Whether you’re logging high weekly mileage on the roads or grinding through double training sessions, as an athlete it is important to protect your bones to avoid an overuse injury. 

While training volume, biomechanics, and footwear definitely play a role in injury prevention, nutrition also holds a big place at that table. Even though bones feel like these rigid things we always carry with us, they are actually a living tissue that is constantly breaking down and rebuilding within our bodies. Without the right fuel, bone remodeling can’t happen the way it should leaving your skeletal system vulnerable to micro-fractures.

So how do you make sure your bones have what they need? 

#1 - Pay attention to Energy Availability 

This is the most common cause of stress fractures in athletes. Your body is in constant need of energy for your heart to pump blood, your lungs to breathe oxygen, your brain to make decisions, and all of your other organs to work in harmony. If you are using all of your energy on things like hiking with friends or training for a marathon and not saving enough for life sustaining tasks, you have what is referred to as low energy availability. This happens if you chronically consume fewer calories than your body needs to support BOTH your training and your metabolic needs. 

When this happens, your body enters an energy saving state to preserve itself. One of the things that happens in this energy saving state is bone-building hormones get downregulated. This is also where we often see Relative Energy Deficiency in Sport (REDs) develop. This energy deficiency and downregulation of hormones directly leads to lower bone mineral density and increases your risk of a stress fracture. 

#2 - Fuel with the right foods

Calcium might be the nutrient that comes to mind when we talk about bone, but it isn’t the only nutrient that matters. On a macro level, carbohydrates are actually the food that makes a big difference in bone health. 

Consuming adequate carbohydrates has been shown to help maintain the proper amount of hormones needed to support the bone remodeling process. They also fuel your heavy workouts, which in turn reduces the stress response within our bodies that accelerates bone loss. If you are looking to get more out of your workouts and minimize stress on your body, make sure you aren’t skipping the carbs. 

#3 - Think about micronutrients 

Building strong bones does require adequate calcium, but it also requires adequate vitamin D. The general recommendation is to get approximately three servings of high calcium foods in your diet each day. This could be dairy, but it could also be tofu, canned fish with the bones, or leafy greens. Even if you are meeting this recommendation, you might still be at risk for poor bone health if you have inadequate vitamin D levels. 

While calcium supports the structure of our bones, vitamin D supports the absorption of calcium within our bodies. You can get vitamin D through the sun, fatty fish, egg yolks, and supplementation. It is important to always have your vitamin D levels tested before starting a vitamin D supplement. 

Here’s your bone health checklist: 

• Fuel adequately to support your training volume, especially with carbohydrate rich foods
• Consume 3+ servings of calcium-rich foods per day
• Maintain daily vitamin D intake either from the sun or food sources (only supplement after speaking to a Sports Dietitian)
• Refuel after your workouts to give your body what it needs to start rebuilding

By prioritizing overall energy balance, fueling for your workouts, and keeping micronutrients optimized you will be giving your body the exact raw materials it needs to adapt, build, and keep performing at your best season after season.