Bone health - Part 2

Further to my previous post about the dietary factors that affect bone density (you can read it here), in this post I want to talk about the lifestyle factors that contribute to bone density. So, in addition to making sure you have enough calcium and protein in your diet, you can also think about things like exercise, sleep and your circadian rhythm, and quitting smoking if you’re a smoker.

First of all, why is bone health so important?

Well, our bones are always being remodelled, so that means we have cells that are resorbing and remaking bone all the time, however after the age of about 35 our bones are resorbed more than they are remade. Therefore, as we age our bones lose density and strength, and can result in an increased risk of fractures and conditions such as osteoporosis.

Our skeleton is not just there for structure, to help with movement, and protect our organs, our bones also produce blood cells and store some minerals and fat.

Post-menopausal women are a high risk population for low bone density, as with menopause comes a drop in oestrogen, a bone protecting hormone. And, as mentioned in my previous blog, those people that avoid dairy also have a higher risk.

Exercise

Moderate exercise of 30 minutes at least four times a week benefits bone health of both premenopausal and postmenopausal women [1]. This is due to cells in the bone responding to mechanical stimuli. However, studies show that it is exercise combined with diet that is most beneficial for bone health [1].

It is not only the mechanical loading that exercise helps to improve bone health, exercise also increases the amount of oxygen and nutrients being supplied to the bone, resulting in stronger, healthier bones [2]. Additionally, exercise can reduce the risk of fractures by preventing falls via improving muscular strength and balance.

Hormones, such as oestrogen, parathyroid hormone, and glucocorticoids, are regulated by exercise [2] and contribute to bone health.

The type of exercise you do depends on your current fitness, health, and injury status. If you are not currently exercising, I can help you find someone who is qualified to help you get started.

Circadian rhythm

The circadian rhythm is the 24 hour sleep/wake cycle, it is important for many biological processes in the body, including hormone and immune function, energy metabolism, and bone remodelling [3].

Markers that indicate bone remodelling are higher at night, meaning that bone turnover is higher at night, for those with a disrupted sleep pattern are at risk, therefore, of an imbalance in bone remodelling [4]. This is evident through epidemiological studies that show that shift workers have a higher incidence of bone fractures and osteoporosis [3].

The importance of sleep is something I talk about a lot in clinic, I have a post about sleep and the circadian rhythm coming up, in the meantime there are some things you can do to help regulate your sleep…

• Go to bed at the same time each night

• Get up at the same time in the morning

• Get natural light first thing in the morning

• Reduce light from screens an hour before bed

Smoking

Cigarette smoking is an independent risk factor for osteoporosis [5] this is due to a number of reasons, including:

• Reduces blood supply to bones and other tissues in the body

• Slows the production of bone-producing cells

• Decreases the body’s ability to absorb calcium and other nutrients

• Affects hormone balance, including oestrogen (bone protective hormone)

• Reduces overall body weight

Your skeleton is an amazing and dynamic organ, and making sure you have enough calcium and protein in your diet, getting enough exercise and sleep, and quitting smoking if you’re a smoker, are some things to think about if you want to improve and maintain the health of your bones. If you have any concerns about your bone health and would like to chat, you can contact me here.

References

1. Willems, H. M. E., van den Heuvel, E. G. H. M., Schoemaker, R. J. W., Klein-Nulend, J. & Bakker, A. D. Diet and Exercise: a Match Made in Bone. Curr. Osteoporos. Rep. 15, 555–563 (2017).

2. Tong, X. et al. The Effect of Exercise on the Prevention of Osteoporosis and Bone Angiogenesis. Biomed Res. Int. 2019, (2019).

3. Luo, B. et al. Circadian rhythms affect bone reconstruction by regulating bone energy metabolism. J. Transl. Med. 19, 1–15 (2021).

4. Swanson, C. M. et al. The importance of the circadian system & sleep for bone health. Metabolism 84, 28–43 (2018).

5. Weng, W., Li, H. & Zhu, S. An Overlooked Bone Metabolic Disorder: Cigarette Smoking-Induced Osteoporosis. Genes (Basel). 13, (2022).