Healthy Bones for Women of All Ages (Part 1)

When we talk about bone health, most of us associate osteoporosis with our Grandmothers. In reality, taking care of our bones is not just a concern for the elderly and should start at an early age. Lack of physical activity, a poor diet and inadequate calcium intake are prevalent among today’s children. Unfortunately, these early bad habits can negatively impact long-term bone health, increase the risk of premature osteoporosis and contribute to the growing osteoporosis epidemic.

It is now estimated that osteoporosis affects 1 in 3 women over 50 years of age (1). Women in general have a lower bone mass and are at a greater risk for osteoporosis (even though the gap narrows when men and women are close to 70 years old). Whether you are working with young girls, adults or elderly women, understanding how exercise, nutrition and lifestyle can influence bone health is an important area of understanding and application.

Bone Health Over the Life Span

Childhood bone growth is gradual and is associated with a child's overall development. At the onset of puberty, rapid bone growth occurs. After a female’s menarche, the additional stimulus of estrogen secreted from the developing ovaries results in the skeleton retaining about 150-350 mg/day of calcium. Calcium absorption efficiency is high during this three to five year maturation period, but adequate total dietary calcium is critical to sustain these high retention levels. Sufficient levels of calcium should be available during the bone building years so that the attainment of the full genetic expression of peak skeletal mass is possible. The opportunity to build bone greatly diminishes in the late teens and up to 95% of the peak bone mass is achieved by age 20. The remaining 5% can be attained up until the early 30's. Children and teens can maximize their peak bone mass and take advantage of this window of opportunity by consuming adequate calcium and vitamin D, as well as taking part in regular weight-bearing physical activity. Calcium, vitamin D and exercise work synergistically to stimulate calcium deposition into the skeleton.

In adulthood, bone mass begins to decline at a very low rate. Prolonging the rate of loss is important to ensure a greater bone density at the time of menopause when bone loss is inevitable and greatly accelerated. A woman can lose up to 20% of her bone mass in the 5 years following menopause and therefore, maximizing peak bone mass potential and maintaining healthy bones during adulthood is critical to the prevention of premature osteoporosis in later years. Osteoporosis is not part of normal aging and a long-term effort toward prevention is needed to educate younger generations about the importance of bone health.

Nutrition and Bone Health

Calcium: Calcium is one of the best life-long defenses against osteoporosis. Calcium is primarily stored in the bones and if there is not enough calcium in the blood and soft tissues, the body will replenish the supply by robbing it from your bones. This slow depletion of calcium from the bones causes the bones to weaken and increases the potential for stress fractures and osteoporosis. The best way to obtain adequate calcium is to eat ample amounts of calcium-rich food from childhood, through menopause and beyond. Ensuring enough calcium in the diet may be difficult (check your status below) and a calcium supplement may be necessary.

Vitamin D: Vitamin D is needed for the absorption of calcium and is just as important for healthy bones and Vitamin D can be found in foods. In addition, your skin produces Vitamin D from sunlight. Approximately 10 minutes of sunlight per day on bare forearms is required for the process. Many older people require a Vitamin D supplement.

Protein: Protein is also necessary for healthy bones. Adequate protein, but not excessive intakes from a variety of sources including both animal & plant sources seems to be the best approach toward healthy bones.
· Fruits & Vegetables: Recent and exciting research has found that a high intake of fruits and vegetables, which are alkali-forming foods, decrease markers for bone turnover (less breakdown). This is a very significant finding and suggests that a high consumption of alkali-forming foods may benefit bone health (2).

Alcohol: There is continuing data (3) that provide support for the beneficial effect of moderate alcohol intake on bone mass. However, more than 3-4 drinks per week can have detrimental effects.

Caffeine: Caffeine may (3) or may not (4) affect bone health and should be limited or used in moderation. Adequate calcium intake with moderate caffeine consumption appears to be the best approach for individuals who consume caffeine. For example, drinking a latte is a better option than black coffee because the milk in a latte will provide an excess of calcium to counter any calcium losses due to the caffeine. (Read next Section...)

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