Foods For Osteoporosis
By Melanie Beasley, RD, LD
February 1, 2024
What is Osteoporosis?
Osteoporosis, defined as low bone mineral density and fragile bones, is considered a “silent disease” because symptoms are absent until a bone fractures or breaks. Unlike other vital signs, like blood sugar or blood pressure, measuring your bone health or risk of bone loss is often overlooked and then only measured every two to three years.
According to the International Osteoporosis Foundation, one in three women and one in five men over the age of 50 will suffer a broken bone due to osteoporosis. A sobering statistic!
There are more days in a hospital stay for women over 45 due to an osteoporotic fracture than many other diseases, including diabetes, heart attack, and breast cancer (1).
Now that we have your attention, we have some good news. There are doable steps you can take at any age to prevent osteoporosis, decrease bone loss, and strengthen your bones. With a bone-healthy balanced diet, key mineral and vitamin supplements (like calcium and vitamin D), and lifestyle changes, you can protect yourself from bone loss.
What Makes Up A Bone?
Before we talk about how to support bone health and reduce bone loss, let's talk about what makes up each of the bones in your body. It might surprise you to learn, bones are active living tissue. The living tissue in bone is constantly breaking down and rebuilding in a process called remodeling.
The hard outer layer of a bone is made up of minerals – about half calcium and a third phosphorus (that blend together to form hydroxyapatite), and the rest of the outer mineral layer is a mixture of trace minerals including magnesium, silicon, iron, zinc, copper, boron, selenium, and manganese. These minerals are held together by an inner meshy layer made up of collagen and healthy fat (2).
As you can see from the makeup of the actual bone structure, for that remodeling to happen, you need to consume some key minerals, proteins, and fats to make up the structure of the bones. If we're not eating a diet rich in the foods that support our bones, we could be setting ourselves up for painful years ahead. There are many factors that help or hinder our ability to keep our bones strong, so let's take a deeper dive into what these are.
A Note On Aging
When we are younger, our bodies are breaking down and rebuilding bone at a high rate. The building cycle outpaces the breaking down cycle and peak bone density occurs in our late 20s. It is crucial in the younger years to lay a good foundation by avoiding sugar and intaking high-quality nutrients and minerals. If you have young people in your life, it is a great time to help them focus on nutrition and bone health now rather than waiting until later in life!
The bone building cycle naturally slows down in our 30s, but again, the good news is that bone building can still be stimulated at any age by getting minerals, protein, healthy fat, and exercise. Aging does not have to mean bone loss or poor bone health if you keep giving your body what it needs to build bone: the right mix of nutrients and weight-bearing exercise for stimulating bone growth.
Are You at Risk for Developing Osteoporosis?
Research has found that the following factors put you at greater osteoporosis risk for bone fractures and low bone mass:
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Drinking more than one soft drinks/soda a week.
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Smoking cigarettes.
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Eating a low fat and/or low calorie diet because of the lack of nutrients and healthy fat needed for bone metabolism.
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Taking medications such as cholesterol lowering meds like statins, seizure meds, acid reflux meds, chemotherapy, or many antidepressants. These medications can deplete the body of important nutrients for bone health or make it difficult to breakdown calcium supplements due to low stomach acid.
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Eating a diet high in sugar and processed foods, like breakfast cereals, bagels, chips, crackers, and candy. Sugar depletes the body of calcium and increases the urinary excretion of calcium, while processed foods containvery little calcium and vitamin nutrients.
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Consuming gluten, which creates gastric distress in most people and disrupts the microbiome's ability to absorb nutrients needed to build bone. You lose bone benefits when the lining of your gut is irritated and can't absorb other nutrients.
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Regular use of alcohol also interferes with the body's calcium absorption. When we drink alcohol, it takes up a lot of our body's nutrients just to metabolize and kind of flush out the alcohol, which is a toxin.
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Entering menopause or post-menopause stage of life, because of the shift in hormones.
This list of "bone robbers" negatively impacts nutrition and bone health because of how they take or "rob" the nutrients away from creating a healthy bone density. The positive news is that the majority of these certain risk factors can be changed to create a healthy lifestyle for strong bones. If you're someone who needs to take some of these medications, these bone-building solutions we'll talk about will help you slow or prevent the risk of bone mineral density loss, like helping your body absorb calcium better.
What Foods Keep Bones Healthy?
A study published by the National Institute of Public Health by researchers at Warsaw University found women suffering from osteoporosis consumed significantly lower amounts of fat, protein, and calcium.
