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The Importance of Diet for Bone Health – Preventing Osteoporosis19th March 2021
In the second instalment from Ben Steele-Turner, Musculoskeletal Physiotherapist and Associate Registered Nutritionist, Ben discusses the importance of diet for bone health and preventing osteoporosis. Ben explores how what you eat can affect your bone density, and which supplements are effective for bone health.
What exactly is Osteopenia and osteoporosis?
Osteoporosis or Osteopenia is the gradual loss of bone tissue, associated with aging, it has some unfortunate side effects. Your diet from when you are much younger, even your mother’s diet during pregnancy, can lay the foundations for bone health. When we are younger, from childhood to adolescence, our bone health is increasing, we want to get the peak as high as possible. From middle-aged onwards it begins to decline. Therefore, we need to focus on getting the peak as high as we possibly can and slow the decline to maintain bone density. Many people think of bone density as an innate structure, which is not the case. It is constantly repairing, remodelling, and rebuilding.
A nice way to think of it, is a ‘bone bank account’. When we are younger, we have two types of cells, firstly, saver cells that want to ‘pay money in’, and secondly the spenders, the cells who want to ‘take money out’ of the ‘bone bank account’. When we are younger, we are paying money in and saving up and we want to save up as big a bone bank balance as possible. But as we get older the spenders start spending faster than the savers are saving. We want to do everything we can to aid the saver cells and slow down the spender cells.A way to think about bone density, is to picture the structure of an Aero or Whispa chocolate bar, which have air bubbles and spaces. The chocolate would be the bone, and as we get older the bubbles get bigger and the amount of bone decreases. Therefore, they become more fragile and more susceptible to osteoporotic or fragility fractures. There is plenty that our diet can do to play a role in this.
Is how much I eat related to my bone density?
It certainly is. We need to be giving our body enough energy to maintain bone density. As the bone is constantly repairing and remodelling, we need to be providing nutrients for rebuilding. Calorie balance or energy balance is how much energy we are taking in and how much we are expending, whether that is your Basal Metabolic Rate (BMR) keeping you awake or for daily activities and exercises.
If you’re constantly eating under your what you should be (your BMR) this could have a negative impact on your bone tissue health and density. This could be because there isn’t enough energy, and you aren’t eating as much food, so you probably aren’t getting the right amount of nutrients. Making sure you are at least eating at an energy balance is important for maintaining bone density.
You can calculate your BMR here: https://www.calculator.net/bmr-calculator.html
Why are calcium and Vitamin D so important?
Calcium and Vitamin D are vital when it comes to bone health, they get a lot of attention in media. Calcium is an essential mineral our bodies need; we don’t produce it ourselves so we must get it through our diet. Think of calcium as one of the foundation building bricks for bone. Over 99% of all the Calcium in the human body is stored in the skeleton and teeth (1). Vitamin D works in harmony with Calcium, Vitamin D regulates or boosts how much of the Calcium you eat gets absorbed to help form new bone.
We don’t want to focus on just one of these. Imagine you have a bow and arrow with two targets in front of you. One of the targets is Calcium and one is Vitamin D, if you hit the Calcium bullseye for the day you won’t get any more points for hitting it again, you should aim to hit the Vitamin D bullseye instead. You should be getting both regularly in your diet.
Calcium sources can be dairy products, green leafy vegetables, oily fish, and plant-based food such as edamame and tofu.
For Vitamin D sources, you could take a supplement or fortified foods. Whole foods to try could be oily fish, eggs and mushrooms.
Which other key nutrients are important for bone density?
As well as Calcium and Vitamin D there are some other key nutrients:
- Protein – important for building strong muscles. It is also important for bone tissue which is a living thing that is constantly rebuilding. One of the main constituents of bone is collagen, which is a protein. There is an outdated theory that excess protein isn’t good for bone health, we know now that isn’t strictly true. Protein is important, and we also need to be getting plenty of healthy fruit and vegetables alongside that, but we do want to be hitting our protein sources.
- Vitamin K - Vitamin K is important for aiding our saver cells, the cells that want to pay into the ‘bone bank account’ for bone health and density.
- Magnesium – women usually see a drop in magnesium during menopause, also a time where women see a drastic drop in bone density. It has been shown, in both human and animal studies that if you restrict magnesium, it is not good for markers of how much our saver cells are paying into our ‘bone bank account’ and bone density.
Good sources are meat, fish and eggs. Those with vegetarian or vegan diets worry about where they are going to get their protein sources from, but you can reach your protein targets, you just have to be more aware of where you are sourcing it from. Good sources for a plant-based diet are tofu, chickpeas and tempeh. (Vegan Protein Sources. Peta.org)
Good sources of Vitamin K are leafy vegetables, asparagus, broccoli. Vitamin K is good for bone health and general diet.
Good sources of Magnesium are nuts and seeds, avocado and spinach.
Please seek guidance from a nutritionist if you require more information or have individual dietary needs.
Key takeaway messages for diet and bone health:
- What we eat is a cornerstone for bone health and is very important.
- There is no magic fix or pill we can take; it takes effort and is an investment, but it gets easier the longer you commit to taking action.
- If you are worried you are osteoporotic or have osteopenia, then I recommend seeing a local dietician. They are qualified to assess your diet and take into account medical factors.
How can I get individual advice on this?
You can speak to a specialist in your area or you find Ben’s details on the OA Knee Pain website.
To view Ben’s full video please follow this link: https://www.oakneepain.co.uk/videos
- Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Washington (DC): National Academies Press (US); 1997.