We hit our peak bone mass at 20 and doing nothing to protect our bones can affect not only our quality of life but also lead to disability and in some cases increased mortality.  Osteoporosis is a silent but pretty deadly disease affecting 1 in 3 women over 50.  In fact for a woman over 45 osteoporosis causes more days in hospital than diabetes, myocardial infarction and breast cancer.  It has no outward warning signs until we have a fracture, which can indicate the first of many – especially if we do nothing. The greatest risk factors include being a woman and getting older but including the right exercise, nutrition and managing stress is an essential & effective way of increasing our bone health. Continue reading here to see why we suffer as we grow older, why bone health is linked to our mortality, and most importantly, what we can do about it

Osteoporosis is a common and silent disease until it is complicated by fractures that become common. “It was estimated that 50% women and 20% of men over the age of 50 years will have an osteoporosis-related fracture in their remaining life” (source: According to this study, these fractures are responsible for lasting disability, impaired quality of life, and increased mortality, with enormous medical and heavy personnel burden on both the patient’s and nation’s economy. 

What is happening?

Bone is a living tissue which is constantly being built up and broken down.  This is called bone turnover.  Good bone health requires a balance between the cells that build (osteoblasts) and the cells that breakdown (osteoclasts).  When there is a mismatch the result is net bone loss and this can result in frail bones and worse case, osteoporosis.

Why the mismatch?

One reason is due to decreasing oestrogen.  Oestrogen promotes the activity of osteoblasts so less oestrogen can mean a slower production of bone.  But lifestyle can also have a big influence and, used in the right way, a positive one, encouraging the production of new bone cells to balance out their demise.  Including the right exercise, bone health nutrition and stress management can all positively influence the balance.

What can we do?

Whilst  we can’t control our age and sex, we can control our exercise, what we eat and how we manage stress.

Exercise – Bones need a bit of micro trauma to facilitate osteoblast activity – “bones stay strong if you give them work to do” (source: Osteoporosis society).  A swim whilst great for our brains and cardio, will not facilitate bone production.  However, over exercising can deplete your body of oestrogen and also allow an imbalance.  Choose weight bearing exercise and start where you are.  Include low impact such as stomping around the house as well as mid to high with moves such as star jumps and other plyometric/jumping moves.  Strengthening muscles is directly linked to bone health (Sunaki et al 2010 “strengthening of the major muscles decreases fragility”) so adding weight to moves such as squats, single leg lunges, push ups, pull ups.  Your body needs to be overloaded and challenged – the final few reps should be difficult but shouldn’t hurt.  

But remember, start where you are and build up progressively! Do not for example, star jump if you have hip, feet or knee issues.  If you need any advice on where to start please do feel free to contact me or see my website for info on strength classes plus other courses that will give you practical information on where to start.


Most people are aware that calcium is needed for healthy bones.  But our bodies also require vitamins and minerals to ensure that the calcium is bio available to our bones and isn’t wasted.  I spoke with Marie Hick, nutritionist and founder of about what else we should be including in our diets to protect our bones both now and in later life.  “Whilst calcium is a non negotiable, vitamin D, vitamin K2 and magnesium are also essential both in ensuring that calcium gets to the right places as well as the Omega 3s (aka good fats) needed to support the growth of new bone cells.”


Calcium – plentiful in dairy but for non dairy eaters it can also be found in green leafy veg, broccoli, bok choi, almonds, sweet potatoes, soy and soy products and sesame seeds.  However, not all calcium sources are equal.  Marie explained  “whilst spinach, for example, has a high amount of calcium per 100g, not all of it is available to be absorbed by our body. This is because green leafy veg has a high amount of substances such as oxalates and phytates which bind to the calcium and make it harder for us to absorb. For this reason, it’s best not to rely on spinach as a source of calcium (lots of other reasons to eat it though) and instead use dairy, broccoli, bok choi or soy products which can all help us meet our calcium requirements without having to eat huge quantities!”

Vitamin K2 – found in fermented foods such as sauerkraut (always the sauerkraut!), organ meats, eggs and is also made by our gut bacteria

Magnesium –  green leafy veg, nuts, seeds, legumes, wholegrain

Omega 3s – fish, algae, nuts and seeds, avocados, eggs, flaxseeds, chia seeds.  If you don’t eat fish it’s worth considering an algae supplement as plant based omega 3 sources such as flaxseeds, walnuts, avocados, chia seeds contain the omega 3 ALA which then has to be converted to EPA and DHA before being used by the body.

It’s interesting to note that osteoporosis in Japan was practically non existent before they started to adopt more of the Western diet.  The traditional Japanese diet includes fish, soy, sea vegetables and ginger (anti inflammatory and beneficial for bone and joint health).   2 to 3 prunes a day have been shown to be good for bone health as well as being great for the gut.  And again a healthy gut and a diverse microbiome has been linked to bone metabolism and bone mass density (Study Parvaneh et al 2014).  

As always, diet is incredibly individual and linked so greatly to our lifestyle at each specific stage, from how we’re sleeping to how much exercise we do to how much stress we’re under.  But a healthy, diverse diet with whole foods, variety, different colours, dark green leafy vegetables, omega 3s is the way to feeling well and our bodies working better, as with so many of the issues we face.

Stress Management 

“Disease loves stress” Jenny Burrell, Women’s Wellness Guru.  Stress and inflammation can stop the osteoblasts as the body will stop making bone to ensure that we can survive that chasing tiger.  And of course it will also upset hormone balance.  Once again daily stress management from pilates (see info for a free zoom pilates session with CasPilates in this newsletter), to meditation, to walking – 5 minutes for yourself – can make all the difference to how you feel and how your body works.  A 15 minute walk brings your cortisol level down to pre stress.  Looking at calming pictures calms your brain.  It’s a daily work in progress for me but I always notice the difference – more when I don’t than when I do!


Bone health is a silent disease and using our knowledge now, stocking up on good nutrition, movement, lifestyle practices, can protect us for the future to ensure that we can continue to live a life full of fun and full of joy! 

NB please contact me for any questions on this, and as always this does not replace advice from your healthcare practitioner and should not be followed if you have any contraindications.