Clinically, we have also found that many women who have osteoporosis or osteopenia (which is low bone density but to a lesser degree than osteoporosis) have been on a low fat, low calorie diet in hopes of managing their weight. They eat a small breakfast, skip lunch and snacks, and usually have a normal dinner with family. However, they are not eating sufficient protein, vegetables, and fat to support bone health.
Nutritional Weight & Wellness has osteoporosis nutrition guidelines for osteoporosis prevention with a meal plan that includes plenty of animal proteins, healthy dietary fat, and carbohydrates in the form of vitamin and nutrient-rich vegetables and fruits.
What we find to be helpful for most people with osteoporosis is to eat five times per day with protein, vegetables and healthy fats at each meal and snack.
What Foods Keep Bones Healthy?
A study published by the National Institute of Public Health by researchers at Warsaw University found women suffering from osteoporosis consumed significantly lower amounts of fat, protein, and calcium.
Clinically, we have also found that many women who have osteoporosis or osteopenia (which is low bone density but to a lesser degree than osteoporosis) have been on a low fat, low calorie diet in hopes of managing their weight. They eat a small breakfast, skip lunch and snacks, and usually have a normal dinner with family. However, they are not eating sufficient protein, vegetables, and fat to support bone health.
Nutritional Weight & Wellness has osteoporosis nutrition guidelines for osteoporosis prevention with a meal plan that includes plenty of animal proteins, healthy dietary fat, and carbohydrates in the form of vitamin and nutrient-rich vegetables and fruits.
Food Sources For Calcium Intake:
Since we've all heard that calcium intake is important for the health of our bones, it is often the first thing people think of when wanting to create strong bones. While we've all been told that dairy products are great for calcium intake and are needed to get enough calcium for healthy bones, we actually like dairy products (if tolerated) as sources of protein and healthy fat for maintaining bone health because of all the other nutrients those whole foods provide beyond calcium. We don't recommend low fat dairy products as those tend to have more added sugars and we want the healthy fat for our bones.
Many people do not tolerate dairy however, and if you live a dairy-free lifestyle, you don't need to be fearful about a low calcium intake, because there are many other foods to include in your meal plan beyond dairy foods and processed fortified foods claiming to be high in calcium, like orange juice (which is also filled with sugar!).
Some of our favorite calcium and vitamin-filled sources are fatty fish (canned sardines and canned salmon with bones), dark leafy greens (spinach, kale, turnip greens, watercress, and collard greens), almonds or almond butter, broccoli, Bok choy, okra, and winter squash.
Other Foods for Osteoporosis and Improved Bone Health
It might be surprising to you that there are other key players nutrient-wise when it comes to osteoporosis prevention and reversal. Just as important as getting enough calcium are getting enough vitamin D, vitamin K, minerals, protein, and fat. If we only focus on getting enough calcium, we are only adding one mineral needed for the outside structure of the bone. We need to also focus on the other components that make up strong bones.
What we find to be helpful for most people with osteoporosis - and for osteoporosis prevention - is to eat 4-5 times per day with protein, vegetables and healthy fats at each meal and snack.
PROTEIN – This macronutrient is so important for building the collagen rod in the bones, which supports the bone structure. Protein makes up a large portion of our bone mass and our volume in our bones as it creates the structural framework for minerals to attach to the bones.
Some great sources of protein could be:
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chicken
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steak
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eggs
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ground beef
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salmon
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nitrate-free deli meat
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cottage cheese
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Greek yogurt
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high-quality protein powder
Adequate protein intake is essential for bone health - we can't stress this enough. And protein needs increase during times of healing and stress. We recommend 4-5 ounces cooked at meals and 2-3 ounces cooked at each snack. As you work to increase your protein, it's easy to underestimate how much you are eating. It might be beneficial to weigh your cooked protein at first, so you'll have more understanding of how much is actually on your plate.
FAT – Since bone is a living tissue, it requires natural dietary fat to build the bone mesh for strong, healthy bones. The bone mesh is where minerals (such as calcium, magnesium, strontium, and zinc) attach to. Eating no fat, low fat, or unhealthy refined fats can leave holes in the mesh. With holes in the mesh, less minerals are able to attach and that results in weak, fragile, soft bones.
The fats for good bone health are:
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butter
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coconut oil
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lard, preferably grass-fed
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avocado oil
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olive oil
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nuts
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nut butters
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olives
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avocados
The fats you want to avoid are refined oils such as:
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vegetable oil
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soybean oil
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corn oil
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canola oil
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cottonseed oils
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sunflower oil
Refined oils can be in highly processed foods or other foods like dressings, sauces, and mayonnaise. Be sure to recheck those labels and make sure it says either unrefined, cold pressed or expeller-pressed. If it doesn't say those words, it'slikely refined.
