Did you know that 90% of your peak bone mass is achieved by the age of 20? Did you know that the amount of bone accrued by 30 years old is about the maximum amount that will be attained? After that, it is hard to generate the sufficient osteogenic or "bone making" stimulus to offset age-related bone loss. So, it might become IMPORTANT to protect your bone health, rather than sacrificing it for a certain body image or short term performance!
So what are some of the risk factors that might increase the risk for low bone mass?
Drastic Changes in Body Weight and Low Body Weight: this might be an indicator of caloric insufficiency and relative energy deficiency.
Inadequate micronutrient intake such as calcium and vitamin D as well as decreased sun exposure.
Hormonal Imbalances causing primary and secondary amenorrhea in female and decreased testosterone in males!
Lack of appropriate stimulus, not a cause, but a contributing factor that might not only affect bone density but muscle mass development.
And what are some of the bone health consequences if I am at high risk for low bone mass?
Osteopenia and Osteoporosis: usually a consequence of low estrogen levels, low energy availability, what is many times seen in very low carbohydrate diets and poor intake of protein for the work required.
Stress fractures and reactions! The overuse injury that develops overtime. This is NEVER a normal response to exercise training!
But how does bone turnover really works?
Bone remodeling occurs by the couple action of osteoclasts and osteoblasts in the non-growing skeleton; what is called bone MODELING in the growing skeleton of young people.
Osteoclasts: responsible for bone RESORPTION or BREAKDOWN
Osteoblasts: responsible for bone FORMATION
This is a continuous and dynamic process and it might vary based on energetic and hormonal status:
Normal: breakdown equals formation of bone tissue.
Poor Estrogen Status: normal formation, but increased breakdown.
Poor Energy Status: normal breakdown, but decreased bone formation and IGF-1.
Poor Energy and Estrogen Status: Increased breakdown AND decreased formation!
So how do we know where are we standing in terms of bone mass?
Bone mineral density (BMD) can be assessed via a DEXA scan that will yield a T-score (comparison to a normal young population's BMD) and Z-score (comparison to an age-matched population's BMD).
Z-Score <-2 is defined as "Below the Expected Range for Age".
Z-score >-2 is defined as "Within the Expected Range for Age".
Now, how do we build STRONG BONES?
The most important thing is to act early! Better safe than sorry, and prevention is always your best friend! There are many modifiable factors that you can adjust to protect your bone health. There are others, such as genetics, that you might not be able to modify, but here are some tips to improve BONE HEALTH!
Have a well rounded diet. Nutrition is key. Eat your carbs and protein for the work required to prevent energy deficiency and promote muscle mass recovery and muscle gains. Consume sufficient healthy fats to support your hormonal balance!
Do not forget micronutrients: vitamin D and Calcium from dairy products, green leafy vegetables, eggs, beans, fish, and get some sun exposure daily. If unable to meet your consume sufficient vitamin D and Calcium, or having increased needs, consider supplementation! There are many other micronutrients that are important such as K2, Boron, Magnesium, Potassium, Phosphorus and many time also added to supplementation.
Don't forget the mechanical load! Add strength training and weight baring exercise into your routine as this supports muscle mass and stimulates bone formation!
Maintain a stable and healthy weight, avoid extreme diets. All this are indicators of sufficient energy intake! Focus on FUELING for the WORK REQUIRED and remember without HEALTH there is NO PERFORMANCE.