Looking after your bones

Keeping your bones healthy can make a big difference to the effect of a fall particularly as you get older. If your bones are strong, the potential for a fall to cause serious damage – such as a broken hip or shoulder – is greatly reduced.

What can I do?

  • eat a healthy balanced diet rich in calcium

  • spend time outside to build up your vitamin D levels

  • do regular weight-bearing and muscle-strengthening exercise

  • stop smoking, and limit the amount of alcohol you drink

Calcium

Calcium is a mineral needed by your body to maintain healthy bones and teeth. As your body cannot produce calcium, you absorb it from the food you eat. The government recommended that adults over the age of 50 eat 700 mg of calcium a day to meet their daily requirement.

Dairy foods – such as milk, yoghurt and cheese – are good sources of calcium. Small amounts of calcium can also be found in:

  • green leafy vegetables — such as broccoli, cabbage and okra but not spinach

  • soya beans and tofu, or soya drinks with added calcium

  • nuts, particularly almonds

  • bread and anything made with fortified flour

  • fish where you eat the bones — such as sardines and pilchards

  • water

Try to avoid excessive amounts of caffeinated drinks. Drinks such as tea, coffee and fizzy drinks – as they can prevent the body absorbing calcium.

Dairy foods

Dairy foods are an excellent source of calcium but tend to be higher in saturated fats. To keep a healthy balance:

  • Choose lower fat options — such as semi-skimmed milk and low fat yoghurt

  • Try eating a smaller piece of a stronger flavour cheese rather than a large piece of a milder cheese

  • Grate rather than slice cheese for sandwiches as it encourages you to use less

  • Aim for 2 to 3 servings a day. A serving is a small matchbox size piece of cheese, one medium low-fat yogurt or a glass of milk

Vitamin D

You need vitamin D for healthy bones as it helps your body absorb calcium from the food you eat.

Your skin makes most of the vitamin D your bodies need from sunlight. Most people in the UK get enough vitamin D by exposing their hands and face to the sun for 10 minutes, once or twice a day (depending on skin type). This has to be without sunscreen and taking care not to burn. For most people, normal levels built up in the summer will be enough to last through the winter. If you struggle to get out an about, your GP might recommend Vitamin D supplements.

You can also get a little vitamin D from fish like grilled herring and tinned pilchards in tomato sauce, but you'll not be able to get all the vitamin D you need from food alone.

Keeping active

To maintain healthy bones you need to keep active and do plenty of weight-bearing and muscle-strengthening exercise. As well as being good for bones, regular exercise can also:

  • benefit your heart and circulation

  • improve mood and contribute to overall well being

Swimming and cycling are good for overall health and fitness and can help keep joints flexible. Swimming and hydrotherapy can also be relaxing and help relieve pain in people with osteoporosis or fractures. These types of exercise aren't weight bearing so won’t improve bone density so effectively.

Weight-bearing exercises

Weight-bearing exercises are exercises where you support the weight of your body through your arms, legs and spine. These exercises can be either high or low impact:

  • High impact — these place the greatest stress on your bones but may not be suitable if you aren't used to exercising. Examples of high impact exercises include high-impact aerobics and jogging or running

  • Low impact — these place less stress on your bones but are still great ways to maintain bone strength. Examples of low impact exercises include tai chi, ‘low impact’ exercise classes and walking

Muscle-strengthening exercise

As well as weight-bearing exercises, you should also attempt muscle-strengthening exercises at least 2 times a week to keep your bones strong. These exercises are designed to work your muscles against resistance and can be done at home, or at your class

Alcohol

Like caffeinated drinks, alcohol prevents the body absorbing calcium from the foods we eat. Drinking regularly to excess can weaken the bones, increasing the risk of a break (also called a fracture) after a fall. 

National drinking guidelines recommend that:

  • men and women shouldn't drink more than 14 units per week

  • we all need at least 2 alcohol-free days a week

One unit is the equivalent of:

  • a small glass of wine

  • one measure of spirit

  • half a pint of normal strength beer, lager or cider

Smoking

Smoking affects how well the bone building cells in your body work. Recent studies have shown a direct relationship between tobacco use and decreased bone density, leading to an increased risk of developing osteoporosis.

In women, it can also cause an earlier menopause — increasing the risk of osteoporosis and breaking a bone.

Giving up smoking won't just benefit your bones; it’ll also help your heart, lungs and overall fitness and wellbeing.

Osteoporosis

Osteoporosis is a common condition that affects bones, causing a reduction in bone density. Having osteoporosis doesn't automatically mean that your bones will break (fracture), but it does mean that you've a higher chance of breaking a bone if you have a bump or fall.

There are usually no warnings you've developed osteoporosis and it's often only diagnosed when a bone is fractured after even minor falls.

Wrist fractures, hip fractures and fractures of the vertebrae (bones in the spine) are the most common type of breaks that affect people with osteoporosis. However, they can also occur in other bones — such as in the arm, ribs or pelvis.

If you've had a broken bone following a simple slip or trip, speak to your GP or other health professional about your bone health.

Where to start

Think about how you currently look after your bones:

  • What positive things do you currently do to keep your bones healthy?

  • What changes can you make that might help?

  • How will you make these changes?

  • Who do you need to talk to?

Claire Edwards