If you do have osteopenia or osteoporosis, it's not too late to start incorporating these healthy natural fats. Most people need to eat 5 to 7 tablespoons of natural fat a day. If you split that up over the course of day, that's about a tablespoon of fat at each meal and then a tablespoon of fat at snacks.
VEGETABLES – Our mothers said that we needed to eat our vegetables, and they were right. We get vitamins and antioxidants from vegetables that prevent free radical damage in our cells, including the cells in our bones. We encourage our clients to eat a variety of vegetables at least three times a day, cooked or raw. Broccoli, asparagus, sweet potatoes, cauliflower, carrots, green beans, cucumbers, dark green leafy vegetables, and the list goes on!
What Supplements Keep Bones Healthy?
As you get your dietary protein and fat from real foods to help the process of remodeling, you'll want to focus on getting those key vitamins and minerals of vitamin D, vitamin K, and calcium. Food contains these important minerals, like mentioned above, but if you already have an increased risk for osteoporosis or osteopenia and want to start to rebuild and strengthen your bone health, we highly recommend adding bone-building dietary supplements into your real food plan as well.
Calcium and vitamin D have a special relationship. Vitamin D helps with calcium absorption and, without enough vitamin D to help you mineralize, you can develop osteomalacia, which is soft bones. Leading expert in vitamin D research, Dr. Michael Holick from Boston University says, "Vitamin D is critical to the formation and maintenance of normal bones. Even if people consume enough calcium, they cannot build and maintain bone density, if they are deficient in vitamin D.” Because it's challenging to get vitamin D from food alone, supplementation might be necessary, especially if you live north of 30 degrees latitude.
We walk you through a few of your options on what calcium supplements to look for, a special vitamin D and vitamin K combo, an excellent collagen on the market, and a comprehensive supplement for bone formation with Key Osteo Plus in this article Supplements For Osteoporosis.
A Note On Exercise & Sleep
Exercise and sleep are both lifestyle habits that help build bone density, as well as habits for overall healthy adults. As the muscles pull against the bone, it triggers the bones to increase in density to support the muscles. For this reason, weightlifting and weight-bearing exercises are critical for stimulating bone growth.
Aim for 30 minutes of physical activity a day. If heavy workouts are a problem, even just walking or stamping your feet can trigger the bones to increase in density. Anything you can do to put pressure on those bones will stimulate the bone building cycle at any age. Doing even just five minutes of jumping rope, box jumps, or heel drops will do remarkable things for your bone health. (Bonus points for movement done outside for that natural vitamin D!)
Sleep is also an important aspect of bone building. Melatonin, which you produce at night, triggers the cellular activities that lead to bone and tooth formation. When you are getting adequate sleep, your body has time to focus on tissue and bone repair along with other health benefits (3). Optimal quantities of sleep are between 7 1/2 to 9 hours. Our dietitians and nutritionists can help counsel you on ways to improve your quantity and quality of sleep, which is important for not only your bones but for overall well-being.
Recap For Bone Health
You can begin focusing on eliminating the bone robbers and increasing the bone-building habits today to help support the health of your bone density:
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Eliminate the sugar and processed foods in favor of whole foods.
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Kick the soft drinks habit and reduce alcohol intake.
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Build your healthy diet by planning meals and snacks around animal protein, healthy fat, and vegetable carbohydrates with some fruit to give your body the building materials it needs to support your bones.
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Incorporate key dietary supplements, such as Key Osteo Plus, a great multivitamin for bone health containing essential calcium and vitamin D
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Find ways to get in weight-bearing exercise and quality sleep.
For immediate help to improve bone health, depending on your health history or lifestyle habits, you may benefit from an individual consultation. Our nutritionists and dietitians can look at your unique needs and customize a bone-building plan with you to support your body's ability to create strong bone health. Not only will a bone-building plan reduce your osteoporosis risk of bone loss, but it will help your overall health and reduce risk factors of other health issues.
For more information on bone health, check out these resources:
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LISTEN: Osteoporosis & Real Food: NWW Client Success Stories - how two real life people used nutrition to change their dexa scan numbers and improve their osteoporosis diagnosis without taking medications
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LEARN: Preventing Osteoporosis with Bone-Building Foods online class - a self-paced class to walk you through a bone-building food plan
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READ: Supplements For Osteoporosis - your guide to all the calcium supplements, how much calcium to take, vitamin D recommendations, and what other dietary supplements will help give you the best support for bone formation
References:
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International Osteoporosis Association - https://www.osteoporosis.foundation/patients/about-osteoporosis
