Tips To Improve Bone Health After Menopause

Strong bones, made up of protein, calcium and minerals are the foundation upon which the body’s frame rests. The bone mass continues to build from childhood through teenage and up to adulthood, with the help of a balanced, nutritious diet and physical activity. After 30, the bones do not build up as fast as they break down.

Women reach their peak in bone mass by around 25-30 years of age. With the onset of menopause (the cessation of periods) around the age of 45-55 years, the levels of estrogen hormone secreted by the ovaries, which regulates bone health in both sexes, begin to decline. This leads to a loss in bone mass (osteopenia) and density (bone mineral density or BMD). The bones tend to become fragile, brittle, and porous (osteoporosis), which makes them vulnerable to frequent fractures. Women lose about 10 per cent of their bone mass in the 5 years following menopause.

Indians have a genetic predisposition towards osteoporosis. A family history of weak bones increases the risk further. Over 95 per cent Indians are deficient in vitamin D, which is essential for the absorption of calcium. Vitamin K helps in modifying osteocalcin protein which is required in bone formation and binding minerals into the bones. 

For women above the age of 50 years and men above the age of 60 years, the daily calcium requirement is 1200 milligrams, in addition to 600 international units (IU) of Vitamin D. A daily portion of 60 gm of protein is essential to maintain strong bones.

Tips to maintain good bone health

- Get a blood test to assess the levels of calcium (serum calcium test), vitamin D (25-hydroxy vitamin-D test) and minerals like copper, iodine, iron, magnesium, manganese and zinc (mineral panel test).

- Bone densitometry test (Dual energy x-ray absorptiometry test or DEXA scan) is a bone x-ray to check their density and porousness. 

- Increase your intake of green leafy vegetables like spinach, cabbage, fenugreek leaves, kale, lettuce, broccoli, soy and parsley and go for colorful vegetables like red, yellow and green peppers, onions, aubergine, peas, beans, tomatoes, carrots, pumpkin, beetroot, lotus stem, turnip, cauliflower, etc. which are rich in proteins, calcium, vitamins and minerals.

- Increase your intake of vitamin, fiber and mineral-rich fruits like banana, orange, guava, mango, papaya, watermelon, gooseberries, lemon, strawberries, avocado, etc. 

- Milk, yoghurt and cottage cheese are good sources of protein and vitamin D. Butter and ghee are good sources of vitamin A E and D, but need to be consumed in small quantities only. 

- Eggs, meat and seafood are rich sources of protein, calcium, and vitamins. 

- Nuts are a good source of protein, minerals and vitamins. Include almonds, walnuts, figs, apricot, pistachio, pine nuts and raisins in the diet. 

- Sprinkle roasted sesame, sunflower and chia seeds on your salads and soups. 

- Honey and jaggery too are rich sources of calcium, but should be consumed in small quantities.

- Go for a brisk walk daily in bright sunshine for 20-30 minutes. Sunlight is a big source of vitamin D. 

- A balanced diet combined with plenty of physical activity will also help maintain a healthy body weight. 

- Stay active and get plenty of exercise. The walk will also give you a dose of your daily physical activity. Combine it with light weight- bearing exercises, stretches and yoga. Walk to short destinations. Take the stairs instead of the elevator.

- Avoid long hours of sitting and shun a sedentary lifestyle to keep your bones in good working order.

- If you smoke, quit today.

- Restrict alcohol intake to no more than 2-3 drinks a week. 

- Consult your physician before taking daily calcium, vitamin D and mineral supplements, as calcium supplements increase the risk of heart disease by 22 per cent.

Dr Angeli Misra

Guest Author The author is Director, Lifeline Laboratory