I broke my wrist on a gorgeous Sunday afternoon in the park. I was doing backflips off the monkey bars with my boys and I might have gotten carried away. I over-rotated the landing and was heading right for my tush (which is what I should have let happen) but instead, I stretched out my hand to protect my fall and landed with the full force of my weight on my wrist — my bone didn’t stand a chance.
Refusal to grow up aside, the incident (which happened a few years ago) reminded me of just how disabling it can be to break a bone.
Although bone mass generally peaks somewhere in our twenties, that’s not the end of the story. Bones are not the fixed, lifeless structures we sometimes imagine. Instead, they are growing, living tissue that is constantly being remodeled and there’s plenty to do – at all ages – to help preserve bone integrity, improve bone strength and minimize our risk of fracture.
background & risk factors
Globally, osteoporosis — a disease that causes bones to become weak and brittle — gives rise to over 8.9 million fractures annually causing both temporary and permanent disability.
Menopause is one of the biggest contributors of bone loss due to the role that estrogen plays in keeping bones healthy. As estrogen levels decline, loss of bone tissue begins to accelerate. The combination of hormone changes and lower muscle mass in comparison to men puts women at higher risk but osteoporosis is by no means a woman’s disease. At least 1 in 5 men will suffer from an osteoporotic fracture during their lifetime (and 1 in 3 women).
The two most important factors we can control in managing our bone health (other than staying off the monkey bars in our forties) are exercise and diet ~
1. Build Muscle Mass
Building muscle mass helps support and fortify the structures surrounding our bones. Spinal fractures, for example, are often caused by forces (or loads) on the vertebrae that are greater than what they can physically withstand. Exercises that target the muscles along the back can help strengthen the spine while improving posture.
Muscle also generates the force (mechanical stress) needed to keep our bones healthy, strong and responsive. When muscle mass declines, less stress is exerted on our bones which eventually makes them weaker and accelerates decline.
We build muscle mass through strength training which commonly comprises of weight lifting (with free weights or weight machines) and resistance exercise (with equipment like rubber bands and balls or by using the body’s own weight to create resistance: push-ups, planks and dips as well as squats and lunges). These exercises can be done at home or in a gym environment. Most fitness classes now also incorporate elements of weight-bearing and resistance exercises such as Pilates, yoga and interdisciplinary cardiovascular training.
2. Practice Balance & Stability
Balance and stability are key to improving movement, fluidity and coordination with a view to reducing our risk of falling ~ especially for those of us walking on ice surfaces 8 months of the year. Balance exercises can be practiced at home and many interdisciplinary group fitness classes also incorporate elements of core stability and balance. The gentle, low-impact art of Tai Chi (meditation in motion) is especially well known for cultivating balance and as a mind-body discipline, it’s also be very helpful for reducing tension and promoting calm.
3. Ensure adequate Calcium from a variety of sources
Calcium, the most abundant mineral in the body, is vital for building strong bones (and teeth) in childhood and maintaining bone health as we age. Our bodies cannot make calcium, it must be acquired through our diet. Calcium-rich dietary sources include plant-based foods, dairy and fish.
Current calcium requirements for adults aged 19 to 50 are 1,000 mg daily with women over the age of 50 requiring 1,200 mg. Children aged 9 to 18 require 1,300 mg of calcium daily.
Plant-Based Options — most of us think of dairy first when it comes to calcium-rich foods and there’s no question that the concentration of calcium by typical serving size of dairy food is impressive. But there’s a couple of reasons why I like to focus on plant sources. For one thing, if you’re a vegan or have an allergy/intolerance to dairy foods or simply prefer to vary your diet outside the dairy fold, it’s important to be aware of other sources of calcium. Another element is that many plant options not only provide calcium they also deliver a whole range of nutrients in the form of vitamins, minerals, antioxidants and fibre. Some of these nutrients also happen to be very helpful for bone health.
For example, calcium containing greens such as spinach, broccoli, Swiss chard, bok choy (pictured below), rapini, beet greens and kale, have the added advantage of being rich in vitamin K, a nutrient needed to maintain healthy bones. Studies have linked higher vitamin K intakes with a lower risk of bone fractures.
Tip: to maximize calcium absorption from greens, it is generally advised to steam/cook them to break down the oxalic acid – a natural compound that binds calcium and reduces its absorption.
