5 Bone Health Secrets Your DEXA Scan Won't Reveal

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I'm not here to scare you. I'm here to show you how to flip the script. Because here's something that no one's talking about. Nearly 1 in 2 women over 50 will break a bone due to osteoporosis. That's half of us. And the scariest part? Most of these women had no ideas their bones were even in trouble until something cracked. Hey, I'm JJ Virgin, and today we're tackling osteoporosis and osteopenia. What they are, how to really assess your bone health—by the way, beyond the outdated DEXA scan—and the cutting-edge strategies to build stronger bones from the inside out. So we're gonna talk first about what actually osteoporosis and osteopenia are. Really what we wanna do is catch bone issues when they're at the early stages, which is osteopenia, before you get to this full-blown osteoporosis, which is where you're in that advanced fragile bone situation. But we've gotta look beyond just bone mineral density, which is how we've classically looked at this, and look at bone quality too. So where I want to start first is with bone mineral density, because that's what we most commonly know. And this is really the amount of mineral content— it's mostly calcium and phosphorus— in a given area of bone. And this is how we've been measuring this on DEXA. And DEXA is dual-energy X-ray absorptiometry. When they do this, they compare your bone mineral density to the average healthy 30-year-old adult of the same sex. So that's how they do it. They look at that, and then they look at you as the average of your, your age and sex as well. But to diagnose osteoporosis, they're looking at a 30-year-old compared to you. And so basically they're going to look at a T-score, and if your T-score is less than 1, you're fine. Osteopenia is if you're between 1 and 2.5, and osteoporosis if you're 2.5 or older. Remember, this is really what's now known as the gold standard for looking at bone loss. I'm going to show you how this is kind of a little deficient, but more on that in a sec. Then there's also a Z-score. You'll get that as well, but again, the T-score is used for diagnosing osteoporosis. The Z-score is average, uh, comparing you to the average of someone who is your age, your sex, your ethnicity. They'll look at this more of like if you're younger, if there's something that's wonky or something problematic. Now, the real issue with bone mineral density is it's telling you how much bone you have, But what it's not telling you is the quality of that bone, and that's super critical. And I'll tell you a little story about myself here in a moment and what shifted for me. Bone quality is an inclusive term that looks at the architecture, the turnover, the damage accumulation, and the mineralization of bone. So basically, it's going to tell you how well your, your bone is built and maintained. So again, it's looking at microarchitecture, it's looking at your bone turnover turnover rates, how much is being resorbed versus formed. It's looking at collagen integrity and cross-linking. It's looking at any microcracks or any kind of damage, and also your bone matrix mineralization. And here's the kicker: you may have normal bone mineral density, but you can still have fragile bones if your bone quality is poor. This is often the case in older adults or diabetics or people with— on certain medications or conditions, like maybe they've got glucosteroid use. I'm going to tell you something wild that happened with me, and I'll talk this different type of test. I've been doing my bone mineral density testing with the DEXA for years because when I was in my 20s, I was put on a medication that put me at risk for osteoporosis later in life. And I knew that, so I've been testing to make sure. And, you know, I thought doing all the things— so I've been doing DEXA tests for years and for years. Guess what? I am great in my scores. So I am not osteopenic. I'm below a 1. On my T-score. So I'm like, perfect, I'm doing great. And then I had this other type of test done, and what I discovered from this other type of test is that lo and behold, I do have some mild osteopenia. So that was pretty big wake-up call. So I want you to think of bone mineral density as looking at like the amount of concrete in a wall, where bone quality is how well that concrete is reinforced, structured, and maintain. And you really got to have both for strong, resilient bones. So that's important. So knowing that now, if you've been doing DEXA— and here's the thing, I know DEXAs are readily available. I've been preaching DEXAs for years because you can also get your whole body composition. So I'm not, you know, saying throw this all the way out. But what I am going to tell you is if you can get your, your hands on this other type of measurement I would highly, highly recommend it, and especially since I just had the big wake-up call after I did my own on this. Now, before we talk about that, the big thing with testing that I really want to emphasize is when you look at insurance in the United States, they tell you to have your first DEXA at 65. This is ridiculous. Our prime years for building bone are really in our teens, and when we get to about like our late 20s, you're kind of where you are with your bone mineral density. So knowing that, why would you wait till 65? To do this, especially when we know that starting around menopause, you literally lose up to 10% of your bone mineral density in like 10 years— or 5 years, rather. So you could lose 10% of your bone mineral density in the next 5 years when you hit menopause. So really what we want to be doing is testing you in your, you know, late teens, early 20s, and then getting you to be as optimal as possible so that you're set up well for later in life. But you're probably listening to this and you're not 19, so let's talk about what we can do now. DEXA, if that's all you have access to, it's going to be better than nothing. But if you can get something called REMS, which is radio frequency echographic multispectrometry, and it's done by Ecolite Medical, get that. And that's what I was fortunate to do, and I'm really hoping this becomes more of something that be done all throughout the country because it is radiation-free, it's accurate, it's real-time assessment, and it is now what I'm recommending to everyone to to do because again, you're going to get bone mineral density, you'll