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The Peter Attia Drive

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

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.77.3K Ratings

🗓️ 18 July 2022

⏱️ 17 minutes

🧾️ Download transcript

Summary

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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.

If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #37 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

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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Transcript

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0:00.0

Hey everyone, welcome to a sneak peek, ask me anything or AMA episode of the Drive Podcast.

0:16.5

I'm your host, Peter Atia.

0:18.3

At the end of this short episode, I'll explain how you can access the AMA episodes in full,

0:22.9

along with a ton of other membership benefits we've created.

0:25.9

Before you can learn more now by going to peteratia-md.com forward slash subscribe.

0:31.5

So without further delay, here's today's sneak peek of the Ask Me Anything episode.

0:36.5

Welcome to Ask Me Anything, AMA episode 37.

0:43.6

I'm once again joined by Nick Stenson.

0:46.6

In today's episode, we dive really deep into one subject, bone health.

0:51.6

This is a topic we get a lot of questions about, but we decided to save our AMA for a time

0:58.9

when we had accumulated enough questions that we could cover this comprehensively, which,

1:02.5

as you've gathered by now, is sort of how we like to do things because it allows us to go

1:05.5

much deeper.

1:07.0

So in this AMA, we're going to cover the following.

1:08.6

We look at why everyone should care about bone health, and whether it's why is this such

1:12.5

a priority, not just for yourselves, but also for your children.

1:16.2

We break down what bone mineral density is, how it's measured, and how much variability

1:21.4

exists between people, between sexes, and how it changes over the course of your life.

1:25.6

We also talk about what influences it, both early in life and later in life.

1:30.2

We look at differences between men and women when it comes to this health, and why menopause

1:33.9

has such a disproportionate effect on the bone mineral density of women.

1:37.6

We then get into ways that you can improve bone health, from exercise to nutrition, supplements,

...

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