National Healthy Aging Month: Tips for Improved Bone Health

As September is National Healthy Aging Month, this blog will discuss nutrition and lifestyle tips for strong bones throughout the life cycle.  Although this topic becomes more critical as we age, it is important to be aware and start earlier in life for optimal results.

Why is Bone Health Important?

The bones in our bodies serve many vital functions. These functions include support, movement, storage, and blood cell generation and maintenance.  

  • Support: Bone provides a rigid framework as well as support for other parts of your body.
  • Movement: The interaction between bones and muscles allows for the body to be capable of a wide variety of movements.
  • Storage: The bones store vital micronutrients to keep our bodies functioning. The bone stores both calcium and phosphorus. When our serum levels of phosphorus or calcium become dangerously low, the bones release both minerals to maintain levels.
  • Blood Cell Generation: Red blood cells, white blood cells, and platelets are all created within our bones. This process is called hematopoiesis and is the formation of blood cellular components which occurs during embryonic development and throughout adulthood to produce and replenish the blood system1.

It is estimated that over 200 million people worldwide have osteoporosis2. Osteoporosis is a condition that causes bones to be weak and brittle leading to fractures, falls, and breaks. With the above listed roles of bones, it is important to be proactive with practicing good bone health!

What can affect bone health?

While some factors that affect bone health are not preventable, many factors can be addressed to reduce risk of disease. These factors can all affect bone health and risk of bone conditions:

  • Calcium intake: Eating a diet lower in calcium can lead to diminished bone density, early bone loss, and increased risk of bone fractures.
  • Physical Activity: People that are less physically active are at greater risk for osteoporosis than those who are more active.
  • Tobacco and Alcohol: Research has shown a direct relationship between tobacco use and decreased bone density3. Also, regularly having more than one alcoholic drink a day for women or two alcoholic drinks a day for men may increase the risk of osteoporosis.
  • Sex: Women have a higher risk of osteoporosis than men do due to lower amounts of bone tissue4.
  • BMI: Having a BMI less than 19 can put smaller framed people at risk due to having less bone mass.
  • Age: As you age, bone becomes weaker and thinner as bone mass is lost faster than it is created.
  • Race or Family History: Caucasians and Asians are at the biggest risk of developing osteoporosis. Furthermore, having immediate family members with osteoporosis increases risk as well.
  • Hormone levels: Hormones of concern are thyroid hormone, estrogen, and testosterone. Too much thyroid hormone can lead to bone loss. Post-menopausal women may have increased bone loss due to decreasing estrogen levels. Lastly, low testosterone levels in men can cause a loss of bone mass.
  • Medication Use: Long-term use of corticosteroid medications, such as prednisone, cortisone, prednisolone, and dexamethasone, can be damaging to the bone. Other drugs that might increase the risk of osteoporosis include aromatase inhibitors to treat breast cancer, selective serotonin reuptake inhibitors, methotrexate, some anti-seizure medications, such as phenytoin (Dilantin) and phenobarbital, and proton pump inhibitors4.

Tips to improve bone health:

Here are some ideas and tips to keep your bones healthy for successful aging:

  • Calcium: Calcium is the most important micronutrient when it comes to bone health.
    • The recommended daily allowance for calcium intake is:
      • Age 9-18 years: 1,300 mg
      • Age 19-50: 1,000 mg
      • Age 51+: 1,200 mg
    • As old bone cells are constantly broken down and replaced by new ones, it’s important to consume calcium daily to protect bone structure and strength5.
    • Ways to increase calcium intake include dietary sources and supplements. Foods containing calcium include:
      • chia seeds, sesame seeds, cheese (parmesan containing the highest amount), yogurt, sardines or canned salmon, edamame, lentils, and dark leafy greens.
    • Vitamin D: Vitamin D is another critical micronutrient for bone health. The recommended daily allowance for vitamin D is: 600 IU for all ages.
      • Vitamin D plays various roles in bone health, including helping the body absorb calcium. Achieving a blood level of at least 30 ng/ml (75 nmol/l) is recommended for protecting against osteopenia, osteoporosis and other bone diseases6.
      • Food sources of vitamin D include:
        • salmon, tuna, tilapia, soy milk, dairy milk, yogurt, mushrooms, orange juice.
      • Physical Activity: Participating in a variety of exercises allows for healthy bone and bone growth.
        • One of the best types of activity for bone health is weight-bearing or high-impact exercise, which promotes the formation of new bone.
        • Research studies have found significant improvements in bone health, bone density, and bone strength with weight-bearing exercises7–9.
        • Furthermore, one study examined the effects of 32 weeks of exercise training on balance, lower-extremity muscle strength, bone mineral density and serum levels of bone metabolism and inflammatory markers in older adults10. This study found that their exercise protocol reduces inflammation and increases BMD, balance, and lower-extremity muscle strength10.
      • Eat a variety of vegetables: Vegetables contain a wide variety of essential vitamins and minerals. Consuming vegetables of different colors and types ensures that you are getting the micronutrients to fuel your body.
        • Many vegetables contain high levels of vitamin C. Emerging research has found vitamin C to be a beneficial micronutrient in maintaining bone health. One study reported that vitamin C exerts a positive effect on trabecular bone formation by influencing expression of bone matrix genes in osteoblasts11.
        • One study researched the relationship between dark green and yellow vegetables with bone health. The study results recommend eating diets rich in both dark green and deep yellow vegetables to lead to bone mass accrual in young children12.
        • Another study done on post-menopausal women found that a varied vegetable intake resulted in positive changes in both turnover markers and calcium conservation13.
      • Magnesium: Magnesium is another mineral that also plays a role in maintaining bone health.
        • Magnesiumplays a key role in converting vitamin D into the active form that promotes calcium absorption. 
        • A prospective cohort study researched 73,684 postmenopausal women enrolled in the Women's Health Initiative Observational Study. Results found that lower magnesium intake is associated with lower bone mineral density of the hip and whole body14. The study recommends magnesium consumption slightly above the RDA (310–420 mg depending on age/gender).
        • Foods that include magnesium:
          • Pumpkin seeds, chia seeds, almonds, spinach, cereal, soy milk, peanut butter, black beans, and cashews.
        • Omega 3 Fatty Acids: Omega-3 are identified as potential key nutrients, safe and effective in the treatment and prevention of several negative consequences of aging15.
          • One crossover study including 23 participants found that plant sources of omega-3s may have a protective effect on bone metabolism via a decrease in bone resorption in the presence of consistent levels of bone formation16.

