I think there is a natural tendency to avoid thinking about problems that we all associate with being older – maybe we just don’t like to imagine ourselves as elderly, or maybe it’s a hangover from when we were teenagers and believed our bodies were invincible (no matter what awful things we did to them). But now I’m 38, and given that I’ve already passed the peak of when my bones are at their strongest, I probably need to see this as a priority. Plus, having worked in hospitals for a number of years, I’m well aware of the devastating effects of having a fall and fracturing your hip. So I thought it might be time for another post that focuses on what we can be doing to prevent this happening later in life.
Although I actually did do biology GCSE, it was weirdly preoccupied with plants and photosynthesis, and seemed to ignore most of what was going on in our own bodies. So although I can’t say I gave it a huge amount of thought when I was younger, I honestly believe I grew up thinking of bones as some kind of inert lump of “stuff”. I doubt many people are this badly informed these days, but just to review: bone is living tissue and is constantly being broken down and rebuilt throughout our lives. Like any living tissue, this process requires constant nourishment. When we are young our bones remodel themselves and repair damage very quickly. In fact, bone size and strength typically peaks between the ages of 30 and 35. As we age there is a tendency for our bones to gradually lose their density, as the careful balance of bone formation and loss changes, leading to slightly increased bone loss in comparison to bone growth. Whilst this is thought to be a normal part of ageing, for some people it can lead to osteoporosis, osteopenia (a precursor to osteoporosis) and an increased risk of fractures. This is actually thought to be due to a number of risk factors, and not just a lack of dietary calcium as is often believed. Bone loss occurs in both men and women, but the patterns of loss are different. In men it is a steadier, gradual process. Whilst women tend to see an acceleration of bone loss post menopause, due to more significant changes in hormone levels.
So the good news is that plenty can be done to reduce the severity of bone density loss by following a few key diet and lifestyle pointers. Although prevention from an early age is the best protection, luckily for all the people who tend to bury their head in the sands about health issues that occur later in life, there has been a lot of positive research into reducing the rate of age-related bone loss too. I’ve listed the key points for you to focus on below.
Get out into the sunshine! We are well aware of the dangers of sitting out in the midday sun and burning ourselves to a crisp, but it is important to get a reasonable level of sun exposure in order to maintain healthy bones. The sun triggers our bodies to produce vitamin D, which is just as essential in bone health as calcium. So waiting a little while before putting on the factor 30 can be a good thing. The amount of time will vary for each person, just make sure you don’t burn as this is a sign you’ve gone too far. Because getting enough sunshine in the UK can be tricky it might be worth getting your vitamin D levels checked with your GP and taking a supplement, if needed. GPs are usually pretty happy to check levels. What I would say is that get yourself a decent supplement, one that you spray under your tongue (this way it doesn’t have to go through your digestive system). Go to a proper health food shop that sells up-market supplements and has an advisor, and ask them to recommend a brand. Better You is the one I use, but there are other options.
Another thing you need to do is to get yourself off the sofa and out into the fresh air. Weight-bearing and resistance exercise such as walking, jogging, dancing and light weight lifting are particularly good at maintaining bone density - running in particular is great - have a look at a blog Rachel wrote about her running exploits! And if you need even more inspiration on why it's important to move a bit more, check out a previous blog on the (many) benefits of exercise. Also, and this will be quite nice news for a few people I can imagine, maintaining an adequate body weight is essential. Being low weight or underweight, particularly for women, puts you at much greater risk of developing osteoporosis. Other lifestyle changes include reducing alcohol intake, which interferes with how our bodies absorb and use calcium, and stopping smoking, which is a well known risk factor in developing osteoporosis.
Getting the right nutrients in your diet is key. Calcium is the most abundant mineral in our bones, and therefore quite rightly the focus of attention in preventing bone density loss. However, there are many nutrients involved in bone health, not just calcium. It is also important to get calcium from a wide range of foods, not simply relying on dairy. And for those of you who are vegan or who avoid dairy for health reasons, then it is quite possible to get enough calcium in the diet with a bit more effort (have a look at the bottom of the blog for vegan sources of calcium). Calcium works with vitamin D, as vitamin D increases our ability to absorb calcium from our diet. Sunshine, as I mentioned earlier, is important. But we can also get vitamin D in oily fish – so regular salmon, mackerel, herring and sardines. Small oily fish are doubly beneficial as they also are a great source of calcium themselves (if they include the bones).
Magnesium and vitamin K are also just as important as calcium in bone health. The kind of foods you want to be eating to get enough of these nutrients include: broccoli, spinach, peas, celery, tomatoes, onions, garlic, eggs, chicken breast, sauerkraut, dried figs, apricots and prunes, bananas, pineapple and oranges. Nuts are also high in magnesium, so go for almonds, cashews, Brazils, pecans and sunflower seeds. If you’re feeling brave, you could try the traditional Japanese fermented soy food, natto. It has extremely high levels of vitamin K and magnesium, as well as calcium and vitamin A. It’s the perfect food for healthy bones – but in my view you’d have to pay me money to eat it, it’s definitely an acquired taste! But worth trying, because if you don’t mind the flavour then really it’s a perfect way to get vitamin K. For a quick reference, use this table of bone supporting nutrients. bone-supporting-nutrients-table
Phytoestrogens are another nutrient you can focus on, and they have the added benefit of being good for hormone health too. You find them in flaxseeds, sesame and sunflower seeds, chestnuts and various pulses such as chickpeas, lentils and kidney beans. They are thought to be beneficial in maintaining bone density in post-menopausal women. Soy products are very high in phytoestrogens, but make sure you get organic, non GM soy products, such as organic tofu or tempeh.
Maybe one recommendation that won’t be joy to people’s ears is that it’s important not to be overdoing it on the caffeine, as caffeine can increase the amount of calcium we excrete in our urine and also interferes with absorption of nutrients from our diet needed for healthy bones. Remember, caffeine is not just found in coffee, but also tea, chocolate and fizzy drinks (the latter should be avoided for multiple reasons anyway).
So, in a nutshell, whether you are male or female, old or young, I think it’s worth thinking ahead a little and putting in the effort now. All the tips listed will be beneficial to your health in numerous ways, so it’s not just helping your bones.
Vegan sources of calcium
Vegetables and Fruit:
Spinach, greens, kale, bok choy, bean sprouts, collard greens, chard, broccoli and French beans, rhubarb, oranges, grapefruit, dried dates and figs
Nuts and seeds:
Sesame, almonds, chestnuts, walnuts and sunflower seeds
Nut milks such as almond or oat milk (often fortified with calcium)
Tofu-ensure it contains calcium sulphate in the ingredients
Edemame (soybeans), garbanzo beans, navy and white beans