Navigating bone health: early life influences and advanced strategies for improvement and injury prevention (#214 rebroadcast)

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Jul 7, 2025

Dive into the essentials of bone health, covering everything from its structure to the crucial role of nutrition and exercise. Discover the alarming statistics around falls and hip fractures in older adults and the differences between osteopenia and osteoporosis. Learn how medications and lifestyle choices, like smoking, impact bone density. Hear strategies for maintaining bone strength during periods of inactivity, including the significance of DEXA scans and early screenings. It's a deep exploration of how proactive measures can lead to healthier bones throughout life.

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INSIGHT

Hip Fractures' High Mortality Risk

Hip fractures in people over 65 carry very high mortality, often exceeding 25% within 6 months.
Fracture-related death rates dramatically increase with age, surpassing many major diseases after 75 years.

INSIGHT

Understanding Bone Density Scores

Bone mineral density varies naturally among individuals by age and sex, measured by T-score (vs young adult) and Z-score (vs age-matched).
Women near menopause with low Z-scores are especially at risk and warrant closer attention.

INSIGHT

Bone Density Lifespan Curve

Bone mineral density peaks in early 20s and then plateaus until around age 40–50.
Women experience rapid BMD loss post-menopause primarily due to estrogen reduction.

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In this episode from July 2022, Peter dives deep into the topic of bone health and explains why this is an important topic for everyone, from children to the elderly. He begins with an overview of bone mineral density, how it’s measured, how it changes over the course of life, and the variability between sexes largely due to changes in estrogen levels. From there he provides insights into ways that one can improve bone health, from exercise to nutrition supplements to drugs. Additionally, Peter discusses what happens when one may be forced to be sedentary (e.g., bedrest) and how you can work to minimize the damage during these periods.

While this original episode is an AMA, it is available in full to all listeners as a special rebroadcast.

We discuss:

Overview of bone health topics to be discussed [2:30];
Bones 101: bone function, structure, and more [6:15];
Bone mineral density (BMD), minerals in bone, role of osteoblasts and osteoclasts, and more [9:30];
The consequences of poor bone health [14:30];
The devastating nature of hip fractures: morbidity and mortality data [18:00];
Where fractures tend to occur in the body [23:45];
Defining osteopenia and osteoporosis [25:30];
Measuring BMD with DEXA and how to interpret scores [28:00];
Variability in BMD between sexes [35:15];
When should people have their first bone mineral density scan? [37:45];
How BMD changes throughout the life and how it differs between men and women [40:15];
How changes in estrogen levels (e.g., menopause) impact bone health [45:15];
Why HRT is not considered a standard of care for postmenopausal bone loss [49:00];
Factors determining who may be at higher risk of poor bone health [52:00];
Common drugs that can negatively impact BMD [55:45];
How children can optimize bone health and lay the foundation for the future [59:30];
Types of physical activity that can positively impact bone health [1:03:30];
How weight loss can negatively impact bone health and how exercise can counteract those effects [1:12:15];
Nutrition and supplements for bone health [1:16:00];
Pharmaceutical drugs prescribed for those with low BMD [1:18:45];
Impact of extreme sedentary periods (e.g., bedrest) and how to minimize their damage to bone [1:23:30]; and
More.

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