Mini Pause #67: Natural Ways to Boost Bone Density

TL; DR (Too Long; Didn't Read)

Maintaining bone density naturally becomes crucial as we age due to shifts in bone metabolism.

Osteopenia, the gradual loss of bone density, is a decades-long process that accelerates significantly during perimenopause and menopause, increasing the risk of osteoporosis.

Bones are dynamic tissues consisting of cortical (outer shell) and cancellous (inner, marrow-rich) bone, both of which change significantly with age.

Increasing bone density through strength training, plyometrics, walking, and adopting nutritional strategies is essential for maintaining overall health, regulating metabolism, and achieving optimal body composition.

WHY

Bone density naturally declines as we age because osteoclastic activity (bone breakdown) outpaces osteoblastic activity (bone formation). This process accelerates dramatically during perimenopause due to hormonal changes, particularly declining estrogen levels.

Estrogen supports bone density by inhibiting osteoclast activity (reducing bone breakdown) and promoting osteoblast activity (enhancing bone formation), thereby maintaining a balanced bone remodeling process.

Bones aren't just structural; they actively secrete hormones such as osteocalcin. This influences metabolism, insulin sensitivity, muscle function, and overall body composition.

WHAT

  • Cortical Bone: Dense outer shell providing structural support.

  • Cancellous Bone: Porous, spongy interior housing bone marrow, essential for metabolic and structural roles.

As we age, cancellous bone density decreases, making bones more susceptible to fractures.

Bone-derived hormones like osteocalcin regulate metabolism by enhancing insulin secretion and sensitivity, promoting glucose uptake by muscle tissue, increasing energy expenditure, and improving overall metabolic health and body composition.

Bones are the scaffolding of the body, but they are also active endocrine organs.

HOW

Practical ways to increase bone density naturally:

  • Strength Training: Increases mechanical load on bones, stimulating osteoblastic activity. Aim for consistent, progressive resistance exercises. šŸ’Ŗ

  • Plyometrics (Jumping Exercises): Improves bone density through high-impact activities, encouraging stronger bone formation. Examples include jump squats, box jumps, jumping jacks, skipping rope, and squat jumps. I personally love to do plyos on a step (complete with my leg warmers and off-the-shoulder top).Ā ā€¼ļø

  • Walking: Regular weight-bearing activity is gentle yet effective for maintaining and improving bone density. šŸ‘Ÿ

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  • Nutrition: Ensure adequate intake of magnesium, vitamin D, vitamin K2, and protein to support bone formation. 🦓

  • Sunlight Exposure: Enhances vitamin D synthesis, crucial for calcium absorption and bone health. ā˜€ļø

NOW

āž”ļø Choose one of the above that you are currently not doing and start integrating these bone-strengthening practices into your routine immediately.

āž”ļø Schedule regular strength and plyometric training sessions, daily walks, and supplements into your calendar or set reminders on your phone! This is one of my best tips for remembering to get all these little habits dialled in.

What I Recommend

TAME STRESS WITH THE RIGHT COLLAGEN

Stress does number on your body. Cortisol, the primary stress hormone, directly breaks down collagen, leading to deterioration of skin and connective tissue. Chronic stress not only accelerates collagen breakdown but also disrupts skin barrier function, leading to increased water loss and dryness. High stress elevates cortisol, promoting glycation, which causes collagen fibers to stiffen, resulting in skin wrinkles and dullness over time.

That's why you want a bioactive collagen that effectively counters the effects of stress!

  • Avoid Heat Degradation: High temperatures can break down collagen into less effective amino acids, reducing digestibility and bioavailability. Heat degradation creates cross-links within the collagen structure, making it more gelatin-like, less soluble, and harder for the body to absorb. This is why controlled low-heat processing, like Health Nag’s patented laser technology, preserves collagen’s full bioactivity and effectiveness.

