, a panel of experts concluded that “progressive muscle resistance training”, using progressively heavier weights, should be performed at least twice a week in adulthood, for optimal bone health. 

Ideally, exercises that target the whole body should be included, including weighted lunges and squats, hip abduction and adduction, leg press, back extension, and abdominal exercises.

“Weight training is fantastic for strengthening bones,” says personal trainer Dalton Wong. “It works by pulling and stressing bones in a good way to trigger bone [formation] and this is one of the reasons we should all be weight training from midlife onwards.”

Play basketball, volleyball or tennis

The ideal exercise for bone building involves changes in direction and some resistance in the form of jumping and landing. 

“From middle age, bone health is supported by exercise that loads the skeleton in a multi-directional way,” says Dr Nicky Keay, author of Myths of Menopause (Sequoia Books). 

“Any ball sports, including rugby, football and netball, are a great way to achieve this, and they also have load-bearing jumps which help to build strong bones.”

According to experts, basketball and volleyball are among the highest-impact activities — and therefore the best bone builders — although all racket sports, including tennis and squash, are helpful.

Aiming for 50 high-impact bone jolts daily — hops, skips, star jumps or running strides — is a benchmark. 

If you are a swimmer or cyclist, aim for 50 high-impact ‘jolts’ a day

Swimming and cycling are great activities for strengthening muscles, but they are less effective for building bones than ‘weight-bearing’ exercise.

“The higher the impact of an activity, the better it is for your bones,” says Keay. “Putting extra load through the skeleton with jumps and hops provides a direct mechanical bone-building stimulus.”

Aiming for 50 high-impact bone jolts daily — hops, skips, star jumps or running strides — is a benchmark. 

These extra jolts are essential for bone health, if you favour swimming, cycling, or low-impact activity, such as gentle walking.

How healthy are your bones?

For an accurate assessment of your BMD, you will need to undergo a dual X-ray absorptiometry (or DEXA) scan. It measures bone-mineral density compared to peak bone mass at around the ages of 20-30. 

Results are provided in terms of a T-score, the number of units above or below the average bone density of a young and healthy person. It tells you whether your BMD is well below its peak. Your GP might arrange for you to have a DEXA scan.

Privately, the procedure costs around €120. However, the scan tells only part of the story, and a doctor will likely conduct an overall fracture risk assessment that looks at other factors — such as a family history of the disease — that might leave a person prone to osteoporosis.

If you are on corticosteroids or cancer treatment that can affect hormone levels and bone strength, you are considered to be at a higher risk of compromised bone mineral density.

A recent study in the journal JAMA Network suggested that weight-loss drugs like Ozempic or Wegovy may result in bone-density loss, but also indicated that exercise can protect against it.

An online risk checker assessment tool is available at theros.org.uk. Speak to your GP if you are concerned.

• See: irishosteoporosis.ie