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Osteoporosis - the facts

Osteoporosity literally means porous bones. Osteoporosis is often called the silent epidemic, silent because most people are unaware that they have this disease until they suffer a fracture. The telltale signs to the medical profession are when a fracture occurs after a relatively minor force.

Osteoporosis is quietly affecting 1 in 3 women and 1 in 12 men over 50.

Sadly as part of our ageing process, bone loss is expected.

Our bones are made up of a mixture of minerals the most important being calcium together with trace elements. There are two types of bone tissue, the hard compact outer layer and the spongey honeycomb-like structure that forms the inner mesh inside. A healthy bone framework can be compared to a new wicker chair where the fibres are sturdy, flexible and resilient. Whereas osteoporotic bone is like an old worn wicker chair with its fibres being brittle and full of holes.

The World Health Organisation has stated that osteoporosis is entirely preventable. So considering the preventable rather than the inevitable rings true with my favourite motto ‘prevention is better than cure’. Or at least, there is hope that with the correct exercises we may be able to improve bone density. It is fact that strength training twice a week dramatically cuts the risk of fractures for most menopausal women.

Risk Factors

As we approach our mid 40’s our bone density can change for a number of reasons the main reason being changes in hormones but there are also other factors to consider below:

  • Menopause especially early menopause (before 45).

  • Women who have undergone hysterectomy especially early (before 45)

  • Female athletes or dancers especially if they have experienced loss of menstruation

  • Women with a history of eating disorders

  • Women who have dieted throughout their life

  • Low calcium intake (dairy free) although recent research points to the fact that animal calcium is harder to absorb than calcium from plant sources such as chia and sesame seeds

  • Smoking

  • Heavy drinking

  • High caffeine.

  • Sedentary lifestyle

  • Genetics

  • Hereditary

  • Low body weight, low body mass

  • Small thin frame - wrists

  • For men, low testosterone

  • Prolonged use of steroid use often for arthritis or asthma

  • Use of other drugs, e.g. dilatin, phenobarbital, thyroid hormones

  • Metobolic and gastrointestinal disorders e.g. Crohn’s disease, celiac disease or ulcerative colitis

  • Depression

  • High protein diets (Atkins) - they cause the body to excrete calcium

  • Chemotherapy - some chemotherapy can affect bone density

Preventative measures

Diet & Nutrition

It is also important to consider how our diet can affect the health of our bones. Marilyn Glenville PHD is an expert in women health and states that the food we eat has a significant effect on our bones and choosing the right foods can help rebuild and maintain bone cells. She suggests eating foods rich in calcium particularly from plant sources and to moderate the amount of acidic food we eat such as meat, hard cheese and eggs, replacing it with alkaline rich foods. It is also worth noting that fizzy drinks pose a great risk to the health of our bones due to the high levels of phosphorus in our bloodstream causing calcium to be leached out of our bone reserve.

Low levels of magnesium can affect calcium in the bones. Soaking in magnesium bath salts, using a magnesium spray oil or eating magnesium rich food such as pumpkin seeds, almonds, Brazil nuts, cocoa rich dark chocolate (70-80%) and oatmeal or whole grains.

The first step in the prevention or treatment of osteoporosis is ensuring adequate nutrition, particularly maintaining an adequate intake of calcium and vitamin D. Vitamin D enhances intestinal absorption of calcium and phosphate. You can help build up your vitamin D levels by getting 15 to 20 minutes of sun exposure every day between May and September and in between, take a supplement.


  • Adequate daily intake of calcium - high calcium food chart - 1000mg 19-50 yrs | 1200mg women 50 yrs + and men 70 yrs +

  • Vitamin D - required for good calcium absorption and to maintain healthy bones. 10 to 15 minutes of sunshine without sunscreen several times a week will give you sufficient vitamin D exposure.

  • Eat a nutritious balanced diet of unprocessed foods that is low in acidity and reduce your salt intake - too much salt in your diet can cause high blood pressure and affect calcium absorption which weakens your bones.

  • Reduce alcohol intake - it is recommended that if you have any pre indications towards osteoporosis that you limit your alcohol to no more that 7 drinks a week - 1 drink = 120 mL of wine, 30 mL of liquor, or 260 mL of beer.

  • Limit caffeine to 1 - 2 servings a day.

  • Limit fizzy drinks

  • Stop smoking cigarettes.

  • Maintain a healthy body weight. Being over weight or underweight can cause physical stress and lead to bone loss.

  • Have check ups. If you are a post menopausal woman or a man over 50 who has recently broken a bone you should speak to your doctor or health practitioner about having a bone density scan.


Exercise is essential for building and maintaining bone density. Your weekly routine should include 3 sessions for a minimum of 40 minutes of weight bearing, resistance, posture and balance exercises to help prevent falls. Pilates widely uses resistance training and the good news is that mechanical force exerted by a simple contraction as it pulls on the bone of its origin leads to an increase in bone density.

An article in the journal of the American Medical Association showed that strength training twice a week dramatically cuts the risks of fractures of post menopausal women and after a year of strength training participants had gained bone in the hip and the spine.


"After having a scan on my spine in 2019, I was expecting my bone density to have deteriorated in the last 4 years. However, when I was rescanned a few weeks ago, the opposite had happened and my bone density had actually improved.

This has to be down to all the fantastic work you do in the classes. My Doctor is delighted and says 'just carry on with what you are doing!'

- Horsley Pilates client, 2023

Recommended Exercises for Osteoporosis

  • Use weights (wrist and ankles)

  • Resistance bands

  • Balance work

  • 4 point kneeling

  • Extension - dart, diamond press, prone leg and arm work

  • Bridges

  • Modified spine curl - Low spine curl

  • Side lying (modified).

  • Squats

  • Arm work

  • Brisk walking

Caution must be taken with flexion, lateral flexion and rotation and especially in combination and loaded.


This is also worth considering with our children - fizzy drinks have the same affect on their bones. It is also so important to encourage children and young adults to be active with weight bearing exercise to help build up their bone bank.

Common Fracture Sites

Areas most vulnerable to fractures are:

  • Wrist

  • Hip

  • Spine

  • Ribs


Osteopenia is known as the precursor to osteoporosis, but it doesn’t have to be. This should just be the warning sign to up your game as there is some but only a small loss of bone density. However, it is still a warning sign so you need to work hard at keeping that bone bank topped up. Currently there are no real contra-indications to exercise with osteopenia but be cautious with flexion, rotation and lateral flexion - remember ‘length is your strength!’.


With or with out osteoporosis or osteopenia, you are never too young to build up the reserves in your bone bank.

“Take care of your body is the only place you have to live”

- Jim Rohn

Recommended resources

The Royal Osteoporosis Society - Osteoprosis:The Silent Epidemic - Marilyn Glenville

Menopause With Out HRT - Marilyn Glenville

Natural Solutions to Menopause - Marilyn Glenville

Healthy Eating for the Menopause - Marilyn Glenville

Ageless Body Timeless Mind - Deepak Chopra

Marilyn Glenville has her own website with extensive information - for free!

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