High peak bone mass is probably one of the single most important determinants of bone health.
Peak Bone Mass is the maximum amount of bone a person can acquire during their formative bone-building years. Think of it as your “bone bank” savings account. And here’s the kicker - women reach their peak bone mass in their early twenties and men reach it in their late twenties. Which means that there are no more deposits allowed into your “bone bank” savings account after that timeframe. Attaining one’s peak bone mass in this time period is a significant milestone because the greater the peak bone mass, the more protection one has against developing osteopenia and osteoporosis.
Okay, I know what you’re thinking right about now….
”Hmmm…I wonder if I was able to max out on my peak bone mass & how do I find out?”
“What does it take to reach peak bone mass?”
“What if I didn’t reach peak bone mass by my twenties?”
Lets look at the answer to these questions:
“I wonder if I was able to max out on my peak bone mass & how do I find out?”
The only test that can provide us with information about our bone density (not necessarily bone quality) is the DEXA scan. And unfortunately, most DEXA scans are not done early enough in life to provide us with that information. Current recommendations are to test women at age 65 and men at 70 years of age. This is too late to use the DEXA scan to determine whether you’ve achieved PBM.
Remember that it’s estimated that women lose up to 10% of the bone mass in the first 5 years of menopause due to normal hormonal changes. Think of those 5 years as representing the withdrawals on your bone bank. The more deposits made in your bone bank in your teens and 20s, the less of an impact that 5 year withdrawal will have on your overall bone density.
Keeping that in mind, if you ever had a T-score on your DEXA scan that was anywhere from +1 to -1, then you’re probably riding the wave of achieving excellent peak bone mass earlier in life.
“What does it take to reach peak bone mass?”
Research tells us that there are 3 key factors to building peak bone mass in our teens and 20’s:
Adequate amounts of calcium (1000 mg/day)
Enough quality protein (46 gm/day for women & 52 g/day for men)
Regular physical activity
Many lifestyle choices, pre-existing health issues and biopsychosocial factors can have an impact on our ability to achieve the required amounts of calcium, protein and exercise. These include:
Poor access to quality food
Digestive issues that negatively impact our ability to digest or absorb our food
Excessive restriction of calories such as those found with severe dieting or disordered eating
Safety issues affecting one’s ability to play outside or engage in sports
Casual approaches to vegan or vegetarian food plans that fail to meet the minimum requirements of key nutrients such as calcium or protein
Hormonal imbalances that interfere with regular menstrual cycles (think of the elite young female athlete)
Poor eating habits that focus on calorie-dense, nutrient-poor eating, especially inadequate calcium & protein intake
“What if I didn’t reach peak bone mass by my twenties?”
My first recommendation is to not panic!
For many of us, we have no idea if we achieved peak bone mass. We won’t know how much we have in our “bone bank”. What we can address though is how quickly we are making withdrawals on that account.
If you suspect that you may not have had the opportunity or the means to acquire peak bone mass then prioritizing your bone health is key. And that means investigating how to slow down any accelerated bone loss, i.e. minimize your withdrawals.
If you’re pretty sure that you hit the mark with peak bone mass, but your DEXA scan results don’t reflect that or your scores continue to move in the wrong direction, then identifying the ways you may be unknowingly sabotaging your bone health might be a priority.
In the spirit of “glass half full”, I encourage you to prioritize and safeguard your current bone health knowing that every small step in the right direction can create a ripple effect of benefits. Remember that being told you have osteopenia does not automatically mean that you’re on the fast track to osteoporosis nor that you are at greater risk of fracture.
Instead of coming from a place of fear, I encourage you to focus on identifying the root causes of accelerated bone loss now so you can take action to preserve what you have and be free to live a vital and active life.
Want to learn more? Join me at the next FOUNDATIONS OF BONE BUILDING WEBINAR or the BONE BUILDER MASTER CLASS (sign up for the Harbor Healthy Lifestyle Blog for updates). We’ll discuss what you can do to reduce your risk of fracture by identifying the root cause of excessive bone loss and build strong healthy bones for your lifetime…naturally!