Other plant-based sources of calcium include: tofu that is produced with calcium (look for calcium sulfate on the ingredients list); beans, almonds, blackstrap molasses and sea vegetables. Alternate milk beverages such as almond, rice, hemp, coconut and soy milk for example that are calcium fortified are also concentrated sources (generally in the range of 330 mg of calcium per cup).
Dairy Options — when it comes to dairy, some of the best sources of calcium can be found in milk, yogurt and cheese. One cup of milk, 3/4 cup of plain yogurt and 1.5 ounces of cheese each contain roughly 300 mg of calcium.
Fish Options — rich in calcium and omega-3 fatty acids, canned salmon and sardines are an excellent and affordable option. 3 ounces of canned salmon with bones delivers approximately 190 mg of calcium while 3 ounces of canned sardines with bones delivers in the range of 325 mg of calcium.
Salmon and sardines also happen to be one of the few dietary sources of vitamin D which is essential for absorbing calcium (more below). Although the calcium in fish comes primarily from their bones, you can grind them up in a blender and combine the paste with a little hummus, natural mayo or your own favorite spread to enjoy in a sandwich. Sardines have a delicious umami flavor that adds great taste to recipes. The small fillets can be chopped up and tossed into salads or ground up entirely and incorporated into soups, sauces and dressings.
For a full breakdown of calcium concentration by food item search the National Nutrient Database.
4. Dose up on Vitamin D
In addition to its potential role in disease prevention, vitamin D is crucial for absorbing calcium.
Very few foods contain vitamin D naturally (though milk, alternate milk beverages and many orange juice brands are fortified with vitamin D) ~ our best source comes from the sun. During the non-summer months, when the northern latitude sun is not sufficiently strong, supplementation becomes necessary for most individuals. Adults are advised to take at least 1,000 IUs (international units) of vitamin D per day while older adults, those with dark-coloured skin and those falling within certain risk categories may require more. Be sure to speak with your health care practitioner regarding appropriate supplementation and keep in mind that your vitamin D levels can be easily tested through bloodwork upon request.
5. Best Practices
Our bodies lose calcium every day through sweat, urine and bowel excretion which needs to be continuously replenished. Certain foods, and food practices, can promote calcium loss while others inhibit absorption. Here are a few of the more common ones to keep in mind:
Sodium: excess salt can cause calcium to be excreted from our body. Most excess salt does not come from our salt shakers but rather from a heavily processed diet. Try to focus on whole foods in their natural state and be especially mindful of sauces, soups and dressings (in both liquid and powder form) that are sodium saturated. Be sure to read labels and opt for low-sodium options whenever possible.
Soft Drinks (cola): both diet and regular soft drinks (though not sparkling water) have been linked to lower bone density. Some experts suggest this is because overconsumption of cola displaces milk in the diet (a primary source of calcium and vitamin D), but other studies point to the phosphoric acid content in cola, a flavour additive/preservative that can interfere with calcium absorption by binding calcium in the intestinal tract and preventing it from being absorbed into the bloodstream. When blood levels of calcium drop too low, the body draws calcium from the bones to maintain balance.
Divided Doses: while it is generally preferable to obtain calcium from food sources first, if you are supplementing keep in mind that the body can only absorb 500 mg of calcium at any one time.
The information in this post is provided for educational purposes only and is not intended as a substitute for the advice of your physician. Always consult your physician or other health care professional directly before beginning or changing a course of health treatment.
Kelly you are wild!!! That sounds awfully painful, though!
Awessssome tips here. I’ve worried about calcium intake in the past, as my dairy intake got lighter and lighter. I’m happy to say that I am addicted to kale and other greens, though, and thankfully no longer afraid of spending too much time in the sun. That vitamin D is SO important. I always supplement with it in the winter, too…. (mid-september through June in grey old Vancouver ;-) )
Wild, yeah, that’s me – haha :) Happy Sunday Love! Thanks so much for dropping by and sharing some sunshine. You always bring a smile. xx
It looks like we’re doing all the right things, mind you exercise has been neglected these days. I have promised myself to get back to it when the humidity breaks (I’m sweating enough from the hot flashes!).
I love kale but eat it mainly raw, now that fall is upon us, I’ll cook it in soups and stews for sure. I love that you were playing on the monkey bars too, great time to bond with your sons.
