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Sticks and stones may break my bones... but not without a fight!
By: Kellie Hogan (profile)
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Building up our peak bone mass is our best defence against developing osteoporosis.

In the past nutrition articles, we have looked at individual nutrients, but in this edition, we are going to look at the effect of nutrients on a very important part of our body – our bones.

In a perfect world, we would all pay particular attention to building strong bones as children, during adolescence and in our early adulthood, as these are the times when we have the greatest capacity to build up our peak bone mass. Building up our peak bone mass is our best defence against developing osteoporosis.

Osteoporosis is a nasty disease as it can literally “creep” up on the sufferer without any real warning signs until the condition is well advanced.  Even some of the imaging techniques available are not always accurate at determining the extent of bone depletion. For example, by the time Xrays can detect osteoporosis, between 25 and 30% of bone mass has already been lost. Bone mineral density scans are better than Xrays at detecting osteoporosis and can be a useful monitoring tool but must be regularly performed. Unfortunately, it is not uncommon for a diagnosis of osteoporosis only to be made following a bone break or fracture, often of the hip, wrist or spine, as a result of a fall. Recovery from these breaks and fractures are slow and can often make day to day living very difficult.  Even without fractures, osteoporosis is often responsible for back pain, rounded shoulders, and shrinking (literally), as vertebrae start to compress as bones weaken.

Women tend to be at higher risk of osteoporosis, however both men and women from the age of ~40 years can start to lose calcium from bones. Post-menopausal women in particular lose calcium more quickly than men due to a decrease in the hormone oestrogen which has a protective effect on maintaining bone mass. It is recommended that women prior to menopause consume between 800-1000mcg of calcium and post menopause 1000mg+. This requirement is increased only by pregnant and breastfeeding women who require 1100-1200mcg calcium per day. Petite women are more at risk due to having less dense bones. Interestingly, alcohol intake, even relatively small amounts, can significantly increase the risk of osteoporosis.

Almost all (99%) of the body’s calcium content is stored in bones and teeth with the remaining circulating in body fluids and tissues. Calcium plays a very important role in the proper functioning of nerve impulses, muscle contraction, blood clotting and even blood pressure regulation. The body is very clever at keeping the levels of calcium in blood constant, by continual balance between blood and bones. If calcium is not available from food, the stored calcium in bones will eventually become depleted as they try to make up the deficit.

Calcium intake is typically well below the recommended amount in women for a range of reasons, but often due to the common misconception that milk is “fattening”. This is actually not the case, as recent evidence suggests that those who consume adequate calcium tend to more successful at maintaining a healthy weight. In addition, in weight reduction studies where calorie intakes of two groups have been controlled, those whose calorie quota included the intake of adequate serves of dairy were more successful in reducing their weight and total body fat over the course of the study.

To achieve the required amount of calcium, the best sources are dairy foods. Not only are dairy foods rich in calcium, but lactose, the naturally occurring sugar in milk products, assists with calcium’s absorption. The table below gives an idea of the calcium content of a range of foods.

Food source

Approx calcium content/serve

Serve Size

Excellent sources

 

 

Milk (regular or reduced fat)

>300mg

250mL

Soy alternative drink

>300mg

250mL

Cheese

>300mg

40g

Yoghurt – plain, flavoured, regular or low fat

>300mg

200g

Good sources

 

 

Cottage cheese

150-300mg/serve

300g

Processed cheese

150-300mg/serve

20g

Ice cream

150-300mg/serve

100mL

Tofu

150-300mg/serve

200g

Salmon (edible bones)

150-300mg/serve

100g

Moderate Sources

 

 

Tahini

50-150mg/serve

40g

Sesame Seeds

50-150mg/serve

20g

Soy drink (not fortified with calcium

50-150mg/serve

250mL

Spinnach, Broccoli, cabbage

50-150mg/serve

½ Cup

Dried Figs

50-150mg/serve

2 whole

Almonds

50-150mg/serve

1/3Cup

Dairy foods are an excellent source of protein, calcium and low GI carbohydrates, however, some women may avoid dairy due to underlying conditions such as milk protein allergies (not common in adults) or lactose intolerance. For those with allergies and intolerances, calcium fortified milk substitutes are a good option and supplementation may be necessary.

There are a number of factors that can interfere with calcium absorption or increase losses including;

  • Salt - A high salt diet accelerates bone loss. As the kidneys undertake the task of removing sodium, along with it goes, calcium.
  • Caffeine – Caffeine acts as a diuretic and can flush more calcium through the kidneys.
  • Soft drinks – Soft drinks have been shown in a range of studies to accelerate calcium losses from bones.

 

Aim to minimise the intake of the above to make the most of your calcium intake.

Exercise is also important for maintaining good bone health. Weight bearing exercise such as walking and running and strength training both stimulate bone growth by putting load onto the skeleton which adapts and strengthens bones.

If you are concerned about your risk of osteoporosis, talk to your doctor and if you need assistance with including more calcium in your diet, contact an Accredited Practising Dietitian or Accredited Sports Dietitian.  

Kellie Hogan

Dietitian/Nutritionist APD

Advanced  Sports Dietitan

B Hlth Sci. (Nutr&Diet) (Hons)

Grad Dip. Sports Nutrition (IOC)(Hons)

For more information check out the  Sports Dietitians Australia website www.sportsdietitians.com and the Australian Institute of Sport’s website at www.ais.org.au/nutrition

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