Monday, March 3, 2008

Building bones

We tend think of our bones as just the scaffolding that holds us together, but they also protect our vital organs. And as we age, we need to continue getting calcium and to exercise to keep our bones healthy.

So when you're pumping iron at the gym or climbing a fourteener, you're doing it not only for your heart and overall health, but for your bones, too. Bone requires stress and strain to stay dense and strong, so walking, hiking, racquet sports and weight lifting are good exercises.

Bones are living tissue with the ability to renew and repair themselves. While they feel hard on the outside, bones have a spongy honeycomb of busy cells inside that are hard at work demolishing old bone and rebuilding with new. This process, known as "remodeling," can last three to six months, which is why a broken bone seems to take forever to fully heal.

The keys to keeping bones strong and resilient are proper nutrition and weight-bearing physical activity.

Calcium is the obvious and most important nutrient in building strong bones. Good sources are dairy foods such as yogurt, skim milk, cheese and cottage cheese, as well as spinach, collards, oranges, canned salmon, nuts, beans and peas.

Many orange juice companies fortify their products with calcium because it absorbs well in the presence of vitamin C.

But vitamin D is the real workhorse because without it calcium does not absorb properly. We produce vitamin D when our skin is exposed to sunshine and ingest it from food and supplements. Primary food sources are fish liver oils, fatty fish (such as salmon, mackerel, catfish, sardines, tuna) mushrooms and whole egg.

Past 50, our bodies become less adept at absorbing vitamin D. Other groups at risk for reduced vitamin D absorption are people in northern climes where there is less seasonal sunshine and those with high skin pigmentation (particularly people of African descent). For these three groups in particular, attention to diet and supplementation becomes crucial.

Potassium and vitamins C and K — found in fruits and vegetables — are also essential for bone health, along with magnesium, which is found primarily in nuts and seeds. A minimum of five servings of fruits and vegetables a day and a small serving of nuts and seeds (pumpkin is the best) are important for preserving bone.

Fruits and vegetables are important because they are alkaline and serve to neutralize the acid produced by grain-based and protein foods, writes Bonnie Liebman in the Nutrition Action Health Letter's January-February issue. Liebman is director of nutrition for Center for Science in the Public Interest. If the body is too acidic, it will dissolve bone (an alkaline reservoir) to neutralize the acid. This is true whenever your body signals that it needs more calcium — it takes what it needs from your own bone if it is not supplied from the diet and/or created by weight-bearing exercise.

The National Osteoporosis Foundation compares bone maintenance to a savings account: There is only as much in the account as you deposit, primarily from before puberty until about age 30. The body has all the calcium it needs in the bones and teeth but allowing these withdrawals from your bone bank will cause osteoporosis. This is a debilitating disease where the bones become frail and brittle and often leads to severe disability if a bone breaks after a fall. Women in particular need to "deposit" as much bone mass as possible into their "account" because, of the 10 million Americans with osteoporosis, 8 million are women.

Healthy bones require stress and strain. The pulling action of the muscles and their connective tissues against the surface of the bone causes the bone-making cells (osteoblasts) to make bones dense and strong. Walking, jogging, dancing, hiking, snowshoeing, racquet sports (tennis, racquetball, squash), and especially weight lifting are good exercises. Swimming and bicycling don't put stress on the bones, so they're not considered good for building bone strength.

According to a study on the effects of strength training on bone density, published in 1994 in the Journal of the American Medical Association, post-menopausal women who strength-trained twice a week for a year increased their bone density compared with a sedentary control group. The study was conducted by Miriam Nelson, director of the Center for Physical Fitness at the School of Nutrition Science and Policy at Tufts University, and her colleagues. "High-intensity strength training exercises are an effective and feasible means to preserve bone density while improving muscle mass, strength and balance," the study found.

Physicians typically schedule a bone-mass measurement test to establish a baseline for bone density when a woman is entering menopause. This is important because estrogen, among other functions, stimulates bone-building osteoblasts and suppresses bone- dissolving osteoclasts. As estrogen levels decline, the balance tips towards the bone-destroying osteoclasts. By establishing a baseline, a physician can monitor bone mineral density more effectively.

Some bone-density machines measure hip, spine and whole body, and others are designed to measure peripheral bones such as wrist, finger, shinbone and the heel of the foot. They typically require only that you lie or sit down, depending on the type of machine recommended for you.

Testing will let you know what shape your bones are in. Then it's up to you to get the calcium, vitamins and exercise to keep them strong.

Resources
"Strong Women, Strong Bones," by Miriam E. Nelson, Ph.D. (Perigee, 2000, $14.95)

"
Ageless Spine, Lasting Health," by Kathleen Porter (Synergy Books, 2006, $24.95)

"
Physical Activity and Bone Health," by Karim Khan (Human Kinetics, 2001, $69)

National Osteoporosis Foundation, 800-223-9994

Linda J. Buch is a certified fitness trainer in Denver;
linda@LJbalance.com

Source: http://www.denverpost.com/fitness/ci_8411857



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