Bone Health
Bone density alone does not indicate bone strength.
Bone strength reflects the integration of two main features – bone density and bone quality.
How can we ensure that we are supporting our bones to grow both in density and quality? It includes consuming the necessary nutrients, challenging the bones (exercise) to stimulate growth, and avoiding certain habits and chemicals that can interfere with healthy bone growth. There is so much we can do to improve the health of our bones, and it begins in childhood.
But first, let’s talk a little about bone anatomy. The basic structure of the bone is called the matrix and is primarily made up of collagen (a protein) and calcium. But to form this matrix, many nutrients are required to form dense and quality bone. There are 3 types of bone cells, osteoblasts, osteoclasts, and osteocytes. Osteoblasts are the construction team. They lay down healthy bone by secreting the organic matrix. They are stimulated by progesterone, testosterone, and exercise. The osteoclasts are the destruction team that comes in to clean up and break down worn, weak, or injured bone. They are stabilized or slowed down by estrogen. Osteocytes are the foremen, live bone cells that direct and monitor bone health and remodeling. In a healthy individual, the building of bone exceeds the breakdown until around age 30 with the help of HGH, human growth hormone. It is critical to achieve peak bone mass before age 30 through exercise (especially strength training exercises) and a healthy diet. After age 30 our level of HGH begins to slowly decline, and we begin to lose bone density and strength over time.
Osteoporosis is a chronic disease characterized by the gradual loss of bone density over time that results in the thinning of the bone making it more vulnerable to fracture. The word is derived from Greek and Latin; osteo = bone, porous = void spaces, and osis = condition of. So, osteoporosis literally means porous bone condition. Osteoporosis is a nutrient related degenerative disease. For prevention or healing to take place it is imperative to have a nutrient dense, not calorie dense, diet. A SOUL based diet is best (Seasonal, Organic, Unrefined, Local). One that includes a wide variety of food colors and sources as well as well sourced and healthy proteins and fats to support healthy bone growth and maintenance. Antioxidants, found in colorful fruits and vegetables, are very important to combat inflammation that can lead to bone loss. When inflammation increases, this signals the body to stimulate the osteoclast activity. Refined foods, sugars, flours, food additives and chemicals increase inflammation and should be avoided. The standard American diet (SAD) is basically an inflammatory diet. The importance of adopting an anti-inflammatory diet with focus on vitamin and mineral rich foods to restore and maintain our bone minerals cannot be emphasized enough.
Risk factors we can control are lack of exercise, smoking, alcohol consumption, and diet. Some classes of medications also contribute to bone loss and should be minimized. These include glucocorticoids, cortisol, blood thinners, diuretics, antibiotics, immune system suppressants, and aluminum containing antacids. Hormonal disturbances will also affect bone density and quality - low estrogen or testosterone, diabetes, delayed puberty, lack of a period, or menopause.
Key nutrients to support healthy bones
Protein: Protein is essential for collagen formation that forms the bone matrix. Paired with vitamin C it will stimulate collagen matrix production. Daily consumption should be around ½ gram per pound of body weight, or approximately 20-30% of calories consumed daily. Rich foods in protein come from animal meat, eggs, dairy products, soy, beans, legumes, nuts and seeds. When choosing animal protein, it is best to be from humanely raised and organic lean, pastured, grass-fed poultry or beef, or wild caught fish from the northern Pacific ocean. When sourcing plant proteins choose fresh, organic, unrefined, and local when possible.
Calcium: Calcium is critical for building bone. 99% of our body’s calcium is stored in our bones. When needed for bodily functions, such as muscle contractions, if there is not sufficient calcium in our bloodstream, calcium will be pulled out of our bones. Foods rich in calcium are dairy (yogurt being one of the best sources), kale, collard greens, bok choy, sardines (with edible bones), bone broth, tofu, almonds, and sesame seeds. Natto, a fermented soybean product, is one of the richest forms of calcium. If supplementation is desired, choose calcium citrate, glycinate, or lactate. Calcium carbonate, oxide, or Tums are poorly absorbed.
Magnesium: Magnesium is just as essential for mineralizing bones as calcium. It is needed for the absorption and integration of calcium. Calcium and magnesium usually come together in plants. Foods rich in magnesium are kelp, wheat bran and germ, dark leafy greens (chard, beet greens, spinach, dandelion, kale, collard greens, mustard greens, parsley), mackerel, halibut, nuts and seeds (especially pumpkin, flax, sesame, almonds, and cashews), quinoa, buckwheat, brown rice, green beans, black and kidney beans, lentils, oatmeal, bananas, and blackstrap molasses.
Vitamin D: Vitamin D plays a major role in bone health. D3, calcitriol, increases the absorption of calcium and phosphorous in the small intestine by 50%. Foods providing vitamin D are fatty fish like salmon, tuna, mackerel, halibut, as well as liver, beef, and egg yolks. During the summer months, we can get vitamin D from sun exposure on our skin (at least 20 minutes daily).
Vitamin K: Necessary for the production of osteocalcin, a protein and key component of the bone matrix. While it does not contribute to bone density, it does appear to improve the bone quality. It can be found in animal products, meat, butter, and egg yolks as well as some fermented foods like cabbage, kimchi, and natto with natto being the best source.
Vitamin C: The primary function of vitamin C in bone health is the production of collagen. In addition, it is critical to immune function and is a potent antioxidant. Paired with protein it stimulates the formation of the collagen matrix in bone and joints, which supports their flexibility and quality. Foods rich in vitamin C include guava, pomegranate, red or green bell pepper, tomatoes, kiwi, citrus, strawberries, Brussels sprouts, and cantaloupe.
Other nutrients important for bone health are zinc, manganese, copper, silicon, and boron.
In summary, to support bone health at any age eat a nutrient dense diet with a variety of colorful fruits and vegetables, eat plenty of quality proteins and fats, exercise and get out in the sunshine regularly, avoid the controllable risk factors, and stay active. Bone loss can be minimized, and in some cases with focused effort, can be reversed when living a bone supportive lifestyle.
