Jun 23, 2017
Inner Strength
Michelle Rockwell

Because there are so many factors related to keeping bones strong, advice to athletes in this area must be multi-pronged. It should include education, screenings, and teamwork.

When educating high school and college athletes, it’s critical they understand they are in a bone-building life phase–taking care of their bones now can help them prevent osteoporosis and other bone-related issues later in life. Up to 45 percent of women and 30 percent of men over 65 years of age experience osteoporosis or non-trauma-related fractures.

But since convincing young people to worry about their future health is not always effective, take the time to explain how all the factors mentioned above can help them stay strong now and not miss any playing time with a stress fracture. I suggest focusing on the following areas:

• The bone consequences of consuming too few calories or of chronic dieting: Some athletes, both male and female, chronically under-consume calories either intentionally (perhaps as a method of weight control) or unintentionally due to time demands, lack of appetite, or poor education about calorie needs to support their daily expenditure. They need to know the negative effects of such practices.

• How to include adequate protein and healthy fats in their diets: A big greasy bacon-cheeseburger has a lot of protein and fat, but also a lot of calories. Educate athletes on how to consume lean protein, such as chicken and fish, and fats from heart-healthy oils, nuts, avocados, and olives.

• Adequate consumption of calcium-rich foods or supplements: It is recommended that athletes get 1,500 milligrams a day of calcium. Provide suggestions on how athletes can add calcium to their diet through milk, low-fat cheese, and yogurt.

Some athletes consume minimal or no dairy products because they are lactose intolerant, vegan, or have some discomfort after consuming dairy. Medications are available to help those with true lactose intolerance, and lactose-free dairy products or calcium-fortified soy milks, yogurts, and cheeses are excellent alternatives. Salmon, almonds, fortified cereals, and some green vegetables are also good calcium sources.

• How to get enough vitamin D: Researchers have learned vitamin D synthesis from sunlight is not quite as efficient as once believed and that sunscreen blocks up to 95 percent of vitamin D synthesis. This is particularly relevant for athletes who participate in indoor sports or train minimally outside. People living at a similar latitude to Atlanta, Ga., are likely to need two hours of sunlight to obtain adequate vitamin D synthesis. Those with darker skin typically have lower levels of vitamin D.

• Consequences of tobacco and alcohol use on bones: Today’s student-athletes often receive preventative education about using tobacco and alcohol. Letting them know about its negative effects on bone health can give them one more reason to say no to these products.


Michelle Rockwell, MS, RD, CSSD, is a private sports nutrition consultant based in Durham, N.C. She works with athletes and teams throughout the country ranging from recreational to professional.


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