Cardiovascular fitness and bone strength rise together. A study in adults shows that heart health can predict bone health. More and more evidence shows that chronic diseases like these are linked. So the better your heart health, the stronger your bones.
Osteoporosis is a significant problem in older adults. The bones lose mineral and thin out, and fractures become more likely. One-third of women over 50 and one-fifth of men live with osteoporosis.
Osteoporosis is not just about too little calcium or vitamin D. It also comes from hormone changes, inflammation, sitting too much and many other causes. That is why people with metabolic health problems are also more likely to have weaker bones.
The link between metabolic health and bone mineral density (BMD) is known. But no one had looked at what heart health does for BMD. One new study used Life’s Essential 8 (LE8) scores to test it. It gave sound evidence that heart health and BMD go together.
In this study, researchers looked at data from 39,156 adults in the National Health and Nutrition Examination Survey (NHANES) 2011–2018 database. They left out anyone younger than 20 or older than 59. They also left out groups at high risk of osteoporosis, like women past menopause and people with chronic diseases known to affect bone. That way they could study heart health and bone health on their own. After these cuts, 2,159 people remained.
To score heart health, researchers used the LE8 system from the American Heart Association. It looks at four habits: diet, exercise, smoking and sleep. It also looks at four health measures: BMI, blood fats (lipids), blood sugar and blood pressure. From these eight factors, each person gets an LE8 score from 0-100. The researchers also used dual-energy X-ray absorptiometry (DXA), a special X-ray scan, to measure BMD at different spots.
The researchers also adjusted the data for other factors like age, lifestyle and vitamin D intake. Even after that, they still found a significant link between LE8 scores and BMD at several spots, such as the low back and mid-back spine and the trunk.
They also found that higher LE8 scores were more likely to go with better health in people of normal weight. Less benefit was seen in people who were underweight or overweight. The link was also stronger in younger adults, those aged 20-34.
So this study shows that better heart health goes with better bone health, or BMD. It also shows that steps to improve heart health are good for bones too. More exercise, more calcium and a healthy body weight were all linked to better bone health.
So this study confirms you can also improve bone health by improving heart health. It adds to the evidence that everything is linked when it comes to metabolic health.
So it is vital to boost your overall health, not just manage one metabolic problem at a time. Improving heart health may also improve bone health, and the other way around. It also shows that a problem in one body system may point to problems in others. So weak bones may also be a sign of failing heart health.
Frequently asked questions
Is heart health linked to bone density?
Yes. Researchers looked at 2,159 adults aged 20 to 59 from the NHANES 2011–2018 database. They scored their heart health with the American Heart Association’s Life’s Essential 8. Even after adjusting for age, lifestyle and vitamin D intake, higher scores went with higher bone density at the spine, trunk and other spots. The better the heart health, the stronger the bones.
Can improving heart health improve bone density?
The study points that way. The same habits that lift heart health scores were tied to better bone health: more physical activity, adequate calcium intake and an optimal body weight. The link was strongest in people with a normal BMI and in younger adults aged 20 to 34. Work on one body system, and the other tends to follow.
What causes osteoporosis besides low calcium?
Osteoporosis is not just a calcium or vitamin D problem. Hormone changes, inflammation, sitting too much and other factors all weaken bone. That is why people with metabolic health problems are more likely to have weaker bones. One-third of women over 50 and one-fifth of men live with osteoporosis.
What is Life’s Essential 8?
Life’s Essential 8 is a heart health score from the American Heart Association. It rates four habits (diet, exercise, smoking and sleep) and four health measures (BMI, blood fats, blood sugar and blood pressure), for a score from 0 to 100. In this study, higher scores went hand in hand with denser bones. Weak bones may be a sign of failing heart health.
Source:
Cui, Y., Xu, Z., Cui, Z., Guo, Y., Wu, P., & Zhou, X. (2025). Association between life’s essential 8 and bone mineral density among adults aged 20–59 years. Scientific Reports, 15(1), 2664. https://doi.org/10.1038/s41598-025-86749-7
Dr. Gurpreet Singh Padda, MD, MBA, MHP
