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In the last article , we introduced the various factors influencing peak bone mass. Amongst all, diet and nutrition is perhaps that area which we have the most control over. So in part 2 of this topic, let us highlight a few nutrients of concern to help you plan a better diet for bone health!

Calcium

Calcium is one of the very main ingredients of our bones. In fact, 99% of our body’s calcium is stored in teeth and bones while the remaining 1% flows in our blood for maintaining blood coagulation and heart contraction. Since we do not synthesize calcium on our own, we must acquire calcium from dietary sources. In case of inadequate intake, calcium will be extracted from bone storage to ensure a safe level of blood calcium, in a way, raiding the bones for supply. Hence, long-term calcium deficiency is a major cause of osteoporosis.
Rich sources of dietary calcium include dairy foods (milk, cheese, yogurt), nuts, seeds, beans, soy, dark leafy greens, fruits, seafood, and certain fortified foods (e.g. breakfast cereal).

Tip: Replace your meat in some meals with firm tofu for more calcium, less saturated fats and a better carbon footprint !

Vitamin D

Vitamin D is a key nutrient for many bodily functions. Amongst all, its role in facilitating calcium absorption by the gut and regulating blood calcium and phosphorus levels make it particularly crucial to bone health. Majority of vitamin D in our body is formed and “activated” with the aid of sunlight.
On the side, a small amount of vitamin D can be obtained from a few foods including fatty fish (e.g. salmon, sardine), egg yolk, and certain fortified foods (e.g. breakfast cereal).
Tip: When treated with UV light, some mushrooms are excellent sources of vitamin D, especially for vegetarians and vegans whose dietary choices are relatively limited!

Protein

Protein is everywhere in our body, including bones. In fact, it contributes to approximately half of bone volume and one-third of bone mass. The bone protein creates a fibrous network which calcium and phosphorus build upon. Through adequate supply of amino acids, our body may then continue to form, remodel and maintain our bone mass across the life span.  

Rich sources include dairy products, fish, poultry, legumes, whole grains, nuts, seeds, and some vegetables such as corn, broccoli, and asparagus.

Tip: Elderly may find it more difficult to consume enough protein with a declining appetite, difficulty chewing and/or swallowing. Try adding appropriately textured low-fat dairy, tofu and eggs to every meal to achieve adequate intake!

Additional dietary tips…

1. Watch your salt and caffeine intake as they promote calcium loss through urine!
2. Excessive alcohol intake may hinder nutrient absorption in general, hence, consume in moderation!
3. Lastly, pursue a balanced diet to ensure nutrients can work in harmony for optimal health!

References:

1. sHKSAR. Press Releases. LCQ10: Osteoporosis. Available at: https://www.info.gov.hk/gia/general/201911/20/P2019112000334.htm. 
2. Heaney R P, et al. Osteoporos Int. 2020;11:985-1009.
3. International Osteoporosis Foundation. Bone Biology. Available at: https://www.osteoporosis.foundation/health-professionals/about-osteoporosis/bone-biology. 
4. Hernandez C J, et al. Osteoporos Int. 2003;14(10):843-847.
5. Prentice A. Proc Nutr Soc. 2001;45-52.
6. Proia P, et al. Front Endocrinol. 2021. 12:704647.
7. International Osteoporosis Foundation. Serve Up. Available at: https://www.osteoporosis.foundation/sites/iofbonehealth/files/2019-03/2015_ServeUpBoneStrengthNutrition_FactSheet_English_0.pdf.
8. Weaver C M, et al. Osteoporos Int. 2016;27(4):1281-1386.