Bone health and diet

I had a conversation with a client in clinic the other day about bone health, and as Halloween is coming up, I thought it would be a good time to talk about the skeleton!

The skeleton is an ever-changing internal framework that supports the body, facilitates movement, protects the organs, produces blood cells, and stores and releases minerals and fat [1]. It is a complex living organ that communicates with other organs in the body. Bones are continually being broken down and remade, and after our peak bone mass between the ages of 20 and 30, bones are broken down more than they are remade [2]. It is therefore really important to maintain healthy bones through diet and lifestyle.

Race, gender, and genetics play a major role in bone mass, however diet, environmental factors, physical activity, and weight and age at the first menstrual period are also contributing factors [3].

The people most at risk of low bone mass are postmenopausal women and people who avoid dairy.

In the diet, calcium and protein are the most important nutrients for attaining peak bone mass [1].

Calcium

There are many reasons why calcium is important in the diet, and bone health is one of them. Low calcium leads to low bone density, which leads to an increased risk of fractures and osteoporosis [4].

How much calcium do we need each day?

The recommended daily intake of calcium for adults

Unfortunately, in Australia, more than 44% of men and 71% of women aged between 19 and 30 do not get the required amount of calcium per day, these percentages increase to 63% for men and 91% of women in the 50 to 70 age range [5].

The calcium and protein content of common foods

This table gives just a few examples of dietary sources of protein and calcium to give you an idea, however calcium is also in other foods in smaller amounts, and it all adds up. It is important to remember that, as with all aspects of nutrition, this information is nuanced, there are factors that enhance and inhibit absorption, so that’s why it is important to focus on a balanced diet, rather than single nutrients.

Also keep in mind that one of the many roles of vitamin D in the body is the regulation of calcium levels [4], therefore it is an important vitamin for the maintenance of bone health.

Protein

Protein intake is required for the maintenance of musculoskeletal function in the body [6].

1.0 to 1.2g of protein per kilogram of body weight per day is recommended, and between 20 and 25g of protein at each meal [6].

How do you know you are getting enough calcium and protein?

• Make sure you are having protein at every meal and snack.

• Think about combining your protein and calcium with foods such as canned fish with the bone in and dairy products.

• If you avoid dairy, make sure you are getting your calcium from other sources or your milk alternative is fortified.

I have another blog post coming up about the lifestyle factors that affect bone density, because it is not just your diet that matters when it comes to a healthy skeleton. In the meantime though, if you have any questions, concerns or want something more specific to you, reach out to me, I’m always happy to chat.

References

1. Rizzoli, R. Dairy products and bone health. Aging Clin. Exp. Res. 34, 9–24 (2022).

2. Santos, L., Elliott-Sale, K. & Sale, C. Exercise and bone health across the lifespan. Biogerontology 18, 931–946 (2017).

3. Chevalley, T. & Rizzoli, R. Acquisition of peak bone mass. Best Pract. Res. Clin. Endocrinol. Metab. 36, 1–15 (2022).

4. Ciosek, Ż., Kot, K., Kosik-Bogacka, D., Łanocha-Arendarczyk, N. & Rotter, I. The effects of calcium, magnesium, phosphorus, fluoride, and lead on bone tissue. Biomolecules 11, (2021).

5. Australian Institute of Health and Welfare. Nutrition across the life stage. Nutrtion Across The Life Stages 581 (2018).

6. Nuti, R. et al. Guidelines for the management of osteoporosis and fragility fractures. Intern. Emerg. Med. 14, 85–102 (2019).