Hi Eva, I much prefer kale fresh too and I don’t mind eating it that way all year long… we are just coming to the end (I think?) of a heat wave here and I’ve been eating garlicky lemon kale salad all week… *so* good! Happy Sunday, I hope you’re having a lovely weekend :)
Ouch, your broken wrist incident sounds so painful, Kelly! I have been lucky to have never broken a bone, but who knows if I’ll be so lucky going forward. These tips are so helpful – I always love your posts about nutrition. I especially liked reading about the plant-based sources of calcium. I’ve recently fallen in love with Swiss chard, so I was happy to see that on the list! Thank you for all of this information, Kelly!
Glad to hear these nutrition features resonate with you Julia and thanks for stopping by. You know, with so many talented bloggers doing gorgeous things with veggies, it’s a pleasure to eat our greens! Growing up in a time long before the internet, we did not always have this sort of appetizing inspiration… :) Happy Sunday, I hope it’s a great day.
Thank you so much for one more extremely informative and useful post. What a relief to learn it happened several years ago and not recently (as I thought reading first words).
I started to worry about my calcium intake several years ago and since then have been eating regular but small bits of hard cheese (before I was ignorant enough to think any cheese or dairy product has lots of calcium… luckily a family member, who is a doctor, told me to check the calcium content of say parmesan/gruyere vs soft goat cheese or yogurt for example…). Luckily living in Switzerland close to the French border means I have access to excellent cheese all the time!
Is it true that vegetables have much less calcium per 100 g than cheese? I must admit I find it easier to just concentrate on cheese as the calcium source… and I eat vegetables without really thinking of the specific health benefits of each of them. I just make sure I eat lots of them :-) Bok choy is one of my favourite ones, I’m glad to learn it’s so healthy! Thank you for sharing all this precious information and tips!
Good morning Sissi, thank you for your thoughtful comment. I also love bok choy – especially the babies :) my favorite way to prepare it these days is sliced in half, brushed with oil, grilled and then topped with a sprinkle of sea salt — so simple and utterly delicious. Yes, absolutely there is variation in calcium content in cheese and greens and while it is not possible for me to give the full breakdown of these things in a singular post without boring my audience to tears ;-) I do provide a link in the post that contains all of these comparisons. If dairy works for you, fantastic. Many of my readers cannot digest dairy and/or prefer not to eat it and so it becomes important to understand plant-based sources. Well, it’s a long weekend here and I’m off to the water polo pool! :) cheers Sissi, have a great one.
I should be more attentive reading your posts :-) Thank you so much, Kelly! I’ll check the link. I don’t tolerate lactose, like many adults, so I cannot have too much milk without tummy ache, but cheese, yogurt, etc. are perfect and I’m glad because I love them!
PS Water polo pool? Lucky you!
You broke your wrist doing what? You little monkey you….:) Bummer! Something like that really makes us realize that we are growing up and may need to start “thinking” before we jump. :) I hope you have a speedy recovery my dear! I can see why this experience got you thinking about bone health. That is SO VERY important as we grow older. You’ve made a great list here (as always) with lots of valuable information. Thanks for taking the time to put it together.
I would like to add one more to your list – weight bearing exercise such as walking, hiking, backpacking and jogging. That saved my bones along with your other items! I walked to work carrying a book pack almost every day for 25 years, in addition to jogging, hiking, and backpacking. When I had a bone density scan a few years ago (@59 years of age, after 10 years of not being able to really exercise anymore) I exceeded 100% in all criteria. My doctor was shocked. He had to check to make sure the results hadn’t gotten mixed up with one of his younger patients. :) Now I keep all of the items you listed in mind and try to follow 4 of them daily. It’s still working. I haven’t broken anything yet. :)
Take care of yourself Darlin!
Sorry…another wordy comment. :)
well I’ve never been a 140 character gal, so wordy works for me :p.
thank you for your kind thoughts MJ — the fall happened quite a few years ago (it’s lost in the post somewhere ;-) and I now where chains around my ankles when I’m at the park so the monkey bars are no longer a temptation – heeheeh. I’m so glad you shared a bit about your journey – it’s so informative (not to mention interesting) to learn about others’ experiences and how great about your bone density results too — rockin’! I hope you have a sunny (and chile-filled :D ) long weekend my friend.
Funny thing — I made the EXACT same mistake on the monkey bars. In grade 4 :-). I think it’s a natural instinct to put your hand down behind you. Silly, right?
And how the heck are you still doing backflips?? I can’t even do a somersault without feeling like I’m going to throw up.
