Nutrition and Osteoporosis: Listen up young men and women!

As mentioned in my previous post, self-care management can help with osteoporosis prevention and assist in maintaining bone mass. Quitting smoking and consuming less alcohol are important for the health of all your body’s systems, including bone health, but diet and nutritional supplements are equally as important.

Calcium and bone health

Prevention of bone fragility is the key to having strong bones. Our “bone bank”—the ability to increase our bone mass—is filled around the age of 30, so building up the bank is particularly important for children, adolescents, and young adults. Milk intake during childhood and adolescence is associated with higher bone mass and reduced fracture risk later in life.  Although milk (low-fat is best) is a great source of calcium, other animal sources such as yogurt and low-fat cheese are also great. Nondairy sources of calcium include salmon, broccoli, spinach, kale, nuts, and beans. Eating calcium-fortified foods, such as orange juice and breakfast cereal, can boost the calcium you ingest. 

How much calcium should I be getting?

Des Moines University Health Topics | Osteoporosis and Nutrition

How much of calcium rich foods should be eaten in a day? A 16-year-old child needs 1,300 milligrams/day of calcium, while an eight-year-old needs 1000 mg.  An eight-ounce glass of 1% milk gives 290 mg of calcium—so the answer is a lot! The post-menopausal woman has similar needs as the growing adolescent in diet and nutrition. For premenopausal women, calcium intake should be 1000 mg/day. Lactating females between 1000-1300 mg/day, post-menopausal women and women with osteoporosis should ingest 1200 mg/day. The best way to ingest calcium is through a calcium-rich diet.

What foods should I eat to get enough calcium in my diet?

Our intake of calcium has changed over the generations. I grew up with the recommendation of three to four glasses of milk a day. The recommendation for my children (now in their 30s) was not focused on milk drinking; the nutritional world was obsessed with animal fat and heart disease and milk intake was not pushed by their pediatrician. As a result, my children drank much less milk, although they drank calcium fortified orange juice. Today, there are many who prefer a plant-based diet or are lactose-intolerant, so  soy, almond, coconut, and other milk sources are used as a substitute. Although alternatives to cows’ milk have many health benefits, cow’s milk is still the highest in protein and calcium. Look for plant-based milks to be fortified with calcium and Vitamin D if you chose to consume alternative milk products.

Vitamin D and bone health

Vitamin D is necessary for calcium absorption and utilization, and the best source is the sun. Vitamin D is synthesized in the skin and transported to the liver, where it promotes intestinal absorption of calcium and phosphorus. Here in Iowa, especially in the winter, our vitamin D intake from the sun can be low. Culturally, children are spending less time playing outside and often wear sunscreen, causing Vitamin D levels to be low. This is a great excuse for you to kick your kids outside to play! Nutritional sources of Vitamin D are fatty fish like salmon or tuna, and fortified foods like yogurt, cheese and milk. It’s important to note though that diet is usually not enough if it’s the sole source of vitamin D. Women under age 50 should get 400-800 international units (IU)/day of vitamin D, while those 50 and older should get 800-1000 IU/day. 

Protein, nutrients and vitamins for bone health

Healthy bones also need a protein-rich, low-sodium diet, so vegetarians and vegans especially need to be very aware of their protein and calcium intake. Interestingly, high protein diets from meat sources can cause a loss in body calcium, so consider getting protein from plant sources when you can. My favorite plant-based protein source is nuts and beans. It’s also been shown that drinking soda, (or pop, since we’re in the Midwest) is linked to bone loss. If pop replaces a milk drink, calcium and Vitamin D intake will decrease, but the exact reasons why pop causes bone loss are unknown. Maybe because there is not one natural ingredient in a bottle or can? Just saying…Get rid of the pop in the fridge, it is not good for any part of your body!

Des Moines University Health Topics | Osteoporosis and Nutrition

Vitamins K and C and the nutrients of potassium and magnesium are also important for bone health. Eating a variety of fruits and vegetables will help you get adequate amounts of these in your diet.

Calcium and Vitamin D supplements (you can find these both separately and combined together) can assist in achieving adequate amounts of these two nutrients, but be sure to discuss appropriate supplementation with your primary care provider; excessive calcium can be just as bad for health as not enough calcium. It does seem logical if you have low bone mass to take lots of calcium, but no! High levels of calcium can cause kidney and heart issues. Your calcium intake should not exceed 500-600 mg at a time and should be ingested with a meal.

Focus on your health as a whole

If all this dietary information seems overwhelming, do not despair! The essential point is that we need good nutrition to have healthy bones and bodies. If a child or young adult eats at least three sources of calcium per day, their bone bank will fill. As adults, we should continue that pattern. As we age—particularly women post menopause—improving our diet should be our first concern. After talking with your physician, we may need to add additional supplements. Also, we need to go outside and get some sun to assist our physical and psychological well-being. Finally, we need to move! That’s my next post, exercise and osteoporosis. We will see you soon!

Are you at high risk for osteoporosis, or just want to make sure you’re taking preventive action? Our exceptional physical therapists at the Des Moines University Clinic can help. For more information, to make an appointment for a bone mineral density test, to sign up for exercise classes and special programs, visit the DMU Clinic website or call 515-271-1717.

Disclaimer: This content is created for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health care provider with any questions you may have regarding a medical condition.

Laura Covill, D.P.T., OCS, COMT

Laura Covill DPT, OCS is a professor and physical therapist in the Department of Physical Therapy at DMU. She has been post-menopausal for over 15 years and accepts the physical changes of lack of estrogen but isn’t exactly happy about them. Dr. Covill’s professional expertise is in musculoskeletal physical therapy, chronic pain, women’s health and the integration of yoga and physical therapy. She is a believer in using lifestyle medicine in conjunction with traditional medical management to achieve her best self.

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