Healthy Bones : Before It Is Too Late

Your grandpa buys the most expensive tiles for his bathroom floor. A few days later he slips in the bathroom, fractures his hip and gets himself admitted to the most expensive hospital in the city.

You become wiser. 

You (still) buy the most expensive tiles for your bathroom floor. Then you cover the floor with the most expensive ani-skid mat. And, you walk on it in your anti-skid slippers.

This only shows that you have a lot of money, and no common sense!

Sadly, this is how capitalism grows...

A. Don't ignore your bones

Bones have three major functions in our body - (i) They carry our muscle frame; (ii) They are important source of minerals, mostly calcium and phosphorous; (iii) They protect our internal organs.

Of all the bones you should take particular care of your backbone and funny bone. That will add joy to your life and (sometimes) misery to others' lives! 

B. Bones, bridges and banks

Strong bones are to our body what high quality steel frame is to a bridge. You can neither see them nor assess their strength from outside. You realize that the contractor had used sub-standard steel in the construction only when the bridge collapses!

Similarly, bone formation is a lifelong dynamic process. You deposit calcium to your bone and your body utilizes some amount of it for its essential functions.

 However, there is a catch here. 

Your bone mineral density (BMD), which adds to your bone's strength, peaks up during your 20s. (Some studies say that the process of peaking continues up to 30.) Afterwards, as you age, irrespective of your calcium intake, you lose more calcium and deposit less of it to your bone. 

Therefore, it's very important to tell our children to deposit maximum possible calcium to their bone while they are still under 30. (Congratulations, if your child acts on your advice!)

"They, who in their youth have neither led a life of purity nor have acquired wealth, lie around helplessly like an arrow shot from a bow, sighing over the past." The Dhammapada

C. What makes your bones weak? 

1. Aging process - as you age, your calcium deposit to bone shows a gradual downward trend. Furthermore, your body's ability to absorb calcium from your diet also declines. This is why older adults require a higher amount of calcium.

2. Poor nutrition, especially, insufficient intake of vitamin D and calcium

3. Smoking, excessive alcoholic consumption, use of certain medications

4. Lack of physical activity.

5. Some studies show that excessive protein intake, i.e., abnormally higher intake than Recommended Dietary Allowance (RDA)* may also result in excess calcium loss. However, the researchers have yet to arrive at a definite conclusion in this regard. [*RDA for protein is 0.8-1.0 gm /kg body weight.]

D. 2 Ways to build strong bones

1. Do regular exercise. Focus on improving your strength, endurance, agility, balance. An agile person with strong muscles and strong bones has a lower probability of falling and fracturing his bones.  

In consultation with your doctor, go for weight-bearing exercises (you can use your own body weight or free weights or machines) depending upon your medical condition and existing level of fitness. 

Exercise stresses your bones. In the process your bones become denser and  stronger. For this reason physically active persons  and sportspersons have stronger bones than sedentary people. 

By the same logic, those who are involved in high-impact exercises will have stronger bones than those in low-impact activities. For example, a gymnast may have stronger bones than long distance runners. Runners will have stronger bones than walkers, and so on. Interestingly, the master hand of a tennis player may have greater bone strength than his other hand. 

2. Take care of your diet. Adequate intake of vitamin D, calcium, protein, magnesium, phosphorous is required for maintenance of healthy and strong bones. Fatty fish, foods fortified with vitamin D, cheese, egg yolks  are good dietary sources of vitamin D. 

Approximately 99% of calcium is stored in your bones. The remaining 1% of it is utilized for muscle contraction and nerve transmission. Maintaining adequate calcium level in blood for essential physiologic functions is a high priority of your body. Therefore, when your calcium intake is inadequate, your bone loss rate will be higher. 

Dairy products, green leafy vegetables# such as kale, okra, collards, broccoli, some mushrooms, soybeans, white beans are good sources of calcium. [# Though spinach contains high level of calcium,  the absorption of calcium from it in our body is very poor because of presence of oxalates in it.]

E. Make vitamin D while the sun shines

Your body produces vitamin D when your skin is directly exposed to ultraviolet B (UVB) rays. There is no use of taking sun bath while sitting behind a glass window. This may give you a pleasnt warmth, but not vitamin D because glass windows block the majority of UVB.

Vitamin D helps your body absorb calcium. It's also important for your immune system and mental health. Several studies have been conducted on vitamin D deficiency in India.

Shockingly, it has been found that despite abundant sunshine almost throughout the year, vitamin D deficiency prevails in 'epidemic proportions' all over the Indian subcontinent.** This is mainly because of a combinationof (i) less exposure to sunshine (due to socio-cultural reasons or scorching sun), (ii) vegetarian dietary habits deficient in vitamin D and (iii) lack of Vitamin D fortified foods. [**You can refer to the article "Vitamin D Deficiency in India: Prevalence, Causalities and Interventions" by Ritu G and Ajay Gupta for more details.]

The best time to make vitamin D from sunshine is noon (not early morning and afternoon). An article "Vitamin D status and sun exposure in India" by C V Harinarayan and others, based on a case study conducted at Tirupati (Andhra Pradesh) mentions that at this latitude exposure to sunlight between 1100-1400 hours promoted maximum vitamin D production. 

F. Duration of sunlight exposure

What should be the duration of your exposure to sunlight for producing adequate vitamin D? The answer to this question depends upon many factors. For the time being, we should satisfy ourselves with these general findings of the studies -

(i) Those with white skin require less exposure to sunlight compared to non-whites. The simple reason behind this is that  melanin pigment, responsible for our skin color (dark-skinned people have higher amounts of melanin), acts as a 'sunscreen'. Naturally, synthesis of vitamin D will take more time in non-white people. 

(ii) As you age, your body will take more time to produce the same amount of vitamin D from sunlight. 

(iii) Air pollution reduces the intensity of UVB thereby slowing down the synthesis of vitamin D. 

(iv) The position of sun during summer or winter, cloudy or clear sky, latitude are other factors that determine the optimum duration of sunlight exposure. 

Confused? Go to your doctor and let him do all these medical and geographical calculations  to determine the exact duration of your exposure to sunshine, if he has time and you have patience... 

Medical disclaimer - The blog content is provided for general educational purpose only. It does not substitute professional medical advice. Reader is advised to consult his doctor before starting any fitness program to avoid any health risks.

Shyam Fitness Fundamentals 

Website: www. fitness-fundamentals.com

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E-mail: shyamfitnessfundamentals@gmail.com