  • Choose Hydrolyzed: Non-hydrolyzed collagen is ineffective because it’s too large to be absorbed. Hydrolyzed collagen is broken down into small peptides that cross the gut lining and are bioavailable to support collagen synthesis in skin, joints, and other tissues. Hydrolysis is key for any collagen to exert real benefits.

šŸ Health Nag’s collagen offers the most unique gel form I’ve seen on the market. And wow!—the delicious green apple flavor doesn’t disappoint. And just in time for spring and summer, Health Nag launched its bioactive collagen jelly in individual packets. Super convenient when you’re on the go or traveling! Learn more and try it HERE. Use code DRSTEPHANIE to save 10%.

KICK-START YOUR PERFORMANCE, ENERGY & FOCUS

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  • Appetite Control: Helps manage hunger by promoting a state of satiety. (Pro tip for my Bettys who find it hard to eat before early morning workouts.)

  • Energy & Focus: Provides a fast and steady energy source that crosses the blood-brain barrier. (I have the energy to focus on my workout and also maintain mental clarity to plan and think through my workday.)

  • Performance & Recovery: Enhances physical endurance and speeds up recovery by supporting mitochondrial function. (I don’t cut corners when it comes to recovery, but I do like the benefits of recovering more quickly and efficiently.

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🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

Mini Pause #18: Deload Weeks & Physical Breaks: Rest=Progress

You Must Squat Before You Jump: Deload, Take a Break, and See Even More Gains

TL,DR (too long, didn't read)

Deloads are a necessary part of training hard [*] when you are chasing all those gainz. They are often a welcome relief when you have accumulated sufficient stress and fatigue in your training regimen. This happens somewhere between four to eight weeks of intense training and allows for proper recovery.

Deloads can be a drop in weight or volume in your regular program, or you can choose to take a week off altogether. This week I am opting for a reduction in both volume and weight to help with my own (very overdue) deload week.

WHY

I’ve been feeling kind of run down and tired lately, and I’ve been trying to put my finger on what it is. I’ve been sleeping well (better than I ever have, truthfully, consistently hitting new PRs at the gym, and my nutrition is no different than it normally is.

But somehow, I’m exhausted, recovery is taking longer, and I’m even dreading the gym.

Now y’all know something is off when I am not excited about gym time. That’s my happy place!

I took a look at my volume and my progression over the last six months and then it hit me like a 1 Rep Max sumo squat.Ā I’ve accumulated too much physical fatigue, and I failed to schedule a deload weekĀ [*].

When I first wrote about training around your cycle inĀ The Betty Body, I naturally built a deload week into Week 4 of the cycle of training with lighter weights than usual. Although it wasn't intentionally programmed as a deload week in the book, for cycling women it’s a nice anchor to be able to think about a lighter workout in the late luteal phase of your menstrual cycle. This helps to reduce the physical and often psychological stress that accompanies this time of the month.

I find I require a lighter week either on Week 4 or Week 8 of steady training. But for whatever reason, I’ve trained 16 heavy weeks in a row. That explains my current disdain for the gym and poor recovery recently. I’ve been noticing I have been much more sore than normal, taking at least a day longer than I normally do to recover. From leg workouts, specifically.

WHAT

Everyone who’s lifting weights close to failure can and should be thinking aboutĀ building in regular deload weeks to reduce physical and mental stress and fatigue and to help you push in the next cycle of lifting. For my Type A Boardroom Bettys where I can ALREADY see your brains working (ā€œMaybe I don't need a deload! I should continue to push despite what she is saying!ā€), deloads are a necessary part of any intense training regimen. It doesn't mean you're broken, failing, or not making gains. By contrast, it’s how you make EPIC gains. In recovery.

Deloading is a crucial part of any well-rounded fitness routineĀ to help reduce overall fatigue, reduce the risk of injury, and help your lifting become stronger in the following weeks. In the same way, you need a break from your diet now and then, the same is true for your physical diet.

