February 19, 2022

Healthy Food—Healthy Bones!

Written by: Omnia Tantawi, MSc

Relationship between Food and Bone Disease

By the wise words of Hippocrates—the father of western medicine—“Let food be thy medicine and medicine be thy food. ”Perhaps this was many decades ago, but it still applies in our modern age today! 

Nowadays, there is an increase in the prevalence of fractures and broken bones. In fact, according to recent data in 2019, it reached almost 178 million individuals worldwide.1 While it may be unfortunate news to hear, it’s still a reality that we’re all living with.

On the bright side, protecting your bone health and healing from fractures faster is easier than you think! All you must do is follow Hippocrates’ advice and understand how diet, nutrition, and lifestyle changes can shield you from complications.

 

Who is at Risk for Developing Broken Bones?

Experts say that some people may be more susceptible to developing bone fractures than others; here’s a list of some of the high-risk groups:2

  • Smokers and Alcohol drinkers
  • Women are more prone than men because they have bone issues, especially post-menopausal women
  • Extremely thin those with a BMI of 19 or less
  • Elderly - your bones become weaker as you age
  • White or Asian ethnicities
  • Family history of fractures
  • Hormonal imbalance
  • Certain medication use
  • Vegans, Vegeterians3

 

What do all these risk groups have in common? Well, they can prevent bone fractures by practicing good diet habits and including nutrients that not only prevent bones from breaking but also play a role in healing bones faster. 

 

The Optimal Post-Fracture Diet

Since several clinical studies link food to the early healing of bones, we have summarized the data for you to get your facts from one source. A good diet for your bone consists of two primary pillars: Vitamin D and Calcium.

It’s a known fact that almost all the calcium inside the body is constituted in bones, which means that the body consumes calcium according to the varying needs of everyone, like growth conditions, maintenance, and development of bones.4

According to an analysis from The European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), they recommend consuming 1000 mg/day of calcium.5

In addition, vitamin D multitasks a dual role in promoting bone health, where it stimulates the absorption of calcium and is linked to healing fractures.6

In the absence of vitamin D, the bone becomes fragile, which is why the National Institute of Health recommends taking around 600 IU, or you can just go straight to the source and be exposed to sunlight!7 If we break down vitamin D possible sources, we will find around 80–90% is attained from skin interaction with sunlight, and 10–20%, from a limited number of foods.8

Lately, there’s an increased realization about the function of other nutrients next to calcium and vitamin D in bone health.9 These are proteins and vitamin C. 

With an intake recommendation of 1.0–1.2 g/kg body weight/day, with at least 20–25 g of high-quality protein at each main meal, proteins prove to be essential for bone health. They compromise around half of the bone structure and a third of bone mass. This is crucial in bone maintenance and healing after fractures.8

Although not proven yet in clinical practice, according to several studies’ vitamin C has shown great potential in decreasing the risk of hip fractures in both males and females, and a lower risk of osteoporosis. Some believe this is due to its antioxidant properties, which have a remarkable role in removing free radicals after fractures; others interpret it to its vital role in collagen formation and anti-inflammatory effects.8
 

Supermarket Shopping for Healthy Bones

Now that you know what to include in your diet to have healthy bones and reduce your recovery time after fractures. Here’s a list of where you can find them when you go shopping: 

 

Calcium Sources:

When you think of calcium, think of dairy foods, these are the primary source. Products like milk, yogurt, cheese, etc., You can also find calcium in fish, especially sardines.8

Vitamin D Sources:

After sunlight exposure, there’s a limited variety of choices for vitamin D sources and these include oily fish (salmon, anchovies, mackerel, and herring), and mushrooms.8

Protein Sources:

Mainly, protein sources come from meat, fish, poultry, eggs, and dairy products.8

 

Vitamin C Sources:

As we’ve just mentioned, the jury is still out on the recommended daily intake of vitamin C for its relationship to bone health. However, antioxidants are always helpful to take. 

Sources for vitamin C can be found in citrus fruit, peppers, strawberries, broccoli, and potatoes.10

 

Vegetarian Diet

The optimal post-fracture diet doesn’t do vegetarians justice! Having most of the diet sources forbidden to vegans and vegetarians. It has been hypothesized that their eating patterns and lack of animal/dairy products included in their diet will make them more vulnerable to bone fractures.9

Experts took this opportunity to explore the association between vegetarian diets and fracture risk. The most recent study was published in 2018 in Nutrition Reviews that examined multiple research studies through the years to compare between a vegetarian diet and an omnivore (those who eat animals and their products) diet. 

