Since our inception, the bones takes care of the complete framework of the body and offer vital protection to internal organs. It gives the strength to crawl, walk, jump, run, hop, stand, sit and perform activities. Bones work silently and tirelessly years after years. We start taking them for granted and stop paying attention to nourishing them. Bones which are the major part of the skeletal system never come on the top of our wellness list. Unexpectedly one day our busy hectic life comes to a break-off due to a minor injury. We become clueless and find everything sudden but the reality is bones are like a savings account, there is only as much bone density in the account as we deposit over the years. Bone health is not just an old age matter but a lifelong concern.
What is bone health?
It is the rigid and dense connective tissue that is a part of the skeleton. ¾ physical activity at all ages, particularly weight-bearing activity, is dependent on bone health. Bones are made up of three major components that make them both flexible and strong. Collagen is a protein that gives bones a flexible framework. Calcium-phosphate mineral complexes make bones hard and strong. Living bone cells that remove and replace weakened sections of bone.
Stages of bone development and renewal
- Childhood- New bone forms quickly as bones grow longer
- Teens and early 20s Quick-bone formation allows bones to grow in density and strength
- In the mid-20s, up to about 40-Balance between the formation of new bone and breakdown of old bone
- 40s onwards-Old bone broken down more quickly than new bone forms, so bones begin to lose density
Why does bone mass loss happen?
It happens when there is decreased bone formation, low intestinal calcium absorption and less physical activity or if there is any hormonal change in the body. Bone loss increases the risk of fracture and diseases known as osteoporosis. Bones become brittle and fragile and lose their strength. As we age, we lose more bone than we replace but with changes in diet and exercise, bone loss can be slowed down. People with low bone density are more likely to break a bone compared to people with normal bone density.
Non-changeable risks factors for bone loss
- Female gender/past menopause or with estrogen deficiency
- Family member with osteoporosis or fractures.
- Thin, petite body frame
- Other health conditions like rheumatoid arthritis, celiac disease and an overactive thyroid gland
- History of a broken bone (fracture)
- Use of certain medicines like corticosteroids, anticonvulsants or others.
- History of falls over the past year
- Modifiable risk factors for bone loss
- Too little intake of calcium, vitamin D and other nutrients
- Too little exercise
- Smoking or history of smoking
- Three or more alcoholic drinks per day
- Excessive intake of coffee, cola or other caffeinated beverages
- What is the Bone mineral density test?
It measures the density of minerals, like calcium and other types in bone. It is a painless procedure that takes less than 15 minutes. It is performed to diagnose bone loss and osteoporosis. Also shows how well osteoporosis medicine is working and predict the risk
Nutrition and bone health
The role of nutrition in bone health is quite important. Adopting a balanced diet, rich in nutrients, minerals, and vitamins contributes significantly to bone health. Proper nutrition is an essential parameter of skeletal health, participating in both the prevention and the treatment of bone diseases. Nutrition holds a dominant role in skeletal health, both in reaching the top bone density, from infancy until about the thirtieth year of life and in maintaining bone health for the rest of adult life.
A balanced diet that covers the daily caloric needs along with daily intake of calcium and vitamin D is a key factor in achieving peak bone mass during the transition from infancy to adulthood and reducing the rate of bone loss in the elderly. A healthy diet with adequate amounts of both macro-and micronutrients is essential, for both decreasing fracture risk and enhancing the healing process after a fracture. Dietary intake is an important modifiable factor for bone health. Inadequate intake of nutrients important to bone increases the risk of bone loss and subsequent osteoporosis. The process of bone formation requires an adequate and constant supply of essential nutrients.
