Understanding what builds bones
Bone density is of particular concern to women. Especially postmenopausal women and women who are pregnant or nursing. There seems to be a lot of conflicting information regarding what is safe and effective for healthy strong bones.
With headlines from the New York Times stating that Vitamin D and Calcium Don’t Prevent Bone Fractures and research from the British Medical Journal showing that calcium supplements could increase the risk of myocardial infarction it is becoming clear that the ways to improve bone density are complicated and less well understood then we previously thought.
I decided to dig around and see if I could find anything useful. I wanted to know more about supplements, diet, exercise, alcohol, smoking and even stress to see what is known, unknown, or still up in the air in terms of healthy bones.
Eating for bone density
The first thing I looked into was calcium, both in food and supplement form. Here’s a video that digs into some of the studies showing that calcium supplements are not effective in improving bone density. The video also talks about calcium in the diet. It seems that there is not a very compelling argument for eating large amounts of calcium either. But don’t go lower than 500 mg a day or there are clear bone issues.
Despite these recent studies, the recommendation is still to eat 1000 mg a day for the general population and 1200 mg for women over 50 or who are pregnant or lactating. With conflicting information, personally, I’m going to err on the side of caution and aim to get close to 1000 mg of calcium a day through a healthy diet. But how to eat that much calcium? And what does that look like in a normal diet? And what if you don’t eat dairy, or don’t want to eat many servings of dairy every day? These were the questions I’ve been digging around trying to find answers for. The National Osteoporosis Foundation provides a list of top calcium rich foods with collard greens and some seafood being surprisingly good sources of calcium. My favorite post on calcium rich foods is from a vegan nutritionist who shows how to combine calcium rich foods in tasty and simple ways to easily reach 1000 mg of calcium a day. I strongly recommend looking at it, even if you include dairy and meat in your diet. One of my favorite combinations from this blog is dried figs and almonds. They are both high in calcium, and it seems almonds have bone health benefits beyond their calcium content.
As I continued digging around in the calcium bone density world I quickly found that as well as calcium, one of the big recommendations is to eat lots of fruits, vegetables, nuts, whole grains, and legumes for bone health. We all know we should be eating more from that list anyways, so here’s one more good reason!
While eating healthy foods, I’ve been focusing on the ones that are also high in calcium. Such as broccoli, soymilk, almonds, chia seeds, white beans, and citrus. I would like to take a moment to highlight chia seeds as a particularly helpful food when trying to increase the calcium in your diet. In just two tablespoons of chia seeds you get 160 mg of calcium, plus omega-3’s, zinc, magnesium, iron, and even protein. See below for my favorite chia seed pudding recipe.
Vitamin D is seemingly also of great importance when it comes to bone health.
Chia Seed Pudding
This recipe makes a perfect breakfast, snack or dessert. Make up a big bowl and store it in the fridge to use throughout the week.
INGREDIENTS:
- 4 tablespoons chia seeds
- 1 cup unsweetened milk of choice, I prefer soymilk
- 1 teaspoon vanilla extract (optional)
- Maple syrup, honey or other sweetener to taste (optional)
- Fresh or frozen fruit
Mix the chia seeds, milk, vanilla, and sweetener together and allow to sit overnight or for at least 2 hours. Stir and add fruit.
Exercise for bone health
Then comes the exercise component. Everything from walking, running, dancing, aerobics, weight lifting, and now even yoga, has been shown to help build or maintain healthy bones. Here’s a list from the National Osteoporosis Foundation on exercise for bone health and from Harvard on the importance of weight bearing exercises.
It is often overlooked that exercise has benefits beyond bone density that impact overall fracture rates. Exercise increases strength, coordination, body awareness, and balance. All of these are key factors in preventing bone fractures caused by falls. Which might in-part explain why Yoga has been shown to be helpful in preventing bone fractures. The New York Times recently wrote about a decade long study following over 200 people (mostly women) with osteopenia or osteoporosis who practiced yoga for 12 minutes a day. The result was 0 fractures during that decade, and some improvement in bone density in the spine and femur.
However, there are some things to avoid if you already have osteoporosis, such as deep twists and flexion of the spine (rounding the spine forward). Learn more about the do’s and dont’s for yoga and osteoporosis.
Stress is another culprit in bone loss. It is worth noting that the 12 minutes of yoga described above included savasana, the part at the end of a yoga class where you lay on your back, close your eyes, and breath.
Other lifestyle factors that impact bone density
And last, but not least, smoking, not surprisingly, is bad for your bones. The WHO states that an estimated “one in eight hip fractures is attributable to cigarette smoking”. However, the risks seem to decrease for people who quit smoking. Interestingly alcohol seems to have evidence for and against it with moderation being key.
What to do for bone health
In the end it all starts to sound like the usual healthy lifestyle prescription, with an emphasis on a few foods. With so much new research coming out and differing opinions in the medical profession I would recommend regularly checking in with your doctor to make sure that you are on the best program for you. For me personally, I’m going to focus on healthy lifestyle choices as well as lots of walking, yoga, Pilates and weight lifting as exercise for healthy bones. For diet, I’m working on ensuring adequate vitamin D, lots of fruits, vegetables, whole grains, and nuts with an emphasis on calcium rich ones such as kale, beans, almonds, chia seeds, figs, and citrus. Oh, and stress reduction. That’s always the hardest one to remember.
Let me know if you have any questions from all this, I’m happy to send more links!