Like all other cells and tissues of the body, our musculoskeletal framework is also composed of living cells that constantly require nutrition and high energy metabolites to maintain normal metabolic processes. Inadequate nutritional intake can significantly compromise the normal mineralization of bones and musculoskeletal framework. This leads to several skeletal disorders and chronic health issues like osteoporosis, osteopenia and other inflammatory or infectious lesions that can significantly compromise the quality of life.
In order to understand the concept of bone re-modelling and how to build bone density, it is very important to understand the composition of bones. The hard looking bone is actually made up of:
- Proteins that exists in the form of collagen fibers tightly linked together.
- Minerals – 60 to 70% of the entire dry mass of bones is made up of minerals or inorganic salts that is present in the form of crystals. These are responsible for the strength and stability of bony matrix. Though calcium and phosphate are the primary salts, there are several other minerals that forms the hydroxyapatite crystals.
- Water – fluid or water forms approximately 10 – 20% of the total mass of bones.
Unlike the popular belief, bones are in constant state of remodeling. There are three primary types of cells in any bone tissues (osteoblasts, osteoclasts and osteocytes). The three cells are in constant state of equilibrium and are responsible for bone building and bone resorption at the same time.
Physical forces that favors excessive bone resorption can lead to osteoporosis and those that leads to excessive bone building can lead to brittle bones. In simple word, any imbalance in the natural balance of bone remodeling can lead to abnormal bone density and risk of injuries.
What are the factors that maintain adequate bone mineral density?
There are several factors that contribute to the maintenance of normal bone mineral density. For example:
- Endocrine hormones: Any imbalance in the secretion or metabolism of normal hormones can affect the mineralization or remodeling of bones.
- Chronic renal or hepatic issues: Long standing chronic health issues (like renal and hepatic dysfunction can affect the natural biochemical rhythm. Additionally, chronic renal dysfunction can lead to secondary deficiency of Vitamin D.
- Physiological aging: With advancing age, normal metabolic processes that regulate bone mineralization deteriorates significantly.
There are a number of other environmental, physiological, pathological and chemical factors that may compromise the integrity of bones, yet the risk of skeletal damage can be significantly minimized by improving the quality of nutrition.
7 Nutritional Tips To Build Bone Density
There are a variety of foods that offer significant help in remodeling processes, for example, dairy products such as milk and yogurt that supply vitamin D and calcium that is very important for bone mineralization and maintenance of mineral density. Yet it is hard to meet all your dietary requirements of bone building foods with dairy alone. Here are 6 primary nutritional tips to build bone density and regulation of overall bone health.
Tip # 1: Avoid high protein diet
There are some foods and nutrients that are capable of destroying bone matrix by interfering with remodeling processes of bones. If you consume these nutrients in high doses, chances are fair that your bone density will be significantly compromised leading to osteoporosis. Proteins are required for healthy bones but excess intake of high protein diets can be harmful for the body.
This is because, proteins produce toxic compounds like sulfates after metabolism that are capable of consuming the calcium present in bones. This can greatly reduce bone mineralization and can compromise the bone strength. This kind of effect is more likely to be caused by animal protein rather than by vegetable proteins.
According to report published in American Journal of Clinical Nutrition (1), investigators reported that high intake of protein-rich diets increases the excretion of calcium in the urine (calciuria) and thereby de-stabilize and de-mineralize bones.
Tip # 2: Avoid caffeinated drinks
Drinking too much coffee or tea can increase the risk of bone fractures, especially if your overall intake of calcium is inadequate. Research and clinical data indicates that excessive intake of soft drinks, cola and diet beverages can directly decrease bone mineral density. This effect is pronounced due to high phosphorous content in these beverages in addition to caffeine. Phosphorous basically decreases the calcium absorption leading to de-mineralization of bones.
A latest research published in peer reviewed American Journal of Epidemiology (2) suggested that intake of more than 4 cups of coffee per day can greatly compromise the bone health and can moderately increase the risk of fractures.
