How to Avoid Height Loss as You Age

Height loss can happen as you age due to osteoporosis of the spine and other spine conditions. Find out how to prevent loss of height.

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When you were young, did you ever look at your grandparents as the years went by and wonder if they got shorter every year, or was it an optical illusion as you grew? You weren’t imagining it – many of those grandparents were getting shorter, some stooped over with their upper back in a painful hunched position.

Elderly man experiencing height lossA little height loss due to aging is natural, but more than about two inches means there's something else at play.

It’s a common misconception that we are all doomed to shrink as we age. A tiny bit of height loss is natural – a half to three quarters of an inch – but two or more inches? That level of height loss is not a natural consequence of the aging process.

Gbolahan Okubadejo, MD, a New York City area spinal and orthopedic surgeon, helps explain some of the most important aspects of abnormal height loss and offers ways to prevent it.

How Much Height Does the Average Person Lose?

In normal circumstances, people build more bone than they lose up until about age 30. However, bone loss occurs faster than bone building after age 35, causing a gradual overall loss of bone mass. People with osteoporosis, when bones become porous and brittle, lose bone mass at an even quicker rate.

Everyone loses some height as they age. Women may lose more height, and are at a particular disadvantage because their rate of bone loss occurs even more quickly after menopause. You lose this height as you age because the discs that act as cushions between your vertebrae flatten a bit from a variety of causes. Your muscles also lose mass, causing the spaces between your joints to narrow, also causing height loss. However, when a more significant loss in height occurs (inches), it may be a sign of accelerated bone loss.

Possible Reasons for Height Loss

Genes are the predominant factor for determining how tall you will be. However, loss of height has more to do with lifestyle and overall health throughout your life than genes. While genetics may play a small role if a family history of osteoporosis exists, just having a genetic link does not mean that you’ll experience spinal shrinkage.

Many ailments experienced during aging can exacerbate the height loss process, such as arthritis, joint inflammation, and osteoporosis. These conditions can also be linked to lifestyle though, so the extent to which they effect height loss is harder to determine from lifestyle alone. These lifestyle factors include poor diet, sedentary lifestyle (lack of physical activity), and smoking.

Illustration of height loss due to agingThe possible causes of age-related height loss are many.

The main offenders causing height loss include:

Osteoporosis

For many people, especially women, this disease is the number one cause of spinal shrinkage. Osteoporosis causes the bones to thin, become porous like a sponge, and brittle, making bone breaks more common as you age. Osteoporosis causes a host of problems besides broken bones. Weakening of muscles results in muscle atrophy. Vertebral fractures, also called compression fractures, often do not cause pain or other symptoms, making them quite dangerous because they go undiagnosed or treated. Spinal deformities like kyphosis (hunchback) and lordosis (sway back) occur, often due to the undiagnosed fractures. And detrimental changes in posture also result from this condition.

Many people feel that osteoporosis is inevitable, if they think of it at all. You should be working to prevent osteoporosis now, regardless of age, because it is more deadly and life altering than you may think. According to Dr. Okubadejo, osteoporosis prevention is the single biggest action you can take to avoid spinal shrinkage.

“Osteoporosis is a serious condition that causes the body to lose too much bone, make too little bone, or in some cases, both,” says Dr. Okubadejo. “Minor bumps, sneezing, falls, or even walking may cause the bones to break, and the condition may cause permanent pain. When osteoporosis affects the vertebrae (bones break in the spine), it often results in a hunched or stooped spine, lost height, and limited mobility. Osteoporosis is sometimes a fatal condition, and many patients require long term nursing home care.”

A healthy diet, exercise—especially weight-bearing exercises and resistance training—and getting enough sleep can help prevent osteoporosis. “You should consume 1200-1500mg a day of calcium, preferably in foods, and 800 units of Vitamin D per day for adults older than 70,” says Dr. Okubadejo. “Regular exercise and high levels of physical activity throughout your life can also result in a higher bone mass when you get older. Exercise regimens should include weight training and exercise decreases the risk of falling by 25%. High growth hormone levels increase bone mass, and the growth hormone is increased by exercise and produced while you sleep. An 8-hour restorative sleep and avoiding carbohydrates two hours before bed maximizes growth hormone production.”

