Introduction
Maintaining good bone health is vital at every age and stage in life. The bone skeleton is the bank for calcium. Calcium is a mineral that is necessary for various body functions (e.g., helping our blood clot, regulating brain and spinal cord function, and regulating muscle contractions). It is also essential for building and keeping our bones and teeth strong and healthy. If the body does not get enough calcium, it causes our bones to grow weaker.1 The loss of bone strength and mass can lead to a condition known as osteoporosis. Osteoporosis is a condition in which bones have become very fragile and are more likely to break (fractures).2
Fortunately, there are some things you can do to keep the bones strong and healthy, you can also discuss having a bone density test or scan with your GP if you meet the criteria. To ensure you are getting enough calcium, you can make changes to your diet by incorporating more calcium-rich foods. Mackerel is one of the common types of oily fish that is full of essential vitamins and minerals. Therefore, mackerel offers significant bone density benefits due to its nutritional composition.
Understanding bone density
Definition of bone density
Bone density is a measure of the total amount of calcium and other minerals present in the bone. When bones have the recommended amount of minerals, they will have a higher density, be stronger and less likely to break.3
Importance of maintaining optimal bone density
The maximum bone size and strength one can have in a lifetime is known as peak bone mass. As you age, your bones continuously change, as new bones develop and old bones are broken down. Therefore, at a young age, your body tends to make new bones faster than it breaks down old bones. Most people reach their peak bone mass around the age of thirty after which you are likely to lose more bone mass than you will gain. Your bones can become less dense due to bone loss, age, certain medical disorders and medications. Having a lower bone density can increase your risk of developing osteoporosis.3
Factors affecting bone health
Lifestyle factors
Poor diet and lack of exercise can affect the bone mass potential. So, it is important to take steps to avoid severe bone loss over time by ensuring proper nutrition containing enough calcium and vitamin D and regular exercise.4
Dosages for calcium + vitamin D vary with different people. You will need more vitamin D if you:
- Live in areas where there isn’t much sunlight
- Have darker skin
- Are obese
It is important to talk to your doctor about the required dose as taking higher than recommended doses of calcium and vitamin D may cause side effects. For advice on recommended nutrition for healthy bones, please click here.5
Genes
Genetics also plays a huge role in how much peak bone we have. People who have problems with the way their bodies remodel bone (the continual process of removing old bone and replacing it with new bone) are at higher risk for bone loss and osteoporosis. Although a healthy diet and exercise can help, the bone will still be lost at a faster rate for people with this problem.6
Age
People with a higher peak bone mass at a young age generally have a lower chance of getting osteoporosis and fractures later in life. Older adults with osteoporosis are most vulnerable to having bone fractures in the wrist, hip, and spine, especially after a fall.4
Gender
People assigned male at birth (AMAB), generally, have a higher peak bone mass than people assigned female at birth (AFAB) as their bone width and size are greater. People with AFAB may have smaller bones with a thinner cortex and smaller diameter, which can make them more likely to develop osteoporosis. However, those AMABs are still at risk for osteoporosis, especially after the age of seventy when bone loss and fracture risk increases with age.4
Nutritional profile of mackerel
Mackerel is a small fish with a firm texture and is often packed in oil and canned for convenience. Mackerel fish is high in protein and provides omega-3 fatty acids. Its mild taste makes it a great addition to your diet if you want to include fish but dislike the strong taste of other fish types.7
Table 1: Nutritional value per 100g of canned mackerel from the U.S. Department of Agriculture.
Nutrients | Nutritional value per 100g |
Water | 69.2g |
Energy | 156kcal |
Fat | 6.3g |
Protein | 23.2g |
Calcium | 241mg |
Iron | 2.04mg |
Magnesium | 37mg |
Phosphorus | 301mg |
Potassium | 194mg |
Sodium | 379mg |
Retinol | 130µg |
Vitamin A | 130µg |
Vitamin B12 | 6.94µg |
Vitamin D | 7.3µg |
Micronutrient content relevant to bone health
Vitamin D helps the body absorb calcium and mackerel is a rich source of vitamin D. According to the food database, a serving of mackerel contains 643 units of vitamin D compared to the 600 units we get from natural sunlight.7,8,9 However, be careful as fish is a common allergen that may cause severe anaphylactic reactions.10
Incorporating mackerel into a bone-healthy diet
Practical tips for including mackerel in regular meals
The recommended UK guideline is to aim to eat at least 2 portions of fish a week, including at least 1 portion of oily fish. Here are some tips on how to add mackerel to your diet:
- Mix it into pasta dishes, salads, or casseroles
- Serve with spicy salsas, tangy relishes, or savoury sauces to complement its taste
- Add it to a soup, stew, or stir fry in place of chicken or any kind of fish, in any dish you would have used fish for.
