For years, women around the menopause have been told to take calcium and vitamin D tablets to protect their bones. But researchers believe there could be another incentive – staying slim.

Women over 50 who regularly take calcium and vitamin D supplements are less likely to gain weight than those who do not, according to a study. Researchers found that those who were deficient in calcium and vitamin D got the greatest benefits. The finding comes from a seven-year study of more than 36,000 U.S. women aged 50 to 79 enrolled in the Women’s Health Initiative Study. Half the women took 1,000mg of calcium and 400 ius of vitamin D every day; the other half took placebo pills.

After the menopause, women tend to gain weight especially around the middle. The results of the study showed that calcium and vitamin D supplements slowed the weight gain — particularly among women who weren’t getting enough calcium to begin with. The important thing about this study is that by taking extra calcium and vitamin D you are not only protecting your bones but can easily prevent some of that weight gain after menopause.

Calcium seems to reduce fat absorption and increase leptin, the substance that curbs appetite. Older women are encouraged to take calcium supplements to prevent osteoporosis, so this research suggests there may be a double benefit. In addition, we’ve seen recent reports that vitamin D may play a part in preventing breast cancer and other disorders. Most good ‘bone’ supplements will contain both calcium and vitamin D so you do not have to take separate supplements of the two nutrients.

Because stress can make the symptoms of the menopause worse, it is important to learn how to relax. Below are a few relaxation exercises. But first, be sure that you have a quiet location that is free of distractions and a comfortable body position.

• Deep breathing: Imagine a spot just below your navel. Breathe into that spot, filling your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon. With every long, slow exhalation, you should feel more relaxed.
• Visualised breathing: Find a comfortable place where you can close your eyes, and combine slowed breathing with your imagination; picture relaxation entering your body as a cooling blue colour and tension leaving your body as an intense red colour. Breathe deeply, but in a natural rhythm. Visualise your breath coming into your nostrils, going into your lungs and expanding your chest and abdomen. Then, visualise your breath going out the same way. Continue breathing, but each time you inhale, imagine that you are breathing in more relaxation. Each time you exhale imagine that you are getting rid of a little more redness and tension.
• Progressive muscle relaxation: Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. (Stop any movements that cause pain!) Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly.
• Relax to music: Combine relaxation exercises with your favourite music in the background. Select the type of music that lifts your mood (not heavy metal!) or that you find soothing or calming. Some people find it easier to relax while listening to specially designed relaxation audio tapes, which provide music and relaxation instructions.
• Mental imagery relaxation: Mental imagery relaxation, or guided imagery, is a proven form of focused relaxation that helps create harmony between the mind and body. Guided imagery coaches you in creating calm, peaceful images in your mind — a “mental escape.” Identify your self-talk, that is, what you are saying to yourself about what is going on with you. It is important to identify negative self-talk and develop healthy, positive self-talk. By making affirmations, you can counteract negative thoughts and emotions. Here are some positive statements you can practice:
  • “I am healthy, vital and strong”
  • “There is nothing in the world I cannot handle”
  • “The menopause is the beginning of a wonderful new phase in my life”

Q: I am now 50 years old and my periods stopped in July of last year. I wondered how I would know if I had brittle bones, which I hear mentioned in the newspapers quite a lot nowadays. I smoke about 15 cigarettes a day and wondered whether this could have an effect on my bones and I know I am not exercising as much as I should.

A: Osteoporosis affects 1 in 2 women over the age of 50 in the UK. And osteoporosis isn’t just a matter of brittle bones. It can kill. In fact it is a bigger female killer than ovarian, cervical and uterine cancers combined.

But the biggest problem is that osteoporosis is so often a ‘silent disease’, bone loss happens gradually over time, without any symptoms. Osteoporosis, at the moment, remains woefully unrecognised and yet it is preventable and treatable.

There are a number of risk factors for osteoporosis and these include: family history of osteoporosis, yo-yo dieting or an eating disorder such as anorexia or bulimia, irregular menstrual cycles or long gaps between periods when younger, certain medications – steroids, heparin, anticonvulsants, diuretics, long-term laxatives or antacids, low level of physical activity and smoking. Smoking not only reduces bone density (by up to 25%) but also increases the risk of hip fractures so you need to think about stopping.

The gold standard for testing for osteoporosis is a DEXA scan but unfortunately is hard to get on the NHS nowadays. In the clinic in Tunbridge Wells I use an ultrasound machine which passes sound through the heel bone. Recent research has shown that ultrasound scans can predict those patients who subsequently go on to have a fracture as well as DEXA scans.

Another way of assessing bone health is to do a Bone Turnover test which measures biochemical markers in urine that show the rate of bone breakdown. Higher levels of these bone resorption markers, indicating higher bone turnover and higher bone loss, have been found to be associated with a two fold increased risk of osteoporotic fracture. This is an easy test to do and can be done by post.

Once you have found out the condition of your bones there is a lot you can do nutritionally and with your lifestyle to improve your bone density. I have discussed the natural approach to osteoporosis in my book ‘Osteoporosis — the Silent Epidemic’).

As well as getting your nutrition right it is also important to take a good ‘bone’ supplement. The first nutrient that comes to mind is calcium. But many other nutrients are equally crucial for healthy bones, and these include magnesium, vitamin C, vitamin D, zinc and boron.

Magnesium helps to metabolise calcium and vitamin C and converts vitamin D to the active form necessary to ensure that calcium is efficiently absorbed. Vitamin C is vitally important in the manufacture of collagen, which is a sort of ‘cement’ that holds the bone matrix together (use an alkaline form of vitamin C like magnesium ascorbate not ascorbic acid).

Boron is an important mineral in relation to osteoporosis as it plays a crucial part in the conversion of vitamin D into its active form, which, in turn, is necessary for calcium absorption, and zinc is needed for the proper formation of bone cells. There are many good ‘bone’ supplements, the one I use in the clinic is called OsteoPlus and also contains digestive enzymes.