Spinal Disc Degeneration and Disc Desiccation

Your discs are like little pillows that protect your vertebrae. Over time, injuries, lifestyle behaviors and genetic factors can lead to disc degeneration and desiccation of these discs. The cushion-like fluid in them dries out (desiccation) and the discs flatten, leading to your spine becoming more compressed.

Muscle Loss

We lose muscle mass as we age for a variety of reasons. Your core muscles are meant to keep you upright in proper posture. As you lose muscle mass throughout your torso, where back muscles and core muscles reside, you begin to stoop forward, just like with osteoporosis.

Poor Posture

 “Sit up straight or you’ll end up like me!” “Sit up straight or your spine will stay like that!” Did you ever hear that from your parents and grandparents as a kid? They were, of course, correct. Maintaining proper posture (keeping your spine in a neutral position), will help avoid spinal deformities and height loss.

Socioeconomic Status

In a study conducted by China and the United States, nearly 18,000 Chinese men and women over age 45 were evaluated for spine health and shrinkage over time. The results showed that participants with lower education and lower income incurred more height loss than their higher educated, wealthier counterparts.

Risk Factors for Height Loss

There are a host of risk factors for loss of height, some controllable and some not. The following list can help you work on a plan with your doctor on how to combat height loss.

Sitting

Sitting in general is one of the most dangerous things you can do to your body. You may not have a choice if you work at a desk job. In one study of sedentary workers, workers had a significant decrease in overall height and sitting height at the end of their workday, as well as significantly increased upper back pain. Spinal shrinkage in men correlated with neck pain and lumbar lordosis (swayback) in women correlated negatively with upper back pain and spinal shrinkage at the end of the day. In a work environment, the study concluded that spinal shrinkage equally and upper back pain affected men and women performing the same work.

Female Sex (Especially Post-Menopausal)

Though all women are at risk, women of short and thin stature, white race, with a history of familial osteoporosis are at the highest risk. The drop in estrogen during and after menopause yet further increases the risk of osteoporosis.

Illustration of height loss and bone loss in men and womenMenopause accelerates bone loss, which means it may speed up height loss as well.

Lack of Physical Activity

This risk factor is modifiable. To be most effective, strenuous activity needs to occur at least 3 times per week at an early age (> or equal to 18).  Research shows that women who reported doing more strenuous exercise at age 18 had nearly 50% decreased odds of significant height loss over 5 years.  But don’t worry—your situation is far from hopeless if you weren’t very active when you were younger. Physical activity at every age also has been linked to higher bone density and reduced rate of bone loss among the elderly.

Obesity (Especially with Predominant Abdominal Fat)

Extra body weight compresses the intervertebral discs, causing height loss. A high body mass indicator (BMI) is also predictive for development of disc degeneration. Belly fat is especially bad for your bones.

Whiel many people may think that obesity is a modifiable risk factor, the answer is more complex. If you are obese or at risk for obesity, you should discuss your options with your doctor and a bariatric specialist. Obesity is a high-risk condition, often with comorbidities, such as diabetes. Obesity carries high morbidity and mortality and requires its own treatment plan, as well as supervision by medical professionals, usually with a team approach.

Use of Oral Corticosteroids

“Prolonged use of oral corticosteroids, which may be necessary for a chronic condition, can cause fractures and thinning bones (osteoporosis), slower wound healing and thin skin, elevated pressure in the eyes, high blood sugar, which can worsen or trigger diabetes, and [pose] increased risk of infections, among others.” warns Dr. Okubadejo.

Quick and Major Weight Loss After Menopause in Women

Fat loss after menopause changes the body’s hormonal balance (less estrogen produced), possibly involves a reduced intake of calcium from dairy products, and negatively impacts bone mineral density. This risk factor is also attributable to rapid weight loss seen in bariatric surgery and should be taken into account if pursuing an obesity treatment plan.

You Can Prevent Bone Loss

If you’re young, you have the most power to avoid future bone mineral density loss and spinal shrinkage – a medical superpower. For those that don’t have a superpower option due to age; unfortunately, there is no way to restore the height you’ve lost. But it’s not just early life experiences and decisions that determine total height loss. You can still prevent future bone mineral density loss and spinal shrinkage by following certain health guidelines:

Get Regular Exercise

This is one of the most important steps you can take to prevent height loss, as well improving overall health and reduction in risk of osteoporosis and many other pathological conditions. You’ll need to do weight-bearing physical activities, such as running, walking and aerobic exercises. Strength training works to build healthy bone and keep it from declining. Working on building up your core muscle strength works to keep you in a healthy posture, which not only keeps your spine straight, but also helps to avoid muscle loss.

