Your bones are the foundation that keeps you active and vibrant as you age, so making sure they're strong is essential not only for living a life you love but also for staying healthy and resilient for years to come! After losing my mom at 76 from complications from vertebrae fractures, I committed myself to empowering women like you to maintain strong, healthy bones at every stage of life.
In this episode, I dive into the science and research on bone health and break down the top ways to help prevent osteoporosis. I also share tips on how to adjust your workouts to support bone density and reveal the surprising truth between your nutrition and bone health. Whether you're managing osteopenia, have a family history of osteoporosis, or simply want to age with strength and confidence, this episode is for you!
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In 2017 my mom sat up in bed and two vertebrae in her cervical spine broke. She never left the hospital after that and died just a few months later. And while that's certainly a bummer, way to start, don't worry, Today's episode will give you three insights so that you can get good bones, stay in your two story home and live happily ever after. So keep listening. Hello and welcome. I am so glad that you're here. If you are new, welcome. I'm Holly Perkins and I sit behind the coaching desk every day, observing what actually works for my clients who want to become more muscle and less fat and create a strong body to carry them through life. And today's episode will help you do just that, because your bones are the architecture to your body, and they are the support structure to keep you out of the rocking chair and in life. Now you may have heard me say that it's your muscles, not your bones, that hold you upright in space, and that's why the strength and relationship between muscle agonists and antagonists is important, and without strong bones, strong muscles don't do you much good. Now, in truth, we pretty much never see that. And I would argue it's probably nearly impossible to have truly strong muscles and brittle bones unless, of course, there is some other extenuating factor, and this is because your muscles are a powerful stimulus for bone cell activity. More on this in a moment. If osteoporosis runs in your family and you're worried about your health, you are in the right place today, and it is probably destiny that you are listening right now. I don't believe in coincidences. If the thought of ending up in a rocking chair or worse, a wheelchair terrifies you, it should. I think we all know a loved one who declined in their old age, and that is not for the faint of heart. If you've already been diagnosed with osteopenia, Today's episode will hit extra close to home. Brittle Bones lead to a fast decline, largely due to falls in older age. Maybe you heard the notion that the elderly person didn't fall down the stairs and break a hip. The hip broke because of brittle bones, and therefore the person fell down the stairs it is a fate I wish upon no one, least of all you, my dear listener.
Holly Perkins:
So in today's episode, you'll learn the truth about weight bearing exercise, basic bone cell physiology that is super important to understand, three tips for strength workouts that actually improve bone density, and 10 questions to determine if Your strength training is actually working for you as always, I've got some relevant research that is linked for you in the show notes. I believe we all have the ability to age well and to go out strong. Longevity is a buzz word these days, and so many people are interested in extending their life. But what's the point if those years aren't great? Honestly, I think I'd rather give up a few years. If the years that I get are good and active and I'm living my life fully. And I can tell you this, regardless of your age, your medical diagnoses and your family history, you have the power to change the course of your future and becoming as strong and as fit as you like. And as I reveal in a moment, the type of activity that you choose can have a profound effect on your bone health, for better or for worse. So my mom passed away way too young in 2017 she was only 76 years old, but she went out like a 90 year old. And really it was terribly tragic, but most of all, I believe it was largely unnecessary, as I mentioned at the top of the episode, one day, she sat up in bed, she had just woken up, and two vertebrae in her neck just broke. She was in excruciating pain, and called 911 at the time, she was living alone, and had to leave her two dogs behind at the house when she. Taken to the hospital. She never returned. And yes, it was absolutely heartbreaking. And while health is a bit mysterious, and I would argue, sometimes fleeting, it doesn't have to be that way. While I didn't plan for this at all, as I was preparing my notes for this episode, I realized that my mom passed away seven years ago this week, so I suppose it's even more poignant that I'm on a mission to help women live healthier better lives, because it doesn't have to be that way for you either. Do you want to live out your life in a slow decline until you can't do much but sit around all day or like me. Do you wanna be that granny who can run circles around family members? There were many choices along the way that caused my mom's poor health. And while it's certainly not as simple as this, I will say that the only exercise I remember my mom doing was walking in the 80s, when it was the rage. And even then, it was only for a few years, if that this was the time when weight bearing exercise became a household phrase, and walking was the preferred type of exercise because, oh gosh, jogging could cause injuries right? Walking was recommended by the doctors who knew enough at the time to even recommend that. And I wonder, would she have lived differently if exercise had played a bigger role in her life? I believe so.