AND…speaking of getting old, these are great tips for warding off osteoporosis and keeping your bones healthy. One of the things that gets me all worried, for sure. What are they saying about hormone replacement these days? Still bad stuff?
reflex indeed — try to fall without putting out your hand; really tough to train yourself out of that one even when it would lead to a better outcome – humph!
yeah… estrogen is a delicate balance and supplementation comes with its own bracket of issues. in the end it’s a cost/benefit analysis depending on the severity of individual symptoms and potential risk.
Hi Kelly, Ouch…that must have hurt! Thank you very much for all the information you have included. I am going to print it and refer to it everyday. xxoo
thanks so much for reading Adele – I’m delighted you found this feature helpful and I really appreciate you taking the time to drop in to let me know. Have a wonderful long weekend.
You are an awesome Mom!!!! My Mom-spiration! XXX
Beautiful
thank you Sandra ❤️ xx
What do you make of the claims about chia seed having more calcium (and omega 3s) than milk/salmon. Any truth to that?
Hi Derek, thank you for dropping in with your question — it’s a good one! when comparing calcium concentration in chia seed vs milk, the thing that these claims don’t go on to explain is that this is a gram per gram comparison which has nothing to do with the actual serving size people eat. A typical serving size of milk is one cup (244 grams) for 310 mg of calcium whereas a typical serving size of chia seed is 1 Tbsp (7.5 grams) for 47 mg of calcium. So while it may be true that on a gram per gram basis, chia contains more calcium than milk you would have to eat a whole lot of chia seed (and invest over 300 calories doing so) to catch up to the amount of calcium in a typical serving size of milk. Marketers can be very tricky that way. This is not to say that chia seed (flaxseed and hemp seed) are not highly nutritious and worth working into the diet — it does mean that the way things are presented (and parroted) is often misleading, at best. Cheers.
Broken bone aside, I love that you were playing on the monkey bars! Such a fun mom! These are great tips for bone health. I’ve got a 1-4 down pat, but could use some improvement on Best Practices. I hope you’re having a beautiful day Kelly!
I’m happy to note that soda water (sparkling water) is all good :) it’s a fave of mine and with all the possible flavor enhancers from herbs to citrus and berries, it’s actually very enjoyable! I hope you have a great long weekend Kristy.
Oh my, how long did it take you to fully heal? It must have been quite a challenge… daily life with a broken wrist? So glad that’s behind you! Hooray for plants providing so much calcium! I have a chard smoothing every morning when it’s in season. It is my favorite leafy green to juice, and it’s easier on my thyroid! Should I be steaming them before juicing? :D Thank you for this informative article, Kelly. I always learn new things from you and appreciate your sharing! xx
Hi Traci, if you’re relying on your greens for calcium then yes, I would say that it’s good practice to steam them. You could then use the water from the steamed veggies in your smoothie to take advantage of any water-soluble vitamins that have leached into the water from the cooking process :)
Oh no! Sorry to hear about the outcome but you’ve just got to love a woman who’s doing back flips off the monkey bars with her kids :) I trust that all has healed well. This feature is so timely. I feel like hip replacement surgery has become almost common among post-menopausal women and I want to do everything in my power to avoid it. I know genetics play a role but as you carve it out so well here, there is so much more we can (and should) be doing. Yes, the dairy reflex – thank you for pointing out the plant-based options (and the recipes) not as sure about the fish bones though ;p. I really need to turn my attention to building muscle mass – it’s coming!
yes, understood. It’s important to know our genetic history but even more important to work with it in an effort to build the best version of ourselves possible. Mistakes will happen but that’s why we keep practicing – we are all works in progress :) And in my world view it’s never too late to start (and restart)! Cheers Elizabeth .
OUCH! I am sure that was tremendously painful… I am SUCH a wimp when it comes to pain…
great post, Kelly – I do pretty much everything I can to maintain bone density, and passed with flying colors on my bone density scan last year – I was thrilled. Apparently shorter woman (such as yours truly) have an even higher chance of problems, so I do need to be on top of the issue. A lot of weight training…
Hi Sally! yeah, it smarted pretty good upon impact but quickly dissipated — I have a bit of experience with broken bones (yikes). But, knock on my very hard head, I’m all done with that :) stature as a predictor? to the extent that it correlates with smaller bones/petite skeletal frame but I’m not sure that’s always the case. Have a beautiful long weekend Sally – I hope you’re hanging on to those last whispers of summer. It got quite cool here overnight (a welcome change) – but looking at the forecast, we will be back up in the 30s (mid 80s) next week.