Your Guide to Stronger Bones

Recently, my grandma had a fall and suffered a fracture in the wrist — a common story that many of us may have heard before. The doctors diagnosed her with osteoporosis, a condition she had never paid much attention to until it became a reality. We were also surprised to learn that osteoporosis-related fractures, typically in the spine and hip, can be life-threatening as they can lead to complications such as pneumonia and blood clots, which can lead to death. ^[1] 

Thankfully, my grandma recovered quite well.

That incident made us realize how important bone health is, and how we need to take care of it, especially as we get older.

Understanding Bone Health: A Lifelong Commitment

Bone health isn't just a concern for the elderly. It's a lifelong commitment that should start early and continue well into our later years.

From the age of 30, our bone density begins to decrease gradually. This natural process speeds up in menopausal women and men who experience age-related hormonal changes, increasing the risk of osteoporosis and fractures. ^[2] 

Osteoporosis is a silent disease with no symptoms and often goes unnoticed until patients experience a fracture, like my grandmother.

In Malaysia, the statistics are quite concerning. Almost 25% of people over 50 have osteoporosis or low bone mass. Although 25% might not seem high, it's important to note that 77% of Malaysian women with post-menopausal osteoporosis (PMO) are still undiagnosed. ^[3]  Adding to the problem is the widespread misconception that osteoporosis is just a natural part of aging.

Why Calcium Matters

Calcium is key to keeping our bones strong. Our bones store calcium, which is also needed for other bodily functions such as muscle movement and nerve transmission. If we don't get enough calcium from our food, the body then begins to withdraw calcium from our bones to maintain these essential functions, weakening the bones over time.

In Malaysia, people generally only get about 357 mg of calcium a day, which is just 43% of the recommended amount. ^[4] Adults aged 30 to 70 should aim for about 1,000 to 1,200 mg of calcium each day, but many Malaysians only get around half of this. This can be a problem for long-term bone health.

Additionally, despite living in a country abundant in sunlight, which helps the body make Vitamin D (important for absorbing calcium), many people still don't get enough of both calcium and Vitamin D, which are essential for strong bones.

Lifestyle Tips for Better Bone Health

To truly support strong bones, a combination of good nutrition, along with a healthy lifestyle is key. Here are some lifestyle tips to help you maintain strong and healthy bones:

1. Increase Your Calcium Intake : Incorporate calcium-rich foods into your diet, such as dairy products, small fish with edible bones like sardines or ikan bilis , leafy greens like kangkong , tempeh , and tofu. If you're not getting enough from your diet, consider calcium supplements, especially those that include Vitamin D, which helps in calcium absorption.
2. Get Enough Vitamin D : Spend at least 15-20 minutes in the sun daily to boost your Vitamin D levels. You can also find Vitamin D in fatty fish like salmon, fortified dairy products, and supplements.
3. Regular Weight-Bearing Exercise : Engage in activities that put stress on your bones, like walking, jogging, or weight training. These exercises stimulate bone formation and help maintain bone density.
4. Limit Salt Intake : Excessive salt intake can lead to calcium loss through urine, weakening bones over time. Reducing salt can help retain more calcium in the body.
5. Consume Caffeine Moderately : Excessive caffeine intake can interfere with your body's ability to absorb calcium. Moderation is key.
6. Monitor Your Bone Health : Regular bone density tests can help you track your bone health and take action if necessary. If you're in the high-risk group, such as postmenopausal women, it's essential to keep an eye on your bone density

The Role of Calcium Supplements

For many adults, meeting the daily calcium requirement through diet alone can be difficult, especially with a busy lifestyle. Calcium supplements can be a valuable addition to your routine that helps fill this gap. In fact, studies show that women who take calcium supplements regularly have lower rates of osteoporosis. ^[5] 

However, with so many options on the market, it's important to choose the right supplement for your needs. Here's a simple guide to help you make an informed decision:

A Guide to Choosing the Right Calcium Supplements

1. Type of Calcium : Calcium supplements come mainly in two types: calcium carbonate and calcium citrate. While calcium carbonate is widely available and should be taken with food, calcium citrate is gentle on the stomach and can be taken with or without food, making it ideal for those with digestive issues.
2. Calcium Content : Check the label to see how much elemental calcium (the actual amount of calcium in the supplement) is in each dose. This will help you ensure you're getting the correct amount as per your daily requirements.
3. Added Nutrients : Look for supplements that also include Vitamin D, magnesium, Vitamin K2, or even collagen:
   • Vitamin D and magnesium: Help the body absorb calcium more effectively.
   • Vitamin K2: Ensures calcium goes to the right places, like your bones and teeth, rather than building up in your arteries.
   • Collagen : While calcium strengthens bones, collagen provides structure and flexibility. Since 90% of bone mass is collagen, a calcium supplement with collagen is ideal for anyone looking to support both bone strength and resilience, especially those who are active.
4. Consider Your Needs : Choose a supplement based on your specific health needs. For instance, if you have digestive issues, calcium citrate might be a better option.
5. Supplement Forms : Calcium supplements are available in various forms, including tablets , powders , and chewables. If you have difficulty swallowing pills, a powder or chewable form may be more suitable.
6. Choose Reputable Brands: Select supplements from reputable brands with good quality control and transparency in their manufacturing processes.

Conclusion: Take Action Today for Stronger Bones Tomorrow

We often take bone health for granted until it's too late. But with the right lifestyle choices and a commitment to getting enough calcium, you can keep your bones strong and resilient as you age. This World Osteoporosis Day, take a moment to consider your bone health. A small step today can make a big difference tomorrow.

Remember, your bones are your foundation—let's keep them strong together.

^{[1] https://www.healthline.com/health/osteoarthritis/can-osteoporosis-kill-you#:~:text=These%20fractures%20can%20lead%20to,reduce%20the%20risk%20of%20fractures .}

^{[2] https://health.clevelandclinic.org/how-do-your-bones-change-over-time}

^{[3] https://codeblue.galencentre.org/2021/01/27/bone-health-malaysia-fights-osteoporosis/}

^{[4] https://www.e-mjm.org/2015/v70s1/mjm-sept-suppl-2080.html}

^{[5] https://pubmed.ncbi.nlm.nih.gov/16234999/}