Lifestyle Changes to Maximize Bone Strength
by Andrew Stevenson (1/9/13)
Half of women and a quarter of men over 50 can expect to break a bone as a result of osteoporosis. Not only do broken bones have an impact on physical health, but they can also affect mental health and emotional well-being. However, thinning bones and their associated fractures do not have to be an inevitable part of ageing. There are numerous steps that seniors can take to protect their bone strength, which focus on avoiding the main risk factors for osteoporosis and primarily relate to diet, activity and smoking habits.
Ensure Adequate Dietary Calcium
After the age of 50 men and women both require 1200mg of calcium daily to maintain optimum bone health. Dairy foods remain one of the best sources of calcium, but to achieve the recommended intake of calcium this would still require the consumption of a pint of milk, a pot of yogurt and an ounce of hard cheese daily. Dairy alternatives such as soya, rice and oat milk are often fortified with a similar calcium content to cow’s milk, but always check the label as not every brand has added calcium. Tinned fish with bones such as sardines, pilchards and salmon are another good source of calcium, with a small tin providing a third of your daily calcium requirements. While green leafy vegetables, beans, dried fruit and nuts provide small amounts of calcium, it would be impossible to achieve adequate calcium from these foods alone. If you are unable to increase your dietary calcium intake sufficiently, a supplement will be required and your physician or pharmacist will be able to provide further advice on this.
Ensure Adequate Vitamin D
Our bodies make Vitamin D when our skin is exposed to sunlight, though as we age this process becomes less efficient and we will also make less if we use sunscreen or have darker skin. You are at particular risk of Vitamin D deficiency if you spend little time outdoors or cover your skin when you do go out. Vitamin D is also naturally present in oily fish and egg yolks and is added to certain foods such as milk and breakfast cereals, so try to increase your consumption of these foods. While it might be possible to meet the required 800-1000 IU of the vitamin daily if you regularly spend time outdoors and frequently include these Vitamin D rich foods, if you are concerned you might be falling short, speak with your physician or pharmacist for guidance on a supplement.
Eat More Fruit and Vegetables
These are rich in Vitamin C, which is essential for collagen formation, and Vitamin K, which plays a role in the synthesis of one of the proteins needed for the production of bone. Fruit and vegetables are also a good source of magnesium, which is required for the body to process calcium and Vitamin D, and potassium, which helps to reduce the loss of calcium via the kidneys. We should try to include fruit or vegetables with every meal, though they do not have to be fresh; canned, frozen and dried fruit and vegetables also count.
Consume Sufficient Calories and Protein
Weight loss frequently occurs as we get older, which often relates to the natural ageing process, but can also be the result of a poor appetite or an underlying condition. As a lower body weight places less force on the bones, they receive less stimulation to create new bone tissue, so it is vital that we try to prevent weight loss. The key is to include foods dense in calories and protein, whilst still ensuring they are nutritious. Meals should include a serving of meat, fish, eggs, nuts or dairy produce, as well as bread, potatoes, pasta, rice or cereals; butter, cream or sauces can be used to increase their calorie content. Milk puddings, yogurts or fruit with ice cream are good options to follow meals.
When appetite is poor the best approach is to eat little and often, having small snacks between meals; try cheese and crackers, a small sandwich, dried fruit and nuts or a dessert pot. Aim to also have more nourishing drinks such as full cream milk, milkshakes, hot chocolate and milky coffees; fruit juice and smoothies are also good options. Although it is difficult to eat when appetite is poor, these suggestions should make it easier to increase your dietary intake to prevent weight loss. However, it is important to consult your physician if problems with appetite and weight loss persist, as they will probably wish to investigate whether there is a particular cause. If you require additional advice and support regarding what to eat when you are struggling, there are a number of helpful resources online, which provide information on this amongst other issues relevant to seniors.
As well as increasing blood pressure, excess salt can increase losses of calcium in the urine, so cutting back on the salt we eat can help on both counts. If you use salt in cooking or at the table, try to reduce the amount you use, instead trying alternative flavorings such as herbs, spices, black pepper, garlic and lemon juice. However, remember that a lot of processed foods are high in salt such as tinned soups, sauces, cooked meats, savory snacks and ready meals. If it is not possible to cook more from scratch, when at the grocery store check the labels and select those products with the lowest salt content.
Limit Tea, Coffee and Sodas
Their caffeine content may interfere with calcium absorption and increase losses of calcium from the body; the phosphoric acid in sodas may also trigger the loss of calcium from bones. However, as dehydration is a common problem in seniors it is important to include this in the equation, particularly as these are all popular drinks. As consumption of these beverages are not considered one of the main risk factors for osteoporosis, sense would prevail to say that it is more important seniors continue to drink these to reduce their risk of dehydration and its associated confusion, tiredness, headaches, urinary tract infections and poor skin condition.
The chemicals in cigarette smoke can damage the bone forming cells hindering new bone formation and also upset the balance of hormones in the body increasing the rate of bone loss. There is evidence that for postmenopausal women who stop smoking, after a year of being smoke free, bone density is improved. Although some people can give up alone, help is available in the form of smoking cessation counselling, nicotine replacement therapy and prescription medications. Obviously in quitting, your heart and lungs will also gain huge benefits.
Drink Alcohol in Moderation
It is recommended to have no more than two or three alcoholic drinks daily to protect your bones. Like smoking, alcohol can destroy bone forming cells and disrupt hormones, but additionally alcohol impairs the absorption of calcium.
Take Regular Exercise
Walking is one of the best forms of exercise to maintain bone strength, as it is weight-bearing yet low-impact so a safe alternative to more high intensity activities. Other similar activities are low-impact aerobics and use of an elliptical training machine. These weight bearing activities should ideally carried out for 30 minutes most days of the week or as you are able. Muscle strengthening exercise using small weights or an exercise band, as well as those that improve your balance such as Tai Chi can help to prevent your risk of falls and therefore fractures.
It is important to remember that even if you can’t make all the suggested changes – as after all making changes are difficult, particularly those that have become ingrained habits – managing to make some will still provide positive benefits towards maintaining the strength of your bones.