Why Do People Lose Bone Density and Strength As They Age?

Bone density refers to the amount of mineral matter, primarily calcium and phosphorus, present in bone tissue. It is a measure of the compactness and strength of bones, indicating their ability to withstand pressure and resist fractures. Bone density is a critical aspect of skeletal health, and changes in bone density can impact overall bone strength and resilience [1].

As we age, our bones undergo a natural process called "age-related bone loss" or "age-related bone resorption." This process involves a sequence of events that impact the structure and strength of our bones. While affecting both genders, it is notably more pronounced in women, particularly post-menopause.

• Reduced Bone Formation: The bone remodeling cycle, a standard process in our bodies, includes breaking down old bone tissue (resorption) and forming new bone tissue. Unfortunately, as we age, this cycle experiences a slowdown in the formation of new bone. In simpler terms, our bodies become less efficient at generating fresh bone to replace the older tissue that is being broken down.
• Increased Bone Resorption: Consequently, the breakdown of old bone tissue, known as bone resorption, becomes more noticeable with age. Specialized cells called osteoclasts are responsible for orchestrating this breakdown process. As the years pass, these osteoclasts become more active. Sometimes their activity surpasses the efforts of osteoblasts, the cells in charge of building new bone [2].

What are the causes of bone loss with age?

Bone density and strength tend to decrease as people age due to a combination of factors, including physiological changes and lifestyle choices. Here are some of the main reasons why this occurs:

• Hormonal Changes: Maintaining bone density relies significantly on hormones. Particularly vital for women's bone health is estrogen. During menopause, women undergo a substantial decline in estrogen levels, hastening bone loss. In aging men, hormonal shifts also occur, and diminished testosterone levels can contribute to bone loss [3].
• Inadequate Nutrition: Poor dietary decisions, marked by insufficient intake of calcium and vitamin D, can gradually undermine bone strength. Calcium stands as a crucial mineral for bone health, and vitamin D is vital for its absorption. Poor nutrition may result in weaker bones. Furthermore, the effectiveness of nutrient absorption in the gastrointestinal (GI) tract may diminish with age, which is influenced by reduced stomach acid production, alterations in digestive enzymes, and the presence of medications and medical conditions [4]. Because of this, it's important to look for a supplement that offers optimal nutrient absorption, such as  Healthycell's Bioactive Multi MicroGel supplement.
• Sedentary Lifestyle: Insufficient physical activity can lead to bone loss. Activities like walking, running, and resistance training, particularly those that bear weight, prompt bone formation and aid in preserving bone density. A sedentary lifestyle may lead to weakened bones [5].
• Genetics: Genetic elements also influence bone health. Some individuals might have a genetic predisposition to lower bone density, elevating the risk of conditions like osteoporosis and fractures as they age.
• Medications and Medical Conditions: Certain medications and health conditions can impact bone health. Prolonged use of corticosteroids, such as prednisone, may result in bone loss. Conditions like rheumatoid arthritis, celiac disease, and hyperparathyroidism can also affect bone density [6].
• Chronic Inflammation: Inflammation tends to increase with age. Conditions associated with chronic inflammation, such as rheumatoid arthritis, may lead to bone loss. Inflammation can trigger the production of substances that promote bone resorption [7].
• Natural Aging Process: The body's ability to repair and regenerate tissue, including bone, naturally diminishes with age. This age-related decline in regenerative capacity contributes to the gradual loss of bone density and strength [8].

What health conditions impact bone density?

Our bones are affected by health conditions. It's important to understand how these conditions impact bone density and strength. This section explores osteoporosis, a common bone ailment, and hormonal disorders that significantly influence bone health.

