Maintaining Bone Health

Gnarly fact: Pound for pound, your bones are 4x stronger than concrete.

Pretty cool, right? Now for the downer, according to the American Academy of Orthopedic Surgeons, peak bone density is reached between the ages of 25-30 and by age 40, density starts to decline. Even worse, our best opportunity to influence peak bone density occurs in early childhood through early adulthood, when the greatest amount of growth is occurring. If you're reading this and you are over the age of 30, you may be asking what the hell you can do about that now then.

Turns out, there is a lot you can do to slow the decline of bone density in your 30's and onward. Proper nutrition and regular resistance exercise. Let's start with nutrition, but before I do, don't just go buy a bunch of mineral and vitamin supplements before consulting with your physician. If you aren't deficient in any of these areas, you don't need to supplement. Over supplementation has its own negative health effects. Just make sure you are getting your daily recommended dosage of Vitamin D and calcium, at every age.

The best source of Vitamin D is the sun. Get 10-30 minutes of midday sunlight several times a week. Your doctor may recommend supplementation if you are deficient, but consuming too much Vitamin D with over-the-counter supplements can be harmful to your health. Just get outside more. As for Calcium, the recommended daily amount is 1,000mg for adults age 19-50. Calcium is much easier to get from foods than Vitamin D is. Think dairy, an 8oz cup of milk has around 305mg or 1/3 of your daily recommended dosage. Greek yogurt (plain to reduce sugar content) has a ton of protein AND Calcium, around 187mg of Calcium (double bonus). Kale and collard greens are high in calcium as well at around 250mg per serving. As a last resort, look for Calcium fortified foods at your local grocer.

You need both the right amounts of Vitamin D and Calcium, as they work together. Calcium can only be absorbed by your body when Vitamin D is present. Don't have enough Vitamin D? Your body won't absorb and convert Calcium to bone.

Now let's talk regular resistance training. According to a report published in the peer-reviewed medical journal, Endocrinology and Metabolism, in 2018, "To stimulate the osteogenic effects for bone mass accretion, bone tissues must be exposed to mechanical load exceeding those experienced during daily living activities. Of the several exercise training programs, resistance exercise (RE) is known to be highly beneficial for the preservation of bone and muscle mass". Said in English we can all understand - in order for bone tissue to grow (accretion), bones must be exposed resistance EXCEEDING the stress they receive through just general daily living. You have to stress your bones beyond whatever it is you do during a regular day.

That part about mechanical load having to exceed the load your body encounters through your regular daily routine, is key. If we are strictly talking about facilitating an osteogenic (bone forming) response in our bodies, the mechanical load, or resistance placed on the musculoskeletal system, MUST be more than what it gets through your regular daily routine. So let's break down the most common forms of exercise.

Low impact exercises: Swimming, cycling, walking are all awesome activities for general health, especially cardiovascular. Zero effect, however, on maintaining bone density. I'm not saying don't do them. I do all three. Just understand what benefits you are, and are not, getting.

High impact exercises: Running, jogging, jumping rope are all great ways to maintain bone density in the lower body. Downside, not everyone's bodies can handle high impact exercise for a variety of reasons.

Resistance exercises are any form of activity that cause the muscles of the body to contract against an external resistance (or force) with the intention of increasing strength, tone, mass, and/or endurance. The external resistance can be free weights, exercise tubing/bands, your own body weight, bricks, bottles of water, or any other object that causes the muscles to contract. In other words, we have A LOT to play with here, no matter what your current physical limitations are. Resistance training is the gold standard for maintaining bone density and muscle mass, especially in combination with a high impact exercise, if your body can tolerate it.

The drawback of resistance training is that it can be intimidating for folks who have never trained before. Where do you start? What exercises are best? How do you do those exercises safely and correctly? How much weight do you use? How many reps and sets? The list goes on. This is where a personal trainer can be extremely helpful. A trainer will create a program with your specific goals and needs in mind. They help their clients perform the movements in a safe way. Trainers also help keep the training program progressive, which is the key to maximizing the benefits of any training program.

Bottom line, we don't want to be frail when we are older, and the sooner you can dial-in your nutrition and start a regular resistance training routine, the better chance you have of being able to let your grandkids jump all over you without the fear of breaking a bone. You want the most out of your whole life, especially the later years. The best chance for realizing the active life you want later, is to start now.

For the data and research nerds, click here for an exhaustive peer-reviewed medical journal article on the "Effects of Resistance Exercise on Bone Health".