When we think of bones, we often think of skeletons – dry, dead and un-moving. But living bone is far from this, it is dynamic, it is flexible, always changing and always adapting. It is very much alive!
Bones do so much more than just store calcium… they play many vital roles in the body. They obvious ones are that they provide solid structure, store calcium and phosphorus, protect the brain and other organs and anchor muscles. But some of the other functions of bones are a little more surprising… bones help regulate our metabolism and control blood sugar and body weight, they act as an energy reservoir by storing fats and they produce our blood cells. They even help us regulate reproductive and cognitive functions.
Why do we need to talk about bone health?
Bone health matters, because increasingly we are are seeing that good bone health contributes to good health overall.
Your bones are continuously changing – new bone is made and old bone is broken down and throughout life, the balance of these two processes changes. When you’re young, your body makes new bone faster than it breaks down old bone, and your bone mass increases. This trend continues to somewhere between the ages of 25 and 30, when most people reach their peak bone mass. After that, the balance begins to shift and over time you begin to lose slightly more bone mass than you gain.
This makes it crucial that we aim to build strong and healthy bones during childhood, adolescence and early adult life. All is not lost from age 30 though, and there are many ways you can can continue to promote and protect bone health in adulthood too.
A word on Osteoporosis
Bone is strong – pound for pound, it’s as strong as steel, but thanks to it’s collagen content, it is also flexible. Osteoporosis occurs when the loss of collagen and minerals (calcium and phosphorus) occurs more quickly than the body can replace them, making the bone both less flexible and more brittle. This loss of bone density or mass occurs silently and progressively, often without symptoms until the first fracture occurs.
Osteoporosis is common, it affects well over 1 million Australians. It is common but it is just one of several conditions that lead to bone weakening and an increased fracture risk.
What factors affect bone health?
- The amount of calcium in your diet – A diet low in calcium increases the likelihood of diminished bone density, early bone loss and increased fracture risk
- Physical activity – People who are physically inactive have a higher risk of osteoporosis than people who are regularly active
- Tobacco and alcohol use – Research suggests that tobacco use contributes to weak bones. Similarly, regularly having more than one alcoholic drink a day for women or two alcoholic drinks a day for men may also increase the risk of osteoporosis
- Gender – You’re at greater risk of osteoporosis if you’re a woman, because women have less bone tissue than men.
- Body mass – You’re at risk if you are extremely thin (with a BMI of 19 or less) or have a small frame because you might have less bone mass to draw from as you age
- Age – Due to hormonal changes your bones tend to become thinner and weaker as you age
- Race and family history – You’re at greatest risk of osteoporosis if you are of Caucasian or of Asian descent. Also, if you have a parent or sibling who has osteoporosis that also puts you at greater risk – especially if you also have a family history of fractures
- Hormone levels – Too much thyroid hormone or hyperthyroidism can cause bone loss. In women, bone loss increases dramatically at menopause due to dropping estrogen levels. Prolonged absence of menstruation (amenorrhea) before menopause also increases the risk of osteoporosis. In men, low testosterone levels can cause a loss of bone mass
- Eating disorders and other conditions – People who have anorexia or bulimia are at risk of bone loss. In addition, stomach surgery (gastrectomy), weight-loss surgery, and conditions such as Crohn’s disease, Coeliac disease and Cushing’s disease can also affect your body’s ability to absorb vitamin D and calcium
- Certain medications – Long-term use of corticosteroid medications, such as prednisone, cortisone, prednisolone and dexamethasone, can be damaging to bone. Other drugs that might increase the risk of osteoporosis include; aromatase inhibitors to treat breast cancer, selective serotonin re-uptake inhibitors used in pain and depression, methotrexate, some anti-seizure medications, such as phenytoin (Dilantin) and phenobarbital, and proton pump inhibitors
What can I do to keep my bones healthy?
Simple changes to your daily life can help slow bone loss as you:
- Include plenty of calcium in your diet – Good sources of calcium include dairy products, almonds, broccoli, kale, canned salmon with bones, sardines and soy products, such as tofu. If you find it difficult to get enough calcium from your diet, ask your doctor or dietitian about supplements.
- Pay attention to vitamin D – Good sources of vitamin D include oily fish, such as salmon, trout, whitefish and tuna. Additionally, mushrooms, eggs and fortified foods, such as milk and cereals, are good sources of vitamin D. Your body also makes its own vitamin D when you’re exposed to sunshine so aim to spend 30 minutes a day outdoors with some skin exposed. If you’re worried about getting enough vitamin D, ask your doctor about supplements.
- Eat a balanced diet – Your meals should contain protein (meat, fish, eggs, nuts, seeds), fresh fruit and vegetables, carbohydrates (pasta, potatoes, rice), and good fats. Fruits and vegetables should make up a clear majority.
- Maintain a healthy weight – Being underweight is a risk factor for osteoporosis. Losing weight fast from a “crash diet” can increase your risk of bone loss and osteoporosis. This is particularly true if your periods stop with weight loss. Being underweight can affect oestrogen levels and oestrogen is highly protective form bone loss. If you need to lose weight, do it sensibly.
- Drink sensibly – Alcohol, tea, coffee, cola and other soft drinks reduce the amount of calcium you absorb, and may contribute to weakening of bones. Stick to the recommended amounts of alcohol, and swap some of your caffeine-fueled drinks for water.
- Include physical activity in your daily routine – Just like muscles, bones become stronger when you use them! Weight-bearing and resistance exercises are great for your bone health. They include walking, hiking, jogging, climbing stairs, playing tennis, and dancing. Bones also benefit if you lift and carry things. Weight training is ideal, but carrying shopping, gardening and housework all count too.
Want to learn more about reducing your risk of Osteoporosis or exercising for bone health? Click the button below to make an appointment with our Accredited Exercise Physiologist, Marissa Hoey.