So I had my third DEXA scan recently. My first one was in 2008, second in 2012, and now this one last December. Each one has shown my osteopenia worsening.
I went through menopause in 2007, took bio-identical hormones for several years to mitigate my crazy-bad hot flashes and night sweats, chronic “on edginess,” and constant brain fog (you know, walking into a room and not remembering why you came in).
Back then, there wasn’t a ton of information about the consequences of women’s sex hormones flatlining after menopause. We didn’t know the full extent of the roles of estrogen and progesterone. How estrogen supports insulin sensitivity, muscle protein synthesis (building lean muscle mass), bone density, heart health, cholesterol levels, mood stability, cortisol regulation, brain clarity, and the list goes on and on. WOW.
Had I known back then how important this information would be for my ongoing health, I would have done a few things differently.
Now we know that there is a LOT we can do compensate for the loss of our hormones and mitigate the dangers. The big ones being heart disease (women out pace men for heart attacks the older we get), diabetes (insulin resistance increases without estrogen), osteoporosis (without estrogen, we lose more bone than we build), loss of muscle mass (without estrogen, we have a much harder time building muscle) and fat gain (due to the increased cortisol and insulin resistance, we end up storing more fat).
I’ve lifted weights, run, hiked and backpacked (all those high-impact activities) pretty consistently for the last 40 years, so getting these bone-density scans that show I’m continuing to lose bone density have been disappointing and frustrating. I know that women tend to lose more bone density during the first few years after menopause, but given that my December scan showed even more bone loss, 15 years post menopause, has me baffled and a bit worried. As an outdoor endurance athlete, I don’t want to be nervous that falling cross-country skiing or mountain biking will lead to a serious, possibly life-changing fracture.
While our biochemistry is complicated, what I have learned is this. It’s imperative that I continue my weight-bearing activities, but if I’m not getting enough calcium from my diet to support my body’s needs, my body will take it from my bones. Calcium plays a huge role in many of the body’s functions, including supporting athletic performance. With 99% of calcium stored in our bones, when the body needs more, it will take it from our bones.
Dairy happens to be one of the best ways to get dietary calcium. Unfortunately, I am sensitive to ALL dairy, even sheep and goat. It’s the casein protein in dairy that causes me congestion, making me cough and feeling like there’s a small man standing on my chest. I stopped all dairy back in 2012 when I tested sensitive to dairy. It ended my symptoms, but it never occurred to me that eliminating dairy would have a negative impact on my bone density.
After my last DEXA scan, my doctor recommended adding a calcium supplement to my mostly plant-based diet. I read several years ago that calcium supplements don’t always help and can cause other issues, so I’ve never taken them. After my doc’s recommendation, I did a little more research, and I discovered that calcium supplements increase the chance of a heart attack, stroke and early death! WOW. Not going down that road!
So, now what? I started researching the best non-dairy foods to make sure I’m getting my 1,200mg of dietary calcium every day (the recommended amount for women past 50), spreading it out during the day (the body can’t absorb any more than 500mg at one time). It’s not easy, but if I get 300mg of calcium at every meal plus 300mg in my recovery food, I could do it!
I discovered there are several plant-foods that have good levels of calcium. (other than dairy, animal foods do not contain much calcium, if any). Here are the ones I now make sure that I include in my diet. There’s a TON of information available on the calcium content of various foods, and I’ve found a LOT of variation in the data (even on the Nutrition Data on food packages). I offer the information below a guideline and not gospel.
| Food | Amount | Calcium (mg) |
| Almonds | 1/4 cup | 96 |
| Almond butter | 1 Tbsp | 55 |
| Amaranth | 1 cup, cooked | 115 |
| Black beans (and most beans) | 1 cup, cooked | 100 |
| Black strap molasses | 1 Tbsp | 180 |
| Brazil nuts | 1/4 cup | 60 |
| Broccoli or Brussels sprouts | 1 cup,cooked | 80 |
| Collard greens | 1 cup, cooked | 300 |
| Figs | 1 cup, dried | 240 |
| Kale, any variety | 1cup, chopped | 90 |
| Kale, any variety | 1 cup, cooked | 120 |
| Orange | 1 medium | 65 |
| Poppy seeds | 1 Tbsp | 125 |
| Sesame seeds | 2 Tbsp | 90 |
| Tahini | 2 Tbsp | 150 |
| Tempeh | 3 oz, 1/3 cake | 100 |
| Tofu | 1/2 cup, 4 oz | 100 |
So the bottom line is this…
To maintain my bone density, not only do I have to stress my bones (through weight training, running, hiking), I have to make sure that I’m getting enough calcium (and Vitamin D!) to provide my body the right tools to keep my bones strong.
If you’d like to know how I’ve incorporated these foods into my diet, send me an email. I’m happy to share with you some of my recipes or help you create a meal plan that will increase your daily calcium intake.
If you’re interested in diving deeper into menopause health, check out Dr. Stacy Sims’ website. Her ongoing research on menopausal athletes can give you more detailed information on how to stay healthy and fit as we age. I’ve been studying with her for the past three years, and I’ve learned a TON of great information!
Stay tuned as I’ll share more of what I’ve learned about menopause, pre-diabetes and upward-creeping cholesterol, some of the other challenges we face when our hormones flatline.