Main Takeaways

Bone health is an important topic of concern throughout every stage of life.

There are many ways to improve one’s bone health and reduce risk of bone disease. Through physical activity and dietary intake, bone mineral density, bone strength, and inflammation can be improved.

Citations

  1. Jagannathan-Bogdan M, Zon LI. Hematopoiesis. Dev Camb Engl. 2013;140(12):2463-2467. doi:10.1242/dev.083147
  2. Osteoporosis: a still increasing prevalence - PubMed. Accessed September 9, 2021. https://pubmed.ncbi.nlm.nih.gov/16455317/
  3. Smoking and Bone Health | NIH Osteoporosis and Related Bone Diseases National Resource Center. Accessed September 9, 2021. https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/bone-smoking
  4. How to keep your bones healthy. Mayo Clinic. Accessed September 9, 2021. https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/bone-health/art-20045060
  5. 10 Natural Ways to Build Healthy Bones. Healthline. Published January 18, 2017. Accessed September 9, 2021. https://www.healthline.com/nutrition/build-healthy-bones
  6. Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008;87(4):1080S-6S. doi:10.1093/ajcn/87.4.1080S
  7. Vainionpää A, Korpelainen R, Sievänen H, Vihriälä E, Leppäluoto J, Jämsä T. Effect of impact exercise and its intensity on bone geometry at weight-bearing tibia and femur. Bone. 2007;40(3):604-611. doi:10.1016/j.bone.2006.10.005
  8. Klentrou P, Slack J, Roy B, Ladouceur M. Effects of exercise training with weighted vests on bone turnover and isokinetic strength in postmenopausal women. J Aging Phys Act. 2007;15(3):287-299. doi:10.1123/japa.15.3.287
  9. Bhatia VA, Edwards WB, Johnson JE, Troy KL. Short-term bone formation is greatest within high strain regions of the human distal radius: a prospective pilot study. J Biomech Eng. 2015;137(1). doi:10.1115/1.4028847
  10. Marques EA, Mota J, Viana JL, et al. Response of bone mineral density, inflammatory cytokines, and biochemical bone markers to a 32-week combined loading exercise programme in older men and women. Arch Gerontol Geriatr. 2013;57(2):226-233. doi:10.1016/j.archger.2013.03.014
  11. Aghajanian P, Hall S, Wongworawat MD, Mohan S. The Roles and Mechanisms of Actions of Vitamin C in Bone: New Developments. J Bone Miner Res Off J Am Soc Bone Miner Res. 2015;30(11):1945-1955. doi:10.1002/jbmr.2709
  12. Wosje KS, Khoury PR, Claytor RP, et al. Dietary patterns associated with fat and bone mass in young children. Am J Clin Nutr. 2010;92(2):294-303. doi:10.3945/ajcn.2009.28925
  13. Gunn CA, Weber JL, McGill A-T, Kruger MC. Increased intake of selected vegetables, herbs and fruit may reduce bone turnover in post-menopausal women. Nutrients. 2015;7(4):2499-2517. doi:10.3390/nu7042499
  14. Orchard TS, Larson JC, Alghothani N, et al. Magnesium intake, bone mineral density, and fractures: results from the Women’s Health Initiative Observational Study. Am J Clin Nutr. 2014;99(4):926-933. doi:10.3945/ajcn.113.067488
  15. Molfino A, Gioia G, Rossi Fanelli F, Muscaritoli M. The role for dietary omega-3 fatty acids supplementation in older adults. Nutrients. 2014;6(10):4058-4073. doi:10.3390/nu6104058
  16. Griel AE, Kris-Etherton PM, Hilpert KF, Zhao G, West SG, Corwin RL. An increase in dietary n-3 fatty acids decreases a marker of bone resorption in humans. Nutr J. 2007;6:2. doi:10.1186/1475-2891-6-2

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