Osteoporosis is a condition that affects bone health and density, making bones weaker and more susceptible to fractures. It is especially common in women over the age of 50, although it can affect men and the young as well. Fortunately, there are several ways to prevent and manage osteoporosis, including eating a healthy and nutritious diet that is rich in key vitamins and minerals that support bone health.
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The importance of healthy bones at all life stages
Bone health is paramount at all stages of life, beginning from childhood when bones are growing and maturing, through the teenage years and young adulthood when peak bone mass is achieved, to menopause in women and advancing age in both sexes, when bone loss becomes more prevalent.
Osteopenia, a condition characterised by slightly decreased bone density, is often a precursor to osteoporosis. Symptoms are typically subtle, including loss of height and recurring fractures, yet can also be absent until a serious bone fracture occurs. It’s crucial, therefore, to undergo regular bone density tests, especially if one has risk factors such as a family history of osteoporosis, vitamin D deficiency, or a sedentary lifestyle.
Osteoporosis, on the other hand, is a more severe condition where bones become weak and brittle due to substantial loss of bone density. This condition can progress from osteopenia if left unmanaged and it often shows similar signs but more severe in nature, such as back pain caused by a fractured or collapsed vertebra, a stooped posture, or broken bones that occur much more easily than expected.
The journey from osteopenia to osteoporosis is gradual and can take years, but timely interventions, including a healthy diet, regular weight-bearing exercises, and/or appropriate supplements can help slow down or even prevent this progression.
Nutrition for bone health
Calcium is the primary building block for healthy strong bones. Good dietary sources of calcium include dairy products such as milk, cheese and yoghurt, as well as leafy green vegetables such as broccoli, kale and spinach. Also try oats, silken tofu, tempeh, tahini, sesame seeds, chia seeds, poppy seeds and almond butter.
Guidelines for calcium intake differ from country to country but generally toddlers up to 3 years old need around 700mg calcium per day and then older children and adults need 1,000 – 1,300mg of calcium per day, so it is important to ensure that the diet includes adequate amounts of this important mineral. One serving of natural yoghurt (240ml) contains about 415mg, 100ml of cow’s milk is 120mg and a tablespoon of sesame seeds is about 90mg.
Vitamin D helps the body to absorb calcium from the foods we eat. The best source of vitamin D is sunlight, so spending time outdoors in the sunshine is important for maintaining healthy bones. However, vitamin D is also found in oily fish such as salmon and mackerel, as well as egg yolks and food supplements which are useful, especially during the winter. The general consensus is that blood levels of Vitamin D need to be at least 50 nmol/L and some research has suggested that 75 nmol/L might be a better level to aim for. It is good to test your Vitamin D levels regularly.
Magnesium helps to regulate calcium levels in the body and supports the uptake of vitamin D from the sun. Good dietary sources of magnesium include dark chocolate, whole grains, nuts, seeds and green leafy vegetables such as spinach and kale. Adults generally require around 300mg of magnesium per day, depending on age and gender, but temporarily they may need double this. 300mg magnesium is around 100g of sunflower seeds, or 400g of spinach.
Boron is a mineral that is less well-known than calcium, vitamin D and magnesium, but is also important for bone health. Boron helps to regulate calcium and magnesium levels in the body, and may also play a role in the production of oestrogen, which is important for bone health in women. Good dietary sources of boron include fruits such as apples and pears, nuts and legumes such as beans and lentils. Also think bone broths, oxtail soups and slow cooked lamb shanks.
The Gut Microbiome is emerging as important for bone strength. The balance of bacteria and other microbes within the intestines influences bone strength and density through the production of short-chain fatty acids, like butyrate and propionate, known to encourage bone formation and slow down bone loss. Importantly, the gut microbiome aids in absorbing and metabolising vital nutrients like calcium and vitamin D, essential for bone growth and remodelling. The microbiome also regulates our immune system, affecting the balance between bone-forming (osteoblasts) and bone-dissolving (osteoclasts) cells, which is crucial in maintaining bone health.
Thus, any disturbance to the gut microbiome, due to factors like diet, antibiotics or stress, can potentially negatively affect bone health. So, nurturing a balanced gut microbiome by consuming a wide range of fruits, vegetables, nuts, seeds, wholegrains and pulses as well as cultured foods (such as natural yoghurt, sauerkraut, kimchi), is key to promoting bone strength and preventing conditions like osteoporosis.
Other factors to consider
As well as a healthy diet it is important to practice weight bearing exercise where your feet and legs support your weight. High-impact weight-bearing exercise such as running, aerobics, skipping, dancing, and even jumping up and down on the spot are excellent choices. It is also important to avoid smoking and excessive alcohol consumption, as these habits can contribute to bone loss.
A nutritious diet that is rich in calcium, vitamin D, magnesium and boron can help to increase bone density and prevent osteoporosis. By incorporating a variety of healthy foods into your daily diet, you can support your gut microbiome and in turn your bone health and reduce your risk of fractures and other bone-related conditions.
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