They say we often miss something after it’s been taken away, and the same could not be truer than with our bones. Osteoporosis, which means “porous bone”, is a common condition that results either due to the natural aging process, genetics, or, perhaps significantly, lifestyle. [1] Although you hear of it happening in seniors, adolescents and adults can get it, too. An estimated 2 million osteoporosis-related fractures yearly, with most patients not realizing they even have osteoporosis until the diagnosis. [2] And worldwide, more than 8.9 million osteoporosis fractures occur; nearly one for every three seconds. It’s estimated that by the year 2050, the worldwide incidence of hip fracture in men is said to increase by 310%, and 240% in women, respectively. [3] With these alarming statistics, is it any wonder that many of us are in for a rude awakening if we don’t take care of our bones? Luckily, there are several things that can be done to prevent this occurrence. It’s by no means a sure-fire safety net, but it’s darn good insurance that can, at the very least, reduce the severity and optimize treatment should a diagnosis be confirmed. (As always, talk with your doctor before making drastic changes in your diet or lifestyle.)

Exercise

Believe it or not, bones are living, reactive tissue that adapts and strengthens from exercise similar to muscles. What you’ll commonly see in osteoporosis-related literature is the recommendation to do “weight-bearing exercise”. What that basically means is doing an activity that has you moving against gravity. It can be either high or low impact. Examples include jumping rope, dancing, hiking, taking the stairs, (speed) walking, or using a treadmill or elliptical machine. [4]  (For my ZGYMmembers, you might like my Jump Rope Cardio (JRC) series or the bodyweight-based Body Crush series.)
However, what’s also important is resistance training, which not only encourages muscle-mass growth, but also bone strength. Of course, there’s incorporating bodyweight exercises such as squats and pushups, but it also helps to lift heavy things like a dumbbell or kettlebell to really ramp up the bone-building benefits. (The Beginner Strengthand Kettlebell workoutsare definitely bone friendly! If you can’t go too crazy with plyometrics and explosive movements, then don’t worry, I’ve got you covered. The Low Impact Full Bodyseries features challenging moves that will get your heart rate going while also focusing on building strength. It also includes equipment like the kettlebell, so you’ll be working those muscles AND strengthening your bones!) [4]

Diet

Getting adequate nutrition is crucial for the longevity of your bones. A deficiency in the key nutrients that are essential for healthy bones is no laughing matter. In fact, it can actually lead to osteoporosis. These key nutrients include Calcium, Vitamin D (which helps your body to absorb calcium; if you’re not getting enough, you’ll only be absorbing 10-15% of the calcium from your diet), Magnesium (it works together with calcium in a number of ways), Vitamin K (in order to guarantee that the calcium you consume goes to your bones and not your arteries, you need this vitamin!), Vitamin C and E, trace minerals (boron, copper, manganese, silicon, selenium, phosphorus, potassium, vanadium, zinc), and protein (50% of bone volume is made of protein- currently, there is little evidence to support the notion that a high protein intake is associated with bone loss, with the opposite being true!). [5] [6]
A word to the wise: crash dieting causes crash results. Insufficient nutrient intake, particularly in these key essential building blocks for healthy bones, can lead to osteoporosis. Restricting nutrients, as in the case of eating disorders, can also place you at an even greater risk for bone loss and osteoporosis. If you’re currently struggling with this, please get the proper help in order to prevent any damage to your precious bones! [7] Supplements may come in handy, and have been shown in some cases to help reduce the rates of both bone loss and fractures in adult and elderly patients- go for a quality supplement that includes calcium and Vitamin D, along with Vitamin K2 (just get the ok from the doc!). [8] [9]
Otherwise, put all of your focus on real food. Let’s start with calcium. If you can tolerate dairy, there’s yogurt, kefir, cheese, and milk (in moderation). Other sources of calcium include bone-in canned salmon and sardines, collard greens, kale, spinach, edamame, tofu, beans, blackstrap molasses, almonds, and fortified non-dairy milk. [10] [11]
As for Vitamin D, the easiest source comes from direct exposure to sunlight. However, not all of us are blessed with sunny skies or are able to be outside for very long. In this case, supplementing would be helpful. As far as diet goes, there is Vitamin D in fortified foods like non-dairy milk, fatty fish (salmon, mackerel, tuna, sardines), dairy products, egg yolks, and (beef) liver. [12]
Finally, Vitamin K can be obtained from dark leafy greens (kale, collards, spinach), brussels sprouts, broccoli, natto, spinach, kiwi, avocado, cheese, (beef) liver, chicken, and pork (chops). [13]
Some bone-friendly recipes I have on the site include:

