Body & bones Up close & personal
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body Up&close
bonespe rsonal
&
healthy bones | strength to last a lifetime
Bones are alive essential to ensure that young Bones need calcium In general, women have 30%
bodies build the best bones less bone mass than men.
Though it may not seem like it, bone Bone mineral density is a
possible. It is important to work Then, during the first five to
is living tissue. It is continually being measure of the strength or
at maintaining this bone mass 10 years after menopause,
renewed through a process called compactness of bone tissue.
throughout adulthood. they may lose two to five
remodelling, in which old bone is It reflects the strength of bones
percent of their bone tissue
broken down and replaced with The tween and teen years are a time in terms of their calcium content
a year.4 This is why women
new bone. Between 10 and 30% of when consumption of milk products and can be measured using a
are at greater risk of
skeletal bone is replaced each year.1 tends to drop, which means kids specialized X-raying technique
developing osteoporosis
this age may not be getting enough called dual energy X-ray
Along with calcium, vitamin D and than men.1 However, by
calcium and vitamin D during this absorptiometry (DXA).
other bone-building nutrients— age 65 to 70, men and
critical time in their life.
most of which are abundant As we age, the two kinds of women lose bone mass
in milk products—physical activity cells that maintain bone density at about the same rate.4
is essential for healthy bone Recent Statistics Canada become less efficient.1 We also
By approaching adulthood
remodelling. Bone tissue responds research has shown that 61% begin to absorb calcium less
with strong, dense bones
to appropriate nourishment and of teenage boys and 83% of effectively. For those of us with
and by minimizing bone loss
physical activity by becoming denser teenage girls don’t consume fairly healthy bones, consuming
during adulthood, we may
and stronger. the recommended amount enough calcium can help
decrease our risk of developing
Bone building begins when we are
of milk products.3 balance the remodelling process.
osteoporosis and osteoporotic
In fact, studies of older adults
very young and continues into our fractures later in life.
show that getting enough
tween and teen years. By our late Girl also tend to become less active
calcium can slow bone loss and
teens, the body will have built up at this age which may potentially
reduce the risk of fractures.2
about 90% of its lifetime bone cause problems later in life.
mass.2 During these years, physical
activity and a bone-healthy diet are
2 3
actively preventing osteoporosis
What is osteoporosis? Who develops osteoporosis?
Osteoporosis is a condition that
develops when bone tissue and key bone
minerals (like calcium) are lost faster than
they are replaced.4 Bones become so
weak and brittle they can easily break.
In extreme cases, even a simple hug
or sneeze could result in a fracture.
Healthy bone
1 in 4 women 1 in 8 men
Osteoporosis affects one in four women and at least one in eight men over the age of 50.1
Reducing the risk Regular physical activity and a impact on bone health, especially
balanced diet rich in calcium, when accompanied by a low
Reducing the risk of osteoporosis
vitamin D and adequate protein calcium intake.
is a lifetime process. It is never too
are essential to building and
early (or too late!) to start taking care
strengthening bones and thus
of our bones. While genetics plays a
BoneOsteoporosis
with osteoporosis reducing the risk of osteoporosis.
large role in determining how dense
Smoking and/or too much alcohol,
our bones are, lifestyle is also
salt or caffeine can have a negative
important.
4 5
active living | a key element of bone health
In combination with a calcium-rich And remember, every little Resistance-strength training Individuals who have osteoporosis
diet, our bones need a lifetime bit counts: strengthens muscles in specific or who are at risk of fracture should
of regular physical activity to areas. Strong muscles tugging on also consult a physiotherapist or
ET
ake the stairs instead
maintain their strength. Regular bone stimulates bone strengthening. occupational therapist. It is
of the elevator
exercise helps the body store Lifting, whether it’s a bag of important to be careful performing
calcium in bones. EG
et off the bus a stop early groceries or a child, is just as activities that involve twisting or
and walk the rest of the way effective as lifting weights when it bouncing. If you are planning to
Weight-bearing activities (i.e.,
ET
ake a brisk walk with comes to keeping bones strong. attend an exercise class, verify
those we do on our feet such as
a friend or colleague that the instructor has had training
brisk walking, skating, dancing,
Activities that improve flexibility, leading classes for people with
hiking and aerobics) are ideal. EP
lay with the kids
posture and balance such as yoga, osteoporosis to ensure that the
Start-and-stop activities like
tai chi and Pilates exercises can program will be safe for you.
tennis or badminton give our
reduce the risk of falling, which is
bones added beneficial challenges. Bones respond to the particularly important later in life.
Find activities you enjoy and make
challenge of carrying They can make it easier to do daily
active living a pleasurable part of
a load, such as tasks and will likely reduce the risk
your everyday life! Have fun being
your body weight, of injury. If you are middle-aged or
active with your friends or family. by becoming stronger. older, consult a doctor before
starting any exercise plan to make
sure it’s right for you.