Tip # 3: Avoid retinol (derivative of vitamin A)
Vitamin A is an excellent nutrient that is highly effective for skin, hair and vision. Yet intake of toxic doses of vitamin A can interfere with vitamin D absorption leading to reduced bone density. Retinol form of vitamin A is found in animal sources like liver, egg yolks and others.
Xue and associates conducted an extensive study to identify the association of high vitamin A intake with depletion in the bone mineral density. Report published in International Journal for Vitamin and Nutrition Research (3) indicated that experimental ingestion of Vitamin A by healthy volunteers led to deterioration of bone mineral density within a period of 2 weeks, that suggests deteriorating effects of Vitamin A on bone density.
Unfortunately, toxic doses of Vitamin A are sometimes needed during the therapeutic protocols of certain diseases such as lung cancer. Caution must be maintained in all such cases by limiting the dose of Vitamin A and reducing the overall time frame of therapy.
Tip # 4: Maintain healthy nutritional balance of dietary salts
Some chemicals and minerals in diet can cause osteoporosis. For example:
- Sodium: Excess sodium can increase the excretion of calcium from urine and sweat by competing at the level of receptors for absorption.
- Oxalates: A kind of salt that is found in many foods like tomato can also interfere with the absorption of calcium from gastrointestinal tract. Healthcare providers advise that the foods that are rich in oxalates and calcium are ineffective at improving bone mineral density due to low bio-availability of proteins.
- Wheat bran: It strictly interferes with the absorption of calcium. As such, any calcium supplements should be taken with at least two hours gap.
Tip # 5: Limit the overall intake of alcoholic beverages
Alcohol releases several powerful metabolites and chemicals after metabolism in the liver that directly promote bone de-mineralization. According to a latest research published in the peer reviewed journal Public Health Nutrition (5), investigators reported that moderate alcoholic consumption is an independent risk factor that greatly increases the risk of osteoporosis and other bone degenerative disorders. Report suggested that women who consume more than 3 alcoholic drinks per day are more likely to develop de-mineralization of femoral neck and lumbar spine than those who drink less than 3 drinks per day.
A new study published in Osteoporosis International Journal (5) proposed a mechanism with which alcoholic beverages produces bone de-mineralization. Investigators reported that the effects are both direct as well as indirect.
Direct effects of alcohol on bones: Alcohol decreases the formation of new bone due to a possible re-modeling imbalance.
- Indirect effects of alcohol in bones: According to new data, alcohol breakdown products creates a toxic environment that leads to oxidative stress. In addition, the toxins can also induce apoptosis in the osteocytes that deteriorates bone mineralization.
Tip # 6: Consumption of fruits, vegetables and fish in the maintenance of bone mineral density
Balance your diet with fruits and vegetables that can help in maintaining healthy bones. A diet rich in proteins, low in fruits and vegetables creates a state of mild acidosis in the blood that leads to bone destruction and de-mineralization. High intake of fiber rich nutritious fruits and vegetables help in neutralizing this acidic effect of proteins while boosting immunological functions and metabolism of the body.
Besides high fiber fruits and vegetables, intake of polyunsaturated fatty acids (with the help of fish and fish oil supplements) is also known to promote bone mineralization by enhancing the uptake and transportation of vitamin D and calcium. Research published in the American Journal of Clinical Nutrition (6) suggested that intake of 3 or more servings of fish (or other sources of polyunsaturated fatty acids) is associated with high bone mineral density.
Some tips are:
- Prefer dark fish sources for high quality lipids (such as tuna and salmon).
- Consume fresh fruits over canned or processed fruits (that are low in antioxidants and nutritional value).
Tip # 7: Consider nutritional supplements
Although research and clinical data indicates gut absorption of dietary nutrients is higher than supplements, it is extremely important to consider nutritional supplements in some situations. For example:
- A lot of individuals are unable to consume healthy diet due to ongoing health issues (such as major surgery, diabetes, hypertension).