Holly Perkins:
So today I'm sharing some high level concepts that you need to know if you're interested in getting good bones. Because one thing is for sure, weight bearing exercise might be the current recommendation, but it is not enough to prevent osteoporosis. In fact, this is related to what I would say is the most common misconception I hear from my clients, that they've been focusing on weight bearing activity, and yet, surprisingly, they just received an osteopenia diagnosis. It doesn't make any sense, right? Does it? Well, it actually does so in case this is an unfamiliar term for you, osteopenia is the clinical term used to describe a decrease in bone mineral density, BMD below normal reference values, yet not low enough to meet the diagnostic criteria to be considered osteoporotic. BMD, bone mineral density is diagnosed via a DEXA scan, d x A or D e x a, which is dual energy X ray absorptiometry. Basically, it's an x ray that looks at your bone. Osteopenia, as defined by the World Health Organization, is a t score between negative one and negative 2.5 which is a standard deviation, while values less than a negative 2.5 are diagnostic for osteoporosis. So it's a sliding scale. Osteopenia is like that warning signal that you need to pay attention decreasing BMD values are reflective of an underlying disruption in the micro architecture of bone, and therefore osteopenia and osteoporosis is considered quantitative, not qualitative disorder of bone mineralization. Osteopenia is the stage of warning where you need to sit up straight, listen in and get to work, because if you do nothing, it's going to get worse. Sadly, the first thing many doctors say is, here's a prescription, and sometimes they'll suggest getting more calcium, and maybe they'll then suggest weight bearing exercise. Now, if I were your doctor, I would actually flip that entire list upside down, and I would write you a prescription for a personal trainer so that you could go learn how to lift weights in a way that actually stimulates bone growth, because progressive resistance is quite possibly the most effective natural way to improve bone density and strength. I say natural because probably the only other faster route would be to take a medication, which there are problems with these medications, and a lot of people just don't want to take them, rightfully so. Did you notice that I did not suggest that you should do quote, unquote, weight bearing exercise. And while strength training is often weight bearing, like, say, doing a squat or a dead. Lift or a walking lunge, the recommendation for weight bearing exercise is usually, and I quote walking, dancing and stair climbing. And the truth is, walking and even jogging just is not enough to create a strong enough stimulus for bone cell activity,
Holly Perkins:
A quick physiology lesson for you. Remodeling is the term used in biology to indicate the process by which tissues are broken down and then rebuilt or restored into a new structure. The human body is incredible at regeneration, and it's constantly being renewed. It's the core reason why strength training is powerful. A good and effective strength workout should create beneficial stress and damage to your muscles, so that when you go home and eat and rest those muscles then heal and they regenerate and they become better. Bone remodeling is a continuous process that involves the constant action of two bone cells, osteoblasts and osteoclasts. Osteoblasts are bone cells that form new bone and lead to stronger, denser bone tissue. Osteoclasts do the opposite. They break down bone tissue that's damaged or old to make way for the osteoblasts to build new tissue. So these two cells work together in tandem. I remember, when I first learned about this in college, I was blown away to think that there are cells in your body that are actually breaking your body down, but that's so that you can rebuild, regenerate and be better. This is another beautiful example of homeostasis at play, one way that osteoblasts, the bone forming cells, are activated, is by mechanical stress, the pulling and tugging by your muscles, where they attach to your bones, that is what stimulates these bone cells. The stronger the mechanical tension, the more cell activity. Pretty cool, huh?
