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Peak Bone Mass in Women

What is peak bone mass (PBM) and why is it important?


PBM is the highest level of bone density and strength that an individual achieves in their life. After reaching PBM, bone density gradually declines with age. As bone density declines, our bones get weaker and are more susceptible to fracture. Studies show that women reach their peak bone mass anywhere from 18-35 years old.  That means that women can start losing bone density as early as 18 years old!!!! 


If peak bone mass is the highest level of bone density and strength that an individual achieves, then we obviously want to strive for the highest possible bone mass by the time we reach our peak and should try to maintain optimal bone health to prevent conditions like osteoporosis and fractures later in life. 


Studies have shown that: “Failure to reach and maintain optimal peak bone mass during adulthood is a critical factor in determining fragility fracture risk later in life.”


Unfortunately for us women, maintaining optimal bone density can be challenging.   As noted above, we reach our peak relatively early on in life. Relatively quickly after that, as early as our 30s, our estrogen levels begin to decline in perimenopause, making our bones more susceptible to loss. Then during menopause, that decrease becomes even more significant! 


Check out this graph! 



This all sounds really depressing and scary, but here’s the good news. “Physical activity is a major factor in bone accrual and can significantly influence annual gains in bone density and mass during the period of bone mass growth” - which is fancy speak for exercise can INCREASE body density. This is great because physical activity is widely accessible, low cost, and highly modifiable! Exercise is especially effective during adolescence, a time period when nearly 50% of peak adult bone mass is gained. 


*Note to self: Encourage my future daughter to participate in physical activity as an adolescent! 


So how does physical activity actually promote bone growth?


Let’s break it down in a way that’s easy to understand…When we participate in a physical activity like walking, running, jumping, resistance training, etc. we are generating internal and external forces through our bones. This, in turn, causes micro trauma to our bone tissue. These little deformations cause bone cells to come to the rescue and initiate a biological response. They call over another team of bone cells that are responsible for the resorption of bone tissue and new bone tissue production. Now, our bones are a bit more dense!


Depending on the stage you’re at in life, experts suggest the following type of physical activity:


Pre pubescent, adolescent, and pre peak bone mass ages (0-30ys): Your goal is to maximize your peak bone mass! Bone-loading exercises are best. These can include high-impact activities such as jumping, aerobics, and running, alongside resistance training.


Middle age (30-60ys): We want to counteract bone loss and maintain the strong bone mass you currently have! Resistance training proves most effective in attenuating bone loss.


Older adults:  “In older adults (≥ 60 years), bone mass cannot be gained through physical activity, but bone loss can be prevented.”  Let’s focus on preserving your bone health and mobility in order to prevent osteoporosis or bone fractures. Walking is great, however according to the literature its impact on bone density remains modest. Cycling, yoga, and swimming can help prevent bone loss however resistance training is still your best option!


Studies suggest that a mere 10% increase in peak bone mass could slash the risk of osteoporotic fractures in older adults by half. This is huge!!! This is why investing in bone health during the formative years is CRITICAL for long-term well-being.


Let’s all work together towards healthy, strong bodies (and bones)!

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