Much of what you hear about diet and osteoporosis is out of date.
Marilyn wrote this week with a question about nutrition and bone health.
I am 54 and have done weight-bearing exercise and eaten a balanced, healthy diet all my life but I recently got diagnosed with severe osteoporosis. My mother was crippled by osteoporosis. What can I do nutritionally to help strengthen my bones?
Well, Marilyn, it sounds like you have been doing all the right things. But, in addition to diet and lifestyle, genetics can play a big role in whether or not you get osteoporosis. The fact that your Mom also had osteoporosis suggests that genetics may have played a role in your case. Your doctor may prescribe a medication to help with your bone loss but you’re smart to be thinking about what you can do nutritionally, as well.
It’s something we all need to think about, whether we are young or old, male or female, and whether we have osteoporosis in the family or not. All of use will lose bone as we age. If you don’t start out with really strong bones, you can get into trouble pretty quickly. It’s never too late to start taking better care of your bones, but it’s best to start young.
A Lot of Out-of-Date Information
I’ve got some good news and some bad news. The good news is that a healthy diet can do wonders to protect your bones. The bad news is that most of what you read about nutrition and osteoporosis is out of date. For example, you’ll find a lot of articles claiming that high-protein diets cause bone loss. You’ll also read that caffeine, sodium, and phosphates weaken bones.
But there’s a little more to the story. It’s true that when you take in more protein, caffeine, sodium, and/or phosphates (which are found in colas), you tend to lose more calcium in your urine. The concern is that this robs your bones of needed calcium. However, your body is pretty smart. It can compensate for these losses by increasing the amount of calcium that it absorbs from the foods you eat.
As long as your diet contains enough calcium and other bone-building minerals, these dietary factors actually have little to no long-term effect on bone health. Unfortunately, most of us aren’t getting nearly enough calcium.
Dairy products like milk, yogurt, and cottage cheese are all good sources of calcium. Non-dairy alternatives like soymilk are often fortified with calcium as well. You can also get calcium from vegetables like spinach, kale, arugula, and grape leaves.
It’s Not Just About Calcium
While calcium is the thing you probably think of first, there are many other nutrients that are important to bone health. In particular, vitamins D and K are critical to strengthening bones. Vitamin K is found in vegetables like spinach, kale, broccoli, and Brussels sprouts.
Notice anything? Many of the vegetables that are high in vitamin K are also high in calcium. Perhaps that explains this mystery: Researchers noticed that people whose diets are high in vitamin K have a much lower incidence of bone fractures as they get older than people whose diets are low in vitamin K. “A-ha!,” we thought. “Vitamin K prevents osteoporosis.”
Later, we were disappointed to find that taking vitamin K supplements had no effect on fracture risk. But the folks with strong bones weren’t taking vitamin K supplements, they were eating foods rich in vitamin K. It just so happens that these foods are also rich in calcium, magnesium, and other bone-building nutrients. In other words, single nutrients don’t prevent bone loss. But a nutrient rich diet does.
There’s one other nutrient that I should mention here and that’s vitamin D, which is actually more like a hormone than a nutrient. One of its key jobs is helping your body absorb and use calcium. Your body makes vitamin D when your skin is exposed to sunlight. Unfortunately, what with clothes, roofs, and sunscreen, we don’t get as much sun on our skin as we used to. You can also get vitamin D from fish and from milk or soymilk that has vitamin D added to it.
Diet for Strong Bones
A nutrient-rich diet beats a handful of vitamin pills every time. But, because most people struggle to get enough calcium and vitamin D, it might be good idea to take a supplement containing calcium and vitamin D. But this does not get you off the hook. You still have to eat your vegetables. (Are you getting tired of me saying that?)
To sum up, here are my quick and dirty tips for keeping your bones strong and healthy.
Be sure your diet contains the recommended amount of calcium and vitamin D. For most people that’s around 1000 mg of calcium and 400 IU of vitamin D. Try to get at least half of that from foods as opposed to supplements. Dairy products are naturally high in calcium and usually have vitamin D added to them. A lot of soy products are fortified with both calcium and D. If you like sardines or caviar, you’re in luck: They are among the few foods that are naturally high in both calcium and D.
Eat tons of vegetables. Most vegetables are rich in bone-building nutrients like calcium and magnesium. Leafy greens and vegetables from the cabbage family are also particularly high in vitamin K. Eat several servings of veggies every day and aim for a lot of variety throughout the week.
Eat enough protein, but don’t go overboard. For strong bones, you want to eat at least one gram of protein per kilogram of body weight, or around fifty to sixty grams of protein per day. If you eat a lot more protein than that, you need to be extra sure you are getting enough calcium. It’s also a good idea to increase your intake of vegetables proportional to your protein intake. This helps to balance the effect of all that protein on your body’s pH.
Obviously, nutrition and bone health is a complicated subject and there’s a lot that won’t fit into a five minute show. But I’ve included links in the show notes to some excellent articles that clear up a lot of misconceptions and out-of-date ideas about nutrition and osteoporosis. So, if you’d like to read further, you’ll find those links below. And be sure to check out Girlfriend MD's episode about osteoporosis.
This is Monica Reinagel, the Nutrition Diva, with your quick and dirty tips for eating well and feeling fabulous.
These tips are provided for your information and entertainment and are not intended as medical advice. Because everyone is different, please work with your health professional to determine what’s right for you.
Have a great day and eat something good for me!