UAB Medicine News
Tips for Strengthening Bones and Reducing Your Risk for Fractures
Osteoporosis (brittle bones) has a genetic component and tends to run in families, so some people think they are doomed to lose bone density and suffer bone fractures just because their parents or grandparents have this disease. However, you may be able to delay the onset of osteoporosis or reduce its severity.
May is Osteoporosis Awareness Month, so UAB Medicine nutritionist and bone health expert Beth Kitchin, PhD, RDN, shares some tips on healthy foods and lifestyle choices that slow the development of osteoporosis and boost bone health in many people.
How Preventable is Osteoporosis?
Kitchin, an assistant professor of Nutrition Sciences at UAB and a patient educator at the UAB Medicine Osteoporosis Clinic, says that while some risk factors for osteoporosis are related to nutrition and exercise, many others have nothing to do with lifestyle or diet.
“For most people, nutrition will not prevent osteoporosis,” Kitchin says. “It might help slow it down or reduce its severity, but a lot of things – such as being a woman, being post-menopausal, being older, and genetics – are bigger factors than the diet-related ones.”
Kitchin goes on to say that many people believe osteoporosis to be a calcium deficiency disease, but actually it’s a bone disease usually caused by mineral and/or bone structure abnormalities. And while osteoporosis can be prevented in some people, it usually involves some type of medication.
“A calcium deficiency can contribute to that, and calcium and exercise can help,” she says. “But with aging, menopause, and loss of estrogen for women, calcium and exercise aren’t going to make up for all of that.”
Many people are searching for a quick and simple way to prevent osteoporosis, but the better approach is to learn how to slow it down and prevent fractures.
“The ultimate goal is to prevent broken bones, because that’s the part of osteoporosis that is dangerous and can be very painful,” Kitchin says. “Osteoporosis is a silent disease because you don’t feel the bones losing their strength. It’s only when you feel a broken bone that you really experience the pain and have many potential problems.”
A big part of preventing fractures associated with osteoporosis is maintaining strong bones. But it also has a lot to do with avoiding falls, improving balance, and practicing good posture to protect the spine.
Top Foods for Bone Health
When it comes to nutrition, it’s important to look at eating properly for overall health and in a way that supports the bones and prevents other diseases. Calcium is important in fracture prevention, and dairy products often are the best sources of calcium for the body. Contrary to many people’s concerns, dairy products and calcium supplements shouldn’t automatically be avoided if you have heart disease, hypertension, or are obese – at least not without consulting a doctor first.
Kitchin points out that while some vegetables contain calcium, many people tend to exaggerate the amounts. This is true for starchy beans, for example, because the calcium they contain is not absorbed well by the body due to the other substances in beans that reduce its absorption.
“You absorb almost none of the calcium in spinach because it contains oxalic acid, which greatly decreases the absorption of calcium,” Kitchin adds. “That being said, I still like for people to eat spinach. It’s a leafy green vegetable that’s very high in vitamin K, which does play a role in bone density.”
Unlike spinach, kale is a leafy green vegetable that contains calcium that actually is absorbed well by the body. The same is true for turnip greens and collard greens. Still, it’s difficult to get enough calcium to help prevent fractures through plant-based sources alone. Therefore, Kitchin recommends fortified foods for vegans and vegetarians, such as orange juice with added calcium, soy milk, and almond milk. In addition to dairy products and certain leafy greens, pumpkin seeds (rich in magnesium) and walnuts (rich in alpha linolenic acid) offer benefits for supporting bone health.
Supplements and Vitamin D
Getting nutrients from whole foods is often advised, but there is nothing wrong with taking supplements to boost bone health and help prevent osteoporosis-related fractures.
“The calcium from supplements is absorbed well, although as we get older, our bodies don’t absorb as much calcium, so our needs increase to make up for that percentage of lower calcium absorption,” Kitchin says. “Also, it’s important to make sure you’re getting the right amount and not overdoing it, because extra calcium is not going to help.”
Many multivitamins and calcium supplements contain vitamin D, which is another essential component for bone health. This is because vitamin D is critical for helping the body absorb calcium. Vitamin D can be obtained from the sun, but it’s hard for people with darker skin tones to absorb vitamin D in this way. The same is true for older adults who have thinning skin and people who always wear sunscreen while outdoors.
“Generally speaking, we recommend anywhere from 1000 to 2000 IUs of vitamin D per day from supplements for our patients who are at risk for fractures,” Kitchin says. Since not everyone requires vitamin D supplementation or different levels of this vitamin, “we measure patients’ vitamin D levels and adjust recommendations based on that.”
Exercises to Boost Bone Health
Another effective natural strategy for boosting bone health and helping prevent fractures is regular exercise. Weight-bearing exercises that involve putting some stress on your bones are recommended, because the simple act of resting body weight on your skeleton can stimulate your bones. These include walking, gardening, dancing, and using a stair machine or treadmill at the gym.
“Unless you’re doing something pretty intense, weight-bearing exercise won’t be enough to stop bone loss,” Kitchin says. “But it will slow down the process, which can really be helpful. Some people may actually get a boost in their bone density from exercise, but it’s not a very common thing.”
Non-weight-bearing exercises also can be helpful, such as cycling and swimming. While these types of exercise don’t necessarily stimulate the bones, they do strengthen lower body muscles to help improve balance and prevent falls. With any exercise, Kitchin and the physical therapists at UAB stress the importance of proper posture.
“When you bend and twist the spine, you’re putting pressure right where the bones may be weak from osteoporosis, and that could actually cause fractures,” Kitchin says. “So we always promote proper posture, which means a minimum of bending and twisting from physical activities if people are at risk for broken bones.”
To learn more about how to get the nutrition your body needs for good bone health, even if you suffer from other medical issues, read Kitchin’s article, “Senior Wellness: Osteoporosis Patients With Comorbidities — All Foods Can Fit”, published in the February 2018 issue of Today’s Dietician.
Click here to learn more about the UAB Osteoporosis Clinic, or call (205) 801-8187 to make an appointment with one of our osteoporosis specialists.
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