When you are training hard, there is a predictable accumulation of stress and fatigue. There is nothing to fear about this, asĀ thisĀ is how you get better and improve your energy levels, body composition, and strength.

But when you have accumulated too much stress and fatigue over several weeks or months of training, you can and should actively reduce it so you can facilitate recovery and get back to progress the next week.

Generally speaking, you know you are ready for a deload week when you have had two or three workouts of the same body part where you are either not making any progress, your recovery is longer than normal, or worse, you are regressing in your program.

Let me illustrate with an example.

Let’s assume you train legs on Tuesday and Friday. On both those days, you’d experience substandard workouts in the absence of any other explanation (jet lag, a child was sick, a stressful time at work, etc.).

And even if it were the case where your psychological stress was acutely through the roof, I’m going to gently remind you that psychological or mental stress also accumulates in the physical realm. This would be your cue to lighten up.

HOW

The No. 1 rule about a deload week is KISS: Keep it Simple Smartypants.

Once your strength is not improving by your typical measurements (weight, volume, etc.) for two or three consecutive workouts, it's time to take a break and amp up recovery.

Here are a couple of ways you can structure a deload:

  • Reduce weights
  • Reduce volume
  • Reduce weightĀ andĀ volume
  • Do absolutely nothing (not a typo and a perfectly reasonable option)

Typically when I deload, I reduce both weight and volume by about 50 percent.

Yes, by that much.
Yes, it seems like a lot.
Yes, these workouts are easy.

So let's say I am regularly squatting 135 lbs for 10 reps for 3 sets. I might structure a recovery week in the following way:

  • Deload Leg Day 1: 3 sets, 10 reps, but the weight will drop to 67.5lbs (this includes the bar at 45lbs, so using gym math that is 22.5 lbs of weight on the bar, so I usually just round up to 12.5 lbs per side)
  • Deload Leg Day 2: 3 sets, 5 reps, 67.5 lbs (weight and volume drop)

So you can see that I initially just dropped the weight, but kept the volume consistent. On the second leg day of the week, I dropped both the weight and the volume. It feels like an easy workout. And that’s the whole point.Ā You’re training easier this week so you can better recover.

When I structure my deloads so that the workouts are progressively easier for the week, I’m absolutely itching and ready to get back at it the next week. This is because I’ve dropped the stress of the workouts considerably, allowing for my body’s recovery processes to get ahead of the stress I have accumulated. I always find that in the weeks following a deload, I often hit a new personal best.

The important takeaway? When you structure your deload weeks this way, you can still work on your technical skills with the lighter weight.

And in total transparency–about once a year–I simply need a complete break from the gym. A 100% complete drop in volume and weights for at least half a week, and often a full week.

I just get to this place where I don't want to be in the gym at all, and I honor that. So I will get in a lot of walking, sleep in, spend lots of time in theĀ sauna,Ā and doĀ cold plunges. (I’ve linked my heat and cold recovery tools here for you to explore. Use code DRSTEPHANIE for each to receive an exclusive discount.)

For me, this week I am opting to drop weights and volume on all workouts all week long.

NOW

If you have been noticing your workouts suffering and an inability to progress with at least two workouts feeling like they were crappy, decide to take the next week to amplify recovery. Here are two possible approaches:

  • Reduce your volume, your weights, or bothĀ while still training at the same frequency.
  • Take the week off completely. Go for some walks, do some yoga, practice mindfulness, sleep in, and allow your magical body to do its thing.

Prepare your mind for the deload. It isn't a failure, a setback, or anything of the sort. Think about jumping. Usually, the lower you can go into a squat, the higher you can jump. Think of deloads this way. The squat part of the jump.

Question of the Week

Q: I know rest days are important when working out. I've heard women in perimenopause and postmenopausal women should have more than two rest days a week. What are your thoughts?

Thank you to reader Gina G. for asking this question that fits in so well with today’s main topic on deloading!

