bone health

malnourished individuals is protein which is a major constituent of bone. However, the role of dietary protein in bone metabolism is controversial (84) as some of the major dietary proteins are classed as acidic and may promote bone resorption (85). Woolfe et al (86) suggest that an intake of 1.5g per kg of protein per day, which equates to 15-20 per- cent of total daily calorific intake, is a reasonable safe target for elderly individuals wishing to optimise their protein intake. A recent study by Hirani et al (87)

proposes that poor vitamin D status of older people continues to be a public health problem in the UK and suggests that there is urgent need for a uniform policy on assessment and dietary supplementation of vitamin D in older people in order to avert negative health consequences. These include an increased risk of falls and osteoporotic fractures (88). Saddler (89) suggests that the frail older adult who is unable to go out of doors and sit in the sunshine may benefit from a regular 10mcg vita- min D supplement.

Exercise and bone health in the elderly

Many people become increas- ingly sedentary as they grow older although this is not inevitable (1). Efforts to sustain physical activ- ity amongst the older population groups are vital (80). Older adults still require at least 30 minutes of mod- erate intensity exercise at least five days a week (54). Resistance training, which is a type

of exercise that challenges the mus- cles to move against an accustomed force, has been shown to be an ef- fective strategy for maintaining bone mass in the elderly (90). One recent study (91) identified that resistance training programs, regardless of intensity and frequency, were effec- tive in improving BMD of the proximal femur and lumbar spine, but not the total body in both elderly males and females. Emerging evidence also suggests that creatine supplementa- tion with or without resistance training has the potential to positively influ- ence bone biology (90).

Dancing is a mode of physical activity that may allow older adults to improve their physical function health and wellbeing and evidence suggests that dancing may also im- prove the older adults bone mineral content and muscle power (92).

16

Conclusion

In order to develop efficient strat- egies in the prevention of osteoporo- sis, it is important to determine which modifiable factors, especially nutri- tional factors, are able to improve bone health throughout the lifespan. There are potentially numerous nutrients and dietary components that can influence bone health and these range from the macronutrients to micronutrients as well as bioactive food ingredients. Abstract functional foods and their bioactive com- pounds have recently been found to play a significant role in improving skeletal health (93).

It is also important that individu- als maintain healthy eating regime in conjunction with regular physical activity in order to maximise their optimal bone health potential.

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