also get bone quality, and you'll also get your body composition. So you get it all. In fact, my buddy Dr. Sarah Gottfried Sals calls REMS a massive upgrade for personalized aging care. So this is what I want to put on your radar because it is so critical for you to start to think about here. And again, the most important thing is not to wait till 65 to go get your bone mineral density tested, go get your bone quality tested, because you want to be really looking at it and starting to do the things you need to do for good bone quality and good bone mineral density as early as possible. It's just like putting on muscle. In fact, those two really go together. If you're doing the things that help you build muscle, they also are going to help with bone, although there are some very specific things that will help you build bone more, and we are going to address those. But first, let's talk about some of the hidden risk factors for becoming osteopenic or osteoporotic. I already mentioned the fact that when a woman goes through menopause, basically your bone mineral density kind of falls off the cliff. You start losing bone up to 2% a year. So low estrogen after menopause is definitely a big one. Low protein or lots of big caloric restriction can cause a big problem here. An inflammatory diet with a lot of ultra-processed foods and sugars— hopefully if you're listening to this, you are eating your protein and you are not eating ultra-processed foods. Doing things like taking those corticosteroids I talked about, PPIs, antacids can create a big problem. I remember I remember having a client who came on, who came to me, who'd been on antacids for a long time. I sent in to get a bone mineral density test and had osteoporosis. So please get that tested. If you're gluten intolerant and you were not diagnosed with celiac for years, definitely make sure you're getting tested for that as well. If you're sedentary, you don't do impact exercise, say your sole exercise is something like swimming Or maybe you're doing things like Pilates where you're not doing any kind of impact and you're doing more stuff on your back. Those things could be issues. Low muscle mass, of course, is also a risk factor. And I just want to point out that, you know, we love, love Dr. Gabrielle Lyon's statement of muscles, the organ of longevity, and muscles, when you work them, will pull on those bones and help stress the bones. There's more you can do. Than just that. And that's what I want to emphasize next, because, you know, one of the things I look at is I think, you know, if we are measuring skeletal muscle and we're focusing on improving that, we are focusing on improving our bones as well. But there's some very specific things that you're going to want to do to help improve bone mineral density and bone quality specifically. One of them is walking with a rucking vest. Now, I think this is one of the greatest things anyway. When I'm starting out someone on an exercise program, I first start them on an activity program, and the first thing I have them do to start to track how many steps they're getting in a day with the goal of before we start adding anything else, I want to just make sure you're getting that baseline of 8,000 steps in every single day. So that's step 1. Then if we can start to add some intensity once we've got that going, my next thing I'm like going, I'm like throw a rucking vest on. Now why do I love a rucking vest so much? I love a rucking vest because rucking is going to load your hips and spine. So not only is it going to cause a little bit more caloric expenditure and add intensity to your movement, but it's also going to load your hips and spine. That's one of the first things I'd love you to do. And you don't need to go crazy heavy, you know, you'll hear these podcasts with these guys throwing 40 pounds. Like, just start with 5 or 10 pounds and get one of those adjustable rucking vests so that you can maybe get it up to 15 or 20 pounds. But honestly, you'll notice 10 pounds, like, it's noticeable. So start there and, and see if you can do that a couple times a week or maybe every night after dinner. That's the first one. The next one, with resistance training, I I want you to focus on a couple specific moves because of the load they put on your spine and your hips. And so this is where I love a squat, and especially a squat where you have a barbell on your back, or you could do a machine squat at the gym where you have pads on your back where you've got some pressing on your spine and your hips. So that's one of the things that I like to do. The other thing that's great is a standing overhead press, because again, I am loading the spine and I'm loading hips. Next up is Power Plate vibration training. I have gotten— I got a Power Plate vibration training machine delivered to my house. I was like, I don't know, like, what am I supposed to do with this? And then I met the people who are behind all of this brilliance. I went, oh, this is amazing, because in 3 minutes a day you can have a dramatic impact on your bones. It's going to increase osteoblast activity with less joint stress, so more bone building. It helps improve balance and strength and does this big nervous system integration. So once I learned this, I was like, okay, I've been doing this every day. You can stand on your Power Plate and do your overhead presses and get a great two-for-one. You can do balance exercise on there. I've been doing my yoga warrior threes on there. So this is great. It's great for you if you are osteopenic or osteoporotic and don't want to start any jumping. Jumping is the next one that I really would love to see you doing because jumping is a great way to spark bone remodeling. And this could be as simple as like hopping, jumping up onto a box, doing some jump roping. Turns out that little bit of jumping, like 20 jumps 3 days a week, can really have an improvement on your bone mineral density. So it doesn't take much. And remember, when you put your bones under stress, it helps strengthen your bones. The exercise is one side of it. Then there's the nutrition and supplements, and Shout out to creatine again, man. Creatine just coming back and back and back for the win. Super exciting. Of course, you know, I have my own creatine product called Sheatine. It's creatine HCL, which is 7 times more bioavailable than creatine monohydrate. Won't give you the GI issues and bloating. And it also