Natural Ways to Keep Bones Healthy and Strong

This article is written by Accredited Practising Dietitians from FEEDinc. Nutrition Clinic and is aimed at Health Professionals to provide the most up-to-date information on bone health for their patients.

Poor bone health affects 1-in-3 Australians.1

You are never too young, or too old, to act when it comes to protecting your bones.

Read below for six natural ways you can help to keep your patients’ bones healthy and strong for life.

1. Exercise

Regular physical activity plays an important role in maintaining and building strong and healthy bones.2 When we perform regular exercise, our muscles pull on our bones, which in turn builds more bone.3 As a general rule, 30 minutes of bone building exercise 4-6 times a week can help maintain and build stronger, denser bones.3 Start where you feel comfortable and gradually work your way up by adding speed, weight, or time to your workouts.

Our bones respond better to certain types of exercise. Including:

  • Weight-bearing exercises e.g. brisk walking, tennis, hiking, jogging, dancing
  • Resistance training e.g. using your body or free weights
  • High impact exercise e.g. skipping, jogging, jumping
  • Balance training e.g. yoga or tai-chi. Whilst balance and mobility exercises do not improve bone or muscle strength, they are important in helping to reduce our risk of falls.3

2. Vitamin D

Vitamin D is essential to bone health, as it plays a key role in absorbing calcium.4 Vitamin D also helps to regulate calcium levels in our blood and helps to support the growth and maintenance of our skeleton.4

Whilst there are some foods that contain Vitamin D (e.g. oily fish, liver and egg yolks), it is difficult to get our daily requirements from diet alone.4 That is why for most Australians, the main source of vitamin D is from exposure to sunlight.4 Vitamin D forms when our skin is exposed to ultraviolet B (UVB) light from the sun.4

In Australia, we need to be mindful of balancing adequate vitamin D levels from sun exposure and the risk of developing skin cancer. That is why exposure to sunlight is recommended between 10am and 2pm during summer time, to avoid peak UV periods.5 Most Australian adults will maintain adequate vitamin D levels simply carrying out their normal day-to-day outdoor activities.5

During winter it can be a little more difficult to achieve adequate vitamin D levels and why longer sun exposure times are needed, preferable around midday.5 Always keep in mind that when the UV index is above three, you should ensure sun protection measures are in place when you are outdoors for more than a few minutes (e.g. slip, slop, slap).4

3. Consuming calcium rich foods each day

Calcium is essential for building and maintaining healthy bones.6 When combined with other minerals, like phosphorus, calcium helps to form hard crystals, giving our bones their strength and structure.6

Because our bodies do not naturally produce calcium, getting it through our diet is essential and is why calcium rich foods are one of the five food groups the Australian Dietary Guidelines recommend we consume every day.7 When calcium levels are low, our body withdraws calcium from our bones and overtime our bones weaken and become brittle, increasing our risk of things such as osteoporosis.8

The recommended dietary intake of calcium depends upon our age and gender.6 For example, calcium requirements are high in our teenage years as our peak bone mass, the point at which our bones are strongest, is achieved by our early twenties.6 It is also during this time that our bodies are their most efficient in absorbing calcium and we see rapid growth of the skeleton.6 With age, however, this absorption efficiency decreases and is one of the reasons we need to consume higher amounts of calcium.6

Dairy foods such as milk, yoghurt and cheese have long been known for their important role in bone health, as they contain a high level of calcium and are most readily absorbed by the body.9 Dairy foods also provide other health benefits, such as protecting us against heart disease and stroke, high blood pressure and some cancers.10 They are also an excellent source of nutrients including protein, iodine, vitamin A, vitamin D, riboflavin, vitamin B12 and zinc.10

Most people need at least two-to-three serves of dairy foods each day, with a serve being equivalent to one cup of milk, two slices of hard cheese, half of ricotta cheese or three quarter cup of yoghurt.9 For those that don’t consume dairy products, green leafy vegetables, oily fish, almonds and soy and tofu products also contain sources of calcium.9 For calcium fortified products, look for labels that have 100mg of calcium per 100mls.1

