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Understanding Osteoporosis

When we think about nutrition, few of us automatically think about our skeletons, beyond making sure that our kids get enough calcium. In fact, our bones need lifelong care to help protect against weakening over time.

Just like other parts of your body, the cells of your bones are constantly breaking down and being rebuilt. As you age, that rebuilding process can slow down, causing bones to weaken. This is where proper nutrition and lifestyle habits can make a difference, helping to keep your bones strong and healthy. This article is going to take a look at what happens when your bones become weak and what you can do to strengthen them.

Understanding Bones

It is understandable that many of us think of bones as unchanging solid masses. Yet bone is actually living tissue, constantly repairing and replenishing itself, via two specially adapted cells: osteoclasts and osteoblasts. Osteoclasts eat away at the old, decrepit bone, breaking it down and creating cavities. Osteoblasts, in turn, fill in these cavities with new bone.

The ratio of breaking down to building changes over time. During childhood, the emphasis is heavily on building. More Osteoblasts are required to increase bone size and density as the body grows. By the time we reach our mid-twenties, an equilibrium is reached and our bone density is at its peak. From around the age of 40, however, our bones start to break down more quickly and our osteoblasts are unable to keep up with the rebuilding process. This can lead to an increase in fractures and posture related issues.


Osteoporosis is the process whereby the bone density becomes so low that fractures start to occur. Even in healthy people, it is not uncommon to lose 25% of bone density by the age of 50.

There are several risk factors for developing osteoporosis:

  • Females are more susceptible than males, due to their lower baseline bone density.

  • Genetics can play a role, so you may be at risk if your parents suffer from osteoporosis.

  • Getting older makes you more likely to develop osteoporosis.

  • Previous fractures

  • Being underweight

  • Being overweight

  • Excessive alcohol or coffee or fizzy drink consumption. These drinks cause you to excrete minerals, including calcium and magnesium, that support bone health.

  • Nutritional deficiency (see below)

  • Sedentary lifestyle

Eating for bone health

Many people are aware that calcium is important for bone strength. 99% of calcium is stored in the bones and teeth and the mineral plays a crucial role in both building and maintaining bones. If your diet permits it, try to get a good variety of plant and animal sources of calcium as your body finds it easier to absorb calcium that comes from animals.

Some of the best sources of calcium include:

  • milk

  • dark leafy greens (kale, rocket, watercress)

  • almonds

  • cheese

  • yoghurt

  • broccoli

  • chia seeds

  • sesame and tahini

  • sardines and canned salmon (because of their edible bones)

  • whey protein

  • edamame beans and tofu

As important as it is, calcium is unable to be absorbed into the body without sufficient levels of vitamin D and will not be retained without vitamin K2. You can get vitamin D from oily fish, egg yolks, liver and cheese, or you can aim to get fifteen minutes a day of direct sunlight. This amount varies for different skin-types. Vitamin K2 comes from many of the same sources as vitamin D and is also present in fermented foods, such as sauerkraut. Many people are deficient in these vitamins and some find it helpful to take a daily D3/K2 supplement.

Magnesium also plays a role in preventing and reversing osteoporosis, helping metabolise calcium and forming an integral part of the bone structure. Phosphorous and boron are also known to be important in maintaining bone health. You can keep your magnesium topped up by including foods such as spinach, almonds, dark chocolate, avocado, banana and figs in your diet.

A healthy, varied diet should provide you with enough nutrients to support your bone health. If you feel that you might be deficient, bone-friendly supplements are readily available, however please do speak with your qualified healthcare practitioner before beginning a new supplement routine to make sure it is suitable for your body's requirements.

Weight and bone health

Maintaining a healthy weight is important for happy bones. Obesity has been found to have a negative impact on the quality of your bones and excess weight can also add undue stress, making fractures more likely, especially in older age.

It isn't just overweight people who are putting themselves at risk, underweight people are also potentially harming themselves. Calorie restrictive diets, especially those that provide less than 1000 calories a day, have been shown to lower bone density. This effect is even more pronounced in peri-menopausal and post-menopausal women.

Stress and Exercise

]When you are stressed, your body releases a hormone called cortisol. Cortisol contributes many important functions within the body that are needed to perform evasive action in an emergency but are harmful in the longer term. One of the roles of cortisol is to inhibit the absorption of calcium, often leading to a cascade of mineral deficiencies.

If you want to take care of your bones, it is advisable to address your chronic stress levels. I have written widely on the health impacts of chronic stress and what you can do to mitigate it. A couple of stress-related articles elsewhere on the site can be found here and here. Studies have shown that people who exercise more tend to have higher bone density than those leading a more sedentary lifestyle, translating to stronger bones. Unsurprisingly, weight-bearing exercise is the most effective for this purpose. By weight-bearing, I dont necessarily mean bench presses or shot-putting, it can really be any exercise where you are supporting the weight of your body, such as walking, dancing, yoga, climbing or even gardening. Anything you can think of that gets you up and moving is going to be helpful, even vacuuming your house or mowing the lawn.

Experts generally recommend getting 30-60 minutes of moderate exercise each day. This is great if you are able to do it but many people are disheartened by the idea of an hour of daily exercise and so end up doing nothing at all. Anything is better than nothing, so start by doing what you can. If that's 10 minutes, do 10 minutes; if it's 60 minutes, do 60 minutes. It all helps and you will feel the benefits in just about every area of your life.

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