Updated: Oct 27, 2020
During my college years, one of my favorite classes was Anatomy & Physiology. I often found myself fascinated at the intricacies and capabilities of the human body. I remember specifically when we learned about the skeletal system - I would leave class amazed at how complex our bones are! If you brought together the best scientists, architects and engineers in the world, they wouldn't be able to come up with something as incredible as the human skeleton. I think previously, I had just assumed that bones were static structures that were there to keep everything moving and stable. This is so far from the truth!
The reality is, bones are incredibly dynamic. They're constantly being torn down and built up at the same time. Some bone cells are in charge of building bone tissue, while others are responsible for the breakdown of bone tissue. Anytime the body needs calcium, those specific cells get to work and take some right from your bones! Think about your bones like a calcium bank that your body is constantly making deposits and withdrawals from.
When children are growing, their bones are obviously growing as well. Once they hit their maximum height, bone mineral density continues to improve in a process called bone consolidation. Around the age of 30 however, bone mineral density peaks and then starts to decline. Age 30, folks- that’s pretty darn early! Further bone loss can be somewhat preventable later in life, but there’s no supplement, diet or exercise that can increase bone mineral density at that point. The key take away here is that you need to build the most solid structure during that first thirty years of life to withstand the decades of gradual breakdown that occurs afterwards. Then you need to preserve the rest as much as possible.
Now that I’ve terrified everyone, let’s talk about how to make those bones nice and healthy:
Since I said bones were like a "calcium bank", it is obviously important to keep calcium in your daily diet. Meeting your calcium needs is the most important step in bone health. Most people need 1000mg per day, but based on your age and sex you may need more. Dairy products contain a lot of calcium, but fortified milk alternatives (soy milk, almond milk and the like) can have the same amount, sometimes even more. As always, make sure to check your food labels!
Weight Bearing Exercise
Exercise not only builds muscle, it builds bone! The important thing is that the exercise needs to be weight bearing, meaning your body is moving against the force of gravity. Basically, any exercise that isn’t swimming or cycling would count. Possibly pilates and yoga too, as it can be debated either way if these are weight bearing. To clarify, non-weight bearing exercises are still good for you, just not necessarily for your bones.
General recommendations for exercise are 60 minutes every day for children and at least 150 minutes a week (30 minutes 5 days a week) for adults. Strength training should be done at least twice a week. If you’re not there yet, gradually increase your physical activity over time.
Vitamin D helps with calcium absorption, so it is an important nutrient to get enough of. The main source of vitamin D is actually sunlight, as our skin synthesizes its UV rays into vitamin D. Unfortunately, if you live in Western New York or any other northern latitude area in the US or Canada, you might not be getting enough. Some foods are fortified with vitamin D, but again, you still might not be getting enough.
Ideally, your medical provider would check your vitamin D level when you go in for routine blood work. If the test comes back low, you can take a supplement. The exact amount of vitamin D you should take is debated, as is what is considered healthy vitamin D levels in your blood. However, most providers generally recommend 1000 or 2000 IU of vitamin D3 daily. Some people may need more such as 5000 IU per day. Getting too much vitamin D shouldn’t be too much of a concern, as you most likely would need to take amounts WAY beyond typical recommendations to have a toxic amount.
The balance of phosphorus and calcium intake is important for bone health. Phosphorus is necessary, but if you're consuming too much phosphorus and not enough calcium, there may not be adequate bone building. Lots of foods contain phosphorus, but cereals, meat, dairy, eggs and brown soda are heavy hitters. If you’re a big soda drinker and aren’t quite ready to kick the habit, consider mixing in some clear sodas such as lemon-limed flavored varieties.
Smoking, Alcohol, Sodium and Caffeine
Smoking, as well as excessive intake of alcohol, sodium and caffeine can lead to bone loss. This is due to a variety of reasons including the affect on calcium absorption and excretion. Those factors can also have a negative effect on bone building cells. Even consuming too much fiber can be negative as it may interfere with calcium absorption. This is not a realistic concern for most people, however some vegans do have a very high fiber intake, and may want to be aware of this.
Generally, the more body mass you have, the higher your bone mineral density. Therefore, being underweight is a risk factor for osteoporosis. Eating disorders and chronic dieting can negatively impact bones as well. In women, if weight loss or intense physical activity has caused a loss of menses, bone health may also be negatively impacted.
Make no bones about it, you need to start taking care of your bones NOW! And your really should be taking care of your children’s bones NOW. Active play should be encouraged, and don’t consider chocolate milk as off limits. Prevention of disease is always the best approach, but with osteoporosis this is especially true!