Men, Wholefoods, Women

Bone health and the menopause

The role of bones is to provide support for our bodies and help form our shape. Bones also protect the significant organs in our body, such as the skull, which houses our brain. During childhood through to our mid-twenties, bone is laid down, and what you have at this point is there to support your bone health throughout life. For this reason, children, especially teenage girls, should be encouraged to build bone density through diet and active exercise. 

During menopause, falling oestrogen levels can result in up to a 20% reduction in bone density. This loss of bone can put women at greater risk of osteoporosis, leading to a prolonged loss of mobility affecting health in other ways. Fractures can be challenging to recover from in later life and even contribute to premature death. 

What is osteoporosis?

Osteoporosis is a disease that results in bone tissue thinning and becoming less dense. It has been estimated that more than 3 million people in the UK have the disease, which affects more women than men1.

Often it is not until someone has a fall and breaks or fractures a bone that the disease is identified. This is because osteoporosis can reach an advanced stage without causing any identifiable problems. 

The exact cause of osteoporosis is not yet understood, but it affects more women than men. Your bones are a living entity that is continually changing. The inner part of your bone has a structure similar to a sponge with small holes through it. In the case of osteoporosis, these holes increase in size and number, leaving them weakened. In this state, bones cannot sustain falls which can result in fractures. In severe cases, fractures can occur without falling over. 

Why does menopause increase the risk of osteoporosis?

The female hormone oestrogen helps preserve bone density by inhibiting bone remodeling and reabsorption2. The lack of oestrogen as such contributes to the development of osteoporosis. More recent thinking has also suggested that low progesterone levels common in perimenopause may also affect bone-building cells, disrupting the natural process of bone breakdown and repair.


  • Other risk factors for osteoporosis include:
  • Family history
  • Gender (women are four times more likely to develop osteoporosis)
  • Body composition (petite or thin women have greater risk than larger-framed women)
  • Smoking has been shown to increase the risk of osteoporosis
  • Ethnicity (the risk of osteoporosis appears to be higher if you’re white or of Asian descent)

How can you protect your bone density?

It would help if you tried to preserve the bone density you banked earlier in life, and there are many ways you can do this by making simple lifestyle changes. Research has also indicated that most bone losses occur during one year before and two years after a woman’s last period3, so these three years are an essential window of bone protection that should be taken advantage of. 

Choose the correct type of exercise

In terms of bone health, weight-bearing exercises and resistance exercises are essential for improving bone strength and helping to prevent osteoporosis. This is because they place stress on the muscles and bones, which helps to strengthen them.

Eat plenty of calcium-rich foods

Include plenty of calcium-rich foods (3-4 servings daily), including dark green leafy vegetables (but not spinach), nuts, seeds, dried fruit, tofu, tinned fish with the bones, and dairy products like milk, yoghurt, and cheese.  

Keep your levels of vitamin D topped up

The primary source of vitamin D is sunlight which is most absorbable during the spring and summer months, so spend plenty of time outdoors. 

You can get some vitamin D from foods such as oily fish, eggs, mushrooms, and fat spreads or fortified breakfast cereals. Food surveys show a lack of vitamin D in many people, especially during the winter months4, so a supplement of 10mcg is recommended between October and April. 

Ditch faddy diets 

Maintaining a healthy weight is essential for health but approaching it in the right way may help to preserve your bone density. Embarking on highly restrictive diets can put your nutrient intake at risk, especially if they involve cutting out dairy foods which are a primary source of calcium in the diet. You can, of course, get calcium from other food sources, but you need to be aware of this to make the right dietary changes.

If you are trying to lose weight, a more balanced approach involving lots of small sustainable changes is a better option. 

Don’t forget about protein

Protein makes up around half of the volume of bone and about one-third of its mass. For this reason, you must be getting enough protein in your diet. Protein also helps maintain muscle mass, which can diminish quicker during menopause. Most people get enough protein in their diet, but it’s worth keeping in mind to incudes a source of good quality protein with every meal. If you’re vegan, then eat various protein sources across the day to ensure a good intake of all the essential amino acids (Quorn, tofu, beans, pulses, lentils, nuts, and seeds). 

Limit your intake of diet drinks 

Soft drinks such as diet coke contain high phosphorus levels and increase the risk of osteoporosis by increasing urinary calcium excretion. This effect can contribute to bone loss if these drinks are consumed in excess.

Protecting bone density is important during menopause and should be made a priority especially for women at greater risk of osteoporosis. Making simple dietary changes and exercising in the right way is the best strategy to avoid fractures in later life. 

References 

  1. https://pubmed.ncbi.nlm.nih.gov/24113838/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424385/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2266953/
  4. https://www.gov.uk/government/statistics/ndns-results-from-years-9-to-11-2016-to-2017-and-2018-to-2019

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