The Surprising Link Between Heart and Bone Health—Plus 5 Ways To Protect Both
Learn about the key test you should ask your doctor about today
Key Takeaways
- A new study shows that heart health can predict the risk of bone fractures in women.
- Simple changes like exercising and eating a Mediterranean diet benefit heart and bone health.
- Women should ask their doctor for a cardiovascular risk score at their next checkup.
We all want to keep our hearts and bones healthy, and new research suggests the two are more closely connected than we might think. And it turns out keeping your ticker healthy may help reduce the risk of future bone breaks in the process. Here, top doctors explain how heart and bone health are linked and share simple strategies to help protect both.
The link between heart health and bone health
A new study in The Lancet Regional Health – Americas found that postmenopausal women who have a higher risk of heart disease are also more likely to have serious bone fractures, especially hip fractures.
“There are many factors that overlap for both heart disease and osteoporosis,” says JoAnn E. Manson, MD, chief of the Division of Preventive Medicine at Brigham and Women’s Hospital (BWH), a professor at Harvard Medical School and coauthor of the paper.
Woman's World Answers
“So we wanted to see if a heart disease risk score could actually predict fractures in postmenopausal women. And it turns out, it did. The cardiovascular risk score was strongly predictive of which women would have a future fracture,” she explains.
This is significant because many doctors already calculate cardiovascular risk scores in their offices. “It suggests that the score could be used to inform women and their clinicians of the likelihood of osteoporosis and future fracture,” she adds.
Risk factors that affect your bones and heart
Dr. Manson shares a few shared risk factors between heart and bone health:
Early menopause
Early loss of estrogen—menopause before age 45 and particularly premature menopause before age 40—increases the chances of both osteoporosis and cardiovascular disease. “Estrogen plays such an important role in both heart and bone health,” she notes.
Smoking
“Smoking is a major contributor to heart disease and osteoporotic fracture,” says Dr. Manson. “It affects the metabolism of estrogen and actually decreases estrogen levels. It also has multiple adverse effects on the cardiovascular system, damaging blood vessels and similarly damaging the bones.” (Check out our best quit-smoking strategies.)
Sedentary lifestyle
A sedentary lifestyle contributes to heart disease, while regular aerobic exercise and strength training are important for both the heart and bones. “The mechanical stress of weight-bearing exercise builds bone,” Dr. Manson notes.
Diabetes
“Diabetes is a strong contributor to heart disease in women,” she explains. “It’s also linked to poor bone quality and an increased likelihood of fracture.”
Obesity and body composition
The relationship between weight and bone health is complex. “Although excess fat mass contributes to heart disease, the relationship with weight is more complex for bone. Really low body weight increases fracture likelihood—that’s probably related to estrogen being lower in leaner postmenopausal women—but excess fat mass is also a risk factor. And building muscle mass is important for bone health.”
“So there are some differences in terms of the association with body composition, but still the same general message: Maintain healthy weight, avoid underweight and overweight extremes. Weight in a healthy range and strong muscles benefit both bone health and heart health.”
Inflammation
Conditions associated with higher systemic inflammation, such as rheumatoid arthritis, psoriasis and lupus, can contribute to both heart disease and bone mass loss, she notes.
Heavy alcohol intake
Excessive alcohol intake contributes to multiple types of heart disease and is also damaging to bone health.
The takeaway? “What’s good for the heart is good for the bones,” says Dr. Manson. “You want to reduce your cardiovascular disease risk by having a healthy lifestyle and good control of risk factors like hypertension, diabetes and cholesterol.
“At your next checkup, ask your doctor to calculate your cardiovascular risk score. Let them know you’d like to understand your risk for both heart issues and bone fractures—this one simple assessment can give you valuable insights into both.” (You can also calculate your own PREVENT risk score at the American Heart Association website.)
5 ways to boost heart and bone health
Here, expert-backed strategies to strengthen both your heart and bones:
Don’t smoke and cut back on alcohol
If you enjoy a glass of wine, moderation is key for both heart and bone health, Dr. Manson advises. “For women, that means no more than one drink a day on average because we metabolize alcohol differently than men.”
Enjoy more walks
“Being regularly physically active—even brisk walking is a really good weight-bearing activity that’s been linked to lower likelihood of heart disease, as well as improving bone health,” says Dr. Manson.
She recommends getting at least two and a half hours a week (about 30 minutes per day on average) of moderate intensity exercise or 150 minutes a week of more vigorous exercise. “Adding strength training two to three times a week is recommended and has a benefit for the heart and bone health,” she adds.
Follow a heart-healthy diet
“I would say a Mediterranean-type diet—high in fruits and vegetables with a reasonable amount of protein, largely from fish, non-red meat sources and unsaturated fats,” Dr. Manson recommends. This eating pattern is low in processed foods and provides adequate vitamin D, calcium and other key nutrients.”
She adds that the DASH Diet, also high in fruits and vegetables, is another good option.
Sprinkle berries in your smoothie
Adding a cup of berries to a balanced diet is one of the easiest ways to support both heart and bone health, says integrative medicine specialist Taz Bhatia, MD, founder of holistic health hub hol+ with clinics in Atlanta, NYC and Los Angeles and author of four books including The Hormone Shift. “Berries deliver powerful antioxidants and fiber that support heart health and help your gut absorb bone-building nutrients optimally.”
Take magnesium before bed
A nightly dose of 200 to 400 mg of magnesium benefits both your heart and your bones, says Dr. Bhatia. Plus, it can help you sleep more soundly, and quality rest is essential for overall health.
The bottom line on boosting heart and bone health
While there’s no magic bullet for protecting your heart and bones, a comprehensive healthy lifestyle comes close. “I think we can add bone health, preventing fractures and preventing osteoporosis to that very expansive list of the benefits of a healthy lifestyle,” says Dr. Manson. The same simple steps that protect your heart—not smoking, staying active, eating well and managing conditions like diabetes and high blood pressure—also build stronger bones and reduce fracture risk as you age.
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