PHW Newsletter - Edition 27

A Word from Joleen Zivnuska, APRN

Building Strong Bones: It’s Never Too Late

If you have ever been in my exam room, you know I grew up on a cattle ranch in the Flint Hills, where my days were filled with carrying five-gallon buckets of grain, hefting hay bales, lugging heavy saddles, and teaching colts and 4-H club calves to lead. Back then, I had no awareness of how all those childhood activities were building the foundation for the bone health I’m still benefiting from today in menopause.

The Foundation Starts in Childhood

Belinda Beck, PhD, an exercise physiologist and bone researcher, states “Osteoporosis is a childhood disease” [1]. The seeds of bone health are planted in our youth through proper nutrition, including adequate calcium and vitamin D, but nutrition alone isn’t enough. Dr. Beck emphasizes diverse sports and movements that create mechanical stress on bones: activities involving impact, jumping, and resistance. Our maximum bone potential is largely determined by the time growth plates fuse, around age 18 for females and 25 for males.

Maintaining Bone Strength Throughout Life

Bones are constantly remodeling through the work of osteoblasts (which build bone) and osteoclasts (which break it down). Estrogen plays a key role by slowing osteoclast activity. Adults in their 30s and 40s can benefit from regular mechanical loading through physical activity [1].

Gender-Specific Considerations

Men typically maintain protective testosterone levels throughout life. For women, both estrogen and progesterone stimulate bone formation. Hormone replacement therapy (HRT) has proven to be the most effective intervention for preventing osteoporosis, with studies demonstrating a 35 to 50 percent reduction in fracture risk [3]. However, benefits are only maintained with continued use. When HRT is discontinued, fracture risk rapidly returns to baseline within six years [4].

This is particularly significant given that 25 to 30 percent of women who suffer a hip fracture die within one year [2]. For these reasons, beginning hormone replacement during perimenopause and continuing lifelong is strongly encouraged.

Risk Factors for Osteoporosis

• Family history of osteoporosis or hip fracture
• Early menopause or low estrogen/testosterone
• Low body weight or eating disorders
• Long-term corticosteroid use
• Smoking or heavy alcohol consumption
• Insufficient weight-bearing exercise

It’s Never Too Late to Improve

Dr. Beck’s LIFTMOR study provides compelling evidence that it is never too late. Postmenopausal women with significant bone loss showed remarkable improvements after just eight months of twice-weekly 30-minute sessions of supervised heavy lifting and jumping [5].

Progression of bone loss can be slowed and reversed through:

• Hormone Replacement Therapy (HRT): The gold standard for postmenopausal women.
• Exercise: Resistance training, weight-bearing activities, and balance work.
• Nutrition: Adequate calcium, vitamin D3, and protein.

Strong bones do not happen by accident. With the right nutrition, movement, and hormonal support, protecting your bone health is absolutely within reach, and the Prairie Health & Wellness team is here to support you every step of the way.