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Last reviewed in April 2020 by Georgina Camfield, AXA Health Programme Lead Physiologist, Registered Associate Nutritionist (ANutr) and qualified fitness instructor.
There’s a lot we can do to build strong bones – including paying attention to diet, exercise and our lifestyle choices – and the earlier we start, the better.
Most of us tend not to think about bone health until we enter our 50s or 60s – or we start to creak! But it’s really important to start looking after our bones when we’re much younger. It may come as a surprise to know that you reach peak bone density in your mid to late twenties. After that, bone starts to decline. This is a natural part of the ageing process but for some the process is faster, leaving them at risk of developing osteoporosis. So the stronger your bones are at their peak – and the more you do to boost your bone health throughout your life time – the less likely you are to suffer from potentially debilitating problems later on.
Why is bone health important?
Jan Vickery, AXA Health's Head of Musculoskeletal Health explains: “Low bone density can lead to a higher risk of osteoporosis – a condition that results in particularly weak and porous bones that can break easily. These breaks are often referred to as fragility fractures. Osteoporosis develops slowly and usually goes undetected until a fracture following a relatively minor fall or impact prompts further investigation – usually in the form of a bone density (or DEXA) scan.”
“Fragility fractures can occur anywhere in the body but the most common injuries suffered by people with osteoporosis are fractures of the wrist, hip and spine. Spinal fractures can be difficult to diagnose, with the pain often being attributed to muscle damage. However they can be incapacitating, sometimes causing severe long term pain. They can also lead to height loss and stooped posture, when multiple fractures cause the spine to compress and eventually become unable to support the body in an upright position.”
“Although osteoporosis itself isn’t painful, the resulting fragility fractures can, cause both immediate and long term (chronic) pain, arthritis and restricted mobility.”
How common is osteoporosis?
Osteoporosis is very common condition in older adults, and women in particular. This is because the rate at which bone density declines rises sharply in the first 5 years or so after they enter menopause (from around 0.5% per year to as much as 3% each year.[1] Research suggests more than half of women over 50 and one in five men of the same age will sustain one or more fragility fractures in their lifetime.[2]
The good news is there are things you can start to do right now to keep your bones stronger for longer and reduce the risk of fractures in later life.
Steps to boost bone health and help prevent osteoporosis, at any age
Diet and bone health – what to eat for stronger, healthier bones
“Healthy bones need a well-balanced diet, incorporating minerals, vitamins and protein from a range of different food groups, including fruit and vegetables, carbohydrates, dairy products, meat, fish, eggs, pulses, nuts and seeds,” advises Georgina.
Government recommendations state that we should aim to consume 700mg of calcium a day to support good health. Calcium acts as the building blocks for bones, with 99% of the calcium in our bodies stored there. Our bodies constantly remove little bits of calcium and replace them with new calcium to remodel our bones, keeping them healthy. If we’re unable to replace the calcium removed from the bones they can slowly become weaker. Dairy products are the richest source of calcium, with milk, cheese and yoghurt all providing great options.
“Fear not if your dietary choices restrict your consumption of dairy products; there are plenty of other non-dairy based foods that can contribute towards your daily calcium intake. Including plenty of broccoli, kale, soy beans and fish (particularly sardines and salmon) in your diet will help keep your calcium stores topped up,” says Georgina.
Vitamin D is also essential for bone health[3], as low levels can lead to inadequate absorption of calcium from the foods that we eat. We absorb most of our vitamin D through the skin from sunlight. There are many factors that affect how much sunlight is enough to make sure we’re getting enough vitamin D, including our skin colour and clothing. However, getting out for a walk on your lunch break and exposing your face, hands and forearms to the sun – being sure to wear sufficient sun protection – should be enough to ensure adequate intake of vitamin D, particularly through the spring and summer months. If you’re someone who works indoors away from natural light or works frequent night shifts, for example, you may need to increase your intake of dietary sources to maintain healthy vitamin D levels. Sources of vitamin D include tuna, mackerel, salmon, cheese, eggs and fortified dairy and cereals.
“While calcium and vitamin D remain the big guns in regard to bone health, there are other nutrients that have been shown to assist in maintaining healthy bones,” Georgina adds.
Magnesium: magnesium deficiency has been associated with an increased risk of osteoporosis.[4] While magnesium deficiency is rare in those with a healthy balanced diet, the body’s ability to absorb it decreases with age, so it’s worth topping up on magnesium rich foods as you get older. Sources of magnesium include green veg, legumes (peas, beans, lentils and peanuts), nuts, seeds and fish.
Zinc: important for bone tissue renewal and mineralisation.[5] Sources of zinc include red meat, poultry, cereals and pulses.
Phosphorus: calcium needs phosphorus to build strong bones and tissues.[6] While we need some, too much can also be a bad thing. Sources = dairy, nuts, seeds, beans, meats.
Fruit and veg: a higher intake of fruit and veg has been associated with a higher bone density.[7] The minerals and vitamins that they contain may influence bone health, particularly vitamin C which stimulates the production of bone forming cells. The antioxidants in fruit and veg may also protect these cells from damage.
Salt: some evidence suggests that a high intake of salt can increase the amount of calcium lost in urine[8] so if you’re at an increased risk of osteoporosis, it may be sensible to limit your intake of salt in future.
Dietary supplements for bone health
Some adults may be advised to take vitamin and mineral tablets for their bones if they have too little calcium in their diet or insufficient exposure to sunlight. We absorb minerals less efficiently as we get older and some older people may benefit from a dietary supplement. Patients on osteoporosis medication may be prescribed a calcium and vitamin D supplement. If you haven’t been prescribed supplements, they are readily available in pharmacies, supermarkets, health food shops and some online retailers. However you should always consult with your GP or other medical professional before you start taking any, to make sure you actually need them and that they won’t interfere with any medication you’re already taking.
