Bone Health 101

Bone health is crucial especially when we age. It is estimated that over 3 million people in the UK are affected by osteoporosis, which is a bone disease that causes a decrease in bone mineral density and bone mass. This can then lead to bones that are weakened and more likely to break and fracture. It’s estimated that 50% of women and 20% of men over 50 will experience an osteoporosis related fracture.

Osteomalacia is the other bone disease that is characterised by the inadequate mineralisation of bone tissue and this could be down to a lack of vitamin D, calcium, or phosphate which weakens the bones over time. It is estimated that 1 in 1000 people are affected by Osteomalacia.

Prevention with diet and exercise could be the way forward to avoid the pitfalls of these debilitating diseases. In this article I want to highlight six vitamins and minerals that will help reduce the risk of developing either osteoporosis or osteomalacia and keep those bones super strong and super healthy. Read on for more details.

1. Calcium

Probably the most important and the one nutrient everybody thinks of when you start talking about bone health. Calcium is the main mineral found in your bones with 99% of your body’s calcium found in your bones. This is why consuming adequate amounts of calcium throughout the day will help boost calcium stores in your body and keep bones strong and healthy.

Calcium also keeps teeth healthy, regulates muscle contractions and heartbeat, and makes sure blood clots normally.

Good sources of calcium include milk, yoghurt, and other diary foods. Green leafy vegetables like spinach and kale contain good amounts of calcium but you would need to eat a lot to get enough, and certain compounds in vegetables, like oxalates, can decrease the absorption. Fish can also be a good source if you eat the bones of the fish like tinned sardines.

Adults aged 19-64 and over are recommended calcium intake of 700 mg a day.

Calcium intake in vegans could be an issue so I would recommend keeping an eye on levels and supplementing if needed.

2. Vitamin D

The sunshine vitamin and equally as important as calcium for bone health is vitamin D.

Vitamin D is essential for calcium absorption and bone mineralisation which are both positively associated with bone mineral density.

Vitamin D deficiency can lead to osteomalacia which is often referred to as “soft bone disease” and as the names suggests leads to a weakening of the bones. This disease can also cause the bones to break more easily. Deficiency of vitamin D could also lead to the decrease in absorption of calcium in the body which would also have a negative impact on bone health.

The main source of vitamin D that we get is from safe sun exposure onto exposed skin for about 5-30 minutes once a day between the times of 10am and 4pm. We need to be careful of too much sun exposure as UV radiation is a carcinogen. Limiting skin exposure to tanning beds would also be considered a wise choice.

We can get vitamin D from food sources as well such as oily fish like salmon and tuna, but this is dependent on the diet the fish consumes. Another good source is cod liver oil. Other possible food sources are beef liver, egg yolks, and cheese which all have small amounts of vitamin D. Some mushrooms treated with UV light have Vitamin D2.

It would appear that vitamin D3 (sunlight, fish, egg, beef liver) is better at raising the active form of vitamin D (25-hydroxyl vitamin D) in the body compared to vitamin D2 (mushrooms, other plants and fortified foods).

During the winter months I would recommend a good supplement of vitamin D which will help boost levels during those cold and dark months.

3. Vitamin K

Vitamin K is a fat-soluble vitamin like Vitamin D. It helps blood to clot in the body or coagulate properly. It also plays an important role in bone health.

This vitamin plays an important role in bone health with a low intake and low blood serum levels have been associated with an increased risk of fracture.

Several studies have shown that low vitamin K intake is associated with lower bone mineral density which explains the increase in fracture rate.

Vitamin K has also been shown to improve bone turnover profile which to my understanding means breaking down old bone and replacing it with new bone. Problems occur when bone is broken down but not replaced properly causing weaker bones like you find with osteoporosis.

Foods that contain Vitamin K are green leafy vegetables like kale, spinach, and broccoli. Other food sources are cereal grains and vegetable oils. When you are trying to absorb as much of a fat-soluble vitamin you can it’s better to be eaten with a good fat source like olive oil or avocado. This will maximise the absorption of the vitamin. This includes vitamin K and D, but also vitamin A and other carotenoids.

4. Magnesium

When it comes to underrated minerals look no further than magnesium.

Magnesium is a nutrient needed by the body to stay healthy, and it has many functions in the body including regulating muscle and nerve function, blood sugar levels, blood pressure, making protein, DNA and the most important one in regard to this article bone health.

It would appear that lower concentrations of magnesium in the body is linked to osteoporosis.

Another study indicates that higher magnesium intake is linked to an increase in hip and femoral neck bone mineral density.

One of the mechanisms for magnesium’s impact on bone health is the influence over osteoclasts (dissolve old bone) and osteoblasts (build new bone). Both osteoclasts and osteoblasts are needed for bone growth and repair.

Foods that contain good sources of magnesium are nuts, seeds, leafy greens, beans, grains, seafood, dairy products, and fruits. Dark chocolate is another good source of magnesium.

5. Protein

The most obvious role of protein is to build muscle which most people have heard. Protein also makes up the structural components of our cells and tissues, enzymes, hormones, and the active proteins secreted from the immune cells.

It has been shown that a higher protein diet has a positive impact on bone health by key mediators of bone health and increases the absorption of calcium.

One study using middle aged females showed that consuming a higher protein diet had a positive impact on bone mineral density.

When adding protein to your diet make sure you have a variety of proteins from animal to plant based options.

Foods that are high in protein are beef, chicken, fish, seafood, eggs, dairy products, nuts, legumes, and quinoa.

I would recommend a protein intake of 1.2g-1.8g per kg of body weight. This would mean a 70kg person would need between 84g to 126g.

6. Phosphorus

This little-known mineral is an important player when it comes to bone health.

About 85% of the body’s phosphorus is in bones and teeth making it quite an important mineral in bone health and bone homeostasis. Phosphorus is also present in smaller amounts in cells and tissues around the body, and also helps to filter out the waste in the kidneys and plays an important role in how the body uses and stores energy.

It would appear that phosphorus is just as important as calcium to bone health, with importance to bone growth and bone mineralisation.

However, a high intake of phosphorus could lead to the disruption of hormonal regulators of phosphate, calcium, and vitamin D leading to bone loss. I feel this is down to an increased consumption of processed foods and limiting the number of vegetables being consumed. This is why a nutritious balanced diet is vital for bone health and overall health.

Foods containing good sources of phosphorus are chicken, turkey, pork, organ meats, seafood, dairy, pumpkin and sunflower seeds, nuts, whole grains, beans, and lentils, and amaranth and quinoa.

Resistance Training

One final note is the use of resistance training in combination with a nutritious diet will help strengthen bones even more.

Resistance training can exert a mechanical load on the bones and in turn help to strengthen them. Resistance training alone or in combination with other interventions could be a good strategy in improving muscle mass and bone mass.

It would appear that resistance training and impact training are recommended for reducing the risk factors of osteoporosis and osteopenia.

I hope this article has given you some useful tips in combating the negative effects of bone disease, or preventing the occurrence in the first place.

For any further help in nutritional advice or resistance training please reach out and I would be happy to help you. If you are interested in personal training or a nutritional consultation please fill out my message form on my homepage and I will get back to you.

Until next time.