Bone Health and Osteoporosis
10 simple things to do to keep your bones strong and feeling great, by Tessa Kitchener
Osteoporosis (porous bones) is a topic close to my heart as my previously fit and healthy 72 year old mother was diagnosed with it. What I’ve seen in her, is that she has progressively become more bent over, and experiencing significant changes and disabilities to her lifestyle as her spine crumbles. This led me at age 44, to get my own bone density tested, which isn’t normally recommended until age 60 onwards unless having suffered from specific medical conditions that can impact bone health. And at the youthful age of 44, I have been diagnosed with Osteopenia (low bone density), which is the precursor to osteoporosis. And as someone who considers themselves healthy and active, and was still diagnosed, I thought I’d put together a bit of information and a few tips for optimising bone health for the thousands of people who get diagnosed Osteoporotic/peanic every year.
Cross section of the top of the thigh bone.
What is bone?
Bone is a living organ which is constantly being built up and broken down, throughout our entire lives. Good bone health requires a balance between the cells that build bone (osteoblasts) and the cells that break down bone (osteoclasts). When there is more bone breakdown than bone building, the result is net bone loss. This is a normal expectation of aging for anyone over the age of 30, when our body has peaked in it’s building phase. It’s also important to understand the slight differences within bone. There is the hard, outer layer that experiences the majority of forces running through it from our muscles pulling on their attachment points, or our interactions between the ground and gravity. And this houses the inner layer which is more like home-made honeycomb, but full of blood and has the amazing job of producing the blood cells that keep us alive and well.
What causes bone loss?
There are several categories that we consider when determining bone loss - such as our genetic blueprint, and our environment. Our DNA which we inherit from our family creates the blueprint of how our body should be designed. But our environment will actually determine how we develop - so with this information in hand, you don’t have to assume your parents' health problems have to be your own, although they will make you more likely to experience them. Being a female, particularly of caucasian background with blonde hair, and having a slight frame will also make you more likely to experience osteoporosis, but does not guarantee it.
Other environmental related factors that contribute to bone loss include prolonged periods of inflammation in your body, hormone imbalances, vitamin and mineral deficiencies particularly vitamin D, and having poor gut health. The breakdown of bone also increases after menopause due to the changes in hormone balance, with a reduction in oestrogen.
Recommendations
Get your bone density tested - especially if you are a small framed, female, perimenopausal or menopausal. If you have a family history, or have concerns about your body density, I would recommend getting it tested anyway as osteoporotic breaks can be silent, in that they have no pain signals, and it’s much easier to prevent or treat in the earlier stages.
Get your Vitamin D levels checked - Vitamin D is essential to enable your body to absorb calcium which provides strength to your bones. Direct sunlight is still the best source, although risky in Australia so try to keep exposure outside of the peak of the sun. If that’s not feasible for you, then there are supplements around with varying potencies, and can be used in conjunction with a good diet.
Eat a nutrient dense diet - lots of colourful fruits and vegetables, especially leafy greens, good quality protein, healthy fats, and include collagen rich broths into your diet. Things like Omega 3, collagen from the broth, and protein will all provide the building blocks for bone.
Avoid foods that can be inflammatory to your immune system - things like heavily processed foods, sugar, and vegetable oils.
Avoid soft drinks containing phosphoric acid - there is some evidence to suggest that phosphoric acid interferes with calcium absorption. Read more here - https://www.health.harvard.edu/staying-healthy/does-carbonated-water-harm-bones
Work on gut health - do you have any digestive issues? Things like prolonged or continual episodes of bloating, heartburn, constipation, or Irritable Bowel Syndrome for example. These are all signs that your digestive system may not be absorbing the nutrients within food, which can have flow on effects across the health of your body, including bones. The old saying of ‘you are what you eat’ should really be reworded to ‘you are what your body is able to absorb!’
Weight bearing exercise increases load on bones and stimulates bone building mode - try walking with a weighted vest or a weight belt around your hips. High impact exercises such as running, dancing, jumping, skipping rope, playing tennis are more effective in building bone strength. However, if you already have osteoporosis, choose low impact exercises as a safe alternative such as walking or using an elliptical trainer or stair climber and hunt out other ways to build strength back into your bones.
Resistance training (weights, resistance bands, and exercises using your own body weight) is also really important to improve muscle and bone strength. However, if you do already have osteoporosis or low bone density, make sure you discuss this with your physio, pilates instructor or trainer as there are some exercises that may not be safe for you (particularly exercises involving loaded flexion).
Balance work is also important to reduce your risk of falling. The other less commonly discussed point here is learning safe falling practices. This may seem silly but most people find they discover their osteoporosis when they fall unexpectedly, and what should have been a strong bone just snaps. Learning to not use outstretched limbs to break falls, but instead fall with gravity and disperse momentum can be a great way to avoid breaks.
Pilates for bone health -
focus on extension based exercises to counteract the dowagers hump such as diamond press and dart. Try using an over ball, soffy ball or gym ball to increase your thoracic extension while staying supported.
Use the vibration plate and work on balancing on one leg.
Balance work - use a wobble board and variety of movements to challenge your balance.
Jumpboard work on the reformer can mirror jumping, but with a more graded approach.
Use weights, resistance bands and springs to increase load on your muscles and bones.
