I’m a bone health expert and this is how to stay strong into old age

Kate Ward, 50, is Professor of Global Musculoskeletal Health at MRC Lifecourse Epidemiology Centre, University of Southampton. She shares the diet and exercise habits that keep her bones healthy. 

Get moving in midlife 

Every morning I take my dog for a brisk, 3k walk. As we age, it’s vital to exercise more to ensure our bones and muscles stay strong. Bone mass peaks in our 30s, then slowly declines. For women, the drop in oestrogen at menopause causes bone loss to accelerate to about 2 per cent a year. 

This means you could lose 20 per cent of your bone mass by the time you’re postmenopausal. Our bones can develop more of a honeycomb-like structure, prone to fractures. One-in-two women and one-in-five men over 50 will have a fragility fracture, and osteoporosis is a major threat. 

We often forget our bones until we’re in pain, but bone is a dynamic, living tissue that’s constantly repairing and replacing itself. High-impact exercise, such as running and aerobics, is best for stimulating bone growth. Jumping and skipping are excellent – the higher you jump, the higher the impact. 

However, they’re hard on your joints and tendons, so if you have knee or hip problems, focus on strengthening your whole body instead. Moderate-paced walking helps slow bone loss during menopause and ageing. Even if you’re living with osteoporosis, don’t stop exercising, just change your approach. The Royal Osteoporosis Society offers useful exercises for all levels.

Join the resistance 

I’m stronger at 50 than I was at 40. Twice a week, I do reformer Pilates. It keeps my muscles and core strong. Even Harry Styles is a fan! I also have weekly weight-training sessions with a PT. Strong muscles mean you’re less likely to fall and break a hip. 

After 30, we lose 3-5 per cent of our muscle strength per decade. Once it’s gone, it’s hard to get back. Resistance training (like weights, press-ups or Pilates), helps maintain muscle mass and preserves bone density. If you’re postmenopausal, a combination of resistance training and high-impact exercise is proven to increase bone density in the spine and hips. You can start with low weights and high reps and still get benefits.

Lots of mackerel and milk

Studies show a Mediterranean-style diet is ideal for bone health and healthy fats such as omega-3 fatty acids (found in oily fish) and monounsaturated fats (found in olive oil, nuts and seeds) are also key to bone health. Calcium is essential as it’s the main mineral in our bones, but protein and other micronutrients, including magnesium, zinc and copper are vital too, as is vitamin D which helps us absorb calcium. 

I aim for 700-1000mg of calcium a day from yoghurt, cheese, milk, oily fish with bones and wholemeal bread. Good sources of vitamin D include oily fish (salmon and mackerel), dairy milk and eggs, plus fortified breads, cereals, non-dairy milks and mushrooms. Supplements can be useful during certain life stages. For instance, if you’re at menopause and losing bone, consider taking calcium and vitamin D.

Watch your weight

Staying trim is key for bone health. Being underweight is associated with low bone density and reduced muscle mass, both risk factors for fracture. Obesity is increasingly associated with poorer bone health too – straining bones and joints, potentially leading to ankle or lower-limb fractures. Type-2 diabetes is also a risk factor for osteoporosis. If you’re dieting, do take in the essential nutrients for bone health, including healthy fats such as omega-3 fatty acids (found in oily fish) and monounsaturated fats (found in olive oil, nuts and seeds).

Feed your gut   

There’s growing evidence that your gut microbiome (the helpful and harmful microorganisms that live in the gut) influences your bone metabolism. A healthy microbiome can help you absorb more vitamin D and K. Research suggests taking a probiotic may influence bone turnover and slow bone loss. Live yoghurt or a probiotic supplement is an option.

Walk around the office 

Sedentary behaviour is strongly linked to poor bone health (it encourages bone loss) so if my smartwatch says I’ve been inactive, I’ll get up. It’s all about maintaining some kind of movement.

Enjoy the sun, safely

When our skin is exposed to sunlight, UVB rays get converted to vitamin D – it’s our main, natural source of the vitamin. Our body can only manufacture enough from April to September when the sun is strongest, so get outdoors then to build up your stores. Aim to spend 10-15 minutes a day outside with your face, neck and arms exposed to daylight.

Avoid the middle of the day when radiation is highest and don’t get sunburnt (sunscreen prevents vitamin D production as it blocks UVB). The NHS recommends 10 mcg (400 international units) vitamin D supplement in winter.  

Drink  

My ideal daily limit is three cups of coffee or tea a day. Excess caffeine, smoking and alcohol change your body’s biochemistry, impacting bone turnover and causing excess bone to be broken down. I do like red wine and G&T but don’t drink midweek. Fizzy drinks – because of the acid – may affectt bone health too. Drink at least a litre and a half of water a day. Staying hydrated helps deliver nutrients to your bones.