1 in 2 women over the age of 50 years old will suffer from a fracture due to osteoporosis. But, bone health shouldn’t just be a consideration as we reach an older age. In fact, optimising bone health during adolescence is critical for long-term bone health. Adolescents experience rapid increase in bone growth and menstruation (which depletes zinc - also important for bone health). This comes increased nutrient requirements for this age group.

Bone healthy nutrients

The minerals we need to form bone include calcium, phosphorous and magnesium. Together this is known as the bone matrix.

Vitamin D stimulates the bone matrix to form and to mature. It works with the parathyroid hormone to regulate calcium and phosphorous stores in the body. Vitamin D deficiency can lead to secondary hyperparathyroidism which has a negative effect on bone health later in life.

Worringly, UK adolescent girls typically have a low dietary intake of the nutrients important for bone health. Low calcium levels occur in almost a quarter (19-24%) of adolescent girls. However, this doesn’t mean you should look to use calcium supplements as too much calcium could lead to kidney stones and an increased risk of cardiovascular disease.

Bone health and diet – how does food fit in?

According to the UK government guidelines females aged 11-18 years old should have 800μg of calcium a day. This is the largest requirement of calcium they’ll have in their life! We get calcium from the foods we eat, but how do we know if we are regularly getting enough in our diet?  

How to meet your daily calcium requirement through diet. Try:

·      Semi-skimmed milk/fortified soya milk (glass or in large cereal bowl)

·      Cheese sandwich OR sandwich with orange + handful almonds

·      Snack pot of low-fat plain yoghurt (dairy or fortified non-dairy)

Top tips:

• Breakfast is a good opportunity for calcium rich foods, so try not to skip it

• Aim to have a well-balanced diet with lots of colour and variety 

• Pulses, nuts, seeds and dried fruits are good calcium sources, but worth noting that they aren’t as well absorbed as animal sources.

• If following a vegetarian/vegan diet choose fortified dairy alternatives.

• In the UK flour, is fortified with calcium and so bread can make up a significant contribution to your daily intake.

Vitamin D, also a key bone health nutrient, can be obtained via skin and sun exposure or from diet. 

A daily 10ug Vitamin D supplement is recommended for all UK adults during the winter months (Oct-March). This is because Vitamin D from food sources usually aren’t sufficient to meet our requirements, and sun exposure is limited in the UK (it is affected by clouds, ozone and atmospheric pollution). Ethnic minorities are more at risk of deficiency as darker skin less easily absorbs sun UV rays.

Protein is involved in several mechanisms of bone health too, especially during adolescent peak growth. Again, there is no need to take protein supplements as too much may actually have a negative effect on calcium stores in the body.  

High potassium and low sodium intakes have a positive impact on bone health. This can be achieved from high fruit and vegetables intake. 

Weight bearing physical activity is also important for optimising bone health as we age. Activities like dancing, football, gymnastics, hopping, jumping and skipping all count. These exercises lead to higher bone mineral density and content, and is recommended at least 3 times a week.

Take home advice: 

1.     If you can, don’t skip breakfast 

2.     Ensure appropriate sun exposure and consider taking a daily 10ug vitamin D supplement in Oct-March

3.     Ensure weight bearing activity at least 3 times a week 

4.     Aim to eat at least 5 portions of fruit and vegetables a day