Regular exercise and calcium and vitamin D rich diets result in strong bones and prevent osteoporosis, according to the Exercise and Sports Science Australia (ESSA) Guidelines.

There is now good quality evidence that weight bearing impact exercises, such as hopping and jumping, and progressive resistance training, such as lifting weights in the gym, are the most effective exercises to ensure you have strong bones throughout your life.

The guidelines describe these exercises for 3 key groups: low-risk individuals, moderate-risk individuals and, importantly, for people at high-risk of fracture.

How to build strong bones

You can get strong bones by:

  • Increasing weight-bearing activities and strength-training exercises – These will strengthen your bones and reduce your risk of fracture.
  • Getting some sun – Expose your skin to at least 10 minutes of sunlight in the morning or late afternoon each day. Vitamin D activation is greatest when the chest and back of the neck and shoulders are exposed.
  • Maintaining your vitamin D levels with fortified foods or supplements – This is important if you aren’t getting regular sun exposure or are over the age of 60.
  • Eating foods high in calcium but low in saturated fat – Consume low-fat milk and dairy, seaweeds, nuts, seeds, legumes, and green leafy vegetables such as silverbeet, okra and spinach. Ensure adequate fiber intake at the same time, as this promotes calcium uptake from the bowel.
  • Taking a supplement of at least 1200-1500 mg of elemental calcium daily – Few of us meet these calcium levels in our diet, so supplements are helpful for most women. Choose supplements that also contain vitamin D and K, magnesium and boron.
  • Making an appointment to get your bone density checked – If you are over the age of 65 it is best to get your bone density checked. This is also beneficial for younger women with an increased risk of fractures, such as those who have a small build, have a personal or family history of fractures, have diabetes, use steroids and have experienced premature menopause.
  • Optimizing your sex hormones – Low levels of estrogen and/or testosterone can cause bones to thin faster. There are many things you can do to get your hormone levels up and keep them that way long term.
  • Stopping smoking – Smoking increases your risks of cancer, osteoporosis, cardiovascular diseases and many other diseases and even passive smoking will thin out your bones.

Dietary and lifestyle modifications

Control your weight

Controlling your weight can not only help you ensure your bones remain strong, but also has a range of other health benefits. These include preventing obesity and diabetes, which are associated with higher rates of osteoarthritis. You can control your weight by:

  • Eating smaller portions
  • Eating more slowly and chewing your food thoroughly, which gives your body time to know when you have had enough to eat
  • Adding fiber to your diet. If you have a problem with appetite control, take fiber tablets with a large glass of water 20 minutes before your meal
  • Increasing your physical activity today and every day

Take a flexibility class

Good health is not just about being strong, but also staying limber, and there are many simple exercises you can learn to stay flexible. Treat yourself to a regular massage to stay even more supple.

Increase omega-3 intake

Some studies suggest a diet high in omega-3 fatty acids may be associated with lower rates of osteoarthritis. In addition, omega-3 fatty acids may also help reduce joint stiffness and increase mobility.

Other health benefits include antioxidant properties, lowering blood triglyceride levels, reducing depression, improving memory and slowing down dementia, and increasing growth in children.

You can increase your intake by eating more cold-water oily fish, flax seed (linseed), purslane, kiwifruit, lignon berries, black raspberries and walnuts, or take a supplement.

Take glucosamine and chondroitin sulphate

Glucosamine is widely touted as an agent to treat and prevent osteoarthritis. Studies have found that glucosamine sulphate may delay the development of arthritis or ameliorate its symptoms. Glucosamine is often sold in combination with other supplements such as chondroitin sulphate, another normal component of cartilage, which also stimulates cartilage health.

To prevent health issues, take 500-1000 mg of glucosamine daily, and to treat health issues, take between 1500-3000 mg daily until symptoms lessen, and then reduce to 1500 mg daily.

Ensure you get enough vitamin D

Optimal levels of vitamin D can reduce the risk and impact of arthritis, and results in strong bones and muscles, taking some of the stress off our joints. You can increase your vitamin D intake by:

  • Going to your doctor so they can check your vitamin D levels. The normal range of 25-hydroxycholecalciferol is 50-150 nmol/L, but if you wish to obtain optimal levels for peak performance then you should aim for 115-128 nmol/L
  • Getting out into the sun – 20 minutes on your back in the not-too-hot part of the day
  • Choosing vitamin D-fortified foods
  • Taking a vitamin D supplement

Reduce exposure to AGEs

Reducing your exposure to advanced glycosylation end products (AGEs) in your diet can promote the flexibility and function of connective tissue.

References

  1. Belinda et al Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis http://dx.doi.org/10.1016/j.jsams.2016.10.001
  2. Eilander A, Hundscheid DC, Osendarp SJ, Transler C, Zock PL. Effects of n-3 long chain polyunsaturated fatty acid supplementation on visual and cognitive development throughout childhood: a review of human studies. Prostaglandins Leukot Essent Fatty Acids. 2007; 76:189-203
  3. Hochberg MC, Martel-Pelletier J, Monfort J, et al Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib Annals of the Rheumatic Diseases  Published Online First: 14 January 2015. doi: 10.1136/annrheumdis-2014-206792
  4. Willett WC. The role of dietary n-6 fatty acids in the prevention of cardiovascular disease. J Cardiovasc Med.(Hagerstown). 2007; 8 Suppl 1:S42-5

Last reviewed 31/Mar/2017

 

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Dr Merlin Thomas

Professor Merlin Thomas is Professor of Medicine at Melbourne’s Monash University, based in the Department of Diabetes. He is both a physician and a scientist. Merlin has a broader interest in all aspects of preventive medicine and ageing. He has published over 270 articles in many of the worlds’ leading medical journals