Keeping Active: Nutrition Support for Bone Health
As well as protecting vital organs, bones and joints form the entire structure of the human body, allowing us to stand, move, be active and ultimately, live our lives. Despite their significance for our very existence, they’re not something we often think about until we get older – and usually when they begin to ache (!) – but paying attention to our bone health and joints is incredibly important throughout our lives. From ensuring proper growth and development in childhood, through to maintenance, and pain and disease prevention in later life, keeping our bones and joints healthy is paramount to living happily and healthily for as long as possible.
Peak bone mass refers to the maximum capacity in size, strength and volume of the bones, and this is reached around the age of 25[1]; after that, bone density slowly begins to decline at a rate of about 2% a year. As such, how we care for our bones in the early years of life can heavily impact our future. Bone density is significant because it not only provides the body with integrity, but also correlates with our risk of developing bone-related disease as we age, such as osteoporosis. Furthermore, musculoskeletal conditions, such as back pain and osteoarthritis, are incredibly common ailments in the UK; in fact, 20% of the UK population see a doctor every year because of musculoskeletal issues[2], resulting in widespread, and often daily, use of pain-reducing medications to manage the symptoms. These medications not only come with their own set of side effects, particularly with long-term use, but chronic pain increases the risk of comorbidities such as anxiety, depression and even heart disease due to inactivity[3].
Essential nutrients for bone health
As holistic beings, almost all essential vitamins and minerals are required to support the health of the skeleton in some way. For example, B vitamins – abundant across a wide range of foods including wholegrains, legumes, vegetables, meat and dairy products – support osteoblast (bone-creating) cell production and prevent breaks by strengthening bone matter[4]. Additionally, vitamin C supports bone health by protecting the body against free radicals and reducing the activity of osteoclasts (cells that break down bone matter)[5]; foods rich in vitamin C include citrus fruits, peppers and berries. As such, eating a balanced, varied and predominately whole food-based diet is the best way to ensure you are consuming all of the required nutrients to support bone health. That being said, there are some nutrients that extra attention should be paid to, particularly as we age, to prevent bone breakdown.
Minerals, including calcium, magnesium, phosphorus and potassium, are important nutrients present in our bones. Calcium is the main mineral comprising bone matter, with 99% of the body’s calcium stored here[6]; it is also required for other essential functions in the body including heart, muscle and nerve function. It is important to note that if there is not enough circulating in the blood, the body will break down bone matter to retrieve calcium in order to return serum levels to baseline, in turn weakening bone and increasing the risk of brittle bones, breakages and osteoporosis. To prevent this, it’s recommended that adults consume approximately 700mg calcium per day; this can be achieved through consuming dairy products like cheese and milk, leafy green vegetables, tofu and fish with bones.
Another bone-supporting nutrient to consider is vitamin D. Due to its widespread action across multiple systems, vitamin D receptors can be found in almost every cell in the body – and it’s no different for the skeleton. Vitamin D plays a pivotal role in bone health through various mechanisms. Firstly, vitamin D supports the absorption of calcium in the gut from the food we eat. It also helps to regulate calcium and phosphorus levels in the blood, ensuring little is leached from the bones[7]. Finally, vitamin D increases the synthesis of osteocalcin, a protein that acts as a hormone to positively influence several metabolic pathways, such as glucose metabolism, which have indirect effects on bone health[8]. While small amounts of vitamin D can be found in foods (such as eggs, oily fish and fortified mushrooms), most of our requirements are produced in the body in response to safe sun exposure.
What other nutrition factors should be considered?
An often-underrated nutrient for skeletal health: protein. Protein, comprised of amino acids, is referred to as the building blocks of the body, because it makes up the vast majority of the volume and mass of all tissues. Adequate protein intake is therefore critical for both bone and joint structure and strength, during childhood and adolescence to promote growth, and adulthood to maintain integrity. Bones form the structure of the body, but it is the joints to allow us to bend and be mobile. Joints are made up of cartilage, the connective tissues that join bones together, thus creating mobility.
