Keeping Your Bones Healthy and Strong

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Bones play many roles in the body — providing structure, protecting organs, anchoring muscles and storing calcium. While it’s important to build strong and healthy bones during childhood and adolescence, you can take steps during adulthood to protect bone health, too.

Why is bone health important?

Your bones are continuously changing — new bone is made and old bone is broken down. When you’re young, your body makes new bone faster than it breaks down old bone, and your bone mass increases. Most people reach their peak bone mass around age 30. After that, bone remodeling continues, but you lose slightly more bone mass than you gain.

How likely you are to develop osteoporosis — a condition that causes bones to become weak and brittle — depends on how much bone mass you attain by the time you reach age 30 and how rapidly you lose it after that. The higher your peak bone mass, the more bone you have “in the bank” and the less likely you are to develop osteoporosis as you age.

What affects bone health?

A number of factors can affect bone health. For example:

1. The amount of calcium in your diet.

A diet low in calcium contributes to diminished bone density, early bone loss and an increased risk of fractures.

2. Physical activity.

 People who are physically inactive have a higher risk of osteoporosis than do their more-active counterparts

3. Tobacco and alcohol use.

 Research suggests that tobacco use contributes to weak bones. Similarly, regularly having more than two alcoholic drinks a day increases the risk of osteoporosis, possibly because alcohol can interfere with the body’s ability to absorb calcium.

4. Gender. .

 You’re at greater risk of osteoporosis if you’re a woman, because women have less bone tissue than do men.

5. Size.

 You’re also at risk if you’re extremely thin (with a body mass index of 19 or less) or have a small body frame because you might have less bone mass to draw from as you age.

6. Age.

Your bones become thinner and weaker as you age.

7. Race and family history.

 You’re at greatest risk of osteoporosis if you’re white or of Asian descent. In addition, having a parent or sibling who has osteoporosis puts you at greater risk — especially if you also have a family history of fractures.

8. Hormone levels.

 Too much thyroid hormone can cause bone loss. In women, bone loss increases dramatically at menopause due to dropping estrogen levels. Prolonged absence of menstruation (amenorrhea) before menopause also increases the risk of osteoporosis. In men, low testosterone levels can cause a loss of bone mass.

9. Eating disorders and other conditions.

 People who have anorexia or bulimia are at risk of bone loss. In addition, stomach surgery (gastrectomy), weight-loss surgery and conditions such as Crohn’s disease, celiac disease and Cushing’s disease can affect your body’s ability to absorb calcium.

10. Certain medications.

 Long-term use of corticosteroid medications, such as prednisone, cortisone, prednisolone and dexamethasone, are damaging to bone. Other drugs that might increase the risk of osteoporosis include aromatase inhibitors to treat breast cancer, selective serotonin reuptake inhibitors, methotrexate, some anti-seizure medications, such as phenytoin (Dilantin) and phenobarbital, and proton pump inhibitors.

Bone Up — The Need-to-Know

Our bodies are building up those bones until about age 30, when they typically reach peak bone mass (which varies from person to person). Bones are constantly being broken down and rebuilt in tiny amounts. Before reaching peak bone mass, the body is creating new bone faster, but after age 30, the bone building balance naturally shifts and more bone is lost than gained.

Some people have a lot of savings in their bone bank because of factors including genetics, diet, and how much bone they built up as teenagers. The natural depletion of bone doesn’t affect these lucky ducks too drastically. But in those with less of a bone fortune, when the body can’t create new bone as fast as the old bone is lost, osteoporosis sets in, causing bones to become weak and brittle and allowing them to fracture more easily. But don’t worry about those bones starting to crumble in your youth — the disease is most prevalent in women over the age of 65 and in men over the age of 70.

Although all this talk of menopause and old age makes the threat of osteoporosis seem like a long way off, know that once it sets in, it’s extremely hard to reverse. Since there’s no way of being 100 percent positive you’ll develop osteoporosis, the best way to counteract it is to take steps earlier in life to beef up bone mass (and prevent its loss) as much as possible.

No Bones About It — Your Action Plan

Unfortunately, some are more likely than others to develop osteoporosis and weak bones in general (namely white and Asian postmenopausal women). Also unfortunately, it’s awfully difficult to change your race, gender, or menopausal status. But never fear — there are some things that can be changed to bump up bone mass. Here are ten tips to make deposits in your bone bank for a healthier future.

1. Know your family history.

As with many medical conditions, family history is a key indicator of bone health. Those with a parent or sibling who has or had osteoporosis are more likely to develop it. “So, how’s your bone density, Grandma?” might seem like an awkward question at Thanksgiving dinner, but ask anyway before she passes the gravy.

2. Boost calcium consumption.

When most people think bones, they think calcium. This mineral is essential for the proper development of teeth and bones. (Not to mention it’s a huge helper in proper muscle function, nerve signaling, hormone secretion, and blood pressure.)

