Healthy bones and joints are important for all age groups as they form the skeletal system of our body which help movement and support the body weight.
Bone formation and resorption is a complex process happening with in the body and it is dependent on several factors such as nutrition, physical activity, hormones etc.
Bone strength starts deteriorating with ageing as well as undernutrition. Menopausal and perimenopausal women are more prone to bone strength reduction and osteoporotic fractures consequent to the declining hormones. Ageing men also are predisposed to weak and fragile bones. Bone fractures are common in undernourished children and adults. To understand the role of nutrition for bones , first and foremost let me guide you through the complex processes involved in the physiology of bone formation and resorption. Simply, it defines how bones maintain their structural integrity and strength.
Bones are constantly undergoing structural and biological change, and it is called remodeling of bones. This process continues throughout the lifespan in humans. Various factors affect this remodeling. Nutrition has a significant role in bone remodeling. Particularly, some vitamins and minerals are crucial for the development of bones.
Vitamin D, vitamin K and minerals including calcium, magnesium, phosphorus etc. have significant role in the formation of healthy and strong bones.
Bones are a type of specialized connective tissue with the capacity to remodel based on the needs. The primary cell forming bone is the osteoblast. Osteoblasts secrete a fluid known as osteoid, which is rich in a protein collagen. For the bone to become hard, the osteoid must undergo mineralization with minerals such as calcium and phosphate.
Role of calcium &vitamin D in bone health
Calcium helps bone mineralization and thus strength or hardness of bones. Calcium requirement for adults is 700mg / day. Calcium can keep your bones healthy and vitamin D helps your body absorb calcium.
Adequate amount of vitamin D and calcium in the diet is essential, especially during the period of rapid growth of childhood and adolescence. [Recommended daily intake of calcium is 1300g].
It has been found with various studies that prevalence of Vitamin D deficiency is very high in patients with hip fragility fractures. Vitamin D deficiency is associated with osteoporosis. Calcium, phosphorus, zinc, and magnesium are very important minerals required for bone development and remodeling. Vitamins A.D and K also play significant role in normal bone metabolism. Deficiency of these nutrients weakens bones and may lead to bone fractures.
Best foods that boost bone health
Human body needs a balanced diet with carbohydrate, proteins, vitamins, minerals in adequate amounts for the healthy functioning of skeletal system. Out of these nutrients, some vitamins and minerals are crucial for bone health. A few bone health boosting foods enriched with these micronutrients are listed below:
- Milk and other dairy foods
Milk and milk products are great source of calcium. Calcium plays a pivotal role maintaining the health of bones.
Cow’s milk contains calcium [118mg], phosphorus [89.6mg], sodium [44.5 mg], potassium[150mg], proteins, lactose and fat.
Calcium in various types of milks[portions-200ml]
- Whole milk 236mg
- Semi-skimmed milk 240mg
- Skimmed milk 244mg
Dietary recommendations for including milk, and dairy products are vital for the prevention of osteoporosis.
According to a study children who had avoided milk and other food fortified with calcium, suffered occurrence of fracture before puberty more frequently than children who had consumed cow’s milk.
Another study indicates that intake of dairy products, increases bone mineral density [BMD] of the femoral bone neck and lumbar spine among subjects with normal 25(OH)D concentration [ vitamin D], but not in a group with vitamin D deficiency. This study throws light into the fact that along with calcium and other minerals vitamin D is crucial for bone health.
Another research study points out that people on a pure vegan diet [who avoid milk and milk products] get only insufficient amount of calcium and vitamin D, which may lead to osteoporosis due to a decrease in bone mineral density .
- Green leafy vegetables
Green leafy vegetables, such as broccoli, cabbage and okra are rich in calcium, zinc and vitamins A,C and K; However, spinach is not considered as a good source. Although spinach contains calcium, it also contains oxalate, which inhibits calcium absorption.
Vegetables high in calcium include collard greens, turnip greens, kale, mustard greens, beet greens, bok choy, okra, Swiss chard, and broccoli.
- Calcium fortified soy milk
About 200 mL of calcium enriched soy milk contains 240 mg of calcium.
- Soya beans
Estrogen hormone is protective of bone. Menopause causes a fall in estrogen level in females. postmenopausal estrogen decline is linked with bone loss and enhances the risk for osteoporotic fracture. Soy products contain isoflavones, plant-based estrogenic compounds or phytoestrogens which show an affinity with the estrogen receptor and protects from loss of bone mass.
Most clinical studies on postmenopausal women and soy products point out a positive effect of soy on markers of bone turnover and bone mineral density. However further extensive studies are needed in this regard.
- Tofu
Tofu, also called bean curd, is a soft, flavorless food product made from soybeans. Tofu is made from dried soybeans that are soaked in water, crushed, and boiled.
Tofu contains nutrients such as protein, calcium, potassium, and iron. Soy products are rich source of high amount of calcium as well as plant oestrogenic compound isoflavones. These help bone mineralization, prevent bone loss and thus prevent osteoporotic fracture.
- Legumes
Beans or legumes contain calcium, magnesium, fiber and other nutrients. But the presence of phytates in legumes limit their role as this compound may interfere with the absorption of calcium that is contained in beans. The phytate level can be reduced by soaking beans in water for several hours and later they can be cooked fresh water.
- Nuts
Nuts are enriched with omega 3 fatty acids, protein, and minerals like calcium and magnesium. Almonds and pistachios are good nuts rich in calcium, omega fatty acids and several other nutrients promoting bone health. Almonds are good source of calcium. A half-cup of the nuts alone has 190 mg of calcium.
- Small fishes with bones
Include fishes such as sardines and pilchards into your daily diet. These are rich source of omega -3 fatty acids which help bone health in elderly females at the risk of osteoporosis. Oily fish, such as salmon, sardines and mackerel contain long-chain omega-3 fatty acids. The most important biologically active omega 3 polyunsaturated fatty acids, eicosapentaenoic acid and docosahexaenoic acid are mainly derived from certain cold-water fish or their oils. Salmon and tuna are also rich sources of vitamin D, which helps the mineralization of bones and help to improve bone strength.
- Egg yolk
Eggs are good source of vitamin D along with several other nutrients which can boost bone strength helping bone mineralization. Consume one egg every day to boost bone health.
- Vitamin D fortified foods
Mostly milk, milk products and margarine are fortified with vitamin D. Consumption of vitamin D fortified foods can increase vitamin D intake and has found to be effective in significantly increasing 25(OH)D levels in the body.
Other types of fortified foods include some cereals, juices, staple food, other dairy products and margarine.
Vitamin D fortified foods can strengthen the bones.
Apart from these proteins and vitamin C are important in collagen formation and proper development of skeletal system. Bone strength depends not only on the quantity of bone tissue but also on the quality.
Collagen, primarily Type I, forms the flexible organic framework of the bones, imparting structure and toughness. Osteoblasts [ bone cells]build this collagen matrix, controlling bone formation and remodeling.
The minerals like calcium and phosphate deposit to form hard hydroxyapatite, creating strong, mineralized tissue.
Therefore, intake of foods such as eggs, milk, legumes and citrus fruits, guava, gooseberry etc. is very important in building and maintaining bone strength.
written by dr sanjana.p
References
1. https://www.nhs.uk/live-well/bone-health/food-for-strong-bones/
2. https://orthoinfo.aaos.org/en/staying-healthy/bone-health-basics/
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