A natural compound, glucosamine, is found within the cartilage and keeps it strong and supple; while the body naturally produces glucosamine, its ability to do so declines with age, resulting in degradation of the joints and associated pain[9]. Glucosamine is not usually found in natural food sources, though can be supplemented. In fact, many studies have shown glucosamine supplementation to be effective for reducing joint pain in conditions such as osteoarthritis[10]. Typically, 500mg three times daily is safe and effective for this condition, though less may be required for maintaining overall bone and joint health. Our glucosamine supplements contain 750mg glucosamine HCl per capsule, with hydrochloride used as a carrier to get bioactive glucosamine where it needs to be.
How else can bone health be sustained?
While nutritional intake plays a pivotal role in keeping the skeletal system healthy, as with most areas of health, maintaining bone and joint integrity requires a holistic approach. Firstly, daily movement is paramount; we live sedentary lifestyles, but our bodies were designed to move! In particular, weight-bearing exercises help to strengthen bones and joints. Maintaining a healthy weight is also important, to avoid putting additional strain on the joints. Finally, abstaining or reducing alcohol and smoking is advised; smoking has a negative effect on bone health by reducing blood flow to the area, while excessive alcohol consumption interferes with vitamin and mineral absorption and storage[11].
In conclusion, ensuring our bones and joints stay strong and supple throughout our life span is critical for a happy, healthy life. Nutrients, including calcium, vitamin D and protein are essential for building skeletal mass and strength and maintaining it throughout adulthood. Holistic aspects, such as daily movement and reducing alcohol consumption, are also important factors to consider to keep bones and joint strong and healthy.
References
[1] Lu, J. et al. (2016) ‘Peak bone mass and patterns of change in total bone mineral density and bone mineral contents from childhood into young adulthood’, Journal of Clinical Densitometry, 19(2), pp. 180–191. doi:10.1016/j.jocd.2014.08.001.
[2] Musculoskeletal health: Applying all our health (2022) GOV.UK. Available at: https://www.gov.uk/government/publications/musculoskeletal-health-applying-all-our-health/musculoskeletal-health-applying-all-our-health#:~:text=There%20are%203%20groups%20of,a%20fall%20from%20standing%20height (Accessed: 10 July 2023).
[3] Dahan, A., van Velzen, M. and Niesters, M. (2014) ‘Comorbidities and the complexities of chronic pain’, Anesthesiology, 121(4), pp. 675–677. doi:10.1097/aln.0000000000000402.
[4] (2022) Osteoporosis: Vitamins, minerals and nutrients. Available at: https://theros.org.uk/information-and-support/bone-health/nutrition-for-bones/vitamins-minerals-and-nutrients/ (Accessed: 10 July 2023).
[5] Price, C.T., Langford, J.R. and Liporace, F.A. (2012) ‘Essential nutrients for Bone Health and a review of their availability in the average North American diet’, The Open Orthopaedics Journal, 6(1), pp. 143–149. doi:10.2174/1874325001206010143.
[6] Vannucci, L. et al. (2018a) ‘Calcium intake in Bone Health: A focus on calcium-rich mineral waters’, Nutrients, 10(12), p. 1930. doi:10.3390/nu10121930.
[7] Segheto, K.J. et al. (2021) ‘Vitamin D and bone health in adults: A systematic review and meta-analysis’, Ciência & Saúde Coletiva, 26(8), pp. 3221–3244. doi:10.1590/1413-81232021268.15012020.
[8] Moser, S.C. and van der Eerden, B.C. (2019) ‘Osteocalcin—a versatile bone-derived hormone’, Frontiers in Endocrinology, 9. doi:10.3389/fendo.2018.00794.
[9] Henrotin, Y. et al. (2013) ‘Physiological effects of oral glucosamine on Joint Health: Current Status and consensus on Future Research Priorities’, BMC Research Notes, 6(1). doi:10.1186/1756-0500-6-115.
[10] Derwich, M. et al. (2023) ‘Oral glucosamine in the treatment of temporomandibular joint osteoarthritis: A systematic review’, International Journal of Molecular Sciences, 24(5), p. 4925. doi:10.3390/ijms24054925.
[11] Yang, C.-Y. et al. (2021) ‘Effects of sex, tobacco smoking, and alcohol consumptionosteoporosis development: Evidence from Taiwan BiobankParticipants’, Tobacco Induced Diseases, 19(June), pp. 1–8. doi:10.18332/tid/136419.