• Osteoporosis: Osteoporosis is a condition characterized by weakened and fragile bones, increasing the risk of fractures. It is prevalent, particularly among older adults. The bones lose density and mass, becoming porous and more susceptible to fractures. Risk factors for osteoporosis include age, gender (women are more prone, especially after menopause), family history, and certain medical conditions. Complications may arise, such as fractures, limited mobility, and a diminished quality of life.
• Hyperthyroidism and Hypothyroidism: Imbalances in thyroid hormones, whether excessive (hyperthyroidism) or insufficient (hypothyroidism), can impact bone health. In hyperthyroidism, excessive thyroid hormone accelerates bone turnover, leading to bone loss. On the other hand, hypothyroidism slows down bone turnover, also contributing to bone density reduction [9].
• Rheumatoid arthritis: Rheumatoid arthritis (RA) profoundly affects bone health through persistent inflammation in the joints. This chronic inflammation triggers bone erosion as immune responses mistakenly attack joint linings. The inflammatory chemicals produced stimulate osteoclasts, cells responsible for breaking down bone tissue, leading to joint deformities and impaired function. Reduced physical activity due to pain and joint stiffness, coupled with the impact of medications like corticosteroids, can contribute to decreased bone density. RA's complex interplay with bone health requires comprehensive management, emphasizing inflammation control, joint preservation, and monitoring for potential bone-related complications [10].
• Celiac Disease: Celiac disease significantly impacts bone health due to malabsorption issues related to gluten intolerance. The damage to the small intestine lining in celiac disease compromises the absorption of crucial nutrients, including calcium and vitamin D, essential for bone health. Moreover, chronic inflammation in celiac disease can contribute to bone density reduction. Inflammation disrupts the delicate balance between bone formation and resorption, favoring the latter. The restrictive nature of the gluten-free diet, the primary treatment for celiac disease, can also pose challenges in obtaining adequate nutrients for bone health [11].
• Other Endocrine Disorders Impacting Bone Health: Various endocrine disorders beyond thyroid issues can affect bone health. These disorders disrupt the delicate hormonal balance required for maintaining optimal bone density. Conditions such as Cushing's syndrome, characterized by prolonged exposure to high levels of cortisol, can result in bone loss over time. The intricate interplay of hormones is essential for the dynamic equilibrium of bone remodeling, and any disruptions can compromise bone strength.

What are the best tips to improve bone strength with age?

Maintaining and enhancing bone strength as you age is crucial for overall health and preventing fractures. Here are our experts top 10 tips to maintaining healthy and strong bones:

1. Eat a Well-Balanced Diet. Ensure you get an adequate amount of calcium in your diet, which is essential for strong bones. Good dietary sources of calcium include dairy products, leafy greens, fortified foods, and almonds. Consume enough vitamin D, as it is crucial for calcium absorption. You can get vitamin D from sunlight exposure, fortified foods, and supplements if necessary. Eat a variety of nutrient-rich foods: A well-rounded diet with plenty of fruits and vegetables can provide essential vitamins and minerals like vitamin K, magnesium, and potassium, which contribute to bone health. 
2. Include sources of protein. Protein is essential for bone health and overall muscle strength. Include lean sources of protein like poultry, fish, beans, and tofu in your diet.
3. Limit Salt, Caffeine and Alcohol Intake. Moderation is key to prevent calcium loss from bones due to excessive salt. Limit caffeine intake, as it may interfere with calcium absorption. Excessive alcohol can disrupt bone remodeling and reduce bone density by reducing the body's ability to absorb calcium and other nutrients important for bone strength. Excessive caffeine consumption may interfere with calcium absorption, so try not to overindulge in caffeinated beverages. High salt intake can lead to calcium loss from bones. Moderating your salt intake is beneficial for bone health [12].
4. Stay Physically Active. Engage in weight-bearing exercises like walking, jogging, hiking, and resistance training to stimulate bone formation and maintain bone density. Balance exercises can improve stability and reduce the risk of falls.
5. Avoid Smoking. Smoking can weaken bones and increase the risk of fractures by reducing blood flow to the bones. Quitting smoking can have a positive impact on bone health [13].
6. Monitor Medications and Medical Conditions. If you are taking medications that can negatively affect bone health, discuss potential alternatives or supplementation with your healthcare provider. Manage chronic medical conditions that may impact bone health, such as rheumatoid arthritis or hyperparathyroidism.
7. Regular Check-ups and Bone Density Testing: If you're over 50 or have a history of frail bones, consult healthcare providers for bone health assessments and interventions.
8. Consider Supplements. If you are unable to get enough calcium and vitamin D from your diet or sunlight, your healthcare provider may recommend supplements.
9. Reduce Stress. Manage stress through techniques like yoga and meditation, as high stress levels can impact bone health [14].
10. Stay Hydrated.  Proper hydration supports overall health, including bone health.

* It's important to note that individual needs and risks for bone health may vary. Consult with your healthcare provider, especially if you have specific concerns about your bone health, to determine the most appropriate strategies and interventions for your unique situation.

Maintaining optimal bone health is pivotal for overall well-being. Addressing bone density concerns proactively reduces the risk of fractures and debilitating conditions like osteoporosis. Our expert's tips offer actionable steps for you to enhance and sustain bone strength as you age. With awareness, lifestyle modifications, and the option of Healthycell's advanced supplements, you can take charge of your bone health.

About the Author

Amanda Herlocker MS, RDN, LDN is a Registered Dietitian with a Master's in Nutrition Science. As the founder of The Queen City Dietitian, LLC in Charlotte, NC, she brings a depth of knowledge to her writings. Amanda's expertise spans clinical nutrition, innovative recipe development, and evidence-based content creation for various platforms.

References

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