But calcium isn’t the end-all, be-all bone loss cure. The key might be to help the body absorb calcium by pairing calcium-rich foods with those high in vitamin D. Some studies on postmenopausal women have shown that simply adding calcium alone to the diet doesn’t have a huge affect on bone density (though follow-up studies have suggested the opposite…)   .

Foods that are good sources of calcium include yogurt, cheese, milk, spinach, and collard greens. Not a dairy fan? Check out our list of non-dairy sources of calcium.

3. Don’t forget the vitamin D!

Where there’s calcium, there must be vitamin D: The two work together to help the body absorb the bone-boosting calcium. Boost vitamin D consumption by munching on shrimpfortified foods like cereal and orange juice, sardines, eggs (in the yolks), and tuna, or opt for a vitamin D supplement. Greatist Expert Eugene Babenko suggests getting your vitamin D (specifically vitamin D3) levels checked at your next doctor’s appointment, and to discuss the use of supplements with your doctor.

The body also produces vitamin D when exposed to the sun — 10 to 15 minutes of exposure three times per week will do. Vitamin D’s importance to bone health has been proven in studies on “seasonal bone loss” — elderly people can lose more bone mass during the winter because of lack of sun exposure  . Though these and many other studies on bone loss looked at elderly people specifically, bone health is all about prevention, so younger folks should catch a few rays to stock up on D.

4. Boost bone density with vitamin K.

Vitamin K is mostly known for helping out with blood clotting, but it also helps the body make proteins for healthy bones. However, the exact way vitamin K contributes to bone health is unclear. Two studies on young girls showed that vitamin K had different effects: One showed that vitamin K slowed bone turnover, but it didn’t have any effect on bone mineral density, while the other found the reverse  .

Another study specifically compared the effects of vitamins K and D on calcium absorption in rats, and it turns out the two vitamins work well as a team: Vitamin D stimulated calcium absorption in the intestines, while vitamin K reduced the amount of calcium excreted by the body .

Regardless of how vitamin K might help, fill up on it with foods like kale, broccoli, Swiss chard, and spinach.

5. Pump up the potassium.

Potassium isn’t necessarily known for aiding bone health: It’s a mineral that helps nerves and muscles communicate and also helps cells remove waste. But it turns out potassium may neutralize acids that remove calcium from the body.

Studies in both pre- and postmenopausal women have shown that a diet high in potassium can improve bone health  .  In fact, the study involving premenopausal women showed an 8% difference in bone density between women with high potassium intake and those with low potassium intake .

Load up on potassium by eating foods like sweet potatoes, white potatoes (skin on!), yogurt, and bananas.

6. Make exercise a priority.

Seriously. Regular exercise is key to keep a number of health issues at bay, and bone health is no exception. In fact, living a sedentary lifestyle is considered a risk factor for osteoporosis . One study comparing bone density in college women with various body weights and activity levels found that athletes with low body weight had the highest bone density of any group in the study, showing exercise (and low bodyweight) can have a positive effect on bone density .

What type of exercise is most effective? Weight-bearing exercises like running, walking, jumping rope, skiing, and stair climbing keep bones strongest. Resistance training has also been shown to improve bone health in several studies, so pick up the weights after going for a jog   . Bonus for the older readers: Improved strength and balance helps prevent falls (and the associated fractures) in those who already have osteoporosis.

7. Consume less caffeine.

Caffeine does have some health benefits, but unfortunately those benefits aren’t for our bones. Too much of it can interfere with the body’s ability to absorb calcium. One study showed that drinking more than two cups of coffee per day accelerated bone loss in subjects who also didn’t consume enough calcium . Another study (albeit on elderly women) showed that more than 18 ounces of coffee per day can accelerate bone loss by negatively interacting with vitamin D . So enjoy the java, but keep it in moderation and consume enough calcium, too.

8. Cool it on the booze.

…But like caffeine, there’s no need to quit entirely. While heavy alcohol consumption can cause bone loss (because it interferes with vitamin D doing its job), moderate consumption (that’s one drink per day for women, two per day for men) is fine — and recent studies actually show it may help slow bone loss   . Bottoms up!

9. Quit smoking.

Here’s yet another reason to lose the cancer sticks: Multiple studies have shown smoking can prevent the body from efficiently absorbing calcium, decreasing bone mass  .

10. Don’t be an astronaut.

Not to kill any childhood dreams, but because of those hours and hours of weightlessness and low-calcium diets, astronauts often suffer from space-induced osteoporosis. Space- anything sounds kind of awesome, but space bones definitely aren’t: Astronauts can lose up to one to two percent of their bone mass per month on a mission! For those who simply must visit the moon, there is a possible solution: Two studies have found that vitamin K can help build back astronauts’ lost bone — more than calcium and vitamin D  .

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