All women should be concerned about their risk of osteoporosis. Osteoporosis is the pathological loss of bone tissue and is one of the most common age-related health problems in women. In response to the loss of bone tissue, skeletal bones become softer, weaker, and more prone to fractures. Women are at higher risk of osteoporosis than men and certain women are at increased risk relative to others. Established risk factors for osteoporosis include:
· Genetics
· Caucasian or Asian heritage
· Lack of physical activity
· Smoking
· Excessive alcohol use
· Certain medications (particularly glucocorticoids)
· Being thin or small-boned
· Certain medical conditions during childhood or adulthood
The problem with osteoporosis is it’s a silent disease. In fact, the first sign that you have it might be a fracture that comes on with minimal trauma. Frighteningly, women with osteoporosis may fracture a bone just by getting up too quickly from a chair or coughing too hard. Other signs include loss of height, changes in posture, or severe, persistent back pain.
The Risk of Osteoporosis – Can You Prevent it?
Efforts to prevent osteoporosis are most effective when they begin during childhood and adolescence when bone cells are still aggressively churning out new bone tissue. Prior to early adulthood, cells called osteoblasts that lay down new bone are more active than osteoclasts, cells that break it down. The goal is to lay down as much bone tissue as possible during these formative years. Lifestyle changes like staying physically active (high-impact exercise and strength training) and getting enough calcium and vitamin D helps maximize new bone formation. Once bone mass peaks, the focus shifts to maintaining what we have. Weight-bearing exercise later in life doesn’t substantially increase bone mass, although it helps preserve what’s already there.
Unfortunately, the risk of osteoporosis goes up after menopause due to loss of the bone-preserving effects of estrogen. Studies show bone loss is greatest in the year before and the first few years after menopause. But, lifestyle makes a difference even after menopause. You can minimize further bone loss by eating a balanced diet that contains enough calcium, vitamin D, and magnesium (minerals important for bone health) and by not smoking and limiting alcohol. Also, watch the soft drinks. Studies link soft drink consumption with a higher risk of osteoporosis. Hormone replacement therapy reduces bone loss but is associated with other potential side effects. If you’re at high risk of osteoporosis, discuss the pros and cons of hormone replacement therapy with your physician.
Physical Activity and Bone Loss
We know that physical activity, particularly high-impact exercise where both feet leave the ground and high-resistance strength training, help prevent bone loss and lower the risk of osteoporosis. But, what’s the most common form of exercise that older people do? Walking! Not surprising since walking is an activity that’s accessible to everyone and requires no special equipment. But, does it have any impact on bone health?
Walking isn’t a high-impact exercise in the sense that both feet leave the ground at the same time, but walking may still lower the risk of bone loss and fractures. In fact, a study published in The New England Journal of Medicine found that walking regularly was linked with a 30% lower risk of developing a hip fracture. That’s substantial!
Walking still doesn’t make the top ten list of best exercises for building bone, but modifying the way you walk can enhance the bone-preserving benefits of this form of exercise. One way to do that is to pick up the pace. In a large study called the Nurses’ Health Study, researchers found that women who walked at a brisk pace or did interval walking, at an intensity where it’s hard to engage in conversation, had a lower risk of developing a hip fracture relative to those who walked at a slower pace.
Changing direction repeatedly when you walk also helps. According to a study published in Osteoporosis International, walking backward or stepping to the side when you walk is more beneficial for bone health than walking in a straight line. It’s good for balance as well. Another option – strap on a weight vest when you walk or add hills or stairs to a walking routine to make it a more effective exercise for preserving bone mass. Research also shows a higher volume of walking and taking longer strides enhances bone architecture as well.
So, walking has a modest benefit for preserving bone, but you can make it more effective by boosting the intensity of your walks and changing your walking patterns. Mix it up by adding intense intervals and doing interval walking where you increase the pace and take longer strides. Add hills and steps whenever you can as well. Doing this will power up the fitness benefits as well.
Walking Isn’t Necessarily the Best Exercise for Bone Health
Higher impact exercise stimulates the laydown of new bone more than a leisurely walk. But, if you need to avoid high-impact exercise, high-resistance, strength training is an effective form of exercise for building or preserving bone mass. However, it must be high resistance. You can’t grab a pair of 3-pound weights, lift them a few times, and expect to benefit your bones. To turn on osteoblasts, the bone-forming cells, you must reach a threshold resistance called the minimal essential strain. This is equivalent to around one-tenth of the amount of force you need to fracture a bone or about 80% of your one-rep max. Also, doing compound exercises, like squats and deadlifts, and including a wide range of exercises in your routine is necessary to ensure you’re loading all of the bones in your spine, hips etc. You won’t get a lot of bone health benefits by just doing biceps curls and triceps extensions.
The Bottom Line
Walking, especially if you increase the intensity or add resistance, may modestly lower your fracture risk, but it’s best to also include high-impact exercises, such as plyometrics, and strength-training in your routine for maximal benefits. So, don’t shy away from weight training, it’s too important for your overall health – and your bones.
References:
J Family Community Med. 2014 Sep-Dec; 21(3): 176–181. doi: 10.4103/2230-8229.142972.
Spine-Health.com. “Lifestyle Changes for Preventing Postmenopausal Osteoporosis”
Am J Clin Nutr. 2006 Oct;84(4):936-42.
N Engl J Med 1995; 332:767-774.
Prevention Magazine. “4 Easy Ways To Strengthen Your Bones While You Walk”
Osteoporos Int. 2009 Aug;20(8):1321-8. doi: 10.1007/s00198-008-0785-x.
American Bone Health. “Is Walking Good for Bone Health?”
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