Eat a Healthy Diet

A healthy diet fuels your body to keep your muscles from deteriorating as well as keeping your bones strong to avoid osteoporosis. Your diet should include 5 to 9 servings of vegetables and fruits per day, whole grains, and healthy fats, like those found in fish. Limit sugar, especially sugary drinks, such as soda. Even diet soda has negative effects, despite lacking sugar. Protein, calcium and enough vitamin D are crucial at all ages for avoiding osteoporosis and height loss.

Limit Alcohol

Alcohol affects height loss because it can reduce calcium levels as well as speed up loss of bone density.

Avoid Smoking and Other Tobacco Products

Smoking contributes to the development of osteoporosis as well as a long list of other health problems and impedes healing in the body.

Maintain Proper Posture

Proper posture isn’t just sitting straight or keeping your spine and neck neutral while upright. You need proper posture for activities, too, like lifting heavy objects – lift with the legs and not the upper body to avoid vertebral fractures. Maintaining proper posture is harder than just developing a habit. You must constantly pay attention to how you are sitting, standing, or walking. Take a few videos of yourself just going about your day – at work, at home, working out. You may be surprised to see how often your posture is stooped, head hanging, upper back hunched over.

Sit Less, Move More

You may have to sit for a job, but you can get up and move around more. When not at work, place more focus on being active and sitting less. If you are watching a show, stand and fold laundry. If you are at work, take the stairs. Park farther away. Get up and move each hour – set an alarm. Just keeping moving.

Get Regular Bone Density Tests

If you are older, having a baseline bone density test—a dual energy X-ray absorpitiometry (DEXA) scan—can help determine if you are developing osteoporosis or other bone-related problems. This information can help guide treatment to stop or slow progression of bone loss.

Woman getting DEXA scan for height lossA DEXA scan can tell you about your bones' health.

Take Osteoporosis Medications

If you have been diagnosed with osteoporosis or are at high risk of developing it, osteoporosis medications can help. Dr. Okubadejo explains that regular exercise and a healthy diet may not be enough to slow down osteoporosis, and that is where medications come into play. These drugs combat the effects of bone loss from osteoporosis and may slow down the loss of bone or help you build more bone, which can improve your bone mineral density and prevent fractures.

These medications are not just for women; however, men need extra testing and evaluation to see if they require osteoporosis medications, says Dr. Okubadejo, “Some medications are only approved for women, while others can work for men. Men should consult with their orthopedic surgeon and consider medication based on their diagnostic workout, clinical evaluation, bone mineral density measurements, and fracture risk assessments.

Lifestyle Changes to Prevent Height Loss

It’s important to be proactive in preventing loss of height, says Dr. Okubadejo. “In order to encourage some level of change in [my patients’] lives, I like to keep it simple. I tell my patients to find foods they really enjoy that are also good for them, so it is easier to make a permanent change in habit: Whole grains, healthy proteins, and fruits and vegetables. I encourage them to make small changes at a time, such as opting for whole-grain bread instead of white bread. In terms of exercise, I remind them that swimming, hiking, biking, or long walks all count as daily exercise, and they do not necessarily need to go to a gym, run, or do other activities they do not like to do.”

If you are between ages 12 and 30, use those medical superpowers and keep it up. You’ll be giving yourself one of the best gifts for later in life – a healthy body that can move and be active no matter your age. If you are more seasoned in life, you don’t have to accept height loss as inevitable. There is plenty of research to show that you do have a large measure of control over spinal shrinkage throughout your entire life, even in later life. Making the lifestyle changes listed above are the best way to avoid spinal shrinkage as well as enjoy a healthy, active lifestyle no matter your age.

Updated on: 06/23/21
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Osteopenia and Osteoporosis: Is There a Difference?
Gbolahan Okubadejo, MD
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Osteopenia and Osteoporosis: Is There a Difference?

While most people experience some loss of bone mass as they age, osteopenia and osteoporosis are not inevitable parts of the aging process.
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