Let’s face it—while health and wellness are all-important concerns for most, taking care of your bones generally doesn’t top the list of priorities if you’re under 60. After all, issues like fall risk and osteopororis are typically relegated to the elderly. However, as medical professionals are keen to point out, it’s actually when you’re young—before the age of 30, to be specific—that most of your lifelong bone health is built up.
As Dr Tan Sok Chuen, orthopaedic surgeon at Mount Elizabeth Novena Hospital, explains: “Peak bone mass is typically reached by the late 20s and is a critical determinant of lifelong skeletal health.” That’s right—how you approach building your bone health before you reach the age of 30 will have ramifications well into old age.
Peak potential
Firstly, it’s important to be aware of what’s meant by terms like ‘bone mass’ and ‘bone density.’
Dr Angel Jung, a doctor at International Medical Clinic Holland Village, explains: “Bone mass and bone density are terms often used interchangeably to describe the concentration of minerals in the bone. This measurement helps to indicate how strong the bones are.” When considering a condition like osteoporosis, this is characterised by low bone density, resulting in weak and brittle bones.
“Individuals with osteoporosis have a higher risk of fractures, which can lead to pain, reduced mobility and a decreased quality of life,” Dr Jung emphasises.
There are many factors that influence your peak potential bone density, including age and genetics. However, whether or not you achieve it—and how well your body preserves your peak bone density—is largely influenced by modifiable aspects of your lifestyle.
Get moving
“Maximising bone mass during childhood and adolescence significantly reduces the risk of osteoporosis and fractures later in life,” confirms Tan. However, even for those whose school days are well in the rearview mirror, adapting your exercise regimen and being mindful of your diet can yield bone health benefits at any age.
“As we age, bone remodelling slows and bone loss accelerates,” continues Tan. “Exercise remains a powerful tool to preserve bone mass, improve muscle strength and reduce fall risk.”
To that end, Tan recommends implementing weight-bearing aerobic exercises like walking, jogging, stair climbing, dancing and hiking, as well as resistance training like using free weights and resistance bands, and body weight exercises such as squats and push-ups. Additionally, balance and flexibility exercises like tai chi, yoga and Pilates reduce fall risk—particularly for older adults.
Mindful palate
“An ideal diet for optimal bone health is one that provides a balanced intake of key nutrients that support bone density, structure and metabolism,” Tan says.
It’s a fact backed up by Jung, who emphasises the importance of calcium. “For adults over 50 years old, a daily intake of 1,000 mg of calcium is recommended, and 800 mg per day for those under 50. This can be achieved by consuming calcium-rich foods such as dairy products, green leafy vegetables, tofu and fortified foods.”
Jung also points out that “low Vitamin D levels reduce calcium and phosphate absorption, leading to a loss of bone mass.” It’s worth checking both your calcium and Vitamin D levels, as supplementation can assist for those with inadequate intakes.
Beyond these, Tan also recommends paying attention to your intake of the following minerals: magnesium, iron, zinc, copper, selenium, sodium and potassium. Each plays a vital yet distinct role in bone health, from supporting bone formation to boosting bone tissue repair.
A gender issue
“Women are more likely than men to develop low bone density and osteoporosis due to a combination of biological, hormonal and lifestyle factors,” says Tan. “One of the most significant contributors is the decline in oestrogen levels that occurs during menopause.”
Oestrogen is a crucial aspect of maintaining bone strength, as the hormone helps to regulate the balance between bone formation and resorption. “Women can lose up to 20% of their bone density within the first five to seven years after menopause,” Tan explains. Furthermore, women generally have a lower peak bone mass than men to begin with.
Fortunately, there are several evidence-based strategies to protect against and manage the extent of this. Being mindful of the nutrition and exercise guidelines above goes a long way. Meanwhile, both Jung and Tan advocate for the importance of other lifestyle changes, including avoiding smoking, limiting your alcohol intake, and avoiding a sedentary lifestyle.
So, while it’s true that you’re unlikely to feel the effects of neglecting bone health until older age, it’s crucial to start taking care of your bones as early as possible. This can look as easy as gradually incorporating beneficial exercises within your regimen, or improving your calcium intake one meal at a time. After all, our bones are there to hold us up for the rest of our lives—and it pays off to be mindful of this early on.
