Written by Dr. Sanjana V.B Bhms,dbrm,cdn

Founder & medical director of siahmsr wellness.in

All rights reserved with siahmsr digital healthcare[siahmsr wellness]

Reviewed by SIAHMSR medical team.

Best foods for bone health

Bones 

  Healthy bones and joints are essential for better health and movement of the body. Bones and joints have crucial role in supporting our body. In addition to its role in providing shape to the human body, bones help in movement, motor capability, protecting vital organs and  facilitating breathing.  Bones also help to produce a variety of blood cells in the bone marrow which are crucial for functioning of circulatory and immune systems of the body.

Bone remodeling

    Bones are constantly undergoing structural and biological change, and it is called remodeling of bone. This process continues the entire life of humans. The skeletal system  responds to increased stress or mechanical load such as resistance training, vigorous physical exercise etc. by increasing  new bone formation [osteogenesis].That means physical exercise or strength training can trigger bone remodeling or new bone formation.

    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.  These minerals are typically absorbed from the diet.

Vitamin D is  another important nutrient required for bone mineralization. Bone mineralization process is important for bone strength.

 The foods and nutrients contained in the foods have crucial role in determining the hardness or strength of bones. Bones need all essential nutrients for its functions; such as protein, minerals, and vitamins to make and regenerate bone.

Calcium, phosphorus, zinc, and magnesium are most important minerals that should be obtained through diet. Vitamins A.D and K are also required for normal bone metabolism. Lack of these nutrients weakens bones and may lead to bone fractures.

Foods supporting bone health

·       Milk and other dairy foods

Milk and milk products are great source of calcium.Cow’s milk contains calcium [118mg], phosphorus [89.6mg] , sodium[44.5 mg],potassium[150mg] ,proteins, lactose and fat.

 Proper intake of vitamin D and calcium is essential, especially during the period of rapid growth of childhood and adolescence.

[Recommended daily intake is 1300g]. 

  Calcium requirement for adults is 700mg / day.

Calcium intake is vital to keep your bones healthy and adequate vitamin D intake to help your body absorb calcium.

Prevalence of Vitamin D deficiency is very high in patients with hip fragility fractures. Vitamin D deficiency is associated with osteoporosis [15]. Dietary recommendations for including milk , and dairy products are vital for the prevention of osteoporosis.

A study shows that children who had avoided milk and had not eaten food fortified with calcium, reported fracture before puberty more frequently than children who had consumed cow’s milk [17].

 Another study shows that intake of dairy products, was associated with higher  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[18].Therefore it is evident that role  of vitamin D is crucial in the body.

According to another study people on a pure vegan diet [who do not take milk and milk products] consume an insufficient amount of calcium and vitamin D, which may lead to osteoporosis due to a decrease in bone mineral density [19].

·       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 a good choice.  Although spinach contains a lot of calcium, it also contains oxalate, which reduces calcium absorption, and hence spinach is not considered as a good source of calcium.

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. The calcium helps bone mineralization and thus strength or hardness of bone.

·       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, more extensive studies are needed to use soy widely as an estrogen equivalent in medical practice [21].

·       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. The mixture is separated into solid pulp (okara) and soy “milk.” The soy milk is poured into molds to allow the carbohydrate-laden whey to drain off. The soft cake residue is cut into squares and stored under water until sold. This is tofu, which contains nutrients such as protein, calcium, potassium, and iron.

Soy products are   generally 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, However they also contain substances called phytates. Phytates may interfere with the absorption of calcium that is contained in beans. You can reduce the phytate level by soaking beans in water for several hours and then cooking them in fresh water.

·        Nuts

Nuts are good source of omega 3 fatty acids, protein, and minerals like calcium and magnesium. All these nutrients are very crucial for bone health.

Some nutrient rich nuts include almonds and pistachios. Almonds are good source of calcium. A half-cup of the nuts alone has 190 mg of calcium. 

·        Small fishes with bones

Small fishes such as sardines and pilchards are rich source of omega -3 fatty acids which aid in bone preservation 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 high in vitamin D, which helps the mineralization of bones and help to improve bone strength.

·       Egg  yolks

Eggs are great source of vitamin D which boosts bone strength helping bone mineralization with calcium and phosphorus.

·       Vitamin D fortified foods 

Mostly milk, milk products and margarine were fortified with vitamin D. Consumption of vitamin D fortified foods, especially milk, increase vitamin D intake and was effective in significantly increasing 25(OH)D levels. Other foods include some cereals, juices, staple food, other dairy products and margarine. Vitamin D fortified food intake  in adequate amounts may help to strengthen bones.

   In  addition to foods physical activity or exercise has crucial role in bone health. To read more click the link below.

http://siahmsrwellness.in/does-physical-activity-help-bone-health 

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/
3.     https://www.kenhub.com/en/library/anatomy/bones
4.     https://pubs.niaaa.nih.gov/publications/arh26-4/292-298.htm#:~:text=In%20particular%2C%20heavy%20alcohol%20use,can%20also%20harm%20bone%20health.
5.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140170/#:~:text=Dietary%20consumptions%20of%20sodium%20chloride,to%20increase%20urinary%20calcium%20excretion.&text=Therefore%2C%20a%20high%20salt%20intake,osteoporosis%20due%20to%20increased%20calciuria.
6.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775240/#:~:text=Magnesium%20deficiency%20contributes%20to%20osteoporosis,by%20promoting%20low%20grade%20inflammation.
7.   https://pubmed.ncbi.nlm.nih.gov/26343111/#:~:text=Background%3A%20Vitamin%20C%2C%20traditionally%20associated,radicals%20detrimental%20to%20bone%20health.
8.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955144/#:~:text=Although%20known%20for%20its%20importance,markers%2C%20and%20regulating%20bone%20reabsorption.
9.     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172791/
10.            https://pubmed.ncbi.nlm.nih.gov/32548903/
11.          https://pubmed.ncbi.nlm.nih.gov/28093633/#:~:text=Abstract,older%20men%20and%20postmenopausal%20women.
12.           https://pubmed.ncbi.nlm.nih.gov/20035439/
13.           https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693714/
14.           https://www.ncbi.nlm.nih.gov/books/NBK537199/
15.           https://pubmed.ncbi.nlm.nih.gov/31708635/
16.           https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8072827/
17.           https://pubmed.ncbi.nlm.nih.gov/14760576/
18.           https://pubmed.ncbi.nlm.nih.gov/30601986/
19.           https://pubmed.ncbi.nlm.nih.gov/21092700/
20.           https://www.myfooddata.com/articles/high-calcium-vegetables.php
21.           https://pubmed.ncbi.nlm.nih.gov/18277912/
22.           https://www.britannica.com/topic/tofu
23.           https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179178/