It happened 30 years back, yet Tandra Banerjee, 53, of Asansol, West Bengal, clearly recalls the excruciating pain she felt when she got off a motorcycle and sprained her right ankle.
A few X-rays and consultations with doctors revealed that she had fractured the fibula of her right ankle.
It took her about six months to regain the lost strength in the ankle. However, over the next three decades, she went on to fracture different parts of the right leg at least seven times. While there was no major discovery relating to the bones, her doctors emphasised that she should lose weight and maintain a healthy diet.
While losing weight has helped to reduce the chances of her breaking more bones, she does not fail to include adequate protein and calcium in her diet. As she was about to hit menopause, she was put on vitamin D and calcium tablets alongside.
Bone heroes
Experts say our bones are complex structures that give shape and strength to the body. However, there is only so much weight our bones can carry. And therefore, an increase in weight proportionally increases the risk of injuries to the bone.
While it is important to maintain a healthy weight, certain other factors come into play as well. The two saviours that are often talked about in the context of keeping our bones strong are calcium and vitamin D.
However, the formation of bones is a lengthy process, involving multiple vitamins and minerals, that are crucial in our current discussion.
Vitamins, minerals and bone health
Vitamins and minerals are indispensable when it comes to maintaining healthy bones. Tara Torres, clinical nutritionist from Tomball, Texas, says, “A healthy balanced diet will support bone health through optimal mineral and nutrient intake, but mostly calcium and vitamin D.”
Torres explains that bones are made up of a combination of living and non-living tissues. The living tissue consists of bone cells, called osteoblasts and osteocytes, which build and maintain the bone matrix. The non-living tissue consists of a mineralised matrix of calcium and phosphate, which provides strength and rigidity to the bones.
While calcium is a core nutrient in ensuring strong bones, vitamins A, D and K along with phosphorus and magnesium also maintain their integrity.
Renewing bone tissues
Srishti D Chatlani, sports nutritionist from Bengaluru, says, “Vitamin D facilitates the smooth absorption of calcium in the body while magnesium is the regulatory nutrient for the two nutrients.”
Phosphorus, too, has a major role in maintaining osteoclasts – the cells responsible for bone turnover – which is a process of renewing bone tissues.
Torres suggests consuming food sources such as lentils, cheese, sardines, beans, and shellfish to get the optimum amount of phosphorus required by the body.
Bone health after menopause
While ageing leads to weakening of bones, post-menopausal women tend to be at a high risk of this. The female hormone oestrogen has a bone-protecting effect. However, the level of this hormone falls after menopause, and such women experience escalated bone loss.
A study published in the International Journal of Preventive Medicine found that ageing and menopause had a significant effect on decreasing bone density in women above 50 years. The study was done on a set of Malaysian women and notes that post-menopausal women have a higher risk of bone fracture than other groups.
Torres says the risk of bone fracture can be significantly reduced by including foods rich in calcium and vitamin D and engaging in weight-bearing exercises such as walking, jogging, or strength training. “This can help improve bone density and strength, ultimately reducing the likelihood of fractures,” she adds.
Foods to support bone lifecycle
The process of bone turnover starts early in life and continues throughout one’s lifetime. However, during adolescence, as one grows in height, bone formation occurs faster than turnover. With age, the turnover accelerates.
Torres cautions, “Osteoporosis often occurs over time as the bones grow weak and fragile due to a lifelong decreased intake of appropriate nutrients. However, this can be avoided by eating mindfully and performing regular exercises.”
If lactose intolerance is an issue, calcium can also be found in kale, broccoli, cabbage, grains, salmon, sardines, and fortified cereals and bread.
Bask in sunlight
Chatlani says a balanced diet that provides essential nutrients such as vitamins A, D and K and calcium ensures optimal bone health. “Standing in the sun before 9.30 a.m., having a glass of regular or soy milk or even snacking on sesame laddoos help to provide all the nutrients for bone health,” she adds.
Torres recommends consuming egg yolk, salmon, tuna, and fortified cereals as vitamin D sources. “Include leafy greens such as spinach, legumes, nuts and seeds, avocado, banana and dairy products to meet the magnesium needs of your body,” she advises.