Holly Perkins:
Now we do know that part of the reduction in bone density observed in older people is due to disuse rather than the aging process itself, and it is for this reason that progressive resistance strength training is recommended because it is a powerful stimulus for bone growth. And this is where the idea of weight bearing activity came in originally, because when you stand or walk or bear your weight, your muscles have to create more mechanical tension than if you were just sitting. Makes sense, right? In fact, the journal osteoporosis international published a review that says, quote, walking is relatively ineffective for the prevention of post menopausal bone loss, and now, if you are not in your menopausal or post menopausal years, okay, tuck it in the back of your pocket, because, my friend, you will be there one day, and now is the time to build up as much bone density as you possibly can, so that you are fortified before you get into those years where estrogen shifts the landscape. Walking in general, weight bearing activity aren't enough, because the mechanical tension created by simply moving your own body weight around is insufficient to produce enough of a stimulus to actually really make a difference. Anything is better than nothing, but one key to positive and effective remodeling of bone tissue is that the new stimulus must be greater than the current stimulus. This is where the term progressive comes into play when we talk about resistance training, it must be progressive in order to stimulate the maximum amount of bone forming activity. So progressive, meaning it grows and expands. Think of it this way, if you were to walk, let's say, three or four times a week, even if it was briskly or aggressively, your muscles are pulling and tugging on your bones in order to cause the movement. The thing is, your muscles only have to generate enough force to move your current body weight day after day. That's the extent of the stimulus against your bones. It's not progressive. The only way to increase the force and tension on the bones would be to gain weight if. And even there, it would be incremental, and it would be over time, and therefore you would see a negligible change. It's just not enough to truly stimulate bone cells to a statistically significant degree. Now let's compare that to truly progressive resistance training three or four times a week where you expose your body, your muscles and your bones to increasing tension and force by lifting weight loads above and beyond your body weight. So let's say a person weighs 150 pounds a body weight squat would mean 150 pounds of resistance right now. It isn't exactly calculated this way, but it's it's a great example to highlight this. Can you see how a greater stimulus to the muscles and bones will occur if that same person adds 20 or 30 or 100 pounds of load to their squat. All of a sudden, it's not a body weight squat at 150 pounds.
Holly Perkins:
It's a body weight squat with whatever you're loading on top of that, if you've been around here for a while, you know that I want every woman to gradually work up to at least a 95 pound barbell squat. That is right. If you weigh 150 pounds, this would be loading your body 63% above and beyond your own weight bearing body weight, and that creates significant tension on the bones, and therefore will stimulate the bone forming cells way more effectively. The first thing to know today is that one weight bearing exercise is certainly better than nothing. If you've been sitting in a chair for six years, standing up at your kitchen table is a great place to start, and then going for a walk is a great next start. But if you're already reasonably healthy, if you're somewhat active, general weight bearing exercise isn't enough. Two using weight loads above and beyond your body weight is way more effective, and some organizations say it's really the only way to stimulate bone forming cells in a meaningful way. If you really want to create strong, dense bones, you've got to go above and beyond, using your own body weight so that your bones and muscle tissue are forced to remodel better than their current state. Next, I want you to be aware of another mistake many women make when it comes to their strength training practices, because lifting weights is nuanced, and you need to know the intensity and volume needed to actually make a difference. If you're ready to use strength training to improve your bone density. Keep listening, but first,
Holly Perkins:
Okay, so I've already alluded to my next point, but I want to drive it home here you might be listening now and thinking to yourself, Okay, Holly, I don't need to worry about this, because I lift weights three times a week. This isn't relevant to me, and just like weight bearing exercise, lifting weights is better than nothing, but unless you're really going after it, it is not good enough to make a measurable change in your bone density. So here are 10 questions to determine if your version of strength training is actually effective for getting good bones. Number one, do you lift weights? Yes or no. Number two, do you lift weights every week? Yes or no. Do you include both simple and compound exercises? And if you don't know the answer is no, do you use a strength training program created by a professional? Number five, do you push yourself to choose heavier weight loads every one to two weeks? Number six, do you actually see an increase in your weight loads each month. Number seven, do you find yourself saying there is no way I could have used a heavier weight on that last exercise? Yes or no. Number eight, do you complete at least 12 work sets every workout, yes or no. Number nine, do you leave your workout feeling wobbly and fatigued, and number 10 in the two days following your workout, do you feel some indication that you worked your muscles in a meaningful way? Now this doesn't mean that you have. To feel sore, but soreness is an indication you should at least feel it in the days following a workout. If you answered no to more than three questions, your version of strength training probably isn't sufficient to really maximize bone forming activity so as to actually impact your bone density. Now, don't worry, we can make it better. And this is a huge mistake that I'm seeing with the clients who join my coaching programs. Many women are either one not strength training with a real intention, they're lifting weights couple times a week. Sure, they're lifting weights, but they're not really going in with determination and grit or two. They do have the commitment and the intention and even the consistency, but they aren't really going for it and going after it in their workouts in order to build muscle and therefore bone, you have to be fighting tooth and nail during your workouts, especially if you're over 40 to 45 if it doesn't feel like war, there is a good chance that you are not maximizing the benefits. And now if this is you, don't worry. I've got tips for you, of course, and simply by asking these questions, you will have already gleaned some insights into what's actually needed to get good bones.