4. Quit smoking

Many studies have shown a direct correlation between smoking and decreased bone density, as well as an increased risk in fractures.11

Aside from the other negative health affects smoking has on our bodies, nicotine in cigarettes causes damage to our bone in many ways. Including:

  • Decreasing the amount of blood supplied to bones
  • Slowing the production of bone forming cells, making less bone
  • Decreasing the absorption of calcium from the diet
  • Breaking down oestrogen in the body more quickly. Oestrogen is an important hormone for building and maintaining a strong skeleton.11

There are also many other factors that place smokers at increased risk of weak and frail bones. For example, people who smoke tend to be thinner than non-smokers, less physically active and have poorer diets.11 

5. Moderate your alcohol intake

Drinking too much alcohol interferes with the balance of calcium in the body.12 It can also affect the production of hormones, which have a protective effect on bone health, and of vitamins needed to help absorb calcium in the body.12 Excessive alcohol consumption can also lead to more falls and an increase in the risk of fractures.12

For healthy men and women, drinking no more than two standard drinks (with a standard drink containing 10g of alcohol) on any day can reduce the lifetime risk of harm from alcohol-related disease or injury.13

6.Maintain a stable, healthy weight

In addition to eating a nutritious and balanced diet, maintaining a healthy weight can help to support bone health.

This is especially important in postmenopausal women, who have lost the bone-protective effects of oestrogen, as being underweight can increase the risk of osteopenia and osteoporosis.14

As weight loss typically involves some bone loss, repeatedly losing and regaining weight also appears to have negative effects on one’s bone health.15 A study following postmenopausal women after modest weight loss and then regain, found that bone mineral density was not fully recovered when weight was regained.15

Therefore, maintaining a stable, healthy weight or slightly higher than normal weight as you age, is your best bet when it comes to protecting your bone health.

Recipes

Looking to add more calcium into your diet? Try these delicious and healthy recipes by Dietitian Georgia Houston from FEEDinc.

Strawberry Ricotta Toast



Ingredients

  • Wholegrain or sourdough bread, sliced and toasted
  • Strawberries, sliced, enough to top toast
  • Ricotta, enough to smother on toast
  • Honey, to drizzle
  • Chopped pistachios, to serve

To make

  1. Spread chilled ricotta over toast.
  2. Top with strawberries.
  3. Drizzle honey over strawberries and top with pistachios. Enjoy immediately


Bircher Muesli



Ingredients

  • 1 + 1/2 cup rolled oats
  • 1 cup milk
  • 1 tbsp pepitas
  • 1 apple grated
  • 1/4 cup freshly squeezed orange juice
  • 1/2 tsp orange rind
  • Raspberries and plain or Greek yoghurt, to serve

To make

  1. Combine oats, milk, pepitas, apple and orange juice in a bowl. Cover and refrigerate overnight.
  2. Stir orange rind through muesli, divide between serving bowls and top with fresh raspberries and a dollop of natural yoghurt.

Serves 2-3 (depending on morning hunger levels).


Banana, Blueberry and Yoghurt Muffins



Ingredients

  • 1 + ¾ cup whole wheat flour
  • 1 tsp baking powder
  • 1/4 tsp sea salt
  • 2 bananas, mashed
  • 1/2 cup Greek yoghurt
  • 1/4 cup milk
  • 1/4 cup honey
  • 2 eggs
  • 1 cup fresh or frozen blueberries

To make

  1. Preheat oven to 160 degrees Celsius.
  2. Combine all dry ingredients into a large mixing bowl.
  3. Combine all wet ingredients into a separate mixing bowl and mix to combine, leaving out the blueberries.
  4. Add wet to dry ingredients and fold together.
  5. Fold in blueberries.
  6. Place batter into muffin cases and cook for 20 minutes or until slightly golden and cooked through

Makes 8-12 depending on muffin tin size.

