This is generally a topic brought up by, for, or around the older population (especially for women), but it’s actually important for all ages. Being mindful of our bone health can prevent minor accidents or rough hits from ending up with broken bone injuries. Our bones are continuously changing — new bone is made and old bone is broken down. When you're young, your body makes new bone faster than it breaks down old bone, and your bone mass increases. Most people reach their peak bone mass around age 30. After that, bone remodeling continues, but you lose slightly more bone mass than you gain. So as we age and bone loss becomes a bigger concern, we should go into it with the healthiest bones we can. Always best to get ready for a trip with a full tank right? Or for the more modern generation make sure your battery is fully charged before you head out. Muscles, blood pressure, weight, even blood sugar are all pretty straight forward as far as how to take care of them and make them better – but how do we care for our bones?
What affects Bone Health?
A number of factors affect our bone health, some of which we can control, others we can’t, but should be aware of so that we can try to counteract them as much as possible, or know when we need to do a little more.
- Physical activity
- Tobacco and alcohol
- If you are male or female
- Race or family history
- Hormone levels
- Eating disorders or other conditions such as weight loss surgery
- Certain medications
Let’s talk about the harder ones to control first – then we can dive into the ones that are easier to control. Genetics: Women (particularly whites and Asians) have a higher risk for osteoporosis than males. Eating disorders and weight loss surgery (for different reasons) affect our ability to absorb calcium, as do hormone levels in our bodies (Estrogen, testosterone, cortisol and prolactin are all important to how we lose and make new bone cells), and finally certain medications (Corticosteroids, heparin, warfarin, cyclosporine, glucocorticoids, medroxyprogesterone acetate, cancer drugs, and thyroid hormone can cause bone loss). Age: The National Osteoporosis Foundation estimates that half of all women over the age of 50 will eventually develop osteoporosis and that 80 percent of Americans with osteoporosis are women. And while Osteoporosis has been considered a “women’s disease,” 20-25 percent of all hip fractures occur in men. As the U.S. population ages, more senior men are expected to become affected by osteoporosis. So what CAN we do to take care of our bones?
THINGS WE CAN DO
There ARE a number of risk factors for bone loss or osteoporosis that we can control and most of them aren’t that hard and can have positive effects on the rest of our health and well-being as well.
Smoking reduces the blood supply to the bones and to many other body tissues. The nicotine in cigarettes slows production of bone-producing cells, called osteoblasts. Smoking decreases the body's absorption of calcium, which is necessary for vital cellular functions and bone health. Alcohol consumption impacts how the body absorbs calcium and vitamin D, both of which are critical for healthy bone development. “Alcohol can decrease the absorption of calcium via the intestine, or it can have effects on the pancreas and vitamin D metabolism, which can impact bone density,”
Weight: Obesity adversely affects bone health by a variety of mechanisms such as an alteration of bone-regulating hormones, increased oxidative stress and inflammation, and altered bone cell metabolism.
Physical activity: Exercising regularly reduces the rate of bone loss and conserves bone tissue, lowering the risk of fractures. Exercise also helps reduce the risk of falling.
People with existing osteoporosis can also benefit from exercise. This is because a sedentary lifestyle (little exercise) encourages the loss of bone mass. Exercising regularly can reduce the rate of bone loss. Numerous studies have shown that strength training can play a role in slowing bone loss, and several show it can even build bone. This is tremendously useful to help offset age-related declines in bone mass. Activities that put stress on bones can nudge bone-forming cells into action. That stress comes from the tugging and pushing on bone that occur during strength training (as well as weight-bearing aerobic exercises like walking or running). The result is stronger, denser bones.
And strength training, in particular, has bone benefits beyond those offered by aerobic weight-bearing exercise. It targets bones of the hips, spine, and wrists, which are the sites most likely to fracture. What's more, resistance workouts — particularly those that include moves emphasizing power and balance — enhance strength and stability. That can boost confidence, encourage you to stay active, and reduce fractures another way — by cutting down on falls.
I’ll spend a little more time here – because, face it, we all eat, every day. It’s one of the easiest places to make changes and can have an effect on our entire life. First, eat a healthy diet to build and maintain strong bones. Eating a well-balanced diet with plenty of fish, fruits, and vegetable should provide enough of the nutrients needed. It’s important to eat a variety of calcium-rich foods every day because it is an essential building block for bones and Vitamin D helps the body absorb calcium, among other things, so it is also important for building and maintaining bone health. The Bone Health and Osteoporosis Foundation recommends at least 1000mg per day of calcium, more as we get older. Other nutrients in a healthy diet also help to maintain bone health throughout the lifespan.
