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Strengthen your bones

Tuesday, July 10, 2018

While calcium and Vitamin D are essential, there are some other nutrients too that are vital for good health, says Dr Naresh Shivdasani

Almost every educated person is aware that calcium is an important component of bones. It helps to build healthy teeth and bones. Vitamin D is also extremely important. There are, however, other factors to consider besides these essential nutrients. We will look at some of the other factors  too.

In ninety-nine percent of the body, calcium is present in the bones. As we get older, our capacity to absorb calcium from our diet becomes less. Even with supplements, we absorb only about 30% of the calcium present, less if antacids are taken. Post-menopausal women lose about four percent of calcium from the bones every year. However, replacing the bone calcium is only about one percent per year.

While dietary calcium is a great way to replace the lost element, our diet is often lacking in the right factors. Dairy products have a good calcium component, but would result in weight increase, as one would need to consume huge amounts of milk to get the required one gram elemental calcium. Hence, supplementation is the way to go.

Vitamin D is considered the miracle vitamin. It helps the absorption of calcium and its integration into the bones, hence it is vital for general health and for the bones. It is made in the skin by exposure to sunlight, though one must be careful to ensure that one does not get sunburnt. Adequate exposure generates enough  vitamin D for our needs. The recommended daily dose is 2000 units per day.

The addition of protein and a balanced diet also help to build strong bones. Growing children, lactating mothers, pregnant women especially should ensure adequate balanced nutrition.

Vitamin K is another nutrient which is needed for good bones. The average person does not suffer from its deficiency as it is available  in leafy vegetables, soya beans and liver.

Magnesium complements the action of calcium. Again, deficiency is rare, but older patients may excrete excessive amounts in urine, and may have to be supplemented.

Vitamins B6, B12 and folic acid all help to build stronger bones and also help in reducing high levels of the amino acid homocysteine. Reduction of homocysteine is beneficial for prevention of stroke and coronary artery disease too.

Zinc, which is found in red meat and meat products, poultry, whole grain cereals and pulses  is essential for many enzymatic processes. Deficiency may occur in the elderly as the appetite may be decreased.

Protein is an essential building block for all tissues; hence, an adequate intake is a must. About one gram per kilogram body weight must be taken. Eggs, meat, fish, soyabeans, and dals must be taken in good amounts. Fruits and vegetables contain many micronutrients and must also for a part of a balanced diet. It is said that we should include five different coloured items daily in our diet.

Certain diseases may prevent adequate absorption of the dietary nutrients. Gluten allergy is one such medical problem. Wheat products should be avoided in such cases. Diabetes and thyroid disorders  affect all systems and one should make sure that strict control is maintained over blood sugars or thyroid hormone levels. Regular exercise, especially walking , is important for building strong bones. Older patients should avoid jogging as the risk of injury is higher.

Some medicines like corticosteroids weaken the bones, so long-term use should be avoided. Smoking and alcohol also are risk factors for osteoporosis. Maintaining a healthy body weight is also important to build bones. Thin patients are more likely to have osteoporosis, hence are prone to fractures.

I have a slogan on my letterhead which says 'Mature Women Take Calcium'. Unfortunately, most postmenopausal women do not take adequate supplements as they have misconceptions about it.

In order to have healthy bones, and general health, one should have a balanced diet and if at a high risk for osteoporosis adequate supplements should be taken. Regular exercise to build muscle mass and control of any risk factors should be done to enjoy good health to a ripe old age.

Dr Naresh Shivdasani (D.Orth, M.S. (Orth) is a Senior Orthopaedic Surgeon, with interest in Acupuncture and Spinal Manipulation. He was recently named President of the Bombay D Ward Medical Association.

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