Women With Lower Scores On This Health Test Had A 47% Higher Mortality Risk
When we think about bone health, fractures usually come to mind first. But new research suggests your your bone density may reflect broader patterns in healthy aging.
This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) and found that lower bone mineral density at the hip is linked to a higher risk of death from any cause in postmenopausal women. The researchers also found that hip bone density appeared to be a better predictor of mortality risk than BMI in this population. Here's what you need to know, and what you can do to protect your bones.
About the study
Bone density has long been used1 to assess fracture risk, but researchers are increasingly interested in whether it might signal something broader about overall health status. This study set out to examine the relationship between femoral (hip) bone mineral density and all-cause mortality in postmenopausal women.
Using NHANES data, researchers analyzed bone density measurements alongside mortality outcomes, controlling for factors like age, lifestyle, and existing health conditions of nearly 3,000 postmenopausal women. The goal was to determine whether bone density could serve as a meaningful marker of longevity risk independent of its role in fracture prevention.
Lower bone density linked to 47% higher mortality risk
Results showed that women with osteoporosis had approximately 47% higher mortality risk compared to those with normal bone density. The association held even after accounting for other health factors, and bone mineral density at the hip emerged as a stronger predictor of mortality than BMI.
It's important to note this is an observational study, meaning it shows a correlation, not that low bone density directly causes earlier death. But researchers believe bone density may serve as a signal of overall health status, reflecting factors like frailty, muscle loss, and cardiometabolic risk that collectively influence longevity.
Why bone density may reflect more than skeletal health
Your bones are connected to your muscles, metabolism, and overall physical function, which is why declining bone density often travels alongside other age-related changes.
Bone and muscle health are closely linked. Both respond to mechanical loading (like resistance training), both decline with inactivity, and both are influenced by hormones, nutrition, and inflammation. When bone density drops, it often coincides with age-related muscle loss, reduced mobility, and increased frailty.
These interconnected declines create a cascade effect. Less muscle means less mechanical stimulus for bones. Reduced bone and muscle mass can limit mobility, which leads to further inactivity. And this cluster of changes is associated with higher cardiometabolic risk and reduced resilience overall.
The menopause connection
Estrogen plays a protective role in bone health, which is why the postmenopausal years represent a critical window. When estrogen levels decline during menopause, bone resorption (breakdown) accelerates while bone formation slows, leading to net bone loss.
The years following menopause represent a period of accelerated bone loss, making this a critical window for intervention. The lifestyle factors that support bone health (strength training, adequate protein, weight-bearing movement) also support muscle mass, metabolic health, and overall vitality.
Addressing bone health proactively during perimenopause and menopause isn't just about preventing fractures. It's about supporting the interconnected systems that determine how well you age.
Building bone strength for the long haul
The strategies that support bone density also support muscle mass, metabolic health, and long-term vitality:
- Prioritize strength training:Resistance training is one of the most effective ways to support both bone density and muscle mass. Aim for at least two sessions per week that challenge your major muscle groups.
- Include weight-bearing movement: Walking, hiking, climbing stairs, and impact-based exercise (if appropriate for you) all provide mechanical loading that stimulates bone remodeling.
- Ensure adequate protein intake: Protein supports both bone and muscle maintenance. Aim to get at least 100 grams of protein a day (if not more). Here are some tips for how to do so.
- Support with key bone nutrients: Calcium, vitamin D, and magnesium all play roles in bone health. Prioritize food sources first (dairy, leafy greens, fatty fish, nuts and seeds), with supplementation if needed. These are the best (expert-approved) vitamin D supplements out there.
- Talk to your healthcare provider about screening: DEXA scans measure bone mineral density and can identify osteopenia or osteoporosis before fractures occur. Discuss screening timing with your provider, especially during and after menopause.
- Avoid prolonged inactivity: Even moderate daily movement supports bone remodeling. Try build in regular movement breaks throughout your day. It'll give your body (and mind) a much-needed reset.
The takeaway
This research adds further evidence to the notion that bone density may be one of the earliest signals to reveal how your body is aging. The same habits that build strong bones (strength training, adequate protein, regular movement, key nutrients) also support the muscle mass, metabolic health, and physical resilience that keep you thriving for decades.