6 7
your whole body counts on calcium
Calcium for life As part of a healthy diet, Teeth You can bank on it The best sources of calcium
milk products may also Helps in the
The human body contains Bones development Think of your bones as a “bank” While it’s true that calcium is found in other foods, trying to actually meet our
protect against colorectal of healthy teeth.
Essential for
more calcium than any in which your body can store calcium needs without milk products can be quite a challenge.
cancer6 and help us the building,
development
other mineral. About 99% is calcium. If your diet is low in
maintain a healthy weight.7 and maintenance
found in bones and teeth. of healthy bones.
calcium, the body withdraws Calcium content of some common foods8
The other 1% circulates in the calcium it needs from bones
the blood where it supports
Always in demand to keep blood levels normal. When Food Portion Calcium (mg)
life-sustaining functions For the body to function your diet is rich in calcium, deposits
Cheese, Cheddar 1½ oz | 50 g 360
such as maintaining properly, the level of calcium Heart are made in the “calcium bank”.
Blood Maintains normal Milk |
whole, 2%, 1%, skim, chocolate
1 cup | 250 mL 300
normal heartbeat, nerve in our blood must stay fairly Important heartbeat and If calcium withdrawals exceed or lactose-reduced
for normal blood pressure;
transmission, blood clotting, constant. The body can’t may help reduce
deposits, bones may begin to Cheese, Mozzarella | 23% MF 1½ oz | 50 g 269
blood clotting
and wound the risk of
and muscle contraction. make its own so calcium hypertension.
weaken and become more
healing.
susceptible to breaking. That’s Sardines with bones 2½ oz | 75 g 286
must be consumed every
Just about every cell in the
day. If not, our blood will when osteoporosis and the Yogurt, fruit-bottomed | 2-4% MF ¾ cup | 175 g 250
body counts on calcium. Muscles
“steal” calcium from our Required serious problems associated
Milk products are a for muscle Colon Salmon with bones | canned 2½ oz | 75 g 187
bones to maintain a normal contraction with it can result.
nutritious source of calcium. May protect
and relaxation. against colon
blood calcium level. That’s Bok choy ½ cup | 125 mL 84
Consuming enough milk cancer.
why a diet rich in calcium
products throughout life not Almonds ¼ cup | 60 mL 79
is so important, particularly Nerves
only helps us build strong
when bones are growing Needed for proper Kidney beans | cooked ¾ cup | 175 mL 64
bones and teeth, it also functioning of the
and developing. nervous system.
plays a role in maintaining Kale | cooked ½ cup | 125 mL 49
healthy blood pressure. 5
Broccoli | cooked ½ cup | 125 mL 33
How calcium helps your body
8 9more about calcium Calcium supplements
well absorbed by the body. We can snack foods such as potato chips,
consume these foods—and, therefore pickles and condiments, sauce
It is important to consume as much
get our calcium—in a variety of mixes, prepared salad dressings,
calcium as we can each day from
forms throughout the day. It is worth and just about all fast foods. The
food sources. Besides supplying
noting that tricalcium phosphate salt shaker is not always the culprit!
Calcium absorption acid which prevents calcium from
(the calcium form added to some
calcium, food sources provide our
being properly absorbed. While such
body with other important bone-
How well our bodies absorb
foods are nutritious they are, in fact,
soy beverages) is absorbed at only Our daily calcium needs building nutrients such as vitamins A,
calcium depends on a number 75% the rate of the calcium found
poor quality sources of calcium. Our calcium requirements vary K and B12, phosphorus, magnesium
of things, for example: our individual naturally in milk.9
throughout life. As you can see from and zinc.
calcium needs, how much calcium
we consume, and most importantly,
You would need to eat four Calcium loss
the table, our body’s demand for
Calcium supplements are
how much we’re absorbing from and a half cups of cooked calcium increases when we—and our
recommended for individuals who
bones—are growing and then later
foods we eat. Calcium from foods broccoli or three cups of cooked Calcium loss is something else to be
can’t meet their calcium needs from
aware of. For example, consuming in life to help maintain bone health.
such as milk, cheese or yogurt kale to get the same amount food alone. In most cases, each
too much caffeine can increase the
is well absorbed; so is calcium of calcium provided amount of calcium lost from the body Recommended
calcium supplement contains 500 mg
from broccoli and kale. Age (yrs) calcium intake
by one cup of milk! in urine. Coffee, tea, cola beverages for Canadians10
of calcium. Calcium supplements
should be taken with lots of water
However it would be very and popular energy drinks all contain 1-3 500 mg
and with food to help ensure that the
challenging to meet all of our caffeine. Consuming up to four 4-8 800 mg
Most milk products are calcium is well absorbed. However,
calcium needs from green 9-18 1300 mg
an excellent source caffeine-containing drinks per day is
19-30 1000 mg calcium citrate does not need to be
vegetables as the amount they not considered a problem as long as
of calcium, not just consumed with food to be absorbed,
31-50 1000 mg
contain is relatively small and, in we consume enough calcium to
because they contain 51-70 1200 mg but with lots of water.