The findings of this study conclusively proved that vegan diets are associated with lower bone density and higher risk for fractures than omnivores.11

This can only lead to weaker, brittle bones increasing the risk of breaking and a longer duration of post-traumatic recovery after bone fractures.

Therefore, Vegans must obtain calcium from other sources such as tofu, soy products, or orange juice with close care of obtaining an adequate amount to avoid any deficiencies. 

 

Supplementation 

Another option is to use supplements of each nutrient; however, it’s not always the best choice to go to due to possible adverse effects and overdosing toxicities.

Keep in mind that supplements are not designed to replace food, but it’s always better to consult your health care provider in this case.

 

The Takeaway

A balanced diet with ample nutrients will always remain a requirement for healthy bones. You may be recovering from a bone fracture or experiencing general fatigue and weakness in your bones.

Nevertheless, the answer will remain the same: make sure to include the optimal post-fracture diet into your daily routine and follow the advice backed by science to achieve great results and improve your health.

And remember, Healthy Food—Healthy Bones!

 

References

  1. Wu A-M, Bisignano C, James SL, Abady GG, Abedi A, Abu-Gharbieh E, et al. Global, regional, and national burden of bone fractures in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. The Lancet Healthy Longevity [Internet]. 2021 Sep 1 [cited 2022 Feb 10];2(9):e580–92. Available from: http://www.thelancet.com/article/S2666756821001720/fulltext
  2. (US) O of the SG. Assessing the Risk of Bone Disease and Fracture. 2004 [cited 2022 Feb 10]; Available from: https://www.ncbi.nlm.nih.gov/books/NBK45525/
  3. Tong TYN, Appleby PN, Armstrong MEG, Fensom GK, Knuppel A, Papier K, et al. Vegetarian and vegan diets and risks of total and site-specific fractures: results from the prospective EPIC-Oxford study. BMC Medicine. 2020 Dec 1;18(1).
  4. Fischer V, Haffner-Luntzer M, Amling M, Ignatius A. CALCIUM AND VITAMIN D IN BONE FRACTURE HEALING AND POST-TRAUMATIC BONE TURNOVER. European Cells and Materials [Internet]. 2018 [cited 2022 Feb 12];35:365–85. Available from: www.ecmjournal.org
  5. Mitchell PJ, Cooper C, Dawson-Hughes & B, Gordon CM, Rizzoli & R. Life-course approach to nutrition.
  6. Fabiani R, Naldini G, Chiavarini M. Dietary Patterns in Relation to Low Bone Mineral Density and Fracture Risk: A Systematic Review and Meta-Analysis. 2019; Available from: https://doi.org/10.1093/advances/nmy073.
  7. Vitamin D - Health Professional Fact Sheet [Internet]. [cited 2022 Feb 12]. Available from: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
  8. Muñoz-Garach A, García-Fontana B, Muñoz-Torres M. Nutrients and Dietary Patterns Related to Osteoporosis. Available from: www.mdpi.com/journal/nutrients
  9. Levis S, Lagari VS. The Role of Diet in Osteoporosis Prevention and Management. EPIDEMIOLOGY AND PATHOPHYSIOLOGY. 2012;
  10. Vitamins and minerals - Vitamin C - NHS [Internet]. [cited 2022 Feb 13]. Available from: https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-c/
  11. Iguacel I, Miguel-Berges L, Omez-Bruton AG, Moreno LA, Juli C. Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis. Available from: https://academic.oup.com/nutritionreviews/article/77/1/1/5146363

 

Article written by Omnia Tantawi, MSc
Omnia is an Assistant Lecturer and Medical Researcher from Egypt. She’s an integral part in many research projects that proved promising in revolutionizing the future of Medicine. As a Research Scholar, she’s particularly interested in Personalized & Molecular Medicine because she believes that this is the prospect of the healthcare industry and can be applied to all medical and pharmaceutical specializations. But at heart she remains a wordsmith, so she currently works as a Medical Writer. This transition was fairly easy with an Academic Medical background, ability to adapt to different audiences and passion for research and creation. She always takes the most complex or mundane topics and turn it into a must-read with an unparalleled style. In her free time, she likes to read books, tunes in Netflix or enjoys the outdoors.

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