Tag Archives: bones


Osteoporosis – Love Your Bones; Protect Your Future

Osteoporosis: Protect Your Bones – Three Key Nutrients You May Be Missing

October 20th is World Osteoporosis Day. This year, the theme of the campaign is Love Your Bones; Protect Your Future, encouraging all of us to take early action to protect bone health.

From the age of 50, one in every three women and one in five men will suffer a bone fracture as a result of poor bone health. “The progressive bone loss that occurs with osteoporosis may be invisible and painless, but this ‘silent’ disease results in fractures which cause pain, disability, and ultimately loss of independence or premature death,” states Prof. John Kanis, President of the International Osteoporosis Foundation.

Fortunately, taking care to adopt a healthy diet and undertake regular exercise is well-known to help protect bone health in later years. Vitamin and mineral supplements containing key nutrients for bone health – such as calcium, magnesium, vitamins D and K, and boron – can also be a sensible way of providing additional protection.

While many of us are aware of the role of nutrients such as calcium and vitamin D in bone health, it is important to note that healthy bones are dependent on a whole host of nutritional factors. Below are the top three commonly overlooked bone-boosters.

1. Protein

In the past, there has been concern over the link between protein intake and bone loss. It was believed that high protein intake might result in loss of bone mass by causing calcium to be leeched from bones.

However, more recent research has found that, provided calcium intake is sufficient, adults with the highest protein intakes have the lowest rates of bone loss (1). Protein makes up about 50% of bone, and so bone requires a constant intake of protein to maintain its mass.

Ensuring a good intake of foods high in both calcium and protein is essential, especially for older people whose protein intake tends to be lower. For those who drink protein shakes, try adding in some calcium-rich kale, Greek yoghurt or a spoon of tahini or almond butter. Aside from dairy, good sources of both calcium and protein are canned salmon (with bones), tofu, almonds, white beans and sesame seeds. The top choice however, is tinned sardines which are cheap, easily available and also provide another little-known bone builder, omega-3.

2. Omega-3

Osteoporosis has strong links with inflammation, because inflammatory compounds have a direct effect on the cells that form and break down bone.

It is widely understood that omega-3 fats have an anti-inflammatory effect. While larger studies are needed to confirm this benefit, research to date is promising. For example, combining exercise with omega-3 supplements has been shown to improve bone density better than exercise alone (2). In a second study, a test diet with a higher amount of omega-3 fats was found to reduce bone breakdown, when compared with a typical Western diet (3).

Taking care to include sources of omega-3 in the diet is recommended to fight chronic inflammation. Omega-3 fats are abundant in oily fish, and are also present in leafy greens, chia and flaxseed.

3. Antioxidants

Oxidative stress is damage that occurs when free radicals attack our body. This can include damage to bone, by reducing bone formation and increasing bone resorption.

Women with osteoporosis have been found to have lower levels of antioxidant nutrients in their blood than women with healthy bones (4). Fortunately, antioxidants in both whole foods and supplements have been found to protect bone health (5,6).

Including antioxidant-rich foods would therefore appear to be a sensible way to help keep bones healthy. While some might choose an antioxidant supplement, key antioxidants are also easy to include in our daily diet. For example, blueberries and green tea supply flavonoids, tomatoes are a rich source of lycopene and red grapes provide resveratrol.

1. Thorpe et al (2008) Effects of meat consumption and vegetarian diet on risk of wrist fracture over 25 years in cohort of peri- and postmenopausal women. Public Health Nutr. 11(6):564-572
2. Tartibian et al (2011) Long-term aerobic exercise and omega-3 supplementation modulate osteoporosis through inflammatory mechanisms in post-menopausal women: a randomized, repeated measures study.” Nutr & Met 8:71
3. Griel et al (2007) An increase in dietary n-3 fatty acids decreases a marker of bone resorption in humans. Nutr J.16;6:2.
4. Maggio et al. (2003). Marked decrease in plasma antioxidants in aged osteoporotic women: Results of a cross-sectional study. J Clin Endocrinol Metab, 88(4), 1523-1527.
5. Peters, B. S., & Martini, L. A. (2010). Nutritional aspects of the prevention and treatment of osteoporosis. Arq Bras Endocrinol Metab, 54(2), 179-185.
6. Rao et al (2007). Lycopene consumption decreases oxidative stress and bone resorption markers in postmenopausal women. Osteoporos Int, 18(1), 109-115.


New research links FOS and Bone Health

A recent study published in the Journal of Nutrition suggests a link between fructooligosaccharides (FOS) and bone health. It indicates that combining a calcium supplement with FOS is more effective than taking a calcium supplement alone (1).

The two-year study followed 300 post-menopausal women and measured markers of bone health. The women were randomly divided into three groups. One group of women were given a daily calcium supplement, while a second group were given a combination of calcium and FOS . The third group were given a placebo supplement. At the end of the study, measures of bone turnover and bone density were taken.