References

  1. Healthy Bones Australia [Internet]. Broadway NSW: Osteoporosis Australia; [year of publication unknown]. Background; [publication date unknown] [cited 2018 October 18]; about 1 screen. Available from: http://www.healthybonesaustralia.org.au/what/background/
  2. Osteoporosis Australia [Internet]. Broadway NSW: Osteoporosis Australia Medical & Scientific Advisory Committee; 2014. Exercise; [publication date unknown] [updated 2018 September 18; cited 2018 October 19]; [about 5 screens]. Available from: https://www.osteoporosis.org.au/exercise
  3. Healthy Bones Australia [Internet]. Broadway NSW: Osteoporosis Australia; [year of publication unknown]. Exercise; [publication date unknown] [cited 2018 October 18]; about 2 screens. Available from: http://www.healthybonesaustralia.org.au/how/exercise/
  4. Osteoporosis Australia [Internet]. Broadway NSW:Osteoporosis Australia Medical & Scientific Advisory Committee; 2014. Vitamin D; [publication date unknown] [updated 2017 July 14; cited 2018 October 19]; [about 5 screens]. Available from: https://www.osteoporosis.org.au/vitamin-d 
  5. Healthy Bones Australia [Internet]. Broadway NSW: Osteoporosis Australia; [year of publication unknown]. Sunshine; [publication date unknown] [cited 2018 October 18]; about 2 screens. Available from: http://www.healthybonesaustralia.org.au/how/sunshine/
  6. Osteoporosis Australia [Internet]. Broadway NSW: Osteoporosis Australia Medical & Scientific Advisory Committee; 2014. Calcium; [publication date unknown] [updated 2017 July 14; cited 2018 October 19]; [about 5 screens]. Available from: https://www.osteoporosis.org.au/calcium
  7. Australian Dietary Guidelines [Internet]. Canberra, Australia: National Health and Medical Research Council (NHMRC); 2013. [cited 2018 October 18]. Available from: https://nhmrc.gov.au/about-us/publications/australian-dietary-guidelines
  8. Better Health Channel [Internet]. Victoria, Australia: State of Victoria; [year of publication unknown]. Calcium; [publication date unknown] [updated 2013 April; cited 2018 October 18]; [about 7 screens]. Available from: https://www.betterhealth.vic.gov.au/health/HealthyLiving/calcium
  9. Healthy Bones [Internet]. Victoria, Australia: Dairy Australia; [year of publication unknown]. Bone FAQs; [publication date unknown] [cited 2018 October 18]. Available from: http://www.healthybones.com.au/bone-faqs/bone-faqs
  10. Heart Foundation [Internet]. [Location unknown]; [year of publication unknown]. Healthy Dairy Foods; [publication date unknown] [cited 2018 October 18]; about 3 screens]. Available from: https://www.heartfoundation.org.au/healthy-eating/food-and-nutrition/dairy-foods
  11. International Osteoporosis Foundation [Internet]. Nyon, Switzerland: International Osteoporosis Foundation; [publication date unknown]. Smoking is a real danger to your bone health; 2015 May 20 [cited 2018 October 19]; [about 3 screens]. Available from: https://www.iofbonehealth.org/news/smoking-real-danger-your-bone-health
  12. National Institutes of Health. Smoking and Bone Health [Internet]. Bethesda, MD: National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center; 2016 May [cited 2018 October 18]. Available from: https://www.bones.nih.gov/sites/bones/files/Smoking_and_Bone_5-16.pdf
  13. National Health and Medical Research Council (NHMRC) [Internet]. Canberra, Australia: NHMRC; 2009. Alcohol; [publication date unknown] [cited 2018 October 19]. About 4 screens. Available from: https://nhmrc.gov.au/health-advice/alcohol
  14. Australasian Menopause Society. Osteoporosis [Internet]. [Location unknown]: Australian Menopause Society; 2014 April [cited 2018 October 18]. Available from: https://www.menopause.org.au/images/stories/infosheets/docs/AMS_Osteoporosis.pdf
  15. Villalon KL, Gozansky WS, Van Pelt RE, Wolfe P, Jankowski CM, Schwartz RS, Kohrt WM. A losing battle: weight regain does not restore weight loss-induced bone loss in postmenopausal women. Obesity [Internet]. 2011 Dec 19 [cited 2018 October 19];12:2345-50. DOI: 10.1038/oby.2011.263