Crucial nutrients to reinforce bone health
- Part of the organic matrix of bone for collagen structure. Has a role in the production of hormones and growth factors that modulate the bone synthesis
- Sources: Low-fat Meat and dairy products (milk, yoghurt, cheese), eggs, fish, nuts, beans, pulses
- A major bone-forming mineral. 99% of the body’s calcium is stored in the bone
- Sources: Low-fat dairy (milk, cheese, and yoghurt), spinach, kale, soybean and ragi
- Plays an integral role in bone formation as it is an essential constituent of the mineralisation of bone
- Sources: Low-fat dairy (milk, yoghurt), meats, poultry, fish, nuts and beans
- More than half of the body’s store of magnesium is in the bone, and it plays an important role in organic matrix bone synthesis.
- Source: Whole grains, spinach, nuts (almonds, cashews, peanuts), quinoa, avocado and dairy products
- Deficiency is associated with poor skeletal development, due to its importance in the initiation of bone mineralisation
- Source: Bananas, beer, green beans, bread, rice and carrots
- It is needed for enzyme activity to increase the cross-linking of collagen and elastin molecules
- source: Nuts
- Plays an important role in the mineralisation of bone tissue and organic matrix bone synthesis. Also important for the physiological action of vitamin D on calcium
- Source: Meats, shellfish, nuts, seeds and legumes
- Have positive effects on vitamin D and oestrogen and also improves calcium and magnesium retention by the kidneys
- Source: Fruits (raisins, prunes), nuts (almonds, hazelnuts, brazil nuts, walnuts, cashews), beans and lentils
- Deficiency has been associated with reduced bone mass, due to its role in the formation of bone regulatory hormones and some enzymes involved in bone metabolism.
- Source: bread and cereals, nuts and fresh green vegetables
- High potassium intake increases bone mass
- Source: Bananas, broccoli, parsnips, nuts, seeds, fish and shellfish
- Vitamin D
- An important direct and/or indirect mediator of bone
- Source: Fatty fish (tuna, mackerel, salmon), cheese, egg yolks and fortified foods
- Has important roles in vitamin D metabolism and collagen synthesis
- Source: meats, beans, nuts, whole grains, dried fruits and fresh green leafy vegetables
- Vitamin K
- Low intake causes osteopenia and increased fracture risk
- Source: Green leafy vegetables, vegetable oils and cereal grains
- Vitamin C
- It is important for collagen synthesis and is also a known antioxidant.
- Source: Fruits (oranges, strawberries, black currants), peppers, broccoli, sprouts and amla
- Vitamin B
- Reduces the risk of osteoporosis.
- Source: Dairy (milk, cheese), eggs, fish, fresh and dried fruits, meats and vegetables
What are bone health-associated lifestyle suggestions?
It is important for getting a head start in life. As per studies poor, early growth due to inadequate maternal nutrition leads to reduced adult bone mineral content at peak bone mass and later in life. Also increases the risk of hip fracture. A good amount of calcium and vitamin D-rich foods and supplementation should be included in the daily routine.
Childhood and adolescence
Strong bones are important at an early age. Children and adolescent should achieve their genetic potential for peak bone mass. Building bone helps stock up for the future. Healthy habits as a child or teenager can pay off years later with stronger bones. The suggestion is to eat good quality protein, and calcium-rich foods, get enough vitamin D (through sunshine or diet) and exercise regularly.
Maintaining bone mass in adulthood is handling well the increase of bone loss, avoiding premature bone loss and maintaining a healthy skeleton. Advice is to eat a balanced diet including bone-healthy nutrients. Avoid alcohol consumption, smoking habit and overindulgence with caffeine. Do a minimum of 30 minutes of physical activity.
The special nutritional needs of seniors are necessary for fighting fragility and reducing falls and fractures. Idea is to prevent and treat osteoporosis. Pay special attention to malnutrition and have a balanced diet rich in bone-healthy nutrients along with regular moderate physical activity.
Adopting bone-healthy behaviours is important throughout the lifespan. Whether one has osteoporosis, had a broken bone or is just interested in keeping bones healthy, proactive action is mandatory instead of waiting for a mishap. Appropriate dietary choices enhance overall health and intensify peak physical performance in all age groups. So it is obligatory always, to build a strong partnership with bones and their special needs without fail.
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