many cases, much of the calcium make up for it.1
a lot of it but 71+ 1200 mg
they do contain is not well absorbed Intake of supplements and
because dairy Too much sodium (salt) can also
by the body. Some compounds in Institute of Medicine, Essential Guide calcium-rich foods should be spread
calcium is increase calcium loss in urine. Most to Nutrient Requirements, 2006.
certain foods bind to calcium making out through the day to provide the
Osteoporosis Canada recommends
of the sodium we consume comes
it unavailable for absorption by the that adults over age 50 consume 1500 mg body with a steady calcium supply.
from processed foods including of calcium daily.
body. Vegetables such as beet
commercial soups and sauces,
greens, spinach and rhubarb contain
frozen dinners, luncheon meats,
calcium, but they also contain oxalic
10 11the importance of vitamin D
D is key The sunshine vitamin need is just a few minutes a day Recommended daily
of unprotected sun exposure,11 vitamin D intake
Vitamin D is critical for helping When our skin is exposed to
so it’s important to achieve a
the body use calcium. It increases ultraviolet light from the sun, it
balance between too much Recommended
calcium absorption by 30% or produces vitamin D. The amount Age (yrs) vitamin D intake10
and not enough. for Canadians
more1 and helps regulate whether of sunlight we need to produce
calcium is deposited into or enough vitamin D depends on age, Getting vitamin D from our 1-3 200 IU
diet is a healthy alternative 4-8 200 IU
withdrawn from the bone “bank”. diet, skin colour, where we live and
to unprotected sunlight but, 9-18 200 IU
how strong the sun is.11
Recent research suggests that 19-30* †
200 IU
unfortunately, vitamin D is quite
vitamin D may be associated 31-50*† 200 IU
In Canada, between rare in food. To help ensure
51-70** 400 IU
with many other health benefits
that we consume an adequate
as well, including the prevention
October and March, 71+** 600 IU
amount, all fluid milk in Canada
of certain cancers. we don’t get enough Institute of Medicine, Essential Guide
is vitamin D-fortified. This is one
sunlight to enable reason why Canada’s Food
to Nutrient Requirements, 2006
our bodies to produce Guide recommends that
Osteoporosis Canada recommends:
*19 to 50 years of age: at least 400 IU of
vitamin D. Canadians drink milk every day. vitamin D per day, **50+ years of age:
at least 800 IU of vitamin D per day.
Even in the summer months, we Encourage your family to follow † Includes pregnant or breast-feeding women
may not produce enough of this Canada’s Food Guide, making
important vitamin. The sunscreen sure they consume the
Health Canada encourages adults
we slather on to protect ourselves recommended number of
over 50 years of age to take a daily
from too much ultraviolet light servings of Milk & Alternatives.
vitamin D supplement of 400 IU.
also prevents the production of Drinking milk with meals is
vitamin D. In some cases, all we always a great idea.
12 13the power of protein
Main food sources of vitamin D8 Protein is necessary to build and Milk products have the advantage
repair bone tissue. In fact, our bones of supplying high-quality calcium
are comprised of about 50% protein. as well as protein and many other
Food Portion IU
Protein and calcium work together to nutrients important for bone health.
build bone, and an adequate amount That’s why they are considered
Salmon | baked or broiled 2½ oz | 75 g 204 - 678
of both is needed to keep bones an ideal food when it comes to
healthy. With age, protein continues nourishing our bones.
Sardines with bones | canned 2½ oz | 75 g 70 - 360
to be important to maintain bone
mass and help fractures heal.
Herring | baked or broiled 2½ oz | 75 g 162
It is a good idea to include some
Halibut, Atlantic or Pacific | baked or broiled 2½ oz | 75 g 144 protein in every meal. Protein is
found in Meat and
Milk | 2% 1 cup | 250 mL 111 Alternatives like beef,
chicken, fish,
Tuna, yellow fin (albacore, ahi) | baked or broiled 2½ oz | 75 g 105 legumes and
eggs, as well
Mackerel, Atlantic | baked or broiled 2½ oz | 75 g 81 as in milk
products.
Margarine | soft 1 tbsp | 15 mL 76
Tuna | canned in water/drained, unsalted 2½ oz | 75 g 28 - 60
Egg | boiled, hard-cooked 2 large 52
Canadian Nutrient File, 2007.