Holly Perkins:
But here are three tips to ensure that your strength training workouts are challenging enough to improve bone density. Number one every week, look for the exercises that are not challenging and force yourself to add some weight to those moves. Okay, hey, quick little interruption here. I've got some really, really fun news. My husband and I relocated to the East Coast, after living in California for a long time, and we have the great, amazing luxury to be building our dream home here on our dream piece of property. It's like the most exciting thing ever. A little insight into my life, and construction has officially begun, and my office is right, not too far from our home site. So going forward, for the next six months, you're going to be hearing some construction noises in the back of my episodes. I might as well go ahead and warn you, so we get that out of the way, because today it begins. You can hear the construction truck backing up. Okay, back on track here to repeat every week. You're going to look for the exercises that are not challenging, and you're going to force yourself to add some weight to those moves. You have to make the choice, this could be as little as three or five pounds to those exercises, which exercises feel good, or which exercises do you like the most? Those are the ones that you're going to increase your weight load on, and it might only be one or two exercises each week. You don't have to increase your weight loads every single workout, for every single exercise. In fact, I would argue that's probably impossible for most people. In reality and in practice, what happens is, each week, you'll increase your weight load on a couple of exercises, or maybe one exercise per workout. And it doesn't have to be much, but you have to actually be using real, heavier loads progressively in time. So the second of these three tips if you complete the final set of an exercise, let's say you're doing three sets of leg press and you get through your final set if you are not cursing under your breath or unsure if you'll survive. You're not using a challenging enough weight. Now, yes, I'm partially kidding here. It doesn't have to be that intense, but the last few reps of the final set of an exercise really should be impossible to hold good technique. And you should say, I really do not want to do any more reps, any more sets. I am officially working hard. And number three, if you're doing more than 10 reps for any of your working sets, you're probably not using a challenging enough weight load. Now, there are nuances here too, because it's not really that simple. And in my experience coaching women for over 30 years now and focusing largely now on clients who are over 40, my clients tend to be still learning some of the best. Practices in the gym about building muscle and getting strong. And so in this case, this holds true. Yes, you can build muscle and bone using higher rep ranges, but it starts to introduce systemic fatigue that you have to fight through as soon as your reps are above, really, above 1210. To 12 is the sweet spot, but more and more in the latter years, I'm really leaning on that 10 rep place, maybe even fewer, when your fitness is up to par, and most of the women I coach already struggle with fatigue and stamina. So if you're using rep ranges of above 1215, 2025, or even going for two or three minutes per exercise, it's just more productive and more doable to focus on multiple sets of 10 reps or less, so that you're not fighting systemic fatigue.