I am not one for hard rules that apply across the board, so I will say thatĀ you should take as much rest as you need. And when you are fully recovered–get back at it!

If you are regularly training legs, let's say, you can aim to train them twice a week, but if you feel like in between those sessions you are not sore, have the energy, and can easily fit in another workout, you should definitely try it out and see how you respond!

I typically take one full day off and my shoulder days are lighter in terms of energetic output. Sometimes I’ll throw in one or two leg exercises at the end of a shoulder day. Not all the time–just when I have the energy.

YOUR TURN!

I’ll be answering your questions every week right here in the Mini Pause! Let me know what’s on your mind. I’ll be checking for both questions and feedback atĀ support@drstephanieestima.com.

Mini Pause #16: Smart Changes to Increase Your Muscle Mass

Try Long-Length Partial Repetitions for Muscle Gains

TL,DR (too long, didn't read)

Long-length partials are a great addition to your already established weightlifting routine. The literature seems to agree that long-length partials–when the goal is muscle hypertrophy (increase in muscle mass)–seem to be at least equivalent to a full range of motion.

They are great to use if you are injured (and cannot perform full range of motion exercises), or as a finisher to a set, or for variety to combat boredom.

Oh, and I have never been so sore. It hurts so good!

WHY

Recently at the gym, as I was peeling myself off of a leg machine, my husband was looking at me, somewhat amused, and I knew what he was thinking so I answered the question before he asked it.

ā€œI’d rather endure the pain of this exercise than the pain of staying the same.ā€

It was one of those ā€œdamn I need to remember that line and tell more peopleā€Ā moments.

There are many reasons why I like to push beyond my comfort zone in the gym. To the point where I am riding the line of pain and excruciating pain. If we ever get to train together, you will find me often shaking my head no as I descend into yet another squat, mentally overriding my desire to stop.

Because staying the same, never growing, and never challenging myself feels like death to me.
Maybe I was a huntress in a previous life, but I find extreme satisfaction in the hunt. In this case, the hunt for hypertrophy.

So on a recent Friday night, I was nose deep down a muscle hypertrophy rabbit hole on PubMed (as one does on a Friday) and came across some interesting meta-analysis on long-length partials compared to full range of motion and their effect on muscle hypertrophy. I was so excited I started rabidly consuming several studies, and have now incorporated them into my training routine and have noticed some exciting preliminary changes in my strength.

WHAT

Long-length partials are essentially a half rep focusing on the lengthened portion of the movement.

For an easy visual, think of a bicep curl. Where the bicep muscle is most lengthened is when the elbow is straight. A half rep would be bending the elbow to about 90 degrees of flexion, rather than bringing the weight to your shoulder.

  • For a pull-up: It would be when the arms are straight, and you pull up halfway.
  • For a squat: It would be at the bottom of the squat and lifting up halfway before going right back down again.
  • For a chest press: It would be when the bar or weight is closest to your chest, with the pec muscles stretched out.

The literature agrees that long-length partials, when the goal is muscle hypertrophy, seem to be at least equivalent to a full range of motion (ROM).

This study [*] looked at women performing knee extension exercises at various ranges of motion varying from full ROM to long-length partial extension to shortened-length partial extensions. They foundĀ partial ROM training in the lengthened phase of the knee extension promoted greater relative hypertrophy in certain muscle regions than training in other ROM configurations.

It holds true for the entire body. This studyĀ [*] looked at muscle hypertrophy in the bicep muscle, again in women, and found an identical result.
This meta-analysis [*] concluded full range of motion or long ROM enhanced results for most outcomes (strength, speed, power, muscle size, and body composition).

HOW

So, should you swap out all your full ROMs for partials? No! They’re a useful tool in the proverbial tool belt but by no means a total replacement for full ROM.

Where you can, proper form and full range of motion should be performed. This preserves muscle movement at all angles and is conducive to range of motion and proprioception at the level of the joint as well.

