Maintaining bone density into older age

[Nooa]

How much strength training do I need to do? I want to maintain a reasonable level of bone density into old age, as osteoporosis runs in the family. I'm coming up to 40 and not likely to start menopause for at least 10 years (based on mother and aunties), but I want to get into a lifelong routine now while I still find it easy.

I currently do 2x 20min HIIT sessions per week - lunges, squats etc using bodyweight only. Also I cycle 10km twice a week on a hilly route. Do loads of walking up hilly terrain (which I know is not strength but just to say i have CV exercise covered).

Is that enough if I continue it? Or do I need to add weights, or do more frequent sessions? I'm after the bare minimum required to avoid snapping bones when I slip on ice 😁

Plenty of calcium and vitamin D. Go outside whenever you can. Sit in the shade, but walk in the sun - wear sunscreen! That will help with bone density too.

https://open.spotify.com/episode/0KoSjFG6z8L6mVjScjPazN?si=FV9UWq_HQpu6x4AxA4W_NA

I listened to this only last week. You might appreciate it. I thought it was really good

It's Mel Robbins talking to an orthopedic surgeon with a special interest in ageing well -Dr Vonda Wright ( in case anyone wants to look her up)

Cycling is great exercise but does nothing for bone density. I'd add in a few weight training sessions per week.

I'm 64, postmenopausal for 10 years (no HRT) and have been weight training for 35+ years. No osteoporosis/osteopenia - weight lifting works! Along with keeping bones strong you definitely want to minimize the muscle loss that comes with aging. Keeping muscle mass/strength lessens your fracture risk.

Get lifting heavy weights. So many health benefits, especially for aging women.

I have a genetic disorder called NF1 which carries a high risk of osteopenia (48%) so I have been working hard to minimise bone loss.
It is a 360 lifestyle intervention around diet, supplements, sunshine and exercise.
Let's start with exercise since this is where you posted. You need to load your bones. You need to use weights and most people forget to load the spine, and the way to do that is weights over head. Do the exercises of your HIIT class with weights, the lunges, the squats, but also do farmer's walk, and overhead squats with a barbell or even walking around with a loaded barbell. As you stated cycling is great for heart and brain but since you are sitting your bottom, not much loading happening. Same with swimming .
Include jumps, rope skipping or jumping on a box or bench if your gym doesn't have a box.
Include soy in your diet, especially something called natto, it is fermented soy and highest source of vitamin K2 which puts calcium in your bones and not arteries
Or supplement with K2 in addition to calcium and vitamin D
Avoid sugar and also strangely saturated fats, that is fat from meat or cheese. It seems those fats will bind to calcium. So cheese is not a good source of calcium. So many are eating cheese for bones when it is actually damaging bones. Also we now know that the gut microbiome modulates bone remodelling especially through oestrogen regulation. One more reason to eat soy and vegetables, fruits, legumes and avoid gut damaging foods
Yes to sunshine but without sunscreen. Just enough to be pinkish, not burn.

And do a bone density scan so you know your baseline. Keep in mind when booking that results vary from machines sometimes so it is better to stick to the same imaging centre to compare future scans.

If you are really invested, pay a consultation with a physio specialising in osteoporosis .

Thanks everyone this is all really helpful.
I get loads of vitamin D and eat well.

I don't currently use weights, and I don't live near a gym. Are weights absolutely vital? It's not possible to keep good bones without weights? If they are essential, what types of weights should I buy to add to my lunges and squats routine at home? What type of weights and how heavy?

I'm not looking to be mega strong, just want to avoid brittleness.

I havent been to a gym in years but i use dumbells at home I have a 5kg pair. I've no idea if that is sufficient, I like to hope it is! 🤞
But await to be corrected by someone more knowledgeable!

Dumbbells in varying weights. You’ll need to start lighter and then as you improve you’ll go heavier. Check out Caroline Girvan on YouTube.

Progressive overload is the buzz phrase for strength training. Quite quickly your body will adjust to either body weight or the same weight exercises. You need to challenge it by lifting progressively heavier weights.