At the end of the study, there were no significant differences in bone density between any of the three groups. However, the results showed that the combination of FOS and calcium had the greatest effect on bone turnover.

Bone is constantly being broken down and rebuilt. The rate at which this happens is known as ‘bone turnover’ and is a known indicator of bone quality. The change in bone turnover markers in the women taking both FOS and calcium indicates ‘a more favourable bone health profile’ according to the researchers in this study.

FOS seems to enhance calcium absorption in the large intestine, and the researchers suggest that this is the reason for its effect on bone health. These findings certainly support the need for more research in this area, particularly for vulnerable groups such as postmenopausal women.

More about FOS

FOS or prebiotics are found in chicory root, jerusalem artichoke, asparagus, leeks, onion, beans, peas and lentils.
FOS or prebiotics are found in chicory root, jerusalem artichoke, asparagus, leeks, onion, beans, peas and lentils.

FOS is a prebiotic nutrient found in plant foods. Prebiotics are not digested, and simply pass through the body. In doing so, they act as ‘food’ for healthy bacteria in the bowel, boosting numbers of health-promoting acidophilus and bifidobacteria, and crowding out disease-causing bacteria. As well as improving calcium absorption, FOS also supports both digestive and immune health.

High concentrations of FOS or prebiotics are found in chicory root, jerusalem artichoke, asparagus, leeks, onion, beans, peas and lentils. FOS can also be taken in supplement form, and its sweet taste means that it works well mixed into oatmeal, yoghurt or smoothies, or simply used as a low-calorie sweetener to enhance flavour.

In the UK, most of us average an intake of around 12g of fibre each day – only half of the recommended amount. More research is still needed in the area of FOS and bone health. In the meantime, increasing fibre intake, and prebiotic foods in particular, seems a sensible measure to ensure the recommended intake for optimal health.


Slevin, M, Allsopp P, Magee M, Bonham V, Naughton J, Strain M, Duffy J, Wallace E, McSorley E. 2014. “Supplementation with Calcium and Short-Chain Fructo-Oligosaccharides Affects Markers of Bone Turnover But Not Bone Mineral Density in Postmenopausal Women”. Journal of Nutrition Jan 2014


Lack of Vitamin D a worry for the frail

Vitamin D has received a lot of attention both in research and in the media recently, and I recently wrote about the importance of this vitamin for expectant mothers and their children. It is becoming clear that adequate levels of vitamin D are critical at all stages of life. A new study published in the European Journal of Clinical Nutrition suggests that low levels of Vitamin D can increase the risk of death in frail, older adults (1).

Sunshine is one of the best sources of Vitamin D

The study, which analysed data on 4300 adults over the age of 60, found that inadequate Vitamin D levels increased risk of death from all causes by 30 percent.

‘Frailty’ is defined as a decrease in physical function, marked by symptoms such as slow walking, muscle weakness, low physical activity and unintentional weight loss.

The study found that those who had lower vitamin D levels were more likely to be frail. It also found that frail adults with low levels of vitamin D also had triple the risk of death over people who were not frail and who had higher levels of vitamin D.

The effect of Vitamin D on muscles and bones has indeed been known for some time. When Vitamin D receptors are activated within the cell, this stimulates new protein synthesis which affects muscle growth (2). In fact a prospective study found that Vitamin D supplementation increased the number of fast-twitch muscle fibres and improved muscle function in elderly women with osteoporosis (3). This is particularly interesting as it suggests that the protective effect of Vitamin D on fracture risk is not solely a result of its effect on bone mineral density. It may also be a result of improved muscle strength leading to better physical function and lower numbers of falls.

The study does not prove whether Vitamin D plays a causative role. In other words, it is not clear whether Vitamin D deficiency contributed to frailty, or whether frail adults were more likely to develop the vitamin deficiency because of health problems.

“If you have both, it may not really matter which came first because you are worse off and at greater risk of dying than other older people who are frail and who don’t have low vitamin D,” says study leader Ellen Smit. “This is an important finding because we already know there is a biological basis for this. Vitamin D impacts muscle function and bones, so it makes sense that it plays a big role in frailty.”

The researchers suggest that older adults should be screened for Vitamin D levels, and that they should spend more active time in the sun. A carefully managed diet can also help to boost levels. For example, oily fish such as salmon or mackerel can provide 350iu per serving, so try to include this a couple of times each week. Eggs can help too, with a single egg supplying 20iu of Vitamin D. For elderly people who spend little time outdoors it may be wise to supplement Vitamin D in order to ensure adequate levels, especially during the winter months. Sunlight is of course the best source, and just 20 minutes outdoors between the hours of 10am and 2pm will provide around 400iu of the vitamin.

