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BLOG BY Aishah Angell BSc ANutr

Taking Care Of Your Bone & Dental Health

Optimising bone and dental health are important in the prevention of several diseases and conditions such as osteoporosis (porous bone), osteomalacia (soft bone) and dental caries (tooth decay) which have the potential to cause us a lot of discomfort.

The good news is that we can reduce the risk of bone and dental related conditions if we eat a healthy and balanced diet, rich in a variety of nutrients. There are several vitamins and minerals which are especially important regarding bone and dental health and can be obtained from a variety of foods.

In saying this, of course, there are several other lifestyle factors such as age, genetics, gender, smoking and physical activity which can also affect the risk – so understanding how diet can help to support our bones and teeth is crucial.

The function of bones

Our bones help to produce blood cells, protect our vital organs and provide us with support[1]. Bones also contain a reservoir of minerals that can be tapped into to maintain homeostasis in the body[2].

What is bone made of?

Bone is made from a matrix of proteins, predominantly collagen, and filled with bone mineral (Calcium Phosphate)[3]. Of all the calcium present in the body, more than 99% of it resides in bone tissue and the rest in blood[4].

Important vitamins and minerals for bone health:

Calcium is a mineral that helps with bone growth and development of the skeleton[5]. Therefore, a calcium deficiency is a risk factor for both osteomalacia and osteoporosis in adults[6]. Dietary sources of calcium include; broccoli, cabbage, okra, nuts, milk and dairy products, fortified white flour (bread), fortified breakfast cereals, fish where you eat the bones and tofu[7]. Spinach is another food which contains calcium, however, is not a good source as it also contains oxalic acid which decreases the bioavailability of calcium[8].

Vitamin D is involved in the absorption of calcium and phosphate and essential for bone growth[9]. Similar to calcium, a vitamin D deficiency increases the risk for both osteoporosis and osteomalacia in adults. Vitamin D can be synthesised by the skin when the body is exposed to sunlight[10]. This means that in winter months, it is much harder to synthesise vitamin D. Although vitamin D can be obtained from the diet, it is difficult to reach the recommended amount of 10 μg/day from food alone, so it is recommended that adults take a vitamin D supplement in winter months to prevent deficiency [11]. Dietary sources of vitamin D include; oily fish, dairy products, egg yolk and red meat[12].

Other vitamins and minerals for optimal bone health:

Vitamin C is involved in the synthesis of collagen, the main protein present in bone[13]. Good dietary sources include citrus fruit, pepper, broccoli, strawberries, brussel sprouts and potatoes[14].

Phosphorous is involved in bone growth and good dietary sources include; red meat, dairy, fish, poultry, bread, brown rice and oats[15]. However, prolonged excess intake of phosphorous has been associated with reduced absorption of calcium and leaching which increases the risk of fracture[16].

Caffeine and bone health

High caffeine consumption has been associated with low bone mineral density in some epidemiological studies through the association between decreased calcium absorption[17][18]. However, there are many other factors that can affect bone health, and several studies have found no association between caffeine intake and reduced bone mineral density[19]. In addition, current evidence suggests that if calcium requirements are met, the effect of moderate caffeine intake is unlikely to affect calcium levels and therefore bone mineral density[20].

Dental health

Sugar is fermented by bacteria in the mouth from plaque on the teeth, producing acid[21]. The acid then causes demineralisation of the tooth enamel and dentine resulting in dental caries which can in turn, cause uncomfortable and chronic pain[22] [23]. Therefore, it is important that dietary sugars are limited to prevent the formation of dental caries[24]. Free sugars are the sugars that we want to limit consumption of[25]. They are present in high amounts of; confectionery, cakes, biscuits, desserts, sugar sweetened drinks and fruit juices[26].

Preventing dental caries

• In order to reduce consumption of free sugars, try to stick to 1 glass of juice a day and swap high sugar desserts for lower sugar options such as fruit and yogurt.

• Eating cheese after a meal or sugary foods can help to neutralise the pH of the mouth, preventing acid attack and also stimulates saliva flow[27] [28]. Saliva is important as it remineralises teeth, making them less susceptible to demineralisation the enamel and therefore, dental caries[29] [30].

