The Blueprint for Better Bone Health

by Nate Widom

Osteoporosis is a condition where bones lose density and become more fragile over time. Because bone loss happens gradually, it’s often called a “silent disease” – many people don’t know they have it until a fracture occurs.¹ Thankfully, a combination of simple dietary changes and exercise can lower your risk. I sat down with Registered Dietitian Jeannie Versagli to discuss.

Your bones are made up of living tissue that your body continually breaks down and replaces. As we get older, people tend to lose more bone than their bodies can regenerate, which slowly weakens bone tissue. This may result in osteopenia and, eventually, osteoporosis. Though most people with osteoporosis do not notice symptoms, some experience aches and pains, loss of height, a hunched back, and digestive or breathing issues.^1,2
The less bone density you have, the greater your chances of breaking a bone from a fall. Moreover, both osteoporosis and fall risk increase with age. But, as Jeannie explains, osteoporosis “puts you at greater risk for fractures without even falling.” In severe cases, a fracture can occur from simply coughing too hard.
Most of the time, osteoporosis affects light-framed, post-menopausal women. This is because estrogen is strongly linked to healthy bones, and women experience significant drops in their estrogen levels during menopause. In fact, the Bone Health & Osteoporosis Foundation reports that 80% of Americans with osteoporosis are women, and one in two women over age 50 will break a bone due to low bone density.³
However, Jeannie stresses “there are other individuals at risk” covering all ages and genders. Other at-risk groups include those with a family history of osteoporosis as well as individuals with hormonal imbalances, HIV, eating disorders, arthritis, certain cancers, and endocrine diseases. Poor nutrition, lack of physical activity, and heavy smoking and drinking will further increase your risk of bone disease.² Do not assume you’re immune!
Easy changes will help maintain strong bones at any age. Here are Jeannie’s suggestions for mitigation:

Get Calcium

Found in: Dairy products, salmon, fortified products, sardines, nuts, seeds, tofu, and kale

It’s common knowledge that calcium helps build strong bones, but Jeannie sees many fall short of the recommended amount. Most adults should aim to reach 1000mg of calcium daily, and 1200mg for those 65 or older.
In addition to its critical role in bone health, calcium plays a positive role in blood clotting, relaxing heart muscles, balancing muscle contractions, and improving cholesterol levels. A deficiency can produce muscle spasms, cramps, depression, confusion, and more.⁴

Get Vitamin D

Found in: Eggs, fortified dairy, mushrooms, and various fatty fish like salmon, mackerel, halibut, sardines, and canned tuna

Vitamin D is also critical to bone health because it helps us absorb calcium. “It enhances calcium absorption,” Jeannie explains. Both are needed together to strengthen your bones.
Our own bodies primarily produce vitamin D with exposure to sunlight. Yet vitamin D deficiency is extremely common, affecting almost two-thirds of Americans.⁵ Effects of deficiency can include depression, muscle pain, hair loss, fatigue, and an increased chance of sickness. Long-term deficiency has been linked to diabetes, obesity, hypertension, fibromyalgia, and certain cancers.
Jeannie acknowledges that getting enough vitamin D from sunlight and food alone is difficult. She strongly recommends supplements if you cannot fill the gaps. The current recommended daily amount of vitamin D is 600 IU for ages 1-70, and 800 IU for ages 70+.⁶ Speak to your doctor to learn more about your vitamin D levels and if you should supplement.

Other Nutrients

Several other nutrients also help build strong bones. Jeannie notes that a healthy diet focusing on vitamin D and calcium will naturally provide the other nutrients below:^7-9

Magnesium is essential for the absorption of vitamin D and for the function of your bone cells. Foods high in magnesium include tomatoes, potatoes, prunes, okra, artichokes, and spinach.
Vitamin C works with collagen, a protein that helps form bone structure, cartilage, and connective tissue. Foods like strawberries, oranges, peppers, broccoli, Brussels sprouts, and pineapple are high in vitamin C.
Vitamin K activates a protein that further helps calcium do its job. Examples of foods rich in vitamin K include dark leafy greens and prunes.
Phosphorus, when combined with calcium, forms calcium phosphate salts that help strengthen bone. It’s relatively common in healthy foods, including meat, fish, dairy, nuts, whole grains, beans, and seeds.

