I’m keen to be walking and exercising and living an active life for many years after menopause. Menopause is the time when our ovaries stop making estrogen, and our menstrual cycle ceases, around about the age of 51 on average. Estrogen is one of the factors that helps women to maintain bone health, so we must be careful to support our bones in other ways post menopause.
HRT is often recommended to women after menopause to maintain healthy bones. However there are a few things to consider before making this choice, such as ensuring your diet and lifestyle are optimised for great bone health.
Did you know that our bones are in a constant state of being broken down and repaired? Older bone is resorbed and new bone is made to take it’s place to keep bones strong throughout our life time. The quality of the bone is dependant on the nutrients available to make new bone. It should be no surprise that the nutrients available for bone health are dependant on what you are eating.
These are my tips for maintaining healthy bones into old age:
1. Enjoy a wide range of foods containing bone building nutrients
We all know that dairy products such as milk, cheese and yoghurt contain calcium as this was one of the main nutritional messages that was drummed into us during childhood. Unfortunately many people are unable to eat dairy for a range of reasons, so it’s helpful to know what other foods contain calcium, and invite these foods to be regulars on your dinner plate.
Calcium containing foods include salmon and sardines with small bones, almonds, broccoli, mustard cabbage, bok choy and tofu. Herbs and spices to add more calcium to your meals include basil, celery seed, fennel seed, thyme, sage, rosemary, dill, cinnamon and nettle.
It’s also important to eat a wide range of fruits and vegetables because there are many other nutrients such as boron, vitamin K, zinc, magnesium, manganese that need to be available for calcium to be absorbed into bone. The best way to ensure that you’re getting a wide range of nutrients is to have variety in your diet.
2. Take a good quality calcium supplement at the right time
Not all calcium supplements are equal. Please check with your naturopath or pharmacist to make sure the supplement you choose contains not just calcium, but a range of other bone supporting minerals. And remember that not everyone benefits from taking a supplement.
Supplements such as iron tablets should not be taken with the same meals as calcium as these can compete for absorption. Thyroid medications should also be taken several hours away from calcium supplements to improve absorption of calcium.
I usually recommend taking nutrients for bone health before bed, as your bones are being replenished while you sleep.
3. Optimise digestion for absorption of calcium and other nutrients
If you experience regular digestive problems such as diarrhoea, bloating, SIBO, coeliac disease, IBS, IBD or reflux, this can be affecting your ability to absorb nutrients from your food (and your supplements).
After menopause I highly recommend that you seek assistance for any digestive health conditions, to make sure you’re maximising nutrient absorption. Nutrients aren’t just needed for bones. We need our nutrients for energy; healthy eyes, skin and nails; and longevity.
Our gut microbiome also assists our intake of essential nutrients because the bacteria that live in our large bowel make nutrients such as vitamin K, from the fibres that we can’t digest. Beneficial gut bacteria can be supported via diet changes to increase prebiotic foods.
Dysbiosis might be suspected if you have regular bouts of bloating and constipation and this can lead to less than ideal nutrient status and have a negative effect on bone health.
4. Medications can affect calcium absorption
There are quite a few medications that can interfere with calcium absorption. It’s good to know if you will need to supplement bone health to counter any medications that you have to take. The information sheet that comes with your medication will tell you if it interferes with bone health and at what dosage.
The most commonly taken medications that interfere with digestion and absorption are proton pump inhibitors that women take for relief from reflux and heart burn. Reflux medications reduce stomach acid levels and compromise digestive function.
5. Be aware of foods that bind calcium
Foods that contain oxalates can bind calcium and make it unavailable for absorption and use in the bones. Oxalates are found in a range of foods such as blackberries, rhubarb, sweet potato, black tea, spinach, beetroot greens, carrots and almonds.
These are common healthy foods that make up a large percentage of many women’s diets. I recommend slowly cutting back on high oxalate foods and replacing them in some meals with the many foods that don’t contain oxalates such as broccoli, celery, lettuce, cabbage, fennel, cauliflower.
Once again, seek professional advice if you need to and remember that eating a wide variety of fresh foods in your diet is the key to maximising the nutrients absorbed into your body.
6. Enjoy an alkaline diet
Another food tip is to aim for a balance of alkaline rather than acidic foods. It’s important for our health to maintain blood pH within a narrow healthy range. If we eat too many acidic foods such as meat and grains, calcium can be extracted from bones to act as a buffering agent against an acidic diet.
An alkaline diet contains many plant based foods. If you don’t enjoy many vegetables, please read my blog about how to eat more plants.
7. Reduce alcohol and smoking
You guessed it! A 2020 report linked smoking with worse bone health after menopause and an increased risk of hip fracture. Smoking is also a risk factor for cancers and other diseases of ageing, so please quit if you can.
The same report was not as clear about the affect of alcohol on bone health and seems to suggest that alcohol in moderation may even play a protective role. Moderate alcohol consumption is considered 2 or less glasses on 2 to 4 days per week.
Resistance exercise using weights can improve bone density and muscle strength as we age. The exercise should be at a level that is greater than usually experienced during daily activities, such as a work out at a gym using weights, exercise bands or your own body weight.
Gentle exercise is also beneficial because when we are moving it improves circulation of blood and nutrients to the extremities. Any exercise you enjoy that gets you moving is good for your circulation and ultimately your bone health.
9. Get out in the sunshine!
Research suggests that up to 40% of Australian women are deficient in Vitamin D, which is a molecule that affects the way calcium is absorbed, transported and used in the body. Vitamin D is important in so many aspects of our health and healthy bones is just another example.
The best way to get your vitamin D is from exposure to the sun. Try to get out in the sunshine for at least 20 to 30 minutes every day.
We don’t make enough vitamin D from the sun in winter or spring because of the angle of the sun in Australia, so I often recommend that women who tend to be low in vitamin D will benefit from taking a supplement during these seasons.
Other naturopathic support for bone health:
I support menopausal women to take a holistic and long term approach to their health. I recommend slow and sustainable diet and lifestyle changes after menopause to improve longevity and bone health.
Supplements can often be part of the picture, especially in the short term, however over the long term there is no better way to age well than making sure your diet and digestive function supports your health goals.
Herbal medicine can play a part by circulating nutrients, supporting healthy capillaries and making nutrients available to bones. If you are approaching menopause then I invite you to have a consultation with me to find out how I can help you to maintain your ongoing health and vitality.