Reviewed by Veena Angle, MBBS, MD and Physician Brandon Yew
High Calcium Diet and Exercise: Essential Elements for Building Bone Density
Published | 7 min read
Find out why your body needs to maintain bone density. Good diet and exercise can help reduce the risk of having osteoporosis and bone fractures.
Bone density is essential to your overall health. Your bone mineral density decreases as you age, and your ability to maintain your bone mass will help prevent future fractures. Traditional Chinese Medicine (TCM) believes that a person’s bones are the foundation of all physical action and movement.
“Your bones are your base because they’re the platform to which all your muscles and ligaments are attached. The bones come together to form the skeleton, which lays the essential foundation to developing a normally structured and functionally mobile physical body. Hence, having good bone health is important as your body will gain greater strength, endurance, agility, mobility, and flexibility.” says Brandon Yew, a TCM physician at Real Health Medical.
Your bones absorb minerals and nutrients to gain strength throughout your childhood, adolescence, and early adulthood. In your early 30s, you reach peak bone mass. If there’s not enough bone mass during this period or bone loss occurs later in life, you may develop a risk of fragile bones or osteoporosis.
Osteoporosis, also known as the “silent disease”, doesn’t show any symptoms until the bone breaks or fractures. This condition is characterised by a progressive weakening of the bone structure, decreasing bone density and bone strength.
The Asian Federation of Osteoporosis Societies estimates that the number of hip fracture cases in Malaysia would increase by 3.55-fold from 2018 to 2050, the highest increase projected in Asia.
Fortunately, you can prevent these numbers from becoming a reality by strengthening your bones through some of these methods.
Bone Density Test: Do You Need It?
A bone mineral density (BMD) or bone density test measures the bone mineral content and helps doctors diagnose osteoporosis and assess your risk of fractures. In general, the risk of fractures is higher in women than men and increases with age.
The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) suggests the early use of fracture prevention strategies in people at increased risk of fractures. These include:
- Low bone density
- Those who are prone to falling
- People who have previously sustained low-energy fractures
Interestingly, young adults can be at a higher risk of suffering bone disorders. There are contributing factors like a sedentary lifestyle and unhealthy food consumption that can trigger this health problem. People who were born with kidney deficient body constitution or weak kidneys are also susceptible to bone disorders. This is because the kidneys govern bone health from the TCM perspective.
In the same way, women who have undergone menopause will also be prone to low bone density. This attributes to a drop in hormone levels. Likewise, older adults who are not consuming enough essential nutrients are also susceptible to skeletal disorders.
If you belong to a high-risk group, consult your doctor on whether a bone density test is necessary. The test uses X-ray to visualise the amount of calcium and other minerals in different segments of your bones. Early detection is crucial in helping you take active steps to build strong bones.
Healthy Diet to Support Your Bone Health
Have you ever heard of the phrase, ‘You are what you eat’? This saying means that to be healthy and fit, you need to eat good food.
A healthy diet comprising adequate calcium, vitamin, and other essential nutrients can help improve your bone health. The following is a list of nutrients relevant to osteoporosis prevention and management.
Calcium and Vitamin D
Calcium and vitamin D form part of the bone mineral matrix. Vitamin D regulates the production of bone tissue using calcium, so both nutrients are necessary for strengthening bones.
Dietary sources of calcium include dairy products, such as milk, yoghurt and cheese, fish – especially sardines with bones – and natural herbs, like black sesame and jamu. However, in instances whereby dietary intake of these nutrients is insufficient or poorly tolerated, calcium supplements could be helpful. Consuming a herbal soup prepared with Eucommia bark will also help strengthen kidney function and, in turn, improve bone strength. Alternatively, consuming black beans or bone broth can potentially improve kidney health.
You can obtain most of the vitamin D you need from adequate exposure to sunlight. “Instead of popping calcium pills or vitamin pills, it will be good for you to get at least some sunlight exposure every day. I know people are concerned with getting sunburnt, which increases the risk of skin cancer, freckles, wrinkles, acne and other skin conditions. Still, the key is choosing the appropriate timing to get sunlight with sunscreen, of course. You can go for a walk or run in the early morning before 10 am or late evening around 5 to 6 pm when the UV levels are not so high,” explains physician Yew.
Consumption of vitamin D-fortified foods from dairy products or vitamin D supplements can also further boost Vitamin D levels.
Proteins form part of the collagen structure in the bone matrix and constitute about half of the bone volume. The primary sources of protein are meat, fish, and poultry. In addition to its role in bone matrix formation and maintenance, protein intake combined with physical activity can help build muscles and improve strength.
Potassium and Magnesium
Minerals, potassium and magnesium, are the most abundant cations in human cells. Potassium helps to maintain the alkaline state in the body, reducing calcium depletion from the bones. On the other hand, magnesium induces the multiplication of bone cells and aids bone formation. Foods rich in potassium include wild salmon and low-fat yoghurt, whereas most whole foods, such as green leafy vegetables, legumes, and nuts, are rich in magnesium.
Vitamins C and K
Vitamin C participates in collagen formation and is present in citrus fruits. Vitamin K facilitates bone matrix formation and can be found in vegetables and cheese.
Omega-3 Polyunsaturated Fatty Acids and Other Nutrients
Omega-3 polyunsaturated fatty acids, present in fish and seafood, are believed to regulate bone formation. Other nutrients such as folate, vitamin B-12 and zinc may also influence bone health.
To a certain extent, herbs like notoginseng in their raw and processed forms can also help improve bone health. Raw notoginseng promotes good blood circulation, whereas processed notoginseng is a potent tonic for nourishing and replenishing blood. Consequently, both these functions can support a strengthening of the bones.
The more commonly used TCM herbs for improving bone health are Eucommia bark (杜仲), Fortune’s Drynaria Rhizome (骨碎补), Himalayan Teasel Root (续断), Malaytea Scurfpea Fruit (补骨脂), East Asian Tree Fern Rhizome (狗脊), Chinese Taxillus Twig (桑寄生).
Optimal Exercises to Support Bone Health
In addition to a healthy diet, research shows that regular exercise helps build strong, healthy bones. When exercising, forces are transmitted through the skeleton, generating mechanical signals that stimulate bone formation.
When someone gains almost half of the peak adult bone mass during adolescence, exercise is especially effective in building strong bones. In the middle age and post-puberty population, exercise can reduce the loss of bone mass and density.
Resistance training and high impact exercises, such as jumping, aerobics and running, generate large and rapid strains on the skeleton and are believed to be the most beneficial in preventing osteoporosis. Lower impact exercises, such as walking and weight training, are also helpful. In the ageing population, some of the recommended moderate impact exercises include cycling, yoga, and swimming.
You can reduce your fracture risk by monitoring your bone density level, adopting a healthy diet, and exercising regularly. Start making positive changes to your lifestyle today.
- RadiologyInfo. 2019. Osteoporosis. [Accessed 1 Sep 2021]
- Osteoporos Sarcopenia. 2018. An updated hip fracture projection in Asia: The Asian Federation of Osteoporosis Societies study. [Accessed 1 Sep 2021]
- Osteoprosis Int. Kanis JA, et al. 2017. Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. [Accessed 1 Sep 2021]
- Muñoz-Garach Araceli, et al. 2020. Nutrients and Dietary Patterns Related to Osteoporosis. [Accessed 1 Sep 2021]
- International Journal of Environmental Research and Public Health. Troy KL, et al. 2018. Exercise Early and Often: Effects of Physical Activity and Exercise on Women’s Bone Health. [Accessed 1 Sep 2021]
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