Dancers and Bone Health

Why should dancers prioritize bone health?

There’s a heavy load placed upon a dancer’s bones–repetitive relieves, jumps, and turns are just part of the equation. Research shows a higher prevalence of stress fractures and low bone mineral density among dancers when compared with the general population. This is further exacerbated among dancers who experience disordered eating.

Despite its tough appearance, bone is living tissue with “blood vessels… cells, proteins, minerals, and vitamins.” As we grow throughout childhood, we build bone mass to eventually reach our peak bone mass. This is the greatest amount of bone a dancer can attain and it’s usually reached by your late teens to early 20s. Throughout life, bone tissue constantly grows and repairs itself. The higher your peak bone mass (or, the stronger your bones become by your 20s), the stronger they remain as you age. So, adequate nutrition provides your body with the tools needed to support this ongoing maintenance.

5 Steps To Build Strong Bones

Get comfortable with calories

It’s straightforward: if you’re not eating enough then you’ll risk injury. Energy balance is the term used to describe a bodily environment where the amount of calories consumed is sufficient to support the amount of energy expended (from dancing and other forms of physical activity).

But when there isn’t enough energy (AKA calories) to go around (such as from restrictive eating habits and/or over-exercising), then you risk a syndrome known as Relative Energy Deficiency in Sport (or RED-S). I’ve previously discussed why dancers need to understand the consequences of the hormonal imbalances that persist with RED-S (read about it here). Your first line of defense: build a meal plan that supports your body’s needs. This is easier said than done, but I have several resources to get you started:

1. How many calories does a dancer need to eat?
2. Prioritize snacks throughout the day.
3. Overcome food fears.

Stop fearing foods high in fat

Hormones play a large role in bone strength. Hormones are chemical messengers that travel through your bloodstream to deliver messages to tissues and organs. Hormones are primarily made from either proteins or fats (found in your diet). The hormones specifically designed to support bone health (mainly estrogen and testosterone) are made from cholesterol, a fat-like substance. If your diet is low in fat, then your body isn’t receiving the tools needed to build these hormones. The fats in food make up a confusing topic for most dancers and one that I detangle in this article. Bottom line: you’ll want to eat sources of fat in almost every meal and snack (yep, contrary to popular belief!)

Seek a licensed practitioner

Dancers need bone strength to support their short-term and long-term performance goals. Medical nutrition therapy is recommended as a nutrition intervention for all dancers looking to reduce their risk of injury. A Registered Dietitian Nutritionist is licensed to provide medical nutrition therapy for appropriate meal planning to ensure dancers are able to meet their body’s needs for specific nutrients for bone health. These include calcium, vitamin D, phosphorus, vitamin K, and vitamin C.

By working with a dietitian, dancers can better determine their need for potential nutrient supplementation if warranted. This might also include the need for diagnostic workup, like a bone density scan (also known as a DEXA scan). This is a pain-free assessment that utilizes low-dose X-rays to see how dense (or strong) your bones are. According to the NHS, “bone density scans are often used to diagnose or assess your risk of osteoporosis.” For dancers, this can help to identify the presence of low bone density and the need for medical nutrition therapy.

Prioritize these foods and nutrients

Calcium and vitamin D are potent in dairy, but they’re also available in dairy alternatives like fortified almond and soy milk, soy yogurt, leafy greens, mushrooms, tuna, and eggs (with the yolk!). Phosphorus is abundant in chocolate. Most green veggies are rich in vitamin K and citrus fruits are potent in vitamin C. But there’s lots more to add. to this list! Learn how to integrate a food-first approach to obtaining these various nutrients and sign up for my free online training.

Reconsider your weight goals

Body weight is a sensitive topic for most dancers and one that I discuss in several articles. But to support strong bones, we need to understand why it’s important to consider your set point weight. Quick recap: your set-point weight is a range at which your body feels most comfortable. In other words, it’s your body’s *happy* weight that is controlled biologically and pre-determined genetically. This is a big conversation and one that spans beyond this article. So, check these out to learn more:

1. If you fear weight gain, start here.
2. If you’re curious about what it means to be a healthy weight, check this out.
3. If you want to lose weight, read this.
4. If you’re interested in gaining weight in a healthy way, read this.