Nourishing your bones

Bone disease is usually a silent risk – with a little effort it is possible to prevent, postpone or manage the effects, says expert Karen Geary

I’m quite focused on bone health – both osteopenia and osteoporosis are prevalent in my family. Osteopenia is characterised by lower-than-normal bone mineral density (BMD), but the bone loss is not as severe as in osteoporosis. It is often a precursor to osteoporosis. Individuals with osteopenia have weaker bones that are more susceptible to fractures than those with normal bone density, but less susceptible than those with osteoporosis.

However, not everyone with osteopenia will progress to osteoporosis – the journey is gradual and can take many years.

Osteoporosis is a more advanced and serious condition, characterised by significantly low bone density and deteriorated bone quality. Bones become fragile and prone to fractures, even with minor stress or trauma. Osteoporosis is often referred to as a ‘silent disease’ because it progresses without noticeable symptoms until a fracture occurs. Common sites of fractures associated with osteoporosis include the spine, hip and wrist. Women, particularly after menopause, are more prone to developing osteoporosis, but it can also affect men and younger individuals due to certain medical conditions or lifestyle factors. Maintaining strong and healthy bones is crucial for overall well-being and quality of life. As we age, the risk of developing either osteopenia or osteoporosis increases. However, by adopting a balanced and nutritious diet, combined with a few lifestyle modifications, you can manage and potentially delay deterioration in bone health. It’s good to know the best foods to promote bone health. Here are some valuable tips to help you maintain strong and resilient bones.

What makes a good bone diet?

• Protein

Protein is essential for bone formation and repair. Ensure that your diet includes lean sources of protein such as fish, poultry, lean meat, eggs, legumes and tofu. However, it’s important to strike a balance – excessive protein intake can lead to increased calcium excretion and place undue pressure on the kidneys. Aim for 0.8g to 1g of protein per kilogram of body weight, more if you are athletic or an older adult.

• Calcium-rich foods

Calcium is an essential mineral that forms the building blocks of our bones. Incorporating calcium-rich foods into your daily diet is vital for bone health. Dairy products such as milk, yogurt and cheese are excellent sources of calcium. If you are lactose-intolerant or prefer non-dairy alternatives, consider fortified plant-based milks, calcium-set tofu and leafy green vegetables like kale, broccoli, spinach and bok choy. Oats, tahini, sesame seeds, chia seeds, poppy seeds and almond butter also contain good amounts of calcium. It’s important to note that studies suggest calcium supplements make NO difference, but ensuring an abundance of cofactors such as vitamins D and K2 and magnesium DO!

• Vitamin D

Vitamin D plays a crucial role in calcium absorption, making it a key nutrient for bone health. Exposure to sunlight is the most natural way to obtain vitamin D, but it can also be found in fatty fish (salmon, mackerel), egg yolks and it’s in fortified foods like cereal. However, many individuals may require vitamin D supplements, particularly if they have limited sun exposure or are unable to meet their dietary needs. It’s recommended to regularly test your vitamin D levels, aiming for an ideal level of 75nmol/L.

• Magnesium, Phosphorus and Boron

Magnesium and phosphorus are two minerals that work alongside calcium to maintain bone strength. Nuts, seeds, whole grains, legumes and dark chocolate are excellent sources of magnesium. Phosphorus-rich foods include seafood, lean meats, poultry, dairy products and nuts. Boron helps regulate calcium and magnesium levels and sources include apples, pears, nuts, bone broth, beans and lentils.

• Vitamin K

Vitamin K is necessary for the production of proteins that regulate bone metabolism and mineralisation. Leafy green vegetables like spinach, kale and collard greens are rich in vitamin K. Other sources include broccoli, Brussels sprouts and fermented foods like sauerkraut and kimchi.

Lifestyle tips to prevent osteoporosis

• Regular exercise

Engage in weight-bearing exercise like walking, jogging, dancing and resistance training, to promote bone strength and density. Incorporate balance and flexibility exercises to reduce the risk of falls.

• Avoid smoking

Smoking can negatively impact bone health. Also be mindful of caffeine, alcohol and fizzy drinks – high consumption of all of these may increase calcium excretion from your bones, removing important minerals and accelerating the loss of bone density over time, increasing the risk of fractures.

• Maintain a healthy weight

Being underweight or overweight can adversely affect bone health. Strive to maintain a healthy weight through a balanced diet and regular physical activity.

Post-menopause

The loss of oestrogen during menopause increases the risk of osteoporosis. Weight-bearing exercises, phytoestrogenic foods (flaxseeds, cruciferous vegetables, sesame, nuts), and good nutrition as described above are all important after the menopause. In summary, a nutritious and varied diet may help improve bone density and delay deterioration.

Supporting your gut microbiome – an emerging focus in bone health research – may also help to regulate bone health.