• Fluoride protects the teeth through reducing mineral loss by preventing acid produced by bacteria and sugar, resulting in a decreased risk of developing dental caries[31] [32].

• Sources of fluoride include; fluoride toothpaste, fluoride mouth rinse, fluoride varnish, fluorinated water[33]. Excess fluoride can cause fluorosis, but this is uncommon as UK water levels are tightly regulated[34].

This blog post was written Aishah Angell Registered Associate Nutritionist who graduated from the University of Leeds with BSc Nutrition. Aishah recently started her job in London as a health advisor giving individuals diet and lifestyle advice to improve their health. You can find Aishah on Instagram @goodnutrients where she posts easy recipes, balanced lifestyle tips and evidence-based nutrition. She grew up in Singapore and aims to incorporate her Asian heritage with her passion for health on @goodnutritients.   

References:

[1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429025/pdf/ijbsv15p0776.pdf

[2]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429025/pdf/ijbsv15p0776.pdf

[3] https://www.bones.nih.gov/health-info/bone/bone-health/what-is-bone

[4] https://www.bones.nih.gov/health-info/bone/bone-health/what-is-bone

[5] https://academic.oup.com/jn/article/137/11/2507S/4664497

[6] https://www.nhs.uk/live-well/healthy-body/food-for-strong-bones/

[7] https://www.nhs.uk/live-well/healthy-body/food-for-strong-bones/

[8] https://www.nhs.uk/live-well/healthy-body/food-for-strong-bones/

[9] https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/

[10]https://www.who.int/dietphysicalactivity/publications/trs916/en/gsfao_osteo.pdf?ua=1

[11] https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/

[12] https://www.nhs.uk/live-well/healthy-body/how-to-get-vitamin-d-from-sunlight/#supplements

[13] https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-c/

[14] https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-c/

[15] https://www.nhs.uk/conditions/vitamins-and-minerals/others/

[16] https://www.nhs.uk/conditions/vitamins-and-minerals/others/

[17] https://academic.oup.com/ajcn/article-abstract/42/5/877/4692054

[18] https://academic.oup.com/aje/article-abstract/132/4/675/102232

[19] https://www.sciencedirect.com/science/article/pii/S0278691502000947

[20] https://www.sciencedirect.com/science/article/pii/S0278691502000947

[21] https://www.scielosp.org/pdf/bwho/2005.v83n9/694-699/en

[22] https://www.scielosp.org/pdf/bwho/2005.v83n9/694-699/en

[23] https://www.cambridge.org/core/services/aop-cambridge-core/content/view/D54F9000FA8C30E3CF68B9FD32341AE1/S1368980001001483a.pdf/dietary_effects_on_dental_diseases.pdf

[24] https://www.nhs.uk/live-well/eat-well/how-does-sugar-in-our-diet-affect-our-health/

[25] https://www.nhs.uk/live-well/eat-well/how-does-sugar-in-our-diet-affect-our-health/

[26] https://www.nhs.uk/live-well/eat-well/how-does-sugar-in-our-diet-affect-our-health/

[27] https://pubmed.ncbi.nlm.nih.gov/1877906/

[28] https://www.scielosp.org/pdf/bwho/2005.v83n9/694-699/en

[29]https://www.who.int/dietphysicalactivity/publications/trs916/en/gsfao_dental.pdf?ua=1

[30] https://www.cambridge.org/core/services/aop-cambridge-core/content/view/D54F9000FA8C30E3CF68B9FD32341AE1/S1368980001001483a.pdf/dietary_effects_on_dental_diseases.pdf

[31] https://www.nidcr.nih.gov/health-info/tooth-decay/more-info/tooth-decay-process

[32] https://www.scielosp.org/pdf/bwho/2005.v83n9/694-699/en

[33] https://www.nidcr.nih.gov/health-info/tooth-decay/more-info/tooth-decay-process

[34] https://www.nhs.uk/conditions/fluoride/

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