Strong Foundations: Understanding Skeletal Success

The phrase “good bones” is often used to describe a sturdy structure. But taken literally, the structure in question becomes the human body. Choices we make — like what we eat and how active we are — play a large role in bone health. 

Structural Health

Sam Dyer, president of Physician Assistants in Orthopaedic Surgery, describes good bone health as the skeletal system, or matrix of the body’s infrastructure and framework, being stable.

“I think of it like the supports and struts holding up a bridge,” explains Dyer, who also hosts the orthoPAc podcast. “With time, these supports can become weak for several reasons and the structure becomes compromised. The same type of process can occur in your bones and skeleton and lead to several problems.”

It’s easy to forget that the skeleton is a metabolic organ responsible for many bodily functions such as storing and processing minerals like calcium and the production of blood cells. Using the bridge analogy again, Dyer explains that if a person develops a deficiency in bone-forming cells or an overproduction of bone absorption, the process becomes unbalanced. If the imbalance is significant, it can result in osteoporosis or loss of the body’s structural framework and skeletal integrity.

Bone Voyage

Lifestyle choices play a critical role in bone health. Diet can either support bone health or have an adverse effect. Dyer points out that the two most important nutrients for bone health are calcium and vitamin D.

“Calcium storage occurs in bones with its primary function being to provide structural integrity," he says. "Calcium metabolism is a complex process with multiple variables including the effects of various hormones, vitamin D, and dietary intake.”

Dairy, dark leafy greens, nuts like almonds and mushrooms are good sources of calcium. Eggs and salmon are excellent sources of calcium and vitamin D. Conversely, there are many things that will sabotage skeletal health, including a salty diet, too much alcohol consumption, soft drinks with high levels of phosphates and preservatives, too much caffeine and sugary food intake such as processed grains and cereal. Smoking, according to Dyer, is also horrible for bone health. For a more detailed source of foods rich with calcium and vitamin D, Dyer recommends an online list published by the Bone Health & Osteoporosis Foundation.

Not surprisingly, exercise also plays an important role in developing and maintaining strong bones. Dyer explains that the weight of the body exerts stress on the skeletal system, which in turn, activates bone formation. Weight-bearing exercises vary and include aerobics, hiking, dancing and even walking. A person should choose what’s appropriate for their age and physical condition.

“In general, bone mass or the density of bone peaks in your mid to late twenties, then stabilizes until about age 50,” Dyer says.

Women need to be especially vigilant as they age. Dyer stresses that menopause is a crucial time because there is a precipitous loss of estrogen, which is another hormone that regulates bone metabolism and protects against bone loss.

In addition to weight-bearing exercises, activities like weight training and using therapeutic bands activate bone formation while strengthening supporting muscles, tendons and ligaments. Yoga and tai chi help improve balance and coordination to decrease risk of falls, a source of bone fractures.

Common Misconceptions

A little knowledge about bone health is helpful, but misconceptions can be potentially harmful. Dyer emphasizes that when it comes to vitamins and supplements, more does not equate to better. Too much calcium can lead to kidney stones or hypercalcemia where bones release calcium storage to achieve homeostasis in the body. Vitamins can also interact with other vitamins to produce undesirable effects such as calcium interfering with iron absorption. He also warns that vitamin supplementation cannot take the place of a healthy diet and exercise habits.

“Talk to your medical provider about your own situation, your risk factors and what additional steps you need to take to maintain good bone health,” Dyer says.