has taurine and magnesium. What I love about creatine is it's going to help you work out harder and recover better. But we also are finding some latest research. Actually, this was 2015. Chilibeck found that creatine can improve bone mineral density in postmenopausal women when paired with resistance training. Remember, you're not going to take creatine, sit on the couch, and get anywhere. So you got to do this with your workouts, but it seems to have an exponential, not just additive effect. The next one is collagen. Now I'm a huge fan of collagen, hydrolyzed collagen pre-workout to help with my joint health, but it also can help with the protein matrix of bone. And you want to take this with with some vitamin C as well. So my Electro Replenish has vitamin C in it. What I like to do is have some collagen before I'm going to work out. So if I'm fasted, I'll do it in my coffee. If I've had breakfast, I put it in my loaded protein smoothie or my Greek-style yogurt. So generally I do 10 grams 30 to 60 minutes before exercise, and then I've got my creatine, my chiatine powder, and my vitamin C in my Electro Replenish and my aminos that I'm taking to the gym with me. Supplements beyond that that I like— of course I mentioned magnesium already D3, K2, really, really important because vitamin D3 is going to enhance the calcium absorption, and then K2 is its very important partner in crime because it directs calcium to the bones rather than the arteries. Obviously super duper important. And then making sure that you are getting enough calcium. I really like to get calcium from the diet. If you are going to take it supplementally, about 250 milligrams is a good place to be. Magnesium is going to enhance your calcium metabolism, so that's important too. And then when I think of calcium, I'm thinking of deep green leafies that are cooked to lower the oxalates. So collard greens, spinach, but cook those, really important. And then if you like them, canned sardines and canned salmon for the bones in them, that's another fantastic one. If you're not dairy intolerant, Greek-style yogurt for the win. And talking about Greek-style yogurt, protein of course super important, 30 to 50 grams for each meal. You gotta hit your protein grams. Now you can support this a little do it with essential amino acids. That's what I do. But you gotta, gotta, gotta get in your protein and get your grams in. And remember, the whole issue that women tend to have with anabolic resistance as we age, it gets harder for us with resistance training and protein to build muscle. So you got to overcome that a little bit by pushing your protein a bit. So I have a free protein calculator that you can get to figure out you need. You can go to jjvirgin.com/proteinfirst for that. I'll put it in the show notes. So what would be my protocol for women 40+ to make sure that you've got that great bone mineral density and bone quality? First of all, go look for the REM scan for accurate bone quality tracking. We'll put information in the show notes on that. At the very least, get a DEXA, but like really try to find the REMs. Again, like I just had that one done and discovered some mild osteopenia. I'm like, oh, Resistance train 3 times a week and incorporate the Power Plate and/or jump intervals. I'm doing all of it because once I found that, I'm like, let's turn up the heat, baby. Supplement creatine HCL, so chiatine every day, collagen peptides, D3, K2, magnesium, and either make sure you're eating enough of your calcium-rich foods or you're going to supplement there as well. Get your protein in each day. I think it's best when we get those bumper meals, breakfast and dinner, like 30 to 50 grams. I'd rather see it 40 and up, but spacing it throughout the day. If you haven't checked your inflammation and intolerance to foods, Virgin Diet, we talk about looking at the top 7 foods that tend to cause leaky gut and inflammation, gluten being a big culprit, because if you're inflamed, that can cause problems with your bone and muscle as well. And then make sure you're tracking this. Get that DEXA or that, REMs. Once you've got a baseline with the DEXA or a REMS, you could be doing the DEXA, but get it in, check it, you know, every 12 months. Takes about 9 months to start to see a shift. But here's the reality: we used to think that if you lost bone, you were just done and you couldn't do anything about it. We now know that that is not the case, that you can turn this around. Remember, you are not destined to shrink or snap or slow down. Your bones are living tissue, and they they can change, which is super cool. This is not like if you find out that you've got some osteopenia, you can actually do something about it. It's just a wake-up call. It's not your countdown clock right now. I've got a supplement guide that might be helpful for you for women 40 plus. You can get that at jjvirgin.com/powerhouse. And we also continue this conversation in my Facebook group, the JJ Virgin Lifestyle Group. Um, go on over there, join and hang out with us. And if you've loved this and have a friend who would, uh, love it too and could use this information about bones, be sure to pass this around and like and subscribe. Thank you so much. Be sure to join me next time for more tools, tips, and techniques you can use to look and feel your best and and be built to last. Would you prefer an ad-free experience? Join my VIP podcast at subscribe2jj.com for just $4.99 a month or $49.99 a year to unlock uninterrupted ad-free access to all the episodes and insights you love. Also, I'd love to connect with you and hear your thoughts on the podcast. Here's how. First, subscribe to the podcast and leave an honest review. Second, take a screenshot of your review. And third, text to 2-813-565-2627. That's 813-565-2627. When you do, I'll reply using my brand new Virtual JJ Virgin. It's my on-demand virtual self built from my books, talks, and years of experience so I can interact with you directly. You'll make my day, and I can't wait to hear from you. Thanks for tuning in, and I'll catch you on the next episode. Hey, JJ here, and just a reminder that the Well Beyond 40 podcast offers health, wellness, fitness, and nutritional information that's designed for educational and entertainment purposes only. You should not rely on this information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional. 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