Bones are often thought of as hard, lifeless structures, but they are living tissues that are continuously broken down and rebuilt throughout life. What we eat and how we live, particularly during childhood, adolescence and early adulthood, can determine how strong our bones remain decades later.
As a nutritionist, I often describe bone health as a long-term investment. The stronger our “bone bank account” is when we are young, and the slower we lose bone as we age, the lower our risk of osteoporosis and fractures.
Osteoporosis is a condition in which bones become weak, less dense and more likely to break. It commonly affects the hip, spine and wrist, although any bone can be affected. Fractures, especially those involving the hip and spine, can result in pain, disability, loss of independence and a reduced quality of life.
Ageing is an important risk factor. Women experience accelerated bone loss around and after menopause because of declining levels of the hormone estrogen. However, osteoporosis is not only a women’s disease. Men also lose bone strength as they age and can develop the condition.
While factors such as genetics, age, sex and family history influence the risk of osteoporosis, nutrition and lifestyle are among the factors we can change.
Calcium is one of the most important nutrients for maintaining strong bones. About 99 per cent of the body’s calcium is stored in the bones and teeth. When dietary calcium is inadequate, the body can draw calcium from bones to support other essential functions, including muscle contraction and nerve transmission.
Milk, yoghurt and other dairy products are good sources of calcium. Small fish eaten with their bones can also provide significant amounts. In Uganda, other useful sources include beans, peas, groundnuts, sesame, dark-green leafy vegetables and some fortified foods.
However, preventing osteoporosis is not simply a matter of taking calcium supplements. For most people, a balanced diet should provide much of the calcium they need. Supplements may be appropriate for some individuals, but this should follow professional assessment.
Vitamin D is equally important because it helps the body absorb calcium and supports normal bone development and maintenance. Exposure to sunlight enables the body to produce vitamin D, making safe and appropriate exposure important. Vitamin D is also found in foods such as eggs, oily fish, liver and fortified products.
People who have limited exposure to sunlight or other risk factors for vitamin D deficiency may require assessment and, where necessary, supplementation.
Protein also deserves attention. Bones are not made of minerals alone; they contain a protein framework that gives them structure. Adequate protein is therefore essential for maintaining bone and muscle strength.
Foods such as eggs, fish, milk, yoghurt, beans, peas, groundnuts and lean meats can contribute to adequate protein intake. This becomes particularly important as people grow older because maintaining muscle strength improves balance and can help reduce falls, which are a major cause of fractures among older adults.
Bone health also depends on a balanced diet rather than concentrating on a single nutrient. Fruits and vegetables provide vitamins, minerals and antioxidants that support overall health, while nutrients such as magnesium, phosphorus and vitamin K also contribute to normal bone metabolism.
At the same time, excessive alcohol consumption, smoking and highly restrictive diets can undermine bone health. Eating too many highly processed foods can also displace more nutritious foods from the diet.
But nutrition alone cannot protect our bones. Physical activity is part of the prescription.
Weight-bearing and resistance exercises stimulate the bones and muscles. Walking, dancing, climbing stairs and strength training can help maintain bone and muscle strength. Older adults should also include exercises that improve balance and coordination to reduce the risk of falls.
Maintaining a healthy body weight is also important because being severely underweight can weaken bones, while obesity combined with physical inactivity can negatively affect mobility and overall health.
The fight against osteoporosis should therefore begin long before old age. Children and adolescents need nutritious diets, adequate calcium and vitamin D, sufficient protein and regular physical activity to build strong bones. Adults need to maintain these habits, while older people require greater attention to nutrition, muscle strength, fall prevention and medical assessment where necessary.
Ultimately, preventing osteoporosis is not about taking one tablet or drinking one glass of milk. It is about developing a lifelong pattern of healthy eating, regular physical activity and healthy living.
Strong bones are built early, protected daily and maintained throughout life. Investing in nutrition today can help us move, work and live independently tomorrow.
The writer, Kamara Daniel, is a nutritionist at Bwindi Community Hospital in Kanungu District.
