Do We Have a Bone Health Crisis?

When was the last time you thought about your bone health? 

The chances are that it’s not something you often think about, especially if you’re young. But bone health is something you should pay attention to.  Whether you’re 17 or 70, eating the right foods, doing bone strengthening exercise, and getting enough calcium and vitamin D, will all help to make your bones stronger.

Bone basics

Bones constantly break down and rebuild in a process called bone remodelling.  Your teens and early adult years are the time when your bone rebuilding capability is at its peak – you are building bone faster than it is breaking down.

Bone remodelling slows down in your early 30s, and from then on you start to lose bone faster than you make it and your bones can start to weaken as you age.  And because you can’t feel this happening, your first sign that things aren’t right may be a wrist or ankle fracture.

Osteoporosis

Normal bone compared to a bone with osteoporosis

Osteoporosis (and its little sister osteopenia) occurs when the mesh-like structure inside your bones becomes porous and susceptible to breaking.  It is diagnosed using a bone density scan or DEXA scan, which shows how much higher or lower your bone density is than that of a healthy 30-year-old - the lower your score is, the weaker your bones are.

Its estimated that 3 million people in the UK have osteoporosis, and shockingly, 50% of women and 20% of men over the age of 50 are expected to break a bone during their lifetime as a result of this disease.

If osteoporosis progresses unchecked, your bones can become so brittle that they can break when you simply cough or sneeze, or the vertebrae in your spine can crack and compress just due to the action of gravity.  And what’s more, blood cell production in your bone marrow will decrease, which can lead to significant fatigue, slow wound healing, low immunity, and increased frailty.

Anyone can develop weak bones but perimenopausal women are particularly vulnerable as their rapid decline in oestrogen leads to faster bone breakdown and a greater risk of fracture.

What can you do?

Diet

The old adage 'you are what you eat' is particularly applicable to bone health. A diverse plant-filled diet that contains quality proteins, calcium and fibre will help to prevent bone loss.

Calcium is vital - about 99% of your body’s calcium is stored in your bones.  Most adults need 700mg of calcium per day but as you age your body’s ability to absorb calcium declines and you’ll need to eat more calcium-rich foods (such as dairy products, canned fish with bones, leafy green vegetables and fortified foods) to have enough to maintain your bone strength.

But calcium alone is not enough.  You need adequate vitamin D (from oily fish, liver, milk, eggs, mushrooms, and fortified foods) to help your body to absorb the calcium effectively.

Exercise

Weight-bearing and muscle-strengthening exercises encourage bone production. You should aim to do both exercise 4 times a week. 

If you already have a diagnosis of osteoporosis, or a health condition such as heart trouble, high blood pressure or diabetes, check with your doctor before you begin a new exercise programme.

Supplements

Supplements aren’t intended to replace food however calcium and vitamin D supplementation can help to improve bone strength where dietary intake is low, or during the winter months when you can’t make enough vitamin D from the sun’s UV rays.

Over the age of 50, the recommended daily intake of calcium for women is 1200mg/d and 1000mg/d for men.  You should not exceed this daily amount (combined dietary sources and supplements) on a regular basis as it may cause you harm. Use the calcium calculator on the Royal Osteoporosis Society website to see whether your dietary calcium intake is sufficient or whether you should consider an additional calcium supplement. If you choose to supplement vitamin D during the winter months, then the maximum safe daily dose for adults is 100mcg or 4000IU.

You should always seek nutritional or medical advice before taking supplements as they can interact with prescribed medication or may not be recommended with certain medical conditions.

Tips for maintaining healthy bones

• Avoid smoking – it reduces bone mass by slowing production of bone-building cells

• Don’t drink alcohol in excess – drinking more than the recommended units per week can weaken bones and lead to osteoporosis even if you have no other risk factors.  Alcohol can decrease your absorption of calcium in your small intestine as well as reduce your ability to use vitamin D

• Reduce (or avoid) fizzy drinks - daily consumption can double your fracture risk by causing a calcium imbalance

• Eat a predominantly whole food anti-inflammatory diet – one that contains quality proteins, fibre, lots of vegetables, and some fruit

• Exercise regularly – focus on weight-bearing and strength-training activities

• Get enough calcium and vitamin D

• Some medications can increase bone loss – ask your doctor about side-effects of your medications

• Cut back on caffeine – it can increase calcium excretion from your body which could affect bone density

• Get expert help - talk to a registered Nutritional Therapist about ways you can support your bone health