Intro

When we think about healthy ageing, we often focus on our heart, brain or joints — but what about our bones?

• Is walking enough for bone health?
• Can you improve bone health after menopause?
• Can stress affect bones?
• Should I take calcium supplements?
• How can I find out about my bone health?

Dr Nick Birch, specialist in spine and bone health, answers all your questions about osteoporosis, bones, exercise, nutrition and why we need to think beyond a single bone scan score.

What is osteoporosis and why does it matter?

Osteoporosis literally means porous bones and it develops when old bone is lost faster than new bone can be created. Over time bones become fragile and more prone to fracture. It is often called a silent disease because there’s no obvious symptoms in the early stages and is often only discovered after you break a bone.

Osteoporosis affects around 3.5 million people in the UK leading to over 500,000 fragility fractures a year – that’s one broken bone every minute.

In fact, half of all women and one in five men over the age of 50 will sustain a fracture due to osteoporosis.

So why don’t we know more – and care more – about our bones?

When we think about osteoporosis, we tend just to think in terms of bone density which can be measured by a type of X-ray called a DEXA scan to give us a T-score. However, bone health is far more nuanced than that and T-scores don’t tell the whole story.

It is also about bone structure, toughness, muscle strength, balance, falls risk, nutrition and how active we are day to day.

That is important because two people can have similar scan results but very different levels of fracture risk, strength, balance and resilience.

So how can we get a more accurate picture of our bone health?

REMS – Radiofrequency Echographic Multispectrometry – is an advanced, non-invasive ultrasound technology which measures bone mineral density and evaluates internal bone microarchitecture to predict fracture risk.

“If a woman has a DEXA scan, and all she’s given is a T–score, she’s getting less than half of the required information to allow her to be able to manage her skeleton, manage her bone health and to understand what she needs to do to maintain health.”

Dr Nick Birch MB BS FRCS (Orth)

What can we do to improve our bone health?

Let’s start with exercise. Walking can help especially when people achieve more than 3,500 purposeful steps a day. But walking is only part of the picture. For stronger bones, we also need to think about strength, resistance, impact, balance and muscle health.

One *research study showed that a combination of impact and resistance training improved bone health over an eight-month period for postmenopausal women with osteoporosis. But we shouldn’t rush into doing high-impact exercise or heavy weight-lifting – exercise needs to be safe, progressive and consistent. Building activity that strengthens our muscles and loads our bones into daily life can really help.

(*The LIFTMOR Randomized Controlled Trial: High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis)https://pubmed.ncbi.nlm.nih.gov/28975661/

Why muscles matter for bones

We often talk about osteoporosis and sarcopenia separately. Osteoporosis is linked to bone loss. Sarcopenia is the progressive loss of muscle as we age. But the two are closely connected.

Strong muscles pull on bones which helps bones respond and stay stronger. Muscles also help with balance, the ability to move quickly to prevent a fall, or to fall without causing injury.

This matters because preventing fractures is not only about the bones themselves. It is also about reducing the chance of falling in the first place.

What about calcium?

Many people think, “I take calcium, so my bones will be fine,” but it is not that simple.

Calcium matters, but it works alongside protein and other nutrients. Calcium and protein are both key building blocks for bone. But we also need vitamin D3, magnesium and vitamin K2 to help calcium move into the bones.

If you can get enough calcium through your diet, you should not need extra supplements. But if your diet is restricted, dairy-free, vegan or low in certain foods, you may need to pay closer attention.

The key point is this: bone health is not supported by one single nutrient, exercise or habit. It is the whole picture that matters.

Is osteoporosis only a women’s issue?

No. Osteoporosis is more common in women, especially after menopause, but men’s risk increases with age, particularly after around 60 and this can also be affected by poor nutrition, inactivity, low muscle strength and other health factors.

This is an important reminder that bone health is everyone’s business. Whether you are male or female, active or inactive, slim or heavier, your bones and muscles need care.

Top tips for better bones

You can start with simple steps:

Move more often.
Build strength gradually.
Add resistance work where safe.
Eat enough protein across the day.
Check your calcium intake.
Think about vitamin D, especially during autumn and winter.
Practise balance every day.
Reduce long periods of sitting.
Stay socially connected.

Watch the full webinar

This blog only scratches the surface.

In the full video, Julie and Dr Nick Birch explore bone density, bone toughness, REMS scans, DEXA scans, menopause, protein, calcium, falls prevention, sarcopenia and the simple actions that can help protect your musculoskeletal health.

Watch the full video now and learn how to take a more proactive approach to bone health.

Understanding your bone health is a powerful first step towards taking action, reducing your risk and staying stronger for longer. If you’re interested in finding out more about REMS or would like to book a bone scan, visit OsteoScan UK at https://osteoscanuk.com.

 

Dr Nick Birch MB BS FRCS (Orth) is one of the UK’s most respected specialists in spine and bone health, recognised internationally for his contributions to musculoskeletal medicine, fracture prevention, and skeletal imaging innovation. With more than 35 years of clinical experience and a career spanning major NHS spinal units and private specialist centres, he has earned a reputation as a trusted, authoritative, and forward-thinking clinician.https://osteoscanuk.com

AI Summary:
Osteoporosis affects millions of people in the UK, but bone health is about much more than a single DEXA scan score. In this blog, Dr Nick Birch explains why we need to look at the whole picture, including bone density, bone structure, muscle strength, balance, nutrition, falls risk and daily movement. Walking is helpful, but stronger bones also need safe strength, resistance and balance exercises, especially after menopause. The blog also explores calcium, protein, vitamin D, REMS scans and why bone health matters for both women and men. Move it or Lose it encourages a proactive approach to staying stronger, steadier and more confident for longer.