Bone Health — Part 3

Beyond Calcium — Energy, Protein, & More

This is the second and final in a series about bone health. In Part 1, we explored bone throughout the lifespan, and Part 2 was all about bone metabolism and the nutrients that support it.

Today, we are moving beyond calcium to better understand the other factors that contribute to bone health.

Bone Fuel

Every process in your body requires energy. Energy that comes from food, which we call calories.

While calories often get a bad rap, energy is essential in fueling bone metabolism and is key to promoting healthy bones throughout life.

While consuming more calories than your body needs is a common concern, consuming an inadequate amount of calories (regardless of weight) also has risks. Inadequate energy intake increases the risk of low bone density, low muscle mass, as well as falls and fractures.

I’ve worked with many individuals who chronically underfuel themselves in an attempt to change the size of their body or to “get healthy.” Yet these often shortsighted attempts overlook the essential role of adequate energy for health, including bone health.

If you are curious about your own energy needs, I encourage you to work with a Registered Dietitian!¹

Protein Power

Protein is having its time in the spotlight. When it comes to bone health, adequate protein intake plays two important functions:

1. Provides the building blocks for bone collagen, which makes up roughly a third of bone mass.

2. Promotes building and maintenance of muscle mass, which acts as an important stimulus for bones to stay strong.

So how much protein do you need? That’s a hard question to answer for everyone reading this. As is the case with most health and nutrition topics, the amount you need is highly individualized and best calculated by a nutrition expert (dietitian!).

As a guideline, most adults benefit from starting with ~1.2 grams of protein per kilogram of body weight, using adjusted body weight for those with high body weight. (If you are thinking, “kilograms!?”, I hear ya. We are stuck in the metric system over here in healthcare…) This is ~0.54 grams of protein per pound of body weight.

Please remember that protein needs vary based on several factors, including age, activity level, and health status.²

Raising the Bar

Ok, we’ve gone through nutrition for bone health, but that is only half the story.

Your body responds to the demands you put on it, and bones are no different. If you don’t ask much of your bones, there is no reason to spend precious energy and resources to maintain them.

This is where resistance training comes in.³ When combined with adequate protein intake, resistance training builds and maintains muscle mass.

Because muscles connect to bone via tendons, the bigger, stronger, and more frequently those muscles are used, the more force the bone has to brace against. It is this demand that motivates your body to prioritize bone structure.

Photo by The New York Public Library on Unsplash

I’ve only recently started doing resistance training. If you are new to it, too, here are a few things to consider:

• Resistance training is any movement that challenges your muscles to work. You do not need a gym membership or a barbell to get started! Bodyweight exercises like squats, lunges, and knee pushups count, as do resistance bands, free weights, and more. Here is an online resource I recommend to many of my patients who aren’t sure where to start.

• To keep your bones motivated to stay strong, resistance training needs to be progressively more challenging. This means that as you gain strength, slowly increase the challenge by adding more resistance and/or trying different movements.

• The ultimate goal is 2–3 strength/resistance sessions per week that work all major muscle groups.

• Working with a professional to learn proper resistance training technique is well worth the investment to decrease the chance of injury.

Of course, check with your doctor first before starting a new exercise program, particularly if you have existing health conditions or known bone loss.

Prevention is the Best Medicine

We’ve now spent the bulk of this three-part bone health series talking about the things you can do to build and keep strong bones. Most of us care (or should care) about this because breaking a bone later in life can be serious and threaten independence, mobility, and, in certain cases, even increase the risk of death.

That being said, preventing a fall in the first place goes a long way toward protecting your bones and the rest of your body. Balance-focused activities such as tai chi, yoga, and single-leg exercises can help promote better balance, stability, and reaction time.

A few simple home modifications can prevent falls at any age: removing trip hazards like loose rugs and floor clutter, installing grab bars in the bathroom, and placing non-slip mats in the shower and on slippery floors. More home fall prevention tips here.

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I hope this series on bone health has been helpful for you. If you have any questions, leave a comment below. And please don’t hesitate to share any of my posts with your friends and family!

Thanks for being here,

~Allison

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Remember that this information is meant to educate and inspire, but is not medical advice. Please consult your healthcare team to determine what is most appropriate for you.

1. I am a Registered Dietitian licensed to work virtually with patients who reside in the following states: CA, IN, MI, MS, NC, TX, FL, OH, GA. You can find more info at allisonmckeany.com.

2. More about protein from Stanford Medicine

3. Strength training and resistance training are often used interchangeably. While strength training refers to the goal of getting stronger, resistance training refers to the type of exercise that results in strength.