BUILDING BETTER BONES
By Rosemary Ann Ogilvie
Intro: Building healthy bones is much more complex than simply eating calcium-rich dairy foods or taking calcium supplements. Calcium is in fact just one of many minerals involved in bone health, even though it tends to be the point of focus. Here we will look at the combination of nutrients, foods and activities that will ensure your bones retain their strength and health throughout your life.
Q: I’m a bit concerned that I may not be doing enough to ensure my bones stay healthy and that I don’t develop osteoporosis, mainly because I can only tolerate some dairy products, not all. Also, I don’t take calcium supplements because they tend to make me constipated. What else can I do?
To build and maintain a strong skeletal system, Osteoporosis Australia recommends eating three servings of calcium-rich dairy products per day as part of your normal diet: a 250ml glass of milk, a 200g tub of yoghurt, a 40g chunk of cheese. These can be full fat or low fat as each contains similar levels of calcium.
There’s no question that dairy foods contain a high level of easily absorbed calcium. But what if you don’t eat dairy: perhaps because you’re a vegan, or follow a paleo diet, or don’t tolerate dairy foods, or you simply don’t like them? Does this mean you're doomed to a lifetime of taking calcium supplements, something else that's not always well tolerated?
The answer is a resounding no – which may come as a surprise, conditioned as we are to the idea that the only way to ensure a strong skeleton is through a high intake of calcium from dairy foods and/or supplements.
The reality is, while calcium is important for healthy bones (and numerous functions in the body), it’s just one of a range of nutrients involved in bone remodelling: at least 12 minerals alone are believed to play a role in this process.
My prescription for building and maintaining healthy bones has always been to eat a wide variety of plant foods: fresh fruits and vegetables, nuts and seeds, pulses and grains. This bounty from nature is not only an incredibly rich source of calcium, it also contains a range of other nutrients that work together synergistically: calcium is never found in isolation in plant foods. As an example, foods rich in calcium are also rich in magnesium, a mineral that works with calcium to maximise that mineral's absorption.
A study reported in the May 2007 edition of the American Journal of Clinical Nutrition (http://ajcn.nutrition.org/content/85/5/1428.abstract) showed that women who obtain calcium from food sources have healthier bones and greater bone density than women who take calcium supplements.
Although participants who received at least 70 per cent of their daily calcium from food rather than supplements ingested the least calcium – an average 830mg per day, they had better hip and spine bone density than participants who consumed 1030mg primarily from supplements.
The reason for this is that calcium found naturally in food tends to be better absorbed than calcium from supplements, which is derived from inorganic sources.
Many of my clients find they suffer either constipation or diarrhoea when they take supplemental calcium, and this is because the body is not assimilating it. The calcium accumulates, which creates mineral imbalances. When calcium and silica are out of balance, kidney stones and foot spurs may develop. Other mineral imbalances or deficiencies can give rise to serious chronic conditions such as cardiovascular disease, gallstones, osteoarthritis, and type 2 diabetes.
A 2015 study from the University of Surrey found the abundant potassium salts (bicarbonate and citrate) present in fruit and vegetables play a key role in improving bone health. For the first time, the results also showed these potassium salts reduce bone resorption, the process by which bone is broken down, therefore increasing their strength. www.sciencedaily.com/releases/2015/01/150114115340.htm.
So bypass the pharmacy and head straight for your neighbourhood greengrocer or local farmer’s market, because here you will find the most potent medicines of all. Stock up on leafy greens, which should be eaten every day as they’re a particularly high-value source of calcium: 100kJ of leafy greens contain more than three times the calcium of 100kJ of whole milk. As a bonus, greens contain vitamin K1, which is yet another vital nutrient for bone health.
But don’t stop there: choose a range of brightly coloured produce with the aim of eating several different coloured fruits and vegetables each day. And use onions extravagantly, for they contain gamma-glutamyl peptides, which are known to increase bone density.
If you own a juicer, buy celery, carrots and apples to make a daily mocktail that will provide you with the full range of vitamins and minerals you need. Or enjoy one at your local juice bar at lunchtime.
High-quality protein, too, is important as amino acids form part of the bone matrix. Oily fish such as salmon is an excellent choice as it provides omega 3 essential fatty acids, yet another important bone nutrient. Other valuable protein sources are free-range eggs, free-range chickens, and pasture-fed meat in moderation. Vegans should focus on lentils, nuts, seeds and fermented soy products such as tempeh.
For those who eat dairy, small amounts of low-fat dairy foods will further boost calcium levels. The dairy industry is doing a fantastic job with the wonderful ranges of low-fat products now available, for it means we can enjoy yoghurt and cheese without the risk of cardiovascular disease. Cheese, especially soft curd cheese, contains vitamin K2, a nutrient associated with bone density that is present in fermented foods, notably natto, a Japanese soy product that admittedly is not to everyone's taste.
As for milk, it appears there are risks attached to its consumption, such as an increased likelihood of developing prostate cancer. A Canadian study found men who drank four 200ml glasses of milk a day have double the risk of prostate cancer (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219618/). Milk was the only dairy product significantly associated with prostate cancer risk. Some evidence links milk to breast cancer, although research is contradictory.
Vitamin D is critical for healthy bones as it promotes calcium absorption. Spend 15 minutes outside enjoying the morning sun, without sunscreen, and your body will manufacture the vitamin D you need for bone health and disease prevention.
Another key factor is weight-bearing exercise. Ideally, use your time in the sun to go for a walk, or perform some resistance exercises using your body weight or free weights.
The wrists, hips and spine are the areas most vulnerable to fracture, so you may consider consulting a qualified fitness instructor to develop a regimen for strengthening these areas.
Practise good sleep hygiene to maximise your chances of having a good night’s sleep. Insufficient sleep has been linked to chronic disease risk, and might also be an unrecognised risk factor for bone loss, suggests a study from The Endocrine Society published in April 2017. Prolonged sleep disturbance can lead to lower bone formation. (www.sciencedaily.com/releases/2017/04/170402111317.htm). Researchers found that after three weeks of cumulative sleep restriction and circadian disruption, healthy men had reduced blood levels of a marker of bone formation, similar to that seen in jet lag or shift work. The biological marker of bone resorption, or breakdown, was unchanged.
Lead investigator Christine Swanson, M.D., an assistant professor at the University of Colorado, explained this altered bone balance creates a potential bone loss window that could give rise to osteoporosis and bone fractures. “If chronic sleep disturbance is identified as a new risk factor for osteoporosis, it could help explain why there is no clear cause for osteoporosis in the approximately 50 percent of the estimated 54 million Americans with low bone mass or osteoporosis,” she commented.
Ditch the processed junk foods, for they can create biochemical imbalances that weaken the skeleton.