The bone expert: THIS increases your risk of death! Fix it before it’s too late

What happened in this episode?

ZOE host Jonathan Wolf interviews Professor Ela Dennison of the University of Southampton about bone biology, osteoporosis and fracture risk. Dennison describes bone as living tissue in constant turnover, with osteoclasts breaking down micro-damage and osteoblasts rebuilding it; she says people typically build towards peak bone mass until about age 30 before gradual decline, accelerated in many women after menopause due to oestrogen withdrawal.

She outlines who is at higher risk of osteoporosis, including older adults, people on long-term steroid tablets, those with a history of anorexia, and people with gastrointestinal diseases that impair nutrient absorption. Dennison argues the main public consequence of low bone density is fragility fracture, and describes severe outcomes after hip fracture, including a substantial early mortality risk.

The discussion covers screening and risk tools (DEXA scans and the FRAX questionnaire), medication options (anti-resorptives such as bisphosphonates and denosumab, plus bone-forming therapies including PTH injections and romosozumab), and lifestyle measures. Dennison recommends weight-bearing and resistance exercise, adequate dietary calcium and vitamin D, and highlights the Mediterranean diet as the most consistently studied pattern associated with better bone health. She also discusses smoking, alcohol, stress and cortisol, and flags open questions about whether GLP-1 weight-loss drugs could affect long-term fracture risk via muscle loss. The episode includes a mid-show promotion for ZOE’s “Daily 30” supplement.

What are the key points?

• Bones continuously break down and rebuild; imbalance towards breakdown underpins osteoporosis.
• Peak bone mass is typically reached around age 30; decline is often faster after menopause due to reduced oestrogen.
• Dennison says hip fracture can carry high short-term mortality risk and major loss of function for many patients.
• Risk factors discussed include steroid use, anorexia history, and gut diseases such as coeliac or inflammatory bowel disease.
• Assessment may involve FRAX risk questions and/or a DEXA scan; several drug classes are used to reduce fracture risk.
• Weight-bearing and resistance exercise are recommended; swimming is described as good exercise but not beneficial for bone loading.
• Dennison flags research questions on GLP-1 drugs and potential long-term fracture risk linked to muscle loss.

Who is speaking?

Named speakers identified in Egleze's source-linked moments from this episode.

• Professor Ela Dennison

Which topics are covered?

How is this page sourced?

Programme

ZOE Science & Nutrition

Published

17 September 2026

Duration

54m

Original episode

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