Queen Camilla warns of the ‘silent thief’ that took her mother – 5 GP-backed ways to strengthen bones after 50

Marking the 40th anniversary of the Royal Osteoporosis Society, Queen Camilla made a powerful and personal speech about the crippling bone disease that took both her mother, Rosalind, and her grandmother, Sonia.

Speaking at Clarence House, she described the condition, which weakens bones and makes them more likely to break, as ‘a silent thief hiding in plain sight’.

‘It wreaks its havoc deep inside our bodies until, too late, we realise that the damage has been done,’ she said. ‘Without being aware of it, our bones have lost their density and strength until suddenly, a simple, everyday act – picking up a grandchild, slipping over or even sneezing – turns into a life-altering event as our bones shatter.’

Osteoporosis and women

Post-menopausal women are most at risk, explains Dr Hannah Burrage, lead GP at Kry Livi: ‘Bone loss doesn’t start at 50 – it accelerates then. Oestrogen protects bone density, so when levels drop during perimenopause and menopause, women can lose up to 10% of their bone mass in the five to seven years around that transition. I see this a lot in my clinics: women who feel perfectly well but have no idea their bone health has quietly changed. That’s what makes osteoporosis and osteopenia so tricky – there are usually no symptoms at all until it shows up on an X-ray or until a fracture happens. The good news is that this is one of the most preventable long-term health risks we deal with, if we act on it early enough.’

So, what can we do?

The best exercise for bone health

‘I always tell patients that not all exercise is equal for bones,’ says Dr Burrage. ‘Swimming and cycling are wonderful for the heart and joints, but they don’t load the skeleton, so they don’t do much for bone density. What matters is weight-bearing and resistance exercise – brisk walking, dancing, stair climbing or light strength training with dumbbells or resistance bands, even just twice a week. You don’t need a gym membership. Carrying shopping bags, gardening or doing squats while the kettle boils all count. The key is consistency, not intensity.’

‘Research supports performing exercises such as double- and single-leg squats, step-ups and lunges at least two to three times per week at moderate intensity,’ adds Riddhi Shroff, physiotherapist at Recover Physio. She suggests upping the intensity as your exercise regime progresses, ‘to continue building stability and maintaining bone health’.

HRT to keep bones strong

In the years before, during and after menopause, your levels of estradiol (the most potent and prevalent naturally occurring estrogen), progesterone and testosterone decline, explains Dr Louise Newson, leading menopause expert, host of the Dr Louise Newson podcast and founder of hormone health app Balance.

‘Estradiol slows down the rate of bone loss and even promotes new bone growth, which helps keep bones stronger for longer,’ she explains. ‘Progesterone collaborates with estradiol, helping bone formation and preventing bone loss, while testosterone plays an important role in maintaining bone mineral density.’ As all three decline, your bone is breaking down at a faster rate than your body can grow new bone tissue.

HRT can help prevent bone loss and reduce the risk of fracture, she says. It’s associated with a 30% significant reduction in vertebral and non-vertebral fractures. In fact, as Dr Newson says, ‘In menopausal women, treatment with both testosterone and estradiol is more effective in increasing bone mineral density than estradiol alone.’

Calcium to combat osteoporosis

Calcium is key, explains Dr Newson: ‘It gives your bones the strength and hardness they need to cope with your everyday activities.’

Most adults need around 700mg a day, adds Dr Burrage, and for most of us that’s entirely achievable through food, without needing a supplement on top.’ Beyond the obvious dairy sources, such as cheese, milk and yogurt, ‘Think leafy greens, such as broccoli, cabbage and watercress, fish like sardines and mackerel, dried figs and oranges, and even white bread, pasta and rice, which are fortified with calcium in the UK,’ says Dr Burrage.

A varied diet for bone health

Protein is another nutrient that is frequently overlooked, says Dr Nikki Ramskill, women’s health GP and founder of The Female Health Doctor Clinic: ‘It’s essential for maintaining both bone and muscle strength, and good sources include fish, lean meat, eggs, dairy, beans, lentils and soy products. Magnesium, vitamin K and potassium also play supporting roles in bone health, so aiming for a varied diet rich in vegetables, fruit, nuts, seeds and wholegrains is one of the best long-term strategies.’

The right supplements for strong bones

‘There’s a real “more must be better” instinct with calcium supplements and I'd gently push back on that,’ says Dr Burrage. ‘Taking more than 1,500mg of calcium a day from supplements can cause problems, including kidney stones, so they’re not something to take as a routine top-up if your diet already covers your needs.

Vitamin D is equally important because it helps the body absorb calcium effectively, says Dr Ramskill: ‘Oily fish, eggs and fortified foods provide some vitamin D, although diet alone is often not enough in the UK.’

For around half the year, we simply don't get enough sunlight for our bodies to make vitamin D, so the NHS recommends everyone considers a daily 10mg supplement from October to March, and year-round for anyone who’s housebound or covers their skin for cultural or religious reasons.

Ultimately, says Dr Ramskill, ‘Healthy bones are built through consistency, rather than quick fixes – regular weight-bearing and strengthening exercise, a balanced diet with enough calcium and protein, maintaining healthy vitamin D levels, avoiding smoking and limiting excess alcohol.’