Dietary Changes

Thankfully, incorporating more calcium and vitamin D into your diet is easy. Try these suggestions:

For More Calcium:	For More Vitamin D:	For More of Both:
Top your food with nuts and seeds. Add kale to your smoothies and salads.	Spend more time outside – just don’t forget UV protection! Consume more eggs. Incorporate more mushrooms.	Eat more dairy products. Plant-based dairy alternatives may also be fortified. Eat more fatty fish like salmon and sardines.

Meal Ideas You Can Enjoy

Yogurt with your choice of nuts, seeds, and fruit
Salmon over a bed of kale
A protein shake blended with your choice of seeds, kale, and fruit
A mushroom omelet served with a glass of milk or fortified orange juice

This article has been reviewed by Jeannie Versagli, RD, LDN. Jeannie is a Registered Dietitian with the Academy of Nutrition and Dietetics, a national professional organization, and is licensed in nutrition with the State of Delaware.

Things to Moderate

“[Unhealthy foods] all contribute to increasing the possibility of someone having osteoporosis,” Jeannie says. “And it highly accelerates someone who is predisposed by their bone structure and their weight.” A few things stand out: ^{7, 10}
Salty foods: Salt causes us to lose calcium naturally through urination. Too much salt can cause excess calcium to be excreted from your body, thereby weakening your bones.
Sugary foods: Sugar has been found to increase inflammation and reduce absorption of magnesium and calcium.
Soft drinks: Soft drinks generally lack calcium and contain phosphoric acid, which may also lead to excess calcium being excreted through urine.
Caffeine: Caffeine can slightly strip calcium away from your bones. While the amount is minor, it’s still recommended to pair your caffeinated drinks with calcium-rich milk.
Alcohol: Excessive drinking can disrupt calcium absorption and hormones, leading to decreased bone density.

The Power of Bone-Stressing Workouts

Aside from a healthy diet, many forms of exercise also help build strong bones. Those who consistently eat well and engage in weight-bearing workouts are less likely to develop osteoporosis down the line.
“Bone really likes to be stressed!” Jeannie explains. Bone is similar to muscle in that, with the appropriate amount of strain, it will not only recover but also grow stronger in the process. While too much skeletal strain can cause stress fractures, a little strength training can do wonders for your bone health. “You can wear [weighted] vests, you can do walking, you can get on strength training programs, yoga, barre class – anything that will help put pressure on the bones.”

Of course, we endorse all kinds of safe exercise, but not all exercises strengthen bones. Below are three specific types of exercises that will help prevent osteoporosis and osteoporosis-related fractures.¹¹ And remember that they don’t have to be strenuous!

Weight-bearing exercises involve bearing your body’s weight against gravity, putting stress on your bones to improve strength and function. Activities like walking, running, dancing, aerobics, pickleball, and squatting are weight-bearing.
Resistance training builds your muscles and also puts stress on your bones. It includes bodyweight exercises like push-ups and squats, as well as exercises using weight machines and resistance bands.
Balance exercises can help prevent falls, which is crucial for those with weak bones, since falls often result in fractures. Tai Chi, yoga, balance board exercises, and lunges are all examples.

At HAC, we offer several classes that will improve your balance and bone health. Try classes in the pool, like Aqua Strength, Aqua Dance, or Aqua Suspension, plus land-based classes like Everyday Strength, Barre, Tai Chi, Mobility and Movement, Hot Yoga, and Shapes. Our treadmills, ellipticals, and expansive fitness floors will help stress your bones, too!

Proper form is critical! Improper form can cause injury and worsen symptoms. HAC Personal Trainer Denise Boyle shares a workout to help on the next page.

In Conclusion

To learn more about your bone health, Jeannie recommends asking your doctor about bone density scans, especially if you’re at increased risk of developing osteoporosis. If needed, they may prescribe medicines to rebuild bone or slow down bone loss.2 Regardless, mitigating osteoporosis can be easily achieved by simply incorporating a few foods and engaging in exercise.

References: