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House Call: Eat well and exercise to keep bones strong

By Dr. Bob Riggs For The Spokesman-Review

Today, I am talking about our bones. We develop most of our bone density in our childhood and young adult years, and unless you’re a jellyfish, you really want to have bones that will last you a lifetime.

Your body works hard doing this into your 20s when most people typically reach what is called peak bone mass. Your calcium intake and daily exercise is crucial during this part of life. That doesn’t mean that you are off the hook and that your work is done when you finish growing. Just as important after the period of bone building is maintaining bone mass and you do it the same way you built those strong bones.

You probably know that we all need calcium and vitamin D in our diet for strong bones, and that milk and other dairy products are good sources of calcium. You should also know that there are other foods that are excellent sources of calcium. This is especially important for people who can’t or choose not to consume dairy products. Some of my favorites include the green leafy vegetables like collard greens, kale, bok choy and spinach, and other vegetables like broccoli and soybeans as well as canned sardines, shrimp and salmon.

Getting your calcium from the foods you eat is the best way to do it. Our bodies absorb nutrients from food more effectively than from supplements plus you get all the other nutrients in those foods that you don’t get from supplements.

The other important part of your strong bone strategy is exercise. Just like the rest of your body, bones are living tissue. In the same way that muscles get bigger and stronger with exercise, your bones respond to exercise by getting bigger and denser. Denser, stronger bones are less likely to break in a fall or other accident.

When it comes to strong bones, not all exercise is created equal. As good for you as things like bicycling and swimming are for your heart and other muscles, they don’t impact your bones as much as weight bearing exercise like walking, running, jumping and weight lifting. That’s why I do a variety of exercises that include weight-bearing ones and recommend the same to my patients. The best exercise for children is running around playing actively. Sports are great, but even kids who aren’t into sports should be encouraged to get out there and play. That’s another reason that I advocate limited screen time for kids and adults.

Weight-bearing exercise involves working against gravity while staying upright. There are high-impact, low-impact and no-impact exercises. People who have already lost some bone density and are at greater risk of fractures and should check with their health-care provider to see if high-impact exercise is right for them. High-impact exercises are the best for increasing bone strength and are those where both feet leave the ground. Examples are running, jumping and some high-intensity aerobics. If you can tolerate these, they are the best to build and maintain bone density. Low impact exercise may be best for you if you have knee or other joint problems. Examples of low-impact exercise are walking, hiking and dancing. These are great too and are good choices for those of us who don’t tolerate the high impact anymore. No impact exercises include things like bicycling, elliptical trainers and swimming. These are great for conditioning without straining joints too much.

The bottom line is to keep moving, exercise to stress your bones and muscles regularly, stay strong and eat a healthy diet with plenty of calcium and enough Vitamin D.

Bob Riggs is a family medicine physician practicing at Kaiser Permanente’s Riverfront Medical Center. His column appears biweekly in The Spokesman-Review.

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