Garlic Lemon Brussels with Salmon
Spaghetti Squash Broccoli and Cheese Casserole Dish
Savory Spinach Oatmeal
Shaved Brussels Sprout Salad with Crispy Tofu and Citrus Vinaigrette

Lifestyle

After you’ve mastered the basics of diet and exercise, there are a few more things to be done in order to prevent osteoporosis. The first is limiting your alcohol intake, with an excessive intake being correlated with a higher risk factor for fractures. [14] In fact, too much alcohol interferes with your body’s natural balance of calcium as well as Vitamin D production. [15] The second tip is to avoid smoking. Similar to alcohol, smoking also has a negative influence over bone density and may also increase one’s risk for developing a fracture (especially with age). [16]
For the ladies, be very careful about your weight and menstrual cycles. Amenorrhea, the loss of periods, dramatically increases the risk of low bone density and osteoporosis, so please, don’t go to extremes with your eating and workouts! [17] An absent period is definitely a cause for alarm, so seek medical help if this is something you’re currently dealing with.

Alright everyone, hope you enjoyed today’s topic! Obviously, there’s a bit more nuance to bone health and treating osteoporosis head-on, but I’m all about prevention. Rather than push the problem aside for later, I’d like to invest in the things that keep it from ever happening. That’s not to say it won’t, but as the saying goes, an ounce of prevention is worth a pound of cure! But let me know if you’ve got any perspective into bone health, and what you have done to keep them healthy. Until then everyone, remember to give your bones some extra love!

Sources:

[1] https://www.iofbonehealth.org/what-is-osteoporosis
[2] https://orthoinfo.aaos.org/en/staying-healthy/osteoporosis-prevention/
[3] https://www.iofbonehealth.org/facts-statistics#category-13
[4] https://www.nof.org/patients/fracturesfall-prevention/exercisesafe-movement/osteoporosis-exercise-for-strong-bones/
[5] https://www.algaecal.com/osteoporosis-treatment/prevention/
[6] https://academic.oup.com/ajcn/article/87/5/1567S/4650438
[7] Legroux-Gerot I, Vignau J, Collier F, Cortet B (2005) Bone loss associated with anorexia nervosa. Joint Bone Spine 72:489.
[8] Dawson-Hughes B, Harris SS, Krall EA, Dallal GE (1997) Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 337:670.
[9] Chapuy MC, Pamphile R, Paris E, et al. (2002) Combined calcium and vitamin D3 supplementation in elderly women: confirmation of reversal of secondary hyperparathyroidism and hip fracture risk: the Decalyos II study. Osteoporos Int 13:257.
[10] https://www.healthline.com/nutrition/15-calcium-rich-foods#section1
[11] https://www.algaecal.com/calcium/foods/
[12] https://www.webmd.com/food-recipes/guide/calcium-vitamin-d-foods
[13] https://www.healthline.com/nutrition/foods-high-in-vitamin-k#section1
[14] Kanis JA, Johansson H, Johnell O, et al. (2005) Alcohol intake as a risk factor for fracture. Osteoporos Int 16:737.
[15] https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/alcoholism#b
[16] Kanis JA, Johnell O, Oden A, et al. (2005) Smoking and fracture risk: a meta-analysis. Osteoporos Int 16:155
[17] Warren MP (1999) Health issues for women athletes: exercise-induced amenorrhea. J Clin Endocrinol
Metab 84:1892.