Why we lose height as we get older (and what to do about it!)

As one of the UK’s leading London physiotherapists, I regularly write about injuries, treatment and assessment techniques.

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A study, published in the online journal BMJ Open last week, has linked height loss in middle age to an increased risk of early death, primarily from heart disease or stroke. I was quoted in Antonia Hoyle’s article for the Daily Mail and interviewed on Tipp FM by the lovely presenter Fran Curry, about how this shrinkage affects women more than men – and about what we can do about it!

What did the study find?

The study itself was carried out on 2400 women based in Sweden and Denmark. They had their height measured twice – once when they were aged between 30 and 60, and then again, 10-13 years later. They then had their health monitored for the next 19 years.

In the 10-13 years between height measurements, the average height loss was 0.8cm, but this ranged from no height loss to a whopping 14cm shrinkage. Over the following 19 years, 625 of the women died, 157 of whom died from cardiovascular disease including stroke; and they found that for every centimetre of height loss, the women had a 14-21% increased risk of death – with those who lost over 2cm accounting for 74% of the deaths.

This does not necessarily mean that the height loss causes the death, but it’s likely that whatever causes the height loss also causes the cardiovascular disease (although it has also been postulated that chronic inflammation, related to osteoporosis and fractures, may also trigger cardiovascular issues).

So, what causes height loss?

Well, the majority of height loss is linked to poor posture (which can lead to spinal disc dehydration) and – in women – to the menopause (which can often lead to osteoporosis – loss of bone density). The combination of disc dehydration, rounded posture and osteoporosis can in turn lead to spinal fractures, which make your spine structurally shorter. Women are more prone to this than men partly due to nature (men don’t go through the menopause; but women are also designed to hold less muscle mass than men) and partly due to nurture (statistically, men are more likely to hold more physical jobs and play more sports than women).

In other words, to reduce the risk of height loss, we need to try to preserve our bone density, spinal disc hydration and muscle mass, and to work on an upright, poised posture (think more “ballet dancer” than “guardsman on duty” – this is about balance rather than rigidity!)

How do I preserve bone density?

Bone density is largely aided by diet and exercise. On the diet side, we need to ensure that we have enough calcium in our bones. This means eating foods and supplements that are rich in calcium (leafy greens, seafood) so that there is calcium available for us to absorb. Vitamin D ( found in fish and sunlight!) and magnesium (leafy greens) help us to absorb the calcium into our bloodstream; and then vitamin K2 (found in fermented foods such as kefir, kombucha and sauerkraut) helps the calcium move from the bloodstream into the bones. On the exercise side, impact exercise such as brisk walking or jogging, lifting weight, boxing and tennis can stimulate the production of bone cells.

How can I keep my discs healthy?

Spinal disc hydration is aided by making sure water is available (ie drink it!) and then by practising big, generous movements to squash and stretch the spinal discs as this encourages them to take on the water, absorb the nutrients and expel waste products. Yoga based exercises and stretching are excellent for this. To read more about keeping discs healthy through exercise, please read my series on Sarah Key’s Five Stages of Back Pain.

How can I maintain my muscle mass?

Muscle mass is preserved by resistance exercise, whether you choose bodyweight resistance (as in my Swiss ball series of exercises) or weights. Muscles also require feeding – protein is an important building block for muscle! Animal protein (meat, fish and eggs) is the most complete form; so vegetarians and vegans have to be a bit more diligent about ensuring that they get all the essential amino acids in their diets.

What do I need to know about posture?

Posture is largely about practice! The idea is that your body should be stacked like a Jenga tower, and relaxed. So if you’re standing, your knees should fall above your feet, hips above knees, pelvis over hips, ribcage over pelvis, shoulders over ribcage, head over shoulders – you should be able to drop a plumbline down from the tip of your ear to the middle of you ankle, and another from the tip of your nose through your pubic bones and falling half way between your feet. Instead, a posture I see all the time is “forward head posture” where your chin is poking forwards, placing strain on the muscles of the neck and back, as they work to prevent you from face planting. Working on flexibility will make it easier to achieve good posture (a useful exercise I use to reverse the effects of “forward head posture” is the Starfish exercise, followed by practising good poise) – and people who can control their stress levels and get enough sleep also tend to sit and stand better, as stress and tiredness tend to make us stiff and slouched.

What if I need more help?

Of course, if you’re already struggling with osteoporosis or pain, then it may be time to seek some professional help. Consultant rheumatologist Dr Millie Stone is my go-to for a proper medical work-up in London; and my friends at Complete Pilates are now also offering online, “on-demand” exercise classes with a specific focus on osteoporosis, which are well worth trying. However, if you’re struggling with pain or injury then of course I’m very happy to help – just call my team on 0207 175 0150 to book an assessment.

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