- The dietary requirement of certain nutrients increase in some situations such as pregnancy, lactation, history of multiple child-births with poor spacing and physiological aging.
- The gut absorption of nutrients is impaired because of gut resection surgeries and inflammatory bowel syndrome.
- If the person is unable to consume a lot of calcium rich foods due to lactose intolerance, milk allergy or related issues.
In all such situations, intake of calcium-rich supplements is advised that are available as over the counter supplements. Besides calcium and vitamin D supplements, there are several other dietary supplements that are helpful in promoting bone strength and stability (7). However, it is highly recommended to seek the advice of a healthcare professional to learn what supplements are best for you.
Additional Tips To improve Bone Density And Health?
Holistic care and dietary consultation: Nutritional counseling and holistic interventions are a magic potion, required for the maintenance of sustained and peaceful existence. Holistic care usually goes hand in hand with nutritional counseling and virtually all other modalities that can improve the overall immunity and wellness.
It is also recommended to address any physical or physiological issue adequately with the help of gait modification, posture adjustment and non-surgical methods. Healthcare providers recommend chiropractic stretching and strengthening exercises, massage therapy and tissue mobilization for the management of acute and chronic musculo-skeletal injuries.
Regular exercise: Regular physical activity is also very important for bone health. Individuals of all age groups require moderate physical activity to facilitate bone remodeling processes. Resistance training mainly deals with isometric contractions (such as weight lifting).
Clinical data indicates that strong muscles are equally important in the maintenance of strong bones and joints. Resistance and strength training improves the muscle strength, tone the body and increase the muscle size, which ultimately maintains bone health and helps to build bone density.
In conclusion, inadequate diet that is high in bone altering foods can compromise bone mineral density. Healthcare providers recommend balanced diet as the key to maintenance of healthy bones and prevention of degenerative bone disorders.
1. Fairweather-Tait, S. J., Skinner, J., Guile, G. R., Cassidy, A., Spector, T. D., & MacGregor, A. J. (2011). Diet and bone mineral density study in postmenopausal women from the TwinsUK registry shows a negative association with a traditional English dietary pattern and a positive association with wine. The American journal of clinical nutrition, 94(5), 1371-1375.
2. Hallström, H., Byberg, L., Glynn, A., Lemming, E. W., Wolk, A., & Michaëlsson, K. (2013). Long-term coffee consumption in relation to fracture risk and bone mineral density in women. American journal of epidemiology, kwt062.
3. Xue, Y., Haub, M. D., Smith, B. W., & Baybutt, R. C. (2011). Decreases in bone mineral content by dietary all-trans retinoic acid precede decreases in bone mineral density in a weanling rat model of cigarette smoke-induced lung injuries. International Journal for Vitamin and Nutrition Research, 81(1), 5-11.
4. Sommer, I., Erkkilä, A. T., Järvinen, R., Mursu, J., Sirola, J., Jurvelin, J. S., … & Tuppurainen, M. (2013). Alcohol consumption and bone mineral density in elderly women. Public health nutrition, 16(04), 704-712.
5. Maurel, D. B., Boisseau, N., Benhamou, C. L., & Jaffre, C. (2012). Alcohol and bone: review of dose effects and mechanisms. Osteoporosis international, 23(1), 1-16.
6. Farina, E. K., Kiel, D. P., Roubenoff, R., Schaefer, E. J., Cupples, L. A., & Tucker, K. L. (2011). Protective effects of fish intake and interactive effects of long-chain polyunsaturated fatty acid intakes on hip bone mineral density in older adults: the Framingham Osteoporosis Study. The American journal of clinical nutrition, 93(5), 1142-1151.
7. Taku, K., Melby, M. K., Takebayashi, J., Mizuno, S., Ishimi, Y., Omori, T., & Watanabe, S. (2010). Effect of soy isoflavone extract supplements on bone mineral density in menopausal women: meta-analysis of randomized controlled trials. Asia Pacific journal of clinical nutrition, 19(1), 33.