In my practice as an orthopedist, I see many over-50 women who’ve fallen and broken a wrist, ankle, or, more importantly a hip.  A high percentage of these women are overweight.  Recent research shows that being an older, overweight woman can put you at greater risk for falls, fractures, disability and the dreaded loss of independence.  If you’re a woman over 50, I’d like to tell you how you can protect yourself.

Ladies Over 50:  Extra Weight Doesn’t Mean Extra Strength

When we think of older women falling and breaking bones, or otherwise injuring themselves, the stereotype is the very thin, frail-appearing women.  Although thin women do break bones and injure themselves in falls, it’s more likely to be the overweight woman who falls and suffers a disabling injury or dangerous fracture.

Even though an overweight woman may look more sturdy, her muscles may actually be weaker and her body less flexible and unable to balance and break a fall, than her normal weight counterpart.  Researchers out of the University of New Hampshire have proven this in their study, “Overweight Older Women Have Less Leg Strength and Power”, published recently in the Journal of Electromyography and Kinesiology.

In that study, the researchers found that the leg strength and power of older, overweight women was significantly less than women of normal weight.  As such, they were at far greater risk of disability and loss of independence from falls and other injuries.  The study is significant in that it dispels the myth that extra weight may somehow be protective against fall injuries.

The truth is, the researchers discovered, the participants extra weight was actually limiting their mobility, flexibility and balance.  When it came to measuring actual strength to weight ratio, the overweight women had 24% lower leg strength – particularly in walking speed which was 20% slower than normal weight women.

Power ratios – the ability to quickly and successfully carry out movements – were even more affected and were felt more important in fall risks than actual muscle strength.  The overweight women were found to have 38% less power than the normal weight participants.  Muscle strength, speed, agility, power of movement, are the factors that directly affect performing simple activities of daily living like climbing stairs or rising from a chair unassisted.  These movement factors can determine whether if, and how well, a woman can live independently on her own and how long.  The researchers concluded that older, overweight women can improve their muscle strength and power, as well as boost their ability to stay independent, by either losing weight or gaining strength – ideally, both.

In a related study out of Australia, “Fat and Obesity Gene Affects Hip Fracture”, published in the journal Online Endocrinology, researchers reported even greater risks for older, overweight women.  Their study found that a group of women who carried the high risk variant of FTO (fat and obesity) gene, already known to predispose women to diabetes and body fat, are also at 82% greater risk for suffering a dangerous hip fracture than normal weight women.

The Australian study followed 934, over-age-60 women, in their Dubbo Osteoporosis Epidemiology Study for a period of 8 years.  During those years, 102 women in this study suffered hip fractures.  While the average risk of fracture for women with the low risk variant of this gene was about 10% to 11%, for overweight women with the high-risk variant of the gene, the risk jumped significantly.

The researchers concluded that the FTO gene also plays a role in bone cell generation and seems to affect how well bone cells regenerate.  It’s thought that, perhaps, women with the high-risk type of this gene also have lower bone mineral density values that make their bones weaker and more likely to fracture.  Whether a woman carried the high risk variant of this gene, and her weight, may be able to predict a woman’s future risk of a dangerous hip fracture.

What these 2 studies show, in different ways, is that, while being overweight is not healthy for a woman of any age, it is especially risky as a woman gets older.  It not only predisposes you for higher risk of diabetes and heart disease, but it increases your risk for fractures and other injuries from falls.

As an orthopedist, I know that when muscles are strong, the bones they’re attached to are also strong.  During exercise, muscles rub against bones causing friction which stimulates bone growth.  So, it stands to reason that if a woman doesn’t get much, or any, exercise, this is likely why she is more prone to being both overweight and having weaker muscles and bones. The answer, clearly, seems to be getting to a normal weight, or at least doing more muscle/bone strength building exercise.

The Best Muscle/Bone Strength Exercise

While you’re working on getting to a normal weight, you can start building your muscle and bone strength immediately by doing the right kind of exercise several times a week. This includes:

1.  Strength/Resistance Training:  Weight lifting, using free weights, or circuit weight machines, resistance bands, kettlebells, yoga, pilates, TRX, etc.  This type of exercise creates resistance in muscles which causes them to grow bigger and become stronger.

2.  Weight Bearing Exercise:  This type of exercise creates shock impact for bones which causes them to respond, in an effort to protect themselves, by growing more bone and becoming more dense.  When bone density increases, bone strength increases and the less likely they are to break.  The best exercise to grow bone density is walking, running, playing basketball, tennis, hiking, dancing.

Women have a tendency to gain weight as they get older, especially during and after menopause.  In addition, metabolisms start to slow down.   While hormone deficiencies and decreased metabolism can contribute to the problem, what I see in many of my own patients is more a lack of regular physical activity.   Be sure your diet includes enough protein to build strong muscles, as well as calcium and Vitamin D to grow stronger bones.

While I encourage everyone to get to a normal weight, I encourage my older female patients, and readers, to start getting more muscle and bone strengthening exercise.  These will not only help you get that extra weight off but will help you decrease your risk of injury and fractures and possibly losing your independence.

Stay Well,
Mark Bromson, M.D.

Overweight Older Women Have Less Leg Strength and Power, http://www.sciencedaily.com/releases/2011/09/110919113853.htm

Fat and Obesity Gene Raises Hip Fracture Risk by 82% in Women http://seniorjournal.com/NEWS/Health/2013/20130925_Fat_and_Obesity_Gene_Affects_Hip_Fracture_in_Women.htm

http://www.niams.nih.gov/health_Info/Bone/Bone_Health/Exercise/default.asp