14 15up to 16 essential nutrients for your health
Milk products every day Look at what a glass of milk contains Nutrients needed for healthy bone growth and development
Milk, cheese and yogurt are an
Nutrients Functions
important part of our diet because
Bone-building nutrients
they provide up to 16 essential Calcium Builds bones, both in length and strength
nutrients. And that can help keep Protein Forms the collagen matrix upon which minerals like calcium and phosphorus build hard bones
our bones healthy. Protein Vitamin B12 Magnesium Hardens bone by linking with calcium and phosphorus
Phosphorus Bonds with the calcium in bone for strength
Potassium Pantothenic acid Vitamin A Enables bone remodelling (breaks down and rebuilds bone)
Vitamin D Aids in calcium and phosphorus absorption
Vitamin A Folate
Vitamin B6 Needed for the body to metabolize protein
Vitamin B12 Needed for growth, maintenance of nerve tissue and normal blood formation
Vitamin D Calcium
Folate Helps the body grow and is required for DNA synthesis
Thiamin Needed to help the body convert carbohydrates into energy
Other essential nutrients
Thiamin Magnesium Riboflavin Helps convert food into energy
Niacin Needed for carbohydrate utilization and to help tissues in the body take in oxygen
Riboflavin Phosphorus Pantothenic acid Needed to help the body convert fatty acids into energy metabolism
Essential for growth and development, wound healing, immunity and other physiological
Zinc
processes
Niacin Zinc
Essential for maintaining the body’s vital fluid balance and important for the proper functioning
Potassium
of nerves and muscles
Vitamin B6 Selenium
Acts like an antioxidant, thereby contributing to the protection of the cells and is essential
Selenium
for the proper functioning of the thyroid gland
16 17following Canada’s Food Guide
Healthy bones the natural way Children Teens Adults
Age (years) 2-3 4-8 9-13 14-18 19-50 51+
Eating a balanced diet based on Canada’s Food Guide provides a sound
Gender Girls & Boys Female Male Female Male Female Male
foundation to keeping your bones healthy year after year. Consuming
the right number of Food Guide Servings from the Milk & Alternatives Milk and
2 2 3-4 3-4 3-4 2 2 3 3
alternatives
food group helps you get the calcium and vitamin D you need
Eating Well with Canada’s Food Guide, 2007.
every day, along with other important nutrients such as protein.
E Vegetables and Fruit: E Milk and Alternatives: Sizing up: what constitutes a serving
Vitamins, minerals and other nutrients Calcium, protein and other E 1 cup/250 mL milk E ½ cup/125 mL grated cheese
help build and maintain healthy bone-healthy nutrients help build,
E ¾ cup/175 g yogurt | almost two 100 g E 1½ oz/50 g firm cheese | a piece
bones. strengthen and maintain bones.
single-serving containers 2 x 2 x 9 cm or about the size of ½ a deck
E Grain Products: E Meat and Alternatives: of playing cards
Carbohydrates and many B vitamins Protein and other nutrients help build,
provide energy for bone-healthy maintain and repair bones.
physical activity.
18 19References
1. Osteoporosis Canada
2. Ilich J, Kerstetter J. Nutrition in bone health revisited: a story beyond calcium.
J Am Coll Nutr 2000;19(6):715-737.
3. Garriguet D. Overview of Canadians’ Eating Habits. Nutrition: Findings from
the Canadian Community Health Survey 2004. Statistics Canada, Catalogue
no. 82-620. MIC-no. 2, 2008.
4. OHIP. http://www.healthyontario.com/ConditionDetails.aspx?disease_id=188
Accessed 29/01/09.
5. Appel LJ et al. A clinical trial of the effects of dietary patterns on blood pressure.
N Engl J Med 1997; 336:1117-1124.
6. World Cancer Research Fund/American Institute for Cancer Research. Food,
Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective.
Washington DC: AICR, 2007.
7. Major GC et al. Recent developments in calcium-related obesity research.
Obesity Reviews 2008; 9:428-445.
8. Canadian Nutrient File 2007b http://webprod.hc-sc.gc.ca/cnf-fce/
nutrientSearch-rechercheAliment.do?lang=eng. Accessed 29/01/09.
9. Heaney RP et al. Bioavailability of the calcium in fortified soy imitation milk,
with some observations on method. Am J Clin Nutr 2000: 71:1166-1169.
10. Institute of Medicine. Dietary Reference Intakes: The Essential Guide to Nutrient
Requirements. 2006; The National Academies Press, Washington, DC,
11. Canadian Cancer Society. Vitamin D. http://www.cancer.ca/ontario/prevention/
use%20sunsense/vitamin%20d.aspx?p=1 09/04/2009.
BNU 1072
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