Having just completed the Lake Placid Ironman Triathlon and qualifying for the Ironman World Championships to be held on October 10th in Kailua-Kona, Hawaii, I thought it might be fitting to talk about exercise and bone strength.
Ironman triathlons cover a distance of 140.6 miles (2.4 mile swim, 112 mile bike, and 26.2 mile run) which, I guess (well, I know), is kind of crazy...especially since competitors do it all in one day. I'm actually not so sure this form of exercise is really that healthy but it just happens to be something I enjoy doing. (It is amazing I can say I enjoy it just 3 days after the Lake Placid race...gosh am I sore!). In any case, exercise IS very important for bone health. But we need to have the right nutrients for that exercise to do its job.
Calcium and magnesium of course are important for bone health, as are trace minerals. Vitamins D and K help us absorb and utilize calcium and without these vitamins the mineral intake would be fairly ineffective. If you have never had your vitamin D level checked, now is the time to do it. Please don't rely on just taking 1,000 or 2,000 IU/day of vitamin D, as I have had MANY patients who have told me they take 2,000 IU/day, yet when I test them we find they are lacking in vitamin D. Some people just have a harder time absorbing D than others and even at 2,000 IU/day they need more...so TEST!!! Your target for an optimal vitamin D level should be between 35 and 60 ng/ml. The best time to test vitamin D is in March or April when your stores are the lowest after a long dark winter with its low intensity sun. That said, if you have never had it tested NOW is the best time.
In addition to supplementing with bone-health promoting minerals and vitamins, another product I often recommend is creatine. Creatine is an amino acid natural to the body and vital for building muscles and for muscle contractions. Creatine is naturally manufactured by the body (from arginine, glycine, and methionine) but as we age our ability to form creatine declines. We can obtain creatine from our diet but the best sources are fish and meat which are acidic and large quantities of these foods may not be the best way to ensure adequate creatine levels. Because creatine is only obtained through animal products, vegetarians have difficulty maintaining adequate creatine levels. For these reasons supplementing with creatine, especially if you have bone loss, is a good idea.
A recent article by Chilibeck, et al. in Medicine and Science in Sports and Exercise showed that "twelve months of creatine supplementation during a resistance training program preserves femoral neck BMD [bone mineral density] and increases femoral shaft subperiosteal width, a predictor of bone bending strength, in postmenopausal women." Creatine can help us maintain muscle strength which is important for reducing falls (falling is the number one cause of fractures). Creatine also helps build muscle tissue and since robust active muscles release bio-chemicals called myokines to signal bone strengthening, muscles are a good thing to develop if you have bone loss.
Once you get the go-ahead from your doctor to start an exercise program, I suggest hooking up with a personal trainer. Trainers can help keep you from injuring yourself by making sure you are doing exercises properly. You wouldn't want to break a bone while loading them to stimulate strengthening. In addition to exercise, take in adequate vitamins and minerals such as our OsteoNaturals products and consider adding creatine to your nutrition supplement list. I typically recommend KreAlkalyn Pro by Designs for Health but there are many other companies that produce good creatine products. Shop around and see what fits you the best. Now, get exercising and have fun making your skeleton stronger and healthier! Maybe I'll see you in Kona!
Chilibeck, P.D., et al. 2015. Effects of creatine and resistance training on bone health in postmenopausal women. Medicine and Science in Sports and Exercise 47(8):1587-95.