Play this combination of punches to effectively prevent osteoporosis

1. Osteoporosis is very harmful, and early prevention is very important

Osteoporosis is a systemic bone disease characterized by decreased bone mass and destruction of bone microstructure, which leads to increased bone brittleness and susceptibility to fractures. It is one of the common chronic diseases in my country.

There are usually no obvious symptoms in the early stage. When it develops to a certain extent, pain or even fractures will occur. It is also called "silent bone disease" and "silent killer". It is common in middle-aged and elderly people and postmenopausal women, and the incidence rate in women is higher than that in men.

Whether bones are healthy or not depends mainly on bone mass, which reaches its peak in your 30s and then continues to be lost.

The higher the peak bone mass, the more reserves in the human body's "bone mineral bank", the lower the probability of osteoporosis in the future, the later the time, and the milder the symptoms and degree. Therefore, early prevention is more important than treatment and concerns people of all ages.

2. Prevention of osteoporosis is no longer just about calcium

Why do people still suffer from osteoporosis even though they take calcium tablets every day? Because this cannot be solved simply by taking calcium supplements.

Multiple nutritional factors play an important role in this, and a "combination punch" is needed.

Tip 1: Adequate calcium

Calcium is the foundation for building bones, and the first choice is to supplement calcium through food.
Milk and dairy products are the most ideal sources of calcium in food. They are high in calcium (100g of milk contains 100-120mg of calcium). The appropriate calcium-phosphorus ratio and lactic acid can also promote calcium absorption. The dietary guidelines recommend drinking 300ml of liquid milk or an equivalent amount of dairy products every day.

Beans and dark green vegetables (broccoli, cabbage, etc.) are high in calcium and low in oxalic acid, and are also good sources of calcium. Nuts, fish, dried shrimp, kelp, seaweed, etc. also contain a lot of calcium. But the calcium in bone soup is actually very little.

The following table shows the reference daily dietary calcium intake (mg) required for different age groups.

If the intake cannot be met through diet, supplements can be used as appropriate under the doctor's advice. However, calcium supplementation cannot be unlimited. Excessive supplementation can cause constipation, stones, and affect iron absorption.

The second trick: supplement calcium first with vitamin D and get more sun exposure

Vitamin D can regulate calcium and phosphorus metabolism, promote calcium absorption and collagen formation. The recommended intake for adults is 10 μg/d, and 15 μg/d for those over 65 years old.
The most natural source of vitamin D is sun exposure. The correct way to sunbathe:

1. Parts: In addition to protecting your face from the sun, try to expose your limbs.

2. Time: 9:00-11:00 am, 3:00-4:00 pm. Avoid strong light exposure to avoid skin burns.

3. Duration: more than 15 minutes a day, 2-3 times a week.

4. Do not use sunscreen, glass or umbrella, otherwise the efficiency of synthesizing vitamin D will be greatly reduced.

Foods rich in vitamin D include egg yolks, liver, marine fish, and fortified milk. Take vitamin D supplements under the guidance of a doctor if necessary.

Tip 3: Adequate protein

Protein is an important raw material for synthesizing collagen. In addition, after protein is broken down into amino acids, it can chelate with calcium to form amino acid calcium, thereby promoting calcium absorption.

Too much protein is not necessarily better. Excessive intake will increase urinary calcium excretion and reduce intestinal calcium absorption. It is recommended that healthy adults consume 0.8-1.0g/kg protein per day (or 65g/d for men and 55g/d for women). The intake should be increased as appropriate during growth, pregnancy, lactation and the elderly.

Foods rich in protein include: eggs, milk, lean meat, soy products, and nuts.

Consuming one medium-sized egg (do not discard the yolk), 300ml of milk, 40-75g of fish (about the size of the palm), 40-75g of livestock and poultry meat (about the size of the palm) every day, eating soy products regularly, and eating nuts in moderation can basically meet the daily protein needs.

Tip 4: Other minerals and vitamins

Magnesium is an important nutrient that promotes calcium absorption. If you only supplement calcium but not magnesium, your bone mass will still decrease. Cereals (especially whole grains), nuts, and green leafy vegetables are rich in magnesium.

The appropriate calcium-phosphorus ratio can promote calcium absorption, otherwise it will increase bone salt loss. The appropriate dietary phosphorus intake for adults is 700 mg/d, and a high-phosphorus diet will affect calcium absorption.

Sodium is the enemy of calcium absorption. Increased sodium intake can promote urinary calcium excretion. Avoid strong flavors and keep your diet light. Normal adults should not consume more than 5 grams of salt a day.

Vitamin K leads calcium into the bones and deposits it in the bones. Foods rich in vitamin K include spinach, kale, broccoli, iceberg lettuce, and natto and cheese also contain high levels of vitamin K. Vitamin K2 is recommended when using supplements.
Vitamin C and vitamin A also play a certain role in the absorption and utilization of calcium and the promotion of bone development.

Tip 5: Exercise moderately

Maintaining normal bone calcium content and density requires constant force and exercise stimulation. Exercise can increase bone density, improve body agility, stability and balance, and help reduce the risk of falls. When exercising outdoors, exposure to sunlight can increase vitamin D synthesis.

Aerobic exercise combined with resistance exercise can help calcium absorption, and it is best to combine it with some flexibility exercises. Moderate-intensity aerobic exercise should be performed 3-5 times a week, 30-60 minutes each time, for a total of more than 150 minutes; resistance exercise should be performed 2-3 times a week, 15-20 minutes each time, every other day, such as sit-ups, dumbbell lifting, elastic bands, etc.

Be safe and do what you can.

Tip 6: Avoid unhealthy lifestyle

Smoking, excessive drinking, excessive drinking of coffee and carbonated drinks, refined sugar and sweets affect calcium absorption or increase urinary calcium.

Tip 7: Healthy Weight

Being too high or too low in body weight is not good for bone health. We should prevent overweight and obesity caused by long-term excess energy, and avoid being thin and malnourished caused by excessive dieting.

Tip 8: Scientific cooking

Some vegetables (spinach, winter bamboo shoots, wild rice stem) contain oxalic acid, which combines with calcium to form oxalate, which reduces calcium absorption. You can remove some of the oxalic acid by soaking or blanching them.

Have you learned the above combination of measures to prevent osteoporosis? Hurry up and practice it with your family and friends!

References:
[1] Chinese Nutrition Society. Dietary Guidelines for Chinese Residents (2022)[M]. Beijing: People's Medical Publishing House, 2022.

[2] Yang Yuexin. Standard Edition of Chinese Food Composition Table (6th Edition, Volume 1)[M]. Beijing: Peking University Medical Press, 2018.

[3] Chinese Nutrition Society Bone Nutrition and Health Branch, Chinese Medical Association Osteoporosis and Bone Mineral Disease Branch. Expert consensus on nutrition and exercise management for patients with primary osteoporosis[J]. Chinese Journal of Endocrinology and Metabolism, 2020, 36(8): 643-653.

author:

Wang Shasha | Registered dietitian and Chinese nutrition expert

Reviewer: Zhao Yong | Distinguished Professor of Chongqing Medical University