Written by Nadia Mason, BSc MBANT NTCC CNHC


1. E Smit, C J Crespo, Y Michael, F A Ramirez-Marrero, G R Brodowicz, S Bartlett, R E Andersen (2012) The effect of vitamin D and frailty on mortality among non-institutionalized US older adults. European Journal of Clinical Nutrition

2. Boland R. (1986) Role of vitamin D in skeletal muscle function. Endocr Rev 7:434-48.

3. Sorensen OH, Lund B, Saltin B, et al. (1979) Myopathy in bone loss of ageing: Improvement by treatment with 1 alpha-hydroxycholecalciferol and calcium. Clin Sci (Lond) 56:157-61.


The importance of bone health

Bone health is an issue which is becoming increasingly more prominent in today’s society. According to the National Osteoporosis Society (1), one in two women and one in five men over the age of 50 in the UK will suffer with a bone fracture. This is mainly due to poor bone health which means that we all need to know how important it is to build and maintain strong bones.

In addition to weight baring exercise, nutrition is absolutely vital for establishing strong bones in childhood and adolescence as this is when the body passes through the bone growth stages to create individual peak bone mass. Within the 4 years surrounding an adolescent’s peak height, around 39% of their total body bone mineral is gained. This highlights how crucial this time is for building strong bones for the future as we go in to adulthood, as low bone mineral growth during youth is linked to the risk of developing brittle bones and osteoporosis in older age.

Fresh Orange Juice
Many Fresh Orange Juice's can be bought fortified with Calcium, Magnesium or Vitamin D.

Nutrients such as calcium, vitamins D and K and magnesium have all been specifically identified for bone health and having an influence on bone mineral density. A recent review (2) published in the journal Clinical Biochemistry focuses in particular on calcium’s effect on bone health. They reviewed numerous research papers looking into the effects of certain calcium rich foods on bone density.

For example, one study reported that women who had a lower intake of milk in childhood and adolescence had low bone density in adulthood and as a result they had a much greater risk of fractures later in life. Additionally, the authors reported on findings that with low intake of cow’s milk, even pre-pubertal children can have a higher risk of fractures which shows how important calcium intake is in early life.

As well as dietary calcium intake, calcium supplementation has also been found to be a fantastic contributor to bone mineral accretion. So be sure you add calcium to your family’s supplement regime to ensure all your bones are as strong as they can be to help prevent breakages.

Once peak bone mass is achieved around the age of 20 it needs to be maintained in the bone maintenance stage which lasts around 10-20 years. Then as we reach middle age our bone density starts to reduce by approximately 0.5–1.0% per year. However, it is important to note that female bone losses can be considerably more around the time of the menopause, at around 2–3% per year due to decreases in oestrogen levels. This represents a crucial time for maintaining bone density through our food and nutrition choices. Not surprisingly, calcium intake has been linked to the prevention of bone loss around this time.

Within the review paper, the research indicates that baseline calcium intakes of 500–1000 mg/day (meeting the recommended intake of 700mg a day) which were increased by 500–1200 mg/day prevented bone loss.

In order to be within this calcium intake, try to include the following foods into your typical day’s food intake, which combined equates to around 1578mg of calcium:

Typical servings: plain low fat yoghurt, 225g (415 mg of calcium), cheddar cheese, 40g (307mg), milk (around 300mg), pink salmon, 85g (181mg), Orange juice, calcium-fortified, 170ml (375mg). Dietary calcium is also available from sources such as other dairy products, bony fish, legumes, certain nuts (such as almonds and Brazil nuts), fortified soya milk and some fortified breakfast cereals also contain smaller amounts of calcium.

However, the report noted that most people’s calcium intake from dietary sources is often not sufficient especially for those that do not drink milk e.g. Chinese cultures. They therefore recommended calcium supplementation to meet the requirement. Vitamin D is also a great contributor to healthy bones on its own however when combined with calcium it has a much greater effect and the review noted that supplemental vitamin D combined with supplemental calcium can help to slow bone loss. This study included 1200 mg/day calcium and 1000 IU/day vitamin D supplementation and found that the two nutrients used together had a greater effect on maintaining bone density than when used individually.

It was also noted that calcium and vitamin D supplementation, at an intake of around 1000–1200mg calcium (depending on dietary calcium intake) and 800 IU vitamin D daily, is particularly important for those with osteoporosis or those at risk of its development. However, make sure that you are not exceeding the recommended upper limit of calcium which is 3,000 mg/day for children and adolescents aged 9–18 years, 2,500 mg/day for 19–50 year olds and 2,000mg/day for those aged> 50 years.

What all of this means it that it is really important to get enough calcium and vitamin D in both food and supplement forms to help keep bones healthy and strong, and also that your kids are getting enough to help build their bones for the future.

Written by Lauren Foster

(1) National Osteoporosis Society

(2) Zhu, K. & Prince, R.L. (2012) Calcium and bone. Clinical Biochemistry, p7.