Is Your Stress Level Bad to the Bone?

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by Joan Pagano

You may be familiar with the well-publicized risk factors for bone loss and osteoporosis, such as being a woman, aging, menopause, family history, being small and thin, an inactive lifestyle, and smoking. But did you know that anxiety can also increase your risk for bone fractures?

New research builds upon previous findings that link anxiety to a higher risk for heart disease and gastrointestinal problems.  In a study recently published in the North American Menopause Society’s journal Menopause, Italian researchers reported that women who had the most anxiety faced a higher fracture risk compared to those with the lowest degree of anxiety.

Higher anxiety was linked to lower bone mineral density scores in both the lower back and the femoral neck of the hip joint in postmenopausal women, raising the risk of a major fracture over a 10-year period. The negative effect of stress hormones on bone status is one factor, as is the tendency to manage stress with unhealthy lifestyle behaviors like smoking, poor diet and lack of exercise.

Bones play an important role in providing structure to our bodies, protecting our organs, moving our joints and storing calcium. Bones are made from living tissue which renews itself continuously throughout our lives.  If your skeleton is to remain strong it needs stimulation from physical activity, without which bones can weaken just as muscles do if not used regularly, as well as adequate calcium and Vitamin D.

Exercise helps conserve bone, offset bone loss, and prevent falls and fractures. The two types of exercise important for building and maintaining bone density are weight-bearing and muscle strengthening.

  • Weight-bearing exercises: Anytime you are standing (weight-bearing), you are resisting the force of gravity, which places positive stress on the bones. Do a variety of brief, frequent bouts every day in normal activities like walking and climbing stairs to maintain their strength.  Choose cardio exercises like fast walking, jogging, hiking, dancing and the elliptical where you are on your feet.  Add high intensity intervals to your usual steady-pace workout.
  • Muscle strengthening, or resistance exercises, causes the muscles to exert force on the bones, which strengthens them at the same time as the muscles are getting stronger. Do exercises for all the major muscle groups (legs, back, chest, shoulders, arms and core) to stimulate bones throughout the skeleton. Lift as heavy a weight as you can while maintaining good form.

A bone density test will help you tailor your exercise program by showing which, if any, areas are at reduced bone density – your spine, hips or wrist.  This will help determine the exercise selection and intensity of your program.  An exercise program for people with osteoporosis should include posture, balance, gait, coordination and trunk stabilization as well as strength training and weight-bearing cardio.  Be sure to consult with a healthcare professional before beginning an exercise program or becoming much more physically active.

National Osteoporosis Foundation Jumping Jack Challenge:  If your bones and joints are healthy, join the challenge to do 10 jumping jacks in under 10 seconds.  Watch me below.  If you’ve been diagnosed with osteoporosis, be sure to check with a healthcare professional on safety guidelines for exercise and activity.

Joan Pagano is the author of best-selling fitness books, including the new release Strength Training Exercises for Women (DK, 2014), an informational speaker on health and fitness topics and the owner of Joan Pagano Fitness in New York City. Former trainer to Jacqueline Onassis and Caroline Kennedy, Joan has specialized in strength training for women since 1988. She is an authority on the benefits of exercise for women’s health issues such as menopause, osteoporosis and breast cancer, as well as strength training through the decades. Joan is the proud finisher of seven marathons and a member of the Shaker Heights High School Alumni Hall of Fame.



  • Joan Pagano has specialized in strength training for women since 1988 – training, teaching, and writing books on the subject, including Strength Training Exercises for Women (DK, 2014). When the health benefits of strength training started making headlines in the 1990s, and in particular how weight training could protect the bones and prevent osteoporosis, it was a natural segue for her. At that time, Joan was developing and delivering fitness training guidelines for osteoporosis to national audiences of exercise professionals. Currently Joan is recognized by the industry as a leading authority on exercise program design for osteoporosis. She is certified as an Exercise Physiologist by the American College of Sports Medicine (ACSM) and is on the Ambassadors Leadership Council for the National Osteoporosis Foundation. Visit Joan at:

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