Vitamin D is made right in our bodies, when we get sunlight – more sunlight, more vitamin D. If you live in colder climates and can’t get enough sun in the winter, consider a supplement.
Kale, collard greens, and broccoli contain high amounts of calcium and are rich in healthy fibers that improve digestion and prevent constipation. Fiber and calcium are a good team: the first slows digestion, allowing the body to absorb more of the second. Kelp, okra, and sardines are also great sources of calcium. Soybeans and white beans also contain good amounts of calcium along with magnesium. The presence of magnesium with the calcium is important, as the two work together to perform vital roles in the body. Soybeans are also a great source of B6, Iron and vitamin C. Last, but not least, eggs are another good source of calcium.
Two things I haven’t mentioned are spinach and dairy. Spinach is high in calcium, but also high in oxalates, which prevents the calcium from being absorbed, so it essentially is NOT a place to get any calcium. Dairy has long been considered “the” place to get calcium, but that is largely due to lobbying and advertising by the dairy association and government. With dairy, only about 31% of the calcium is bioavailable (IE absorbable by our bodies). Consider that one cup of Bok choy, 1½ cups of kale, or 2 cups of broccoli provide the same amount of calcium as you get from a glass of milk, due to their much better calcium absorption rate (in the 50–60% range!). Additionally, “Consumption of dairy products, particularly at age 20 years, was associated with an increased risk of hip fracture in old age. Research undertaken by a team of Swedish scientists shows a link between milk consumption with increased mortality, bone fractures and osteoporosis.
In women over 20 years, drinking more than 200g of milk daily (less than one glass) was linked to increased mortality. This increased risk ranged from 21% for one to two glasses to 93% for those consuming three or more. More than one glass a day was also linked to an increased risk of fractures in women.
Things to avoid:
Excess protein. As the intake of dietary protein increases, so does the urinary elimination of calcium. So when you double your protein, your calcium loss through urination increases by 50%. On average men need 56 grams of protein per day and women about 46. Americans tend to eat 50-100% more than that. So consider how much protein you are getting vs how much you really need.
Salt. The more salt you eat the more calcium you lose. “Salt is known to cause excessive calcium excretion through the kidneys,” says Felicia Cosman, MD, an endocrinologist, professor of clinical medicine at Columbia University in New York. She recommends staying below 2300mg per day, but for anyone considering their blood pressure when thinking about their diet the newer recommendations are 1500 mg per day. Easy if you eat whole foods, not so easy when you throw processed foods into the mix.
Caffeine “Caffeine leaches calcium from bones, sapping their strength,” explains Dina Khader, RD, CDN, an integrative nutrition consultant in Mount Kisco, New York. “In fact, roughly 6 milligrams of calcium are lost for every 100 milligrams of caffeine you ingest.”
Soda If you drink a lot of soda, it could negatively affect your bone health. “Drinking seven or more colas per week is associated with a reduction in bone mineral density and an increase in risk of fracture,” Cosman says. “The mechanism is not totally understood,” she says, but “no soda is good for general health” (And since most soda contains caffeine, it’s a double edged sword, see above)
Certain beans (particularly pinto beans and peas) contain phytates, which can interfere with the body’s ability to absorb the calcium that’s also found in the beans. But you don’t have to avoid the beans, just soak and rinse them thoroughly before cooking (which incidentally also helps with the other problem that beans are famous for).
IT’S REALLY NOT HARD OR A MYSTERY
Take care of yourself by doing some strength exercises to help build muscle and you will build more bone mass. Support that by eating natural healthy foods that are rich in calcium so that your bones have it available to build from (and don’t forget to make sure you are getting enough vitamin D and magnesium to help with the calcium absorption). Then make sure that you’re not doing anything in excess that could interfere with the calcium doing its job – IE smoking, drinking to excess (recommendations generally say no more than 2 drinks per day), eating foods high in sodium or taking medications known to interfere with calcium. If you are on a medication that fits that description, talk to you doctor about alternatives – or find out what you need to do get off of that medication. The fewer medications and supplements we have to take, the better our bodies will be able to take care of themselves.
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 https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/bone-health/art-20045060  https://creakyjoints.org/diet-exercise/alcohol-and-osteoporosis/  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/osteoporosis-and-exercise  https://www.bonehealthandosteoporosis.org/healthy-bones-guide  https://www.forksoverknives.com/wellness/milk-myth-why-you-dont-need-dairy-for-calcium/  t-need-dairy https://iphysio.io/osteoporosis/
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