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Maintaining Bone Health: Tips for Stronger Bones

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Strong bones play a crucial role in supporting our bodies, enabling movement, and safeguarding our vital organs from injury. As we age, the vulnerability to bone diseases increases, particularly osteoporosis – a condition that renders bones weak and brittle, increasing the risk of fractures.

Adopting a diet rich in calcium and vitamin D, coupled with engaging in weight-bearing and resistance exercises, helps maintain strong bones and reduce fracture risks. Explore strategies for enhancing bone mineral density and ensuring lasting bone health.

The Role of Nutrition in Bone Health

Calcium: The Cornerstone of Bone Health

According to the Health Promotion Board (HPB), the recommended daily intake of calcium for adults aged 19 to 50 is 800 mg, and for adults aged 51 and above, it is 1,000 mg. Good dietary sources of calcium include:

  • Beans and Legumes
  • Shrimp
  • Broccoli
  • Almonds
  • Plant-Based Milks
  • Calcium-Fortified Oatmeal and Fruit Juice
  • Green Leafy Vegetables – Kai Lan, Spinach, and Chye Sim
  • Canned Salmon and Sardines With Edible Bones
  • Dairy Products – Milk, Cheese, and Yogurt
  • Soy Products – Tofu, Soy Milk, and Soybeans

If your diet falls short of the recommended daily calcium intake, consider incorporating over-the-counter calcium supplements. However, be sure to seek advice from a doctor or pharmacist to ensure you are consuming safe products at an appropriate dose.

Vitamin D: The Key to Calcium Absorption

Calcium is most effective when paired with vitamin D, facilitating the absorption of calcium and phosphorus, another essential mineral. In Singapore, where there is strong sunlight exposure throughout the year, the recommended daily intake for vitamin D is 2.5 mcg. Few foods naturally contain vitamin D, including:

  • Beef liver
  • Mushrooms
  • Cod Liver Oil
  • Sardines
  • Cheese
  • Egg Yolks
  • Fatty Fish – Tuna, Mackerel, and Salmon
  • Vitamin D-Fortified Cereal, Fruit Juice, and Milk (Dairy or Plant-Based)

To ensure sufficient daily vitamin D for bone health, the optimal approach is a 15 to 20-minute outdoor walk, preferably in the morning or late afternoon when the sun is less intense.

If your dietary intake falls short of the daily recommended amount of vitamin D, consulting with a doctor or pharmacist about incorporating vitamin D supplements into your overall plan for maintaining bone health is advisable.

Other Essential Nutrients for Bone Health

Magnesium is essential for creating new bones, enhancing bone cell function, and forming the bone’s crystal structure. Rich sources of magnesium include green vegetables, nuts, seeds, whole grains, and legumes.

Phosphorus is important for the development of bone-building cells and in providing rigidity to bones. It can be obtained from a variety of sources including dairy products, whole grains, legumes, eggs, fish, meat, and poultry.

Vitamin K supports bone health by activating various protein molecules. It may also have a positive impact on bone mineral density, thereby reducing the risk of fractures. Dark green vegetables such as spinach, kale, broccoli, bok choy, kai lan, and chye sim are excellent sources of Vitamin K.

Vitamin C aids in the formation of collagen, a vital protein that forms the framework for bones. Additionally, it plays a role in eliminating harmful free radicals. Citrus fruits, bell peppers, strawberries, tomatoes, cruciferous vegetables, and white potatoes are rich sources of Vitamin C.

Protein is fundamental for the building and repair of various tissues, including bones. Healthy sources of protein encompass dairy products, fish, poultry, legumes, whole grains, nuts, seeds, and certain vegetables such as corn, broccoli, and asparagus.

Foods and Dietary Habits for Strong Bones

Dairy & Dairy AlternativesTo make your bones stronger, dairy or similar alternatives can be introduced in your meals. You can do this by making smoothies with milk, fruits, and veggies, using milk or high-calcium soy milk in your oatmeal instead of plain water, and swapping coconut milk for low-fat or fat-free yogurt or milk in curry dishes.