Holly Perkins:
One last thing that I'll mention here is that you can take it a step further by adding an impact exercise practice to your week. This means that you're very strategically adding jumping, leaping and bounding impact exercises to create an even stronger stress on the bone. This could be, let's say, jumping jacks or jump rope, or it could be something like burpees, even though I don't love them. It could be skipping. It could be running. And I love impact exercise practice and I teach it, but listen up. It comes with a warning, a big, bright yellow warning, because the rate of injury is very high, small doses go very far. Please don't randomly just begin an impact exercise program because you saw an influencer or someone on social media telling you to start doing impact exercise. There is a very prominent, very respectable, loud voice in this space and social media right now who is telling women in their 40s, 50s and 60s to do impact exercise you cannot just pick up on a Tuesday and start bounding around. Rate of injury is so high. Please do not do that. This is something that warrants its very own episode. So if you're interested in hearing more about an impact exercise practice, please let me know. But for now, I just want to kind of plant that seed so that we can circle back around to it, because, yes, impact bounding and leaping is fabulous for your bones, but you really need to be following a prescription so that you do it effectively without injury.
Holly Perkins:
Moving on, I would be remiss if I didn't mention nutrition in this episode. Of course, that being said, I fully believe that your strength training practices are far, far more effective for getting good bones, to the point where I almost side eye nutritional efforts to create good bones, I'll explain if you've got a solid strength training practice and you eat well generally, well, you're going to be just fine. I don't like to use myself as an example too frequently, but from time to time, I think it's relevant. I've mentioned on other podcast episodes here that I had my DEXA scan for bone density earlier this year, and my bone mineral density is like off the charts. It's insane. It's incredible. And I can tell you, I've never supplemented with calcium, other than maybe a year or two in my 20s. I have always done impact exercise, like running. I don't do a lot of leaping and bounding and jumping because it's very problematic, but I was a runner for many, many years, but I can tell you, I believe it's good general nutrition and it's a lifetime of commitment to muscle and strength training. It is powerful, and I realize that I am probably gifted genetically, although my mom doesn't necessarily prove that right, and so I can't use myself as the rule. I really am the exception, but I do find myself to be more similar to my clients than dissimilar. So that's another one to just kind of ponder for yourself, I will always argue that eating calcium, rich foods can't make up for insufficient muscle, building activity. I'll say it again, supplementing with calcium, eating calcium fortified foods, or even eating natural calcium. Calcium, rich foods will not make up for your muscle building practices, according to this episode, in fact, I've got the client case studies to prove it. Over the years, I have counseled women who had been getting their calcium each day, either through supplementation or foods, but not getting enough strength training. And those are the women who often come to me because of an osteopenia diagnosis, calcium intake will never make up for the absence of progressive resistance strength training. And yes, calcium is important. It's the most predominant mineral in bone, but so is vitamin D and magnesium. The mistake I see here is women eating yogurt and milk for its calcium content and thinking that that will protect them. So I want you to think on this for a moment. I'm not suggesting that you quit eating dairy products if you love them or if you feel strongly about them, okay, but I want you to ponder this. I'm also not commenting on naturally calcium rich foods like leafy greens and fish, but something to think about nearly all commercial produced dairy in the United States anyway, is very low in naturally occurring calcium, because where does the calcium come from? The grass that the cows are supposed to be eating. But in commercially produced dairy, we don't see that so much unless you've got a cow on your property that's truly free range and grass finished. The calcium in the dairy that you're buying is simply a supplement that's added by the manufacturers after they've pasteurized and homogenized the milk. Did you ever think about that? It's fortified, even now, our almond milk is fortified. Our oat milk is fortified. Our juices are fortified, our cereals are fortified. So you could just be supplementing with your own calcium of choice, instead of leading it up to the lower quality supplement being added to your food sources. Have you ever thought about that you're putting the calcium supplement decision into the food manufacturers now, I don't want to go out on a limb too much here talking about food manufacturers, because I know I'm going to get a lot of kickback, and that's not really what I'm interested in. I just want you to kind of think about it and say, Hmm, is this really serving me, if you like dairy, which, by the way, I am obsessed and I love dairy, but after a lot of health issues and a lot of lab tests over a lot of years and a lot of doctors, I've learned dairy is no bueno for me. It is not good for me, and so I really can't eat it. I try over and over and over. I love cottage cheese, I love high protein Greek yogurt. I love the dairies. I'm a huge fan of it, right? And it certainly does not help my health. If you're eating it simply because your doctor said to eat it for the calcium you've got other options, and I would argue those other options are better.
