Hello and welcome to Making Sense of Women's Health. I'm Roberta and whether you've been with me for the past few episodes or you're tuning in for the first time today, I'm so glad you are here. If this is your first time listening, don't forget to hit that subscribe or follow button depending on where you're listening so you never miss an episode. To those of you who have been listening regularly, thank you so much for your support. It means the world to me.

Today, we are going to talk about how to keep your bones strong and healthy throughout your life. So you might not think about your bones very much, but they are constantly working hard to support you, protecting your organs and keeping you moving. Now, as we age, particularly after our thirties, our bones start to lose density, which can unfortunately lead to conditions like osteoporosis as we get older.

There are, however, simple and manageable changes that you can make in your lifestyle that will help keep your bones strong as we age. And if you already have osteoporosis, the information in today's episode is vital to keep you and your bones healthy. So let's start by understanding what's inside of our bones as we age.

our bones are living tissue so they break down and they rebuild in a process called bone remodelling and when we're younger we actually build bones faster than we break it down but once we hit our 30s the balance shifts and we start losing bone mass so for women this is particularly important because when we hit menopause the drop in oestrogen levels accelerates bone loss. This is why women are more prone to osteoporosis than men. I have treated many women with osteoporosis in the past years and I've seen how much it can impact on the quality of life. 

Now there have been a few lovely little women who I've treated that had osteoporosis and they were so kyphosed that means they're really hunched over and bent forward.

And this is because they had wedge fractures. So wedge fracture is where the front of the vertebrae, which is the bones of our spine, kind of collapses, but the back part stays intact. Then we get that wedge shape. And these women could barely lift their heads off of their chests. 

And all I could really do physio -wise at that point was just to work on the endurance of their postural muscles to try and help straighten them up as much as possible so they could at least see where they were going. This is why it's so important to take care of your bones before that damage is done. 

Now, I know we often think of bone health as something to worry about in these later years, but it's actually something we should be focusing on from a young age. And if you have children like I do, this is especially important because children and teenagers are in this critical window for building up their peak bone mass, which happens kind of early 30s. And the more bone density they can build when they are young, the better protected they'll be in later life when bone loss starts. 

But here's the problem. This generation of children is much less active than I was when growing up or previous generations and if your household is anything like mine you've probably seen your kids spend a lot of time sitting down or lying down watching TV or like my son playing computer games and I'll admit my own kids could easily spend hours in front of the screen and dragging them out for a walk can be a challenge and there's lots of moaning involved, certainly from one of my children. But this lack of movement means that they're not getting the physical activity they need to build these strong bones. And it's not just about movement, they're also missing out on vitamin D from sunlight, which is crucial for absorbing calcium and building bone density.

So when we were kids, we used to spend so much more time outdoors. I remember playing outside for hours, playing in the neighbour’s garden. She was a gymnast, so she was trying to teach us to do forward rolls. We were riding bikes, fell off my bike and got concussion, but that's another story. But just being more active. But now kids spend far more time indoors and it is a real concern.

Physical activity is essential for developing strong bones and that is why it's so important to encourage them to take part in activities like PE. Though I'll be the first to admit I absolutely hated PE when I was at school. Anything that involved running, I was always the slowest and I remember doing cross country and I used to walk with the legs and then do running arms so they would see me at the top of the field and think that I was trying my hardest jogging around but I was walking. But looking back now I can see the value in it. That regular movement was helping build my bone density. So whether it's getting your kids outside to kick a ball around or go for a family walk or just running around in the park, every bit of activity helps.

Not only does this build strong bones, but there's also lots of other benefits of being outdoors, not to mention fresh air, mental clarity, and of course, they sleep better after a good play outside, wear them out, get them to sleep through the night. Now, once we've got these kids moving and ourselves thinking about bone health, let's dive into nutrition. 

Building and maintaining strong bones isn't just about exercise, it's also about what we put in our bodies. And when it comes to bone health, calcium is probably the first thing that comes to mind, rightly so. Calcium is a major building block of our bones, but it doesn't work alone. Calcium needs help from other nutrients even, like vitamin D, magnesium, vitamin K they all keep our bones strong and healthy. 

So we're just going to go into each of those so we'll start with calcium. We probably all know that dairy products like milk, cheese and yogurts are well -known sources of calcium but what if you're vegan or like most of my family lactose intolerant? Don't worry there are plenty of plant -based sources of calcium too so you get plant meals that are fortified with calcium such as almond milk, soy milk, oat milk, they're all excellent options as they have that calcium added. Dark green leafy vegetables like kale if you like it, broccoli, bok choy, they're all packed with calcium. Tofu, especially if it's been set with calcium, is another great sauce. Things like chia seeds and almonds are also kind of really good.

You can get calcium from fortified juices and cereals as well, so it's really helpful if you are on a vegan diet, there are lots of different options. However, calcium alone isn't enough. To absorb that calcium effectively, your body needs some vitamin D. Vitamin D helps your body take the calcium you eat and move it into your bones where it's needed.

In the UK though, especially during the winter months, we probably don't always get enough sunshine to make that vitamin D naturally through our skins. That is why it is important to include vitamin D rich foods, things like fatty fishes such as salmon or mackerel, I've never liked mackerel but salmon, but things like that and fortified plant -based foods, mushrooms, exposed sunlight could also contain vitamin D. But if you are worried about getting enough vitamin D, then it's always worth adding a supplement in but also make sure that you are checking with your health care provider before you add any supplements to make sure it's not going to interact with any other kind of medication or anything that you're taking. 

So magnesium is another key player. It helps activate that vitamin D which in turn helps your body absorb calcium more efficiently. You can find magnesium in plant -based foods like spinach, almonds, avocados and seeds. And including these in your diet can really help to support both your bones but also overall health because they've got lots of other health benefits as well. And then let's not forget vitamin K. 

