It's an often-forgotten fact that in order to be strong on the outside, we need a healthy, solid frame on the inside. Many gym-goers spend a lot of time focusing on their aesthetics without paying attention to the all-important foundation, but it's important to realize that big and beautiful muscles need the support of strong, healthy bones. Skeletal density is important for mobility, protection from injury and mineral storage, but as we age our bones often require more attention, leading many to wonder if it's still okay to lift weights, as we speed through our 40s.
Maturity also comes with an increased risk of a lack of bone density, leading to more fragile or fragile bones (osteoporosis). Linda A. Russell, MD, a New York City-based expert in rheumatology, perioperative medicine and metabolic bone, explains how we can keep our bones strong and if it's still okay to lift weights as we age.
What happens to our bones as we get older?
"There are two main types of bone cells," says Russell. "The osteoclast and the osteoblast. From the day we are born until around the age of 25 to 30, we build more bone than we lose. Bone strength keeps getting better. And then, unfortunately, somewhere between 25 and 30, we all hit our maximum bone density, and that's the strongest our bones will ever have. Then, as we begin the normal aging process, we lose more bone than we build, and slowly bone density begins to decrease.”
Can men simply be given testosterone replacement therapy to reverse this process?
"Men don't go through menopause," says Russell. “But they have a slow decline in their testosterone levels. We do not want to give TRT to older men as it increases the risk of prostate cancer. I saw a young gentleman in his 30's who had low testosterone and osteoporosis. We would probably supplement it (with testosterone), but we don't generally do that with older men.”
Is weight lifting a good way to naturally maintain healthy bones even as we age?
"You know, it really depends on the person and how much time they devote to fitness," says Dr. Russell. “The interesting thing is that weight training is wonderful for the bones. So if you engage in a regular weight training program, your bone health will absolutely be better. And we know, for example, that when astronauts go into space, they lose a lot of bones because there is no gravity. If you take someone who is
sick and you put them in a hospital bed, within about two weeks they start losing bones. The more activities you can do against gravity, the better your bone health will be.”
How important is the relationship between muscle mass and strong, healthy bones?
“Muscle is connected to bone. Muscle pulls on bone. The stronger the muscle, the greater the pull on the bone and the better for the bone,” says Russell. "So if you've got someone who's really toned, they've got a nice cardio routine and a nice weight-building routine, that's going to be an advantage. If you take a 40-year-old who is a couch potato and has some obesity (fat) in the middle, he's not going to be as healthy as someone who goes to the gym five days a week. Strong muscles help bones, age matters, but for me as a rheumatologist and with people of all ages, fitness speaks more than age.”
Russell points out that a good exercise regimen becomes even more important as we hit our 40s, since muscle mass is already starting to decrease naturally. "You lose about a third of a pound of muscle a year," she says. "You can work hard so that doesn't happen. You can work out and do your strength training, but if you're just a guy who doesn't really work out, you're going to start losing muscle, and when you look at an MRI of that muscle, there's more fat interspersed with the muscle. For someone who is very fit, there is very little fat in the muscle on the MRI.”
What should men avoid to maintain healthy bones?
"One risk factor for osteoporosis is having more than three alcoholic beverages per day," says Russell. “There are probably many people who drink at least that much alcohol a day. It's not ideal for bones."
Additionally, Russell adds that it's important to get checked out by a doctor, as bone problems can often be caused by other medical issues. "Rheumatoid arthritis is associated with bone loss," she says. “Many liver diseases are also associated with bone loss. If you have rheumatoid arthritis and are treated with medication, you reduce the likelihood of bone loss. But some drugs have been linked to bone loss, like prednisone or drugs used to treat prostate cancer, because they try to lower testosterone levels. Tobacco is also very bad for bone health. Tobacco is directly toxic to the osteoblast, the bone-forming cell.”
So it's good to keep exercising in my 40s and beyond?
At any age, it's a good idea to study proper lifting form and not try to lift a force that is too heavy for you to prevent injury, bone and joint problems. And in terms of minerals, Dr. Russell points out that vitamin D and calcium are and can be essential for bone health
are often ingested through a regular diet, so make sure you include the right nutrition in your exercise résumé. But when it comes to lifting weights, there's still a lot of life in those old bones!