Bone is the basic element of our skeleton. It has many functions, including bearing the weight of our body, protecting internal organs, enabling and supporting body movements, producing stem cells, and storing minerals such as calcium, phosphorus, magnesium, potassium, and sodium.
Bone remodelling
Bone remodelling, also called bone metabolism, is a process in which bone is continually depleted and renewed throughout life. This process varies from person to person with age, diet, physical exercise, body weight, lifestyle, and medications.
It is thought that peak bone mass occurs at the end of adolescence, between the ages 18-20, with the most critical periods for bone mass growth reported to be between 13 and 14 years of age.
Risk factors for bone fractures
Fractures are a result of both trauma, such as a fall, a sports injury or a car crash, and decreased bone strength (weak bones). There are many factors that may increase your risk of fracture:
Age. As we get older, bones become more fragile and brittle and are more likely to break. Additionally, the chances of falling may be greater due to factors such as visual impairment and cognitive decline.
Small body frame. People with thin small body frame are at a higher risk of fractures due to lower bone mass.
Gender. Women are more likely to fracture their bones than men, because they generally have smaller and less dense bones. Furthermore, after menopause, women lose bone naturally due to the decrease in oestrogen.
History of previous fracture. Previous fractures increase the risk for subsequent fractures.
Family history. A family history of osteoporosis increases your risk.
Smoking and alcohol. Regular smoking and excessive Alcohol consumption are risk factors for bone loss.
Use of steroid medications. Long-term use of corticosteroids, such as cortisone and prednisone, can reduce bone density and increase fracture risk.
Rheumatoid Arthritis. The inflammatory nature of this autoimmune disease increases the risk of bone loss and fractures.
Diabetes. Patients with type 1 and type 2 diabetes are at a greater risk of bone fractures.
Digestive disorders. Chronic digestive disorders such as coeliac disease, Crohn’s disease, and ulcerative colitis, as well as gastric-bypass surgery and gastroesophageal reflux disease, may compromise absorption of minerals that are crucial for bone health.
Eating disorders. Serious eating disorders, such as anorexia nervosa, can impact bone density by depriving the body of essential nutrients. Low body weight in females with anorexia may lead to absent menstrual periods and contribute to bone loss due to loss of oestrogen.
Diet. It appears that high rates of fractures exist in countries in which a Western diet is consumed, such as the United States, Canada, and northern Europe. High consumption of caffeine, soft drinks, sugar, salt and animal protein, and not enough fruit and vegetables, may promote nutritional deficiencies and loss of calcium, leading to fractures.
Lack of exercise. Active people have a lower risk of fractures than people who do not exercise. Weight bearing exercises, such as jogging, walking, gardening and dancing, and resistance training (weight lifting) help strengthen bones and muscles.
Thyroid problems. Overactive thyroid is associated with higher risk for fractures.
How to heal broken bones with diet
Fracture healing is a complex process in which the bone needs to be rebuilt. A balanced diet, rich in nutrients, minerals, and vitamins, and low in can speed the healing process and may reduce the likelihood of a future fracture. If are unable to get enough nutrients from the diet, supplements may be a useful.
Foods and supplements that reduce inflammation
As inflammation is part of the healing process, anti inflammatory foods may speed healing as well as reduce pain.
Turmeric. Curcumin, the yellow-coloured phytochemical that is thought to be the primary active compound in turmeric, is a potent anti-inflammatory compound. The best way to take turmeric is to add it to your food. However, to achieve therapeutic benefits you may need to take turmeric (curcumin) capsules, as they usually contain higher levels of concentrated turmeric extract.
Fish and other foods that contain omega-3 fats. Increasing consumption of these good fats has been shown to reduce markers of inflammation. Eat cold-water fish like salmon, sardines, and mackerel, as well as flaxseeds and walnuts. If necessary, supplement with fish oil capsules.
Fruit and vegetables. Plant foods contain thousands of compounds called phytonutrients that act as antioxidants and can repair tissue damage. Choose colourful fruits and vegetables such as dark leafy greens (e.g. spinach and kale), beetroot, blueberries, cherries, pomegranate, plus garlic, onions, and tomatoes. In addition, carotenoids – compounds found in orange foods such as carrots, mango, papaya, and pumpkin - are important for bone remodeling, and increase bone formation.
Ginger. Contain substances that inhibit inflammation.
Protein
Adequate protein is essential to provide the collagen and amino acids required for bone strength. Indeed, low protein intake has been shown to lower bone mass and alter muscle strength. Studies reveal that protein supplementations in patients, who have had a fracture increase muscle strength, reduce medical complications and accelerate fracture healing. Protein foods include milk, yoghurt, cheese, meat, fish, chicken, eggs, nuts and seeds, legumes (beans, lentils, chickpeas), and tofu. There are also many protein powders to choose from.
Bone strengthening vitamins and minerals
Calcium and vitamin D. Calcium is essential during bone regeneration, while vitamin D increases calcium supply by enhancing its absorption. Both are essential for bone formation and mineralisation. Studies show that sufficient supply of calcium and vitamin D improve bone repair.
Calcium can be obtained from dairy products as well as from certain vegetables, such as kale, broccoli, bok choy, and cabbage. Other sources include sesame seeds and canned salmon and sardines. Sunlight exposure stimulates the production of vitamin D, but many people are still deficient and require supplements. Vitamin D is found naturally in only a few foods such as oily fish (mackerel, salmon, sardines), and cod liver oil.
Vitamin C. Supplementation has been shown to accelerate fracture healing. For dietary sources of vitamin C, enjoy citrus fruit, kiwifruit, strawberries, capsicum and broccoli.
Vitamin K. Vitamin K, abundant in dark-green leafy vegetables and seeds, improves bone density and reduces fracture risk
Zinc. Required for growth, development and maintenance of bone health and may help fracture healing. Zinc can be found in a wide variety of foods. Oysters are the richest source of zinc, but other types of seafood (such as crab and lobster), as well as red meat, are high in zinc. Other good sources of zinc include beans, nuts, seeds, and whole grains.
References
- American Bone Health. Fracture Risk Factors. Available at: https://americanbonehealth.org/what-you-should-know/fracture-risk-factors/
- Better Bones. How to Speed Bone Fracture Healing. Available at: https://www.betterbones.com/fractures-and-healing/speed-healing
- De la Roza, G., et al. Histology of bone. Medscape, April 01, 2016. Available from: https://emedicine.medscape.com/article/1254517
- Fischer, V. et al., 2017. Calcium and vitamin-D deficiency marginally impairs fracture healing but aggravates posttraumatic bone loss in osteoporotic mice. Scientific reports, 7(1), p.7223. Available at: http://www.ncbi.nlm.nih.gov/pubmed/28775273
- Giganti, M.G. et al., 2014. Fracture healing: from basic science to role of nutrition. Frontiers in bioscience (Landmark edition), 19, pp.1162–75. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24896342
- Karpouzos, A. et al., 2017. Nutritional Aspects of Bone Health and Fracture Healing. Journal of osteoporosis, 2017, p.4218472. Available at: http://www.ncbi.nlm.nih.gov/pubmed/29464131
- O’Keefe, J.H. et al., 2016. Nutritional strategies for skeletal and cardiovascular health: hard bones, soft arteries, rather than vice versa. Open heart, 3(1), p.e000325. Available at: http://www.ncbi.nlm.nih.gov/pubmed/27042317
- Rizzoli, R. & Bonjour, J.-P., 2004. Dietary Protein and Bone Health. Journal of Bone and Mineral Research, 19(4), pp.527–531. Available at: http://doi.wiley.com/10.1359/JBMR.040204
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