Where I think long-length partials (LLPs) may be handy:

  • When you areĀ injured and cannot perform a full ROM. This can be useful as a rehab tool for getting back to full ROM and preserving muscle tissue.
  • When you have a condition like rheumatoid arthritis, adhesive capsulitis/ frozen shoulder, or bursitis andĀ cannot perform full ROM without pain. Again, LLPs can preserve tissue, and act as a stepping stone to full ROM.
  • When you are close to completing a set but can no longer move the weight through the full range of motion, you can begin using long-length partials. I have found I can punch out five or six more reps this way.
  • When you want variety and are combating boredom. I have been playing with alternating a full ROM repetition with a LLPl rep in many of my leg and upper body days.

NOW

For your next workout, choose to incorporate LLPs in one of the following:

  • All sets and all reps are LLPs
  • Full ROM reps until you cannot anymore, then switch to LLPs to really finish the muscle you are working
  • Alternating between a full ROM and a LLP

Which one are you going to try?

Also a word of warning–it might be the novelty, but I have never had such an amazing pump and ensuing soreness the next day! Have your favorite recovery tool at the ready.

A few of my go-to recovery tools include: ColdtureĀ cold plunge, SunlightenĀ sauna, Bon ChargeĀ sauna blanket, and Bon ChargeĀ massage gun. (Curious? You can use code DRSTEPHANIE to get special discounts.)

Question of the Week

Q: I’ve noticed on Dr. Stephanie’s IG that she tends to use machines rather than free weights/barbells during her strength workouts. I’m very interested to learn her recommendations for women around this—the difference between using free weights vs. machines.

Thank you to April who sent in this question that I get asked a lot!Ā I use a combination of all of the above.

For legs, I often use a Smith machine (which is a barbell with a fixed range of motion), a barbell for deadlifts or squats, walking lunges with dumbbells, Bulgarian split squats, and then machines like abduction and hamstring curls or leg extension.

Same goes for back days and shoulder days–it’s usually a combination of free weights, some type of axial loading with a barbell, and machines.

There is no right way or wrong way to train.

Machines have a predetermined line of drive, so in a sense, they are more stable because you do not need to create the stability yourself. There is an inherent trade-off to this. We want stability when we’re focusing on strength because the less stable the surface, the less strength you generate. But we also want to endogenously generate stability with accessory muscles and joints. So, I often use certain machines for six to eight weeks and then switch it up.

As long as you are going close to failure (making ugly faces, grunting noises, and getting to a place where you can no longer perform a full range of motion rep and drop down to long-length partials)–truthfully do whatever you love to do.

YOUR TURN!

I’ll be answering your questions every week right here in the Mini Pause! Let me know what’s on your mind. I’ll be checking for both questions and feedback atĀ support@drstephanieestima.com.

WHAT I RECOMMEND: Tips for nutrition, hydration, sleepĀ & stress

I love hearing from my Bettys! When you write in, DM me, or comment on my socials, consistent themes emerge, like: Ways to keep your nutrition on point, how to stay hydrated, what to do to get good sleep, and how to handle stress. Here are some simple choices I make that you may find useful.

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SLEEP:

  • Hello NED: A unique combination of CBN plus full-spectrum hemp and botanicals (non-addictive). Check out theĀ Sleep Blends. On April 29 & 30, all Sleep Blend tincture + capsules will be buy one, get one free with code DRSTEPHANIEBOGO.
  • Qualia Night.Ā Help your nervous system naturally wind down, starting after dinner. Learn more about how this supplement works differentlyĀ here. If you try it, use codeĀ ESTIMA15Ā to save 15%.

STRESS:Ā TheĀ ApolloĀ wearableĀ uses the gentle vibrations of touch therapy to promote stress resilience. (My kids use it, too.)Ā Explore its featuresĀ and use codeĀ DRSTEPHANIEĀ to save $50.

***

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