Supporting Bone Health for Athletes
To support healthy bones, individuals need to regularly participate in weight bearing activities, eat adequate amounts of calcium and vitamin D containing foods and maintain normal hormonal levels.¹ Failing to meet any of these requirements may place an individual at an increased risk for osteoporotic fractures. To prevent osteoporotic fractures, individuals should strive to maximize their bone mineral density by age 30 and aim to reduce the rate of bone loss thereafter.¹ Fracture risk increases by up to 3 times for each 10% reduction in bone mineral density from that of a level normal for a young healthy adult.
Exercise: When engaging in exercise, it has been suggested that both weight bearing aerobic and strength-focused exercises can help to cause a slight increase in bone mineral density. Optimal exercise activities for bone health should occur in shorter intervals throughout the day and should encourage individuals to move in a variety of directions.¹
Calcium: Calcium is a mineral that helps to build and maintain strong bones and teeth. It also plays a role in supporting metabolic functions such as muscle contraction.² Consuming enough calcium is essential for achieving maximal bone mass and to assist in slowing age associated bone loss.¹ It has been suggested that athletes and active individuals who consume lower quantities of calcium-rich foods have lower bone mineral density levels than age matched individuals who ingested adequate or higher amounts of calcium.¹ Individuals are encouraged to meet recommended intakes for calcium to maximize the bone-stimulating effects of weight bearing activity and optimize bone health.¹
Hormones: Unfortunately, it is more difficult to control hormone levels. Age related decreases of estrogen in women and testosterone in men may contribute to bone loss. In addition, long-term use of medications that increase glucocorticoid hormone levels such as Prednisone and Dexamethasone can lead to significant bone loss over time. It is important to discuss these concerns with your doctor and allied health professionals to design a bone health plan for you.
Athletes at risk of sub-optimal calcium intakes or poor bone health include:
- Athletes with low calcium intakes because of calorie restriction/high energy requirements.
- Athletes with inadequate intakes of calcium rich foods.
- Athletes with malabsorption diseases affecting the small bowel (i.e. celiac disease)
- Female athletes with impaired menstrual function
* Calcium supplementation does not guarantee improved bone health in the absence of adequate hormonal status, enough energy availability, adequate absorption and weight-bearing exercise.²
|Age in years||Aim for an intake of milligrams (mg)/day||Stay below*|
|Men and Women 19-50||1000||2500|
|Men and Women 71 and older||1200||2000|
* This includes sources of calcium from food and supplements.
Table from Dietitians of Canada³
Calcium Content of some Common Vegetarian Foods:
|Food||Serving Size||Calcium (mg)|
|Spinach, frozen, cooked||½ cup||154|
|Collards, cooked||½ cup||141|
|Kale, frozen, cooked||½ cup||95|
|Orange juice, fortified with calcium||½ cup||155|
|Soy beverage, fortified with calcium||1 cup||321|
|Dry powdered||4 Tbsp||302|
|Low fat cheddar/mozzarella||50g (1 ½ oz)||396-506|
|Cottage cheese||1 cup||146-217|
|Tofu, prepared with calcium sulfate||¾ cup||234-347|
|Blackstrap molasses||1 Tbsp||179|
Table from Dietitians of Canada³
Makes 6 servings
1 package Halloumi cheese (~250g)
1 medium yellow or red bell pepper
1 large zucchini
1 container grape or cherry tomatoes
1 tbsp olive oil
2 tbsp fresh lemon juice
2 tbsp chopped fresh basil, or 1 tsp dried basil
6 large or 12 small wooden/metal skewers
Optional: 6-10 brown mushrooms
- If using wooden skewers, submerge them in water and allow to soak while you are preparing the vegetables.
- Cut halloumi into 2.5 cm cubes (hallmoui tends to crumble, so don’t be concerned if your cubes don’t look like cubes). Please in a large mixing bowl.
- Chop the pepper into 2.5 cm squares and add to mixing bowl.
- Cut zucchini into 1 cm thick half moons and add to mixing bowl.
- If using brown mushrooms, cut in half and add to mixing bowl.
- Add olive oil, lemon juice, and chopped basil to bowl, and mix well to coat vegetables and cheese.
Recipe adapted from: http://www.jamieoliver.com/recipes/vegetables-recipes/greek-vegetable-kebabs/
- Optimizing Bone Health: Impact of Nutrition, Exercise, and Hormones. Gatorade Sports Science Institute Website. http://www.gssiweb.org/Article/sse-82-optimizing-bone-health-impact-of-nutrition-exercise-and-hormones. Published 2014. Accessed March 21, 2016.
- Calcium Supplement. Australian Institute of Sports Website. http://www.ausport.gov.au/__data/assets/pdf_file/0007/594178/CORP_33413_SSF_Calcium_Supplement_FS.pdf. Updated May 2014. Accessed March 22, 2016.
- Food Sources of Calcium. Dietitians of Canada Website. http://www.dietitians.ca/getattachment/f739d485-d113-4a46-8122-eb2d33730c64/Factsheet-Food-Sources-of-Calcium.pdf.aspx. Updated 2014 . Accessed March 22, 2016.