Written by: Nazish Taban Yazin
It is said that during the first two decades of life is when you can largely influence your peak bone mass by getting enough calcium and vitamin D and doing bone-strengthening exercises [1].
So, does that mean that if you are over the age of 20, it’s too late? Absolutely not! It’s never too late to adopt bone-preserving habits [2]. In fact, many nutrition and lifestyle habits can help you build strong bones and maintain them as you age.
Here are 4 things you need to keep in mind.
- A Healthy Diet
Nutrition and bone health are closely related. Adequate dietary intake of certain key nutrients contributes to bone health and reduces the risk of osteoporosis (brittle bones) and fragility fractures later in life.
The key nutrients for bone health at all ages are Calcium, Vitamin D and Protein.
Eat high-calcium food throughout the day
Calcium is the most important mineral for bone health, and it’s the main mineral found in your bones [3]. As old bone cells are constantly broken down and replaced by new ones, it’s important to consume calcium daily to protect bone structure and strength.
The Recommended Dietary Intake (RDI) for calcium is 1,000 mg per day for most people, although teens need 1,300 mg and older women (51-70) and men (over 71) require 1,200 mg [3].
Interestingly, if you eat a meal containing more than 500 mg of calcium, your body will absorb much less of it than if you consume a lower amount [3]. Therefore, it’s best to spread your calcium intake throughout the day by including one high-calcium food from this list at each meal.
Good dietary sources of calcium include:
| Food type | Examples |
| Milk and milk products | ● One cup of milk
● 200 g tub of yoghurt or 200 ml of calcium-fortified soymilk ● Calcium-fortified milk can provide larger amounts of calcium in a smaller volume of milk |
| Leafy green vegetables | ● One cup of cooked spinach contains 100 mg (although only 5% of this may be absorbed due to the high concentration of oxalate, a compound in spinach that reduces calcium absorption)
● One cup of cooked broccoli contains about 45 mg of calcium (but the absorption from broccoli is much higher at around 50-60%) ● Collards (cabbage family), bok choy, Chinese cabbage |
| Soy and tofu | ● 1 cup or 260 g of tofu
● 1 cup of tempeh ● 250 ml of calcium-fortified soymilk |
| Fish | ● ½ cup of canned salmon or sardines |
| Nuts and seeds | ● Brazil nuts,
● almonds ● sesame seed paste (tahini) |
| Calcium-fortified foods | ● 1 cup of calcium-fortified breakfast cereal (40 g)
● ½ cup of calcium-fortified orange juice (100 ml) ● 2 slices of bread (30 g) ● Plant-based milk (oat, almond, rice, etc.) may or may not be calcium-fortified, so it is important to check the label of these products if you intend to use these in place of regular dairy milk to boost your calcium intake. |
Boost your vegetable intake!
As seen from the table, vegetables are not only high in calcium but also are one of the best sources of vitamin C, which stimulates the production of bone-forming cells. In addition, some studies suggest that vitamin C’s antioxidant effects may protect bone cells from damage [1].
The Importance of Vitamin D
What does vitamin D do for our bones? [4]
- Helps absorb the calcium we get from food.
- Along with calcium, helps protect older adults from osteoporosis.
- Promotes healthy functioning of our muscles and immune system.
We need strong muscles to help us balance and reduce the risk of falling and breaking bones. Unfortunately, it is difficult to get all the vitamin D we need from our diet as only a few consist of it. For example:
- Egg yolks, liver, oily fish (salmon, tuna, mackerel, herring) and selected products fortified with vitamin D (eg milk powder, margarine and cereal) [5].
Sunlight also contributes to the body’s production of vitamin D. However, it is important to balance the need for limited sun exposure for vitamin D, while avoiding the risk of any sun damage [5]. Due to seasonal changes, in summer a few minutes mid-morning or mid-afternoon is generally adequate for vitamin D and in winter longer exposure times are needed.
The Sunshine Map below provides recommendations for sun exposure for vitamin D based on location within Australia.
Vitamin D supplements : Healthy adults with no vitamin D deficiency should be able to get adequate amounts of vitamin D from sunlight and by consuming a well-balanced diet. People with osteoporosis and low bone mass should discuss their vitamin D levels with their healthcare provider to ensure they are getting an optimal amount [6].
Don’t forget your Protein!
Protein is one of the building blocks of bone. Adequate dietary protein is essential for optimal bone mass gain during growth and also for preserving bone and muscle mass with aging [7].
Research has shown that low protein intake decreases calcium absorption and may also affect rates of bone formation and breakdown [8]. Make sure your diet includes lean sources of protein, such as eggs, lentils, white-meat poultry, lean beef, dairy, shrimp and soy.
- Strength training and weight-bearing exercises
A combination of weight-bearing exercises (such as brisk walking, hiking, stair climbing, running or skipping) along with resistance training — also called strength training or weightlifting — can strengthen your muscles and bones. These exercises should be done at a moderately hard intensity to achieve the greatest benefit [9].
Talk to your doctor or visit an exercise physiologist/physiotherapist before starting any new exercise activity to make sure it is right for you.
- Smoking & Alcohol
Smoking, or having a history of smoking, increases your risk of broken bones [9]. If you currently smoke, the best thing you can do for your bones and overall health is to stop smoking as soon as you can.
Drinking more than 10 alcoholic drinks in a week or drinking every day has been proven to significantly increase your risk of fracturing or breaking a bone [9]. By not drinking alcohol to excess, you can help keep your bones strong as well as reduce your risk of falling over or getting injured due to the influence of alcohol.
- Weight Management
In addition to eating a nutritious diet, maintaining a healthy weight can help support bone health. Being underweight increases the chance of bone loss and fractures [7]. Excess weight now is known to increase the risk of fractures in your arm and wrist [7]. As such, keeping body weight in check is good for bones just as it is for health in general.
The Bottom Line
Bone health is vital for living independent, active and healthy lives. Furthermore, nutrition plays an important role in maintaining the health of our bones throughout all life stages.
If you are concerned about your dietary management revolving around your bone health and would like to receive personalised advice, feel free to book an appointment with one of our dietitians at Inside Health Nutrition.
Reference:
- https://www.healthline.com/nutrition/build-healthy-bones
- https://www.health.harvard.edu/womens-health/5-ways-to-boost-bone-strength-early
- https://www.betterhealth.vic.gov.au/health/healthyliving/calcium
- https://www.niams.nih.gov/health-topics/calcium-and-vitamin-d-important-bone-health#:~:text=Vitamin%20D%20promotes%20bone%20health,our%20muscles%20and%20immune%20system.
- https://healthybonesaustralia.org.au/wp-content/uploads/2022/10/hba-fact-sheet-vitamin-d.pdf
- https://www.bonehealthandosteoporosis.org/patients/treatment/calciumvitamin-d/
- https://www.osteoporosis.foundation/health-professionals/prevention/nutrition/protein-and-other-nutrients#:~:text=Adequate%20dietary%20protein%20is%20essential,and%20muscle%20mass%20with%20ageing.&text=In%20childhood%20and%20adolescence%2C%20protein,role%20in%20bone%20mass%20acquisition.
- https://pubmed.ncbi.nlm.nih.gov/12612169/
- https://www.healthdirect.gov.au/healthy-bones
