#214 - AMA #37: Bone health—everything you need to know

The Peter Attia Drive

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In this “Ask Me Anything” (AMA) episode, Peter dives deep into the topic of bone health and explains why this is an important topic for everyone, from children to the elderly. He begins with an overview of bone mineral density, how it's measured, how it changes over the course of life, and the variability between sexes largely due to changes in estrogen levels. From there he provides insights into ways that one can improve bone health, from exercise to nutrition supplements to drugs. Additionally, Peter discusses what happens when one may be forced to be sedentary (e.g., bedrest) and how you can work to minimize the damage during these periods.

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We discuss:

• Overview of bone health topics to be discussed [1:45];
• Bones 101: bone function, structure, and more [5:15];
• Bone mineral density (BMD), minerals in bone, role of osteoblasts and osteoclasts, and more [8:30];
• The consequences of poor bone health [13:30];
• The devastating nature of hip fractures: morbidity and mortality data [17:00];
• Where fractures tend to occur in the body [23:00];
• Defining osteopenia and osteoporosis [24:30];
• Measuring BMD with DEXA and how to interpret scores [27:00];
• Variability in BMD between sexes [34:15];
• When should people have their first bone mineral density scan? [36:45];
• How BMD changes throughout the life and how it differs between men and women [39:00];
• How changes in estrogen levels (e.g., menopause) impact bone health [44:00];
• Why HRT is not considered a standard of care for postmenopausal bone loss [47:30];
• Factors determining who may be at higher risk of poor bone health [50:30];
• Common drugs that can negatively impact BMD [54:15];
• How children can optimize bone health and lay the foundation for the future [57:45];
• Types of physical activity that can positively impact bone health [1:02:30];
• How weight loss can negatively impact bone health and how exercise can counteract those effects [1:10:45];
• Nutrition and supplements for bone health [1:14:15];
• Pharmaceutical drugs prescribed for those with low BMD [1:17:15];
• Impact of extreme sedentary periods (e.g., bedrest) and how to minimize their damage to bone [1:22:00]; and
• More.

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