Vitamin K helps to regulate calcium in the body by directing it to the bones and preventing it from being deposited in our arteries, which is never a good thing. So things like dark leafy greens, kale, spinach, Swiss chard are all excellent sources of vitamin K. Now, finally, let's talk about protein, which is often overlooked when it comes to bone health, but it is just as essential as calcium and those other nutrients. 

Protein helps maintain the structures of your bone and is crucial for preserving bone mass as we age, but also helping to prevent things like osteoporosis. If you eat meat, good sources of high quality protein include chicken, turkey, eggs and fish. Organic is always better. However, be mindful of red and processed meats because if you are eating a lot of them, they do have a higher level of omega -6 fatty acids which actually promotes inflammation when it is eaten to excess. Chronic inflammation has been linked to various health issues including a potential negative effect on bone health. 

So to balance this we need to make sure that we are having the omega -3 rich foods like our fatty fish such as salmon and mackerel and sardines because they are known for their anti -inflammatory properties. So therefore you're balancing it out. For plant -based eaters, there are still plenty of good sources of protein. Legumes like lentils, chickpeas and black peas are fantastic options along with tofu, nuts, seeds and whole grains like quinoa. These foods not only provide the protein that you need but also really important nutrients for bone health as well. 

Whether you are a plant based or you eat meat, are lots of variety protein sources and including those in your diet will be supporting your bone health. But just remember that balance is key, especially when we're considering some of those foods that might cause inflammation within the body. 

So now that we've covered nutrition, let's talk about exercise. One of the best things you can do for your bones is to stay active. But not all exercise is created equal when it comes to bone health. Weight bearing exercises are key because they force your bones to work against gravity, which helps strengthen them. This includes activities like walking, jogging, hiking, dancing, even if you're going up the stairs instead of going up in the lift. 

You might be thinking, I'm not a runner, or I don't have time to hit the gym every day. That's okay. There are many ways to incorporate weight bearing activities in your daily routine. And even getting out for a brisk walk, maybe at lunchtime for 30 minutes, a few times a week can have a really positive effect on your bone health.

Resistance training is another game changer. This involves exercises where your muscles work against an external force, such as lifting weights using resistance bands, or simply doing things that are bodyweight exercises like squats and lunges. Resistance training helps build muscle and the stronger muscles provide better support for your bones reducing your risk of fractures. 

You don't need to lift heavy weights and even light resistance, even just getting a can of beans out the cupboard or a bottle of water can make a real difference. The other thing that we need to be doing is some balance exercises because they are equally as important, especially as we get older. Good balance reduces our risk of falls, which is a major cause of fractures.

I often recommend my chair Pilates classes to my older clients as well as other classes like Tai Chi or yoga, because these exercises are fantastic for improving balance, working on flexibility and coordination. And certainly my classes I do have a bit of a laugh because I always add in some coordination exercises. And it can be a bit tricky. They are gentle on the body, but they are still helping you build strength and stability which is especially important as we age. 

Things that you could do at home, simple balance exercises like standing on one leg when you're brushing your teeth or practicing like tightrope walking, so heel to toe walking can easily be done at home, but make sure that you have something nearby, that if you need to grab it, if you're gonna wobble, then do so. But they are great for working on your balance and maintaining your stability, even if you just did one or two of those things a day. 

Along with exercise and nutrition, there are lifestyle choices that we make every day that can either help or hurt our bones. Smoking, for example, is terrible for many things but particularly is terrible for your bones as well. It reduces blood flow to your bones, slowing down the bone building process. So if you are a smoker, quitting can dramatically improve your bone health, not to mention all those other health benefits from quitting. Alcohol is another thing to be mindful of. Drinking too much alcohol can interfere with your body's ability to absorb calcium which weakens your bones over time. So it is best to keep your alcohol consumption within recommended limits. I hate alcohol, it doesn't bother me whatsoever not having any. 

Maintaining a healthy weight is also key. So this goes both ways. So being underweight increases your risk of fractures, because it often means that you're not getting enough essential nutrients. But on the other hand, if you're overweight that puts extra stress on your bones and joints and both of which can lead to fractures. So it is important to find that balance. Eating a nutritious diet and getting regular physical activities can help with that. 

One of the most serious consequences of bone loss is that increased risk of fractures, particularly from falls. Hip fractures for example can be life -threatening.

And actually statistics show that around 20 % of women who suffer a hip fracture actually die within a year of the injury. And for those that survive recovery can be long and difficult. Some never regain full mobility, which dramatically affects their independence and their quality of life. I have worked with women in the past who have suffered from hip fractures, getting them up out of bed can be a struggle in the early days and I've seen how challenging that recovery can be. Often they require surgery and their months of rehabilitation and even then they may struggle to return to their previous activity levels. So this is why prevention is so important.

Keeping our bones strong through regular exercise, our good nutrition, making smart lifestyle choices can reduce the risk of these devastating fractures. So to wrap everything up, keeping your bones strong is about more than just avoiding osteoporosis. It is about maintaining your quality of life, your independence and your ability to stay active as we age.

So by focusing on good nutrition, regular weight bearing exercise, making healthy lifestyle choices, you can keep your bones in great shape no matter what age you are. And those of you with children, remember that helping them build strong bones now will protect them in later life and encouraging them to get outdoors, take part in physical activities, limiting time sat in front of a screen is one of the best things that you can do for their long term health. So thank you so much for joining me today. I hope that you have found these tips helpful and that you'll start incorporating them into your daily life. If you have enjoyed today's episode, please share it with your friends and your loved ones. And don't forget to subscribe to this podcast so that you never miss an episode. So until next time, stay strong.

Take care of those bones.