Holly Perkins:
So foods with high naturally occurring calcium are collard greens at 268, milligrams per standard serving, which is one cup cooked spinach, same serving size, 245 milligrams, cooked bok choy, my favorite at 185 milligrams per one cup cooked kale. 177 milligrams, same serving size, three ounces of canned sardines. 325 milligrams. That's like way high. And now listen, I know people kind of get the ick factor with sardines, but if you put it with a really delicious cracker, or maybe some pickled onions, delish, one and a half ounces of chia seeds, 300 milligrams of calcium, powerful, right? And interestingly, when you search for the tables and charts on the interwebs of the highest calcium foods, you'll notice that the food items they put on those lists are nearly all four to five. I got really excited because I saw tofu was like, super high in calcium, until I realized it too is fortified. In general, good nutrition is important, and I would argue, focus on that, get more vegetables. Focus on that. Make sure that you're getting the right amount of protein paired with sufficient carbohydrates to balance blood sugar that is so important for bone health. Yes, be sure to just eat well with general knowledge, and yes, up the amount of dark leafy greens that you're eating, because you will never get enough, and that is one of the best sources for calcium. And, oh, by the way, it's where the cows originally got their calcium. Anyway, leafy greens are one of the best foods to eat and get it in as many times a day as possible, bare minimum, once a day. In my opinion, I am always stressing this to my clients. They are probably sick of me saying you need more green vegetables. Now. Listen, I could continue on and on and on here about various dietary considerations for improving your bone health, but I'm going to save that for my upcoming book, muscle and bone. That is right. My point here, for the tip today, is to know that dairy is not your only source for calcium, and by the way, it's fortified anyway, personally, I find that commercial dairy products are often problematic for women over 45 because it has a tendency to be inflammatory to the gut lining and women over 45 as their estrogen is declining, inflammation is naturally on the rise, and when you pair certain inflammatory foods to it, that's where we start to see this kind of Sucker Punch Out of nowhere issues like allergies or skin irritation or digestive issues. In my private practice, I find that my clients symptoms improve when we remove or minimize dairy I find this particularly true if you're an A or an O blood type, the symptoms I see related to dairy intake are digestive issues like gas, bloating, constipation. This was a huge one for me. I spent most of my life constipated, until I figured this out and looked at my lab work and I quit eating dairy. Everything changed next. Skin issues, allergies, anxiety and depression mood issues, because those are symptomatic of an inflammatory response, largely coming from the gut. I also really don't love the use of whey in casein protein powders. I know there are a lot of respectable colleagues and voices out there that are proponents of it. I get it. I am not. Lately I have been leaning almost exclusively towards recommending grass fed beef protein isolate powder to supplement with protein if you need it. I'm not pushing that, but it can be hard to get sufficient protein each day, and supplement powders are a great way to do that, and there you have it, some high level ideas to help you get good bones.
Holly Perkins:
Hey, if you like what you're learning from me, why don't you add your name to my email list so that we can be in touch more closely. My weekly emails are focused on providing real tips and resources to help you create the body that you need to keep up with this crazy life that we love. And I want to know who are my most passionate community members who want to hear about my latest updates, and in particular my upcoming book muscle and bone when that releases in the far future, 2026 hopefully sooner. So you can join me for a regional book release event that will happen near you when the time comes. So if you would please come on over to my website, Holly perkins.com and click the Start Here button at the top of the page, add your name to my email list. Listen if you feel a bit overwhelmed by all of the messages that you hear each day about ways to improve your health, just know that any step forward today is a good one. Just pick one, even if it's just drinking more water, you can become even healthier, stronger and more fit than you already are today, and you don't even need me to do it, but if you want my help, just let me know my next group coaching program opens up in March of 2025 and it is the place to be if You are ready to start making some real and permanent changes in your health, energy and quality of life again, come on over to hollypurkins.com add your name to my email list, and then stay tuned for the next round of the body composition project coming in March of 2025 and please stay tuned for another brand new episode on Tuesday of next week. Stay strong, my friend.