Plant-Based SourcesFor vegans, good plant-based sources of calcium include fortified soya, rice, and oat drinks, soybeans, calcium-set tofu, sesame seeds, tahini, pulses, brown and white bread, and dried fruits like raisins, prunes, figs, and dried apricots. To get enough vitamin D, consider fortified fat spreads, breakfast cereals, and plant-based drinks like soy milk.

Moderation In All ThingsA balanced diet is key for healthy bones. Foods like beans, spinach, and wheat bran have calcium, but they also contain stuff that can stop our bodies from absorbing it. Excessive salt intake has been linked to bone loss, while additives with inorganic phosphorus can disrupt the balance between phosphorus and calcium, harming bone health. Caffeine from beverages like coffee and tea has the potential to reduce calcium absorption. Additionally, an overconsumption of fat, protein, refined carbs, salt, and phosphorus can negatively impact bone health.

It is crucial to be mindful of your overall diet composition. Inadequate calorie intake, even with resistance exercise, can lead to decreased bone density. Aim for a balanced diet with a minimum of 1,200 calories daily to support optimal bone health. To maintain strong and healthy bones, focus on a diverse range of nutritious foods while remaining cautious of these dietary factors.

Stay HydratedAdequate hydration is crucial for bone health as it supports collagen synthesis, facilitates mineral transport (e.g., calcium, phosphorus), and aids joint lubrication, reducing wear on the body. It also helps prevent dehydration-related issues, supports temperature regulation, and lowers the risk of kidney stones. While eight glasses a day is a common guideline, individual hydration needs may vary based on personal factors.

Lifestyle Choices for Bone Health

Falls can result in numerous injuries, including ankle sprains, fractures in the hip, shoulder, and knee, as well as tears in the rotator cuff, meniscus, and labrum of the hip or shoulder. Taking care of your overall health through good dietary habits and exercise helps to reduce your chances of falling.

According to the Singapore Physical Activity Guidelines, a healthy adult should engage in 150-300 minutes of moderate-intensity exercises in a week. A combination of these weight-bearing, resistance training, and balance exercises is best for building and maintaining healthy bones and preventing falls and fractures:

Weight-Bearing Exercises

  • Brisk Walking
  • Jogging or Running
  • Racket Sports
  • Climbing Stairs
  • Dancing

Resistance Training

  • Weight Machines
  • Free Weights
  • Resistance Bands
  • Calisthenics

Balance Training

  • Yoga
  • Tai chi
  • Walking backwards
  • Step-ups
  • Lunges

Apart from nutrition and physical activity, here are a few more ways to reduce your risk of falls:

  • Do not smoke as it can reduce bone mass and increase your risk for a broken bone.
  • Limit alcohol use as it can reduce bone mass and increase your risk for broken bones.
  • Maintain a healthy weight to avoid underweight-related risks like fractures and bone loss, and to prevent overweight-related issues such as reduced sensation, weakness, and instability during standing or walking.
  • Go for regular eye checks, at least once a year, to ensure clear vision.
  • Wear non-slip shoes to give you secure footing on the ground and prevent injury.

Conclusion

Maintaining strong bones is vital for overall well-being, particularly as we age. To support bone health, focus on a nutrient-rich diet with adequate calcium and vitamin D, supplemented if necessary. Embrace a balanced lifestyle by engaging in weight-bearing exercises, resistance training, and balance activities. Adopt healthy dietary habits, staying mindful of factors like hydration and avoiding harmful substances such as tobacco and excessive alcohol. Regular eye checks and medication reviews are crucial, while orthopaedic consultations ensure early detection and management of potential bone issues. Bone health is a long-term investment, empowering yourself with informed choices for a resilient skeletal system and a healthier future.

References

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Dr Yung Shing Wai, Consultant Orthopaedic Surgeon: With his decades of specialist experience, Dr Yung is committed to providing not only high-quality, personalized and modern orthopaedic treatments; he also shares his knowledge by reviewing and contributing informative articles to provide patients with trustworthy and up-to-date orthopaedic insights.

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