It is important to make sure you're eating a kind of mackerel that is low in mercury, like the North Atlantic mackerel. Species of mackerel like king mackerel and Spanish mackerel have high levels of mercury and can cause mercury poisoning. The U.S. Environmental Protection Agency (EPA) has advised that king mackerel must be avoided in special populations like young children and pregnant women.11
Before eating mackerel, it is important to keep it fresh as there’s a risk of getting scombroid fish poisoning which happens when fish spoils due to not being refrigerated properly and producing excess histamine. You can also cure it immediately (on the same day of capture) either by cooking it as smoked fish or adding salt and vinegar to keep it fresh.12
Histamine production resulting from scombroid fish poisoning may result in the following symptoms:
Your symptoms should resolve on their own within 12 hours. If symptoms do not improve, seek medical help as soon as possible.12
Cooking ideas featuring mackerel as the main ingredient
If you’re new to eating mackerel, you may want to start with milder varieties such as Atlantic mackerel, which tends to have a less intense flavour compared to other species.
Quick steps, you can try:
- Marinate it in a flavourful sauce like citrus, garlic, and herbs or dressing to help mask the fishy taste
- Grill or smoke the mackerel to add a smoky flavour
- Baking, broiling, or pan-searing mackerel can help reduce its fishy flavour while still retaining its nutritional benefits
- Breading and frying for a crispy, flavourful appeal
Dietary considerations for maximising bone density benefits
You can choose from fresh, frozen and canned, but please note that canned and smoked fish can be high in salt. You can find out more about the recommended limits of fish.
Summary
Bone health is an important aspect of life as one gets older, therefore, a good bone density maintained at a young age is essential to prevent the risk of fractures and osteoporosis when one is at an at-risk age. Incorporating mackerel into one's diet serves as a nutritious food source rich in calcium, vitamin D, and omega-3 fatty acids, all essential for bone density maintenance. The nutritional profile of mackerel is examined in detail, emphasising its significant contribution to bone health. It is important to note to keep mackerel fresh, preferably consumed on the same day of capture as it can spoil quickly unless it's properly refrigerated. So, it's best to eat it fresh on the same day of capture as there’s a risk of fish poisoning if it’s not cooked appropriately.
References
- Cashman KD. Diet, nutrition, and bone health12. The Journal of Nutrition [Internet]. 2007 Nov 1 [cited 2024 Jul 5];137(11):2507S-2512S. Available from: https://www.sciencedirect.com/science/article/pii/S0022316622094408
- Tucker KL. Vegetarian diets and bone status123. The American Journal of Clinical Nutrition [Internet]. 2014 Jul 1 [cited 2024 Jul 5];100:329S-335S. Available from: https://www.sciencedirect.com/science/article/pii/S0002916523048785
- Haseltine KN, Chukir T, Smith PJ, Jacob JT, Bilezikian JP, Farooki A. Bone Mineral Density: Clinical Relevance and Quantitative Assessment. J Nucl Med [Internet]. 2021 [cited 2024 Feb 25]; 62(4):446–54. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8049374/.
- General (US) O of the S. The Basics of Bone in Health and Disease. In: Bone Health and Osteoporosis: A Report of the Surgeon General [Internet]. Office of the Surgeon General (US); 2004 [cited 2024 Feb 25]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK45504/.
- Cosman F, Beur SJ de, LeBoff MS, Lewiecki EM, Tanner B, Randall S, et al. Erratum to: Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int [Internet]. 2015 [cited 2024 Feb 25]; 26(7):2045–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643600/.
- Huang QY, Recker RR, Deng HW. Searching for osteoporosis genes in the post-genome era: progress and challenges. Osteoporos Int [Internet]. 2003 Sep 1 [cited 2024 Jul 5];14(9):701–15. Available from: https://doi.org/10.1007/s00198-003-1445-9
- Karpouzos A, Diamantis E, Farmaki P, Savvanis S, Troupis T. Nutritional Aspects of Bone Health and Fracture Healing. J Osteoporos [Internet]. 2017 [cited 2024 Feb 25]; 2017:4218472. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804294/.
- Calories in Mackerel and Nutrition Facts [Internet]. [cited 2024 Feb 25]. Available from: https://www.fatsecret.co.uk/calories-nutrition/generic/mackerel.
- Branch NSC and O. Calcium and Vitamin D: Important for Bone Health. National Institute of Arthritis and Musculoskeletal and Skin Diseases [Internet]. 2023 [cited 2024 Feb 25]. Available from: https://www.niams.nih.gov/health-topics/calcium-and-vitamin-d-important-bone-health.
- Kalic T, Radauer C, Lopata AL, Breiteneder H, Hafner C. Fish Allergy Around the World—Precise Diagnosis to Facilitate Patient Management. Front Allergy [Internet]. 2021 [cited 2024 Feb 25]; 2:732178. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8974716/.
- Chen B, Dong S. Mercury contamination in fish and its effects on the health of pregnant women and their fetuses, and guidance for fish consumption—a narrative review. Int J Environ Res Public Health [Internet]. 2022 Nov 29 [cited 2024 Jul 5];19(23):15929. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9739465/
- Eyer-Silva WA, Arteaga Hoyos VP, Nascimento L. Scombroid Fish Poisoning. Am J Trop Med Hyg [Internet]. 2022 [cited 2024 Feb 25]; 106(5):1300. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9128715/.