Oh right, that sucks then! So there's no way to maintain bone density without going to a gym then? I have space for a couple of kettle bells or something, but not lots of massive weights.

How did people do it in the past, before gyms? Did all women over 60 just break bones all the time? Surely not.

You don't have to go to the gym, I've weight trained for about 4 years now and I do it at home. I follow an app and stream it onto my TV.

I have a little corner in the house with a mat and a mixture of dumbbells from 2kg-10kg. I do 3 X 30 mins strength, 2 X 20 mins of stretching/mobility. I then do fun stuff on top of that to keep moving - cycling, 5k jogs, a LIIT or boxing session. I do something most days. I'm 45 and Im the fittest and strongest Ive ever been.

No you don’t have to lift weights, see this article

https://www.osmifw.com/sports-medicine/bone-density-and-weight-bearing-exercise/

Quote from the attached article

If you want to build healthy bones, the best thing you can do is make an impact with the ground. In other words, try running, jumping, or walking. These activities create forces that move through your bones and help with the bone remodeling process that adds density.

Slight derail but does anyone have advice or knowledge of someone offering advice/info on doing all of this with a pelvic prolapse? I've done a few light/short exercise videos with light handweights but am v nervous of making my prolapse worse. Ditto any jumping or high impact stuff - I walk, swim and cycle to avoid too much pressure but i know the arguments for more impact and weight bearing

Nobody ever said one or the other. Walk or lift. Walk alone might not be enough. Lifting alone might not be enough. If bones are your priority, it is a 360 approach.
You don't need a gym, you can use a skipping rope, a bench at the park, fill a backpack with packet of salt, rice, cans of beans, and put it on your back, above your head or on your shoulder if doing side lunges.

I am extremely serious about my bones, because in my case, the treatment for osteoporosis do not work for people with NF1. My specialist physio insisted on overhead because one can break the spine in their sleep by simply turning in bed. Walking, jumping, carrying stuff is great for hip and femur, the spine is often neglected.

It also depends where you are in your bone loss journey. Dexa scan is still green, you don't have to go crazy, but yellow or orange, buy a few weights.

The cause of bone is multifactorial, its prevention is multifactorial . I wouldn't trust just a brisk walk.

I posted about this on another thread but I have just finished reading "Strong Women Stay Strong" which was recommended on several threads. It is about 30 years old but still relevant. She recommends a simple at home workout with weights to strengthen muscles and ward off osteopoenia (which I have). I'm going to start this week.

Got the title wrong! Should be Strong Women stay YOUNG!

My DM had osteoporosis, had a really bad ankle break and curved spine. I went to my GP years ago and now have regular DEXA scans. I have osteopenia and take calcium & vitamin D. Excellent you are being proactive, but might be useful to know what state your bones are.

I read another of hers called stong women stay slim. Excellent book! Also years ago.
OP did you look at the link I posted to the podcast? They discussed gradually increasing the load, so you start where you're at. She's all about movement, and how when muscles are worked they send messages all round your body, improving bone health, brain health, heart health. The biggest message was that it's never too late to start ( but earlier is better) I highly recommend a listen. Good posts on here too!

I would also add in exercises that focus on balance too. So important as we get older.

How did people do it in the past, before gyms? Did all women over 60 just break bones all the time? Surely not.

Well lifestyles were a lot more physical. Lots more walking, carrying shopping, coal, babies... beating carpets, sweeping stairs, growing veg, hand washing, scrubbing floors... There was no need for gyms!

My grandmother (she'd be about 110 if she were still alive) and her sisters and friends were terrified of broken bones. It was not unusual to see an older woman with a dowager's hump". So I think yes, osteoporosis was more common. No HRT either.

I lift at home and have done for years. I am so strong now. It’s so important for bone health.

Walk all year round, carry heavy shopping, get out in the sun as much as possible.

After a scan, and if there's an issue, do you have to use bone injections as given by gp or can lifestyle still repair?