Building Better Bones One Bite at a Time

According to the Cleveland Clinic, an estimated 40 million Americans have osteopenia, and one-third of adults over 50 have some amount of bone density loss. Osteopenia, or reduced bone density, is the precursor to osteoporosis—a warning sign that you are at an increased risk of developing the disease and suffering bone fractures, even from minor slips. Osteopenia is a silent disease, meaning it progresses with virtually no symptoms.

Who is at Risk?

Women are four times more likely to develop osteopenia, though anyone can get it. Adults over 50—particularly post-menopausal women—have the most risk. Other factors that increase risk include smoking and tobacco use, alcohol use, certain health conditions including diabetes and hyperthyroidism, and those on certain medications including diuretics, corticosteroids, and proton-pump inhibitors.

Preventing and Slowing Osteopenia Through Diet

If you are concerned about osteopenia, or have already been diagnosed, one of the best ways to strengthen your existing bone tissue, as well is slow bone loss, is through diet. The best foods for bone health are those rich in calcium, vitamin D, protein, magnesium, and vitamin K. Your diet should also include plenty of fruits and vegetables. After the age of 50, women should up their calcium intake from 1,000 milligrams to 1,200 milligrams, as should men over the age of 71.

Here are some of the best foods to help you reach your goals:

• Leafy green veggies: Proof that dairy isn’t the only way to get calcium? Cooked kale has more per serving than milk, at 177 milligrams per cup. Cooked collard greens have the highest amount of calcium of all the leafy greens at a whopping 268 milligrams. Spinach, also high in calcium, contains oxalates, which can decrease the amount of calcium your body can absorb.

• Fatty fish/ Canned fish with bones: Canned salmon is one of the best sources of calcium, with 181 milligrams per three ounces. Salmon also contains vitamin D which your body needs to properly absorb calcium. Other calcium-rich options include fish packed with bones such as sardines, anchovies, and herring. Canned tuna is another excellent option, with 120 milligrams of calcium per three-ounce serving. Tuna is also rich in magnesium and vitamin D, both crucial to bone health.

• Dairy: Dairy can be a good source calcium, and your best options include grassfed milk, cheese, plain yogurt (especially Greek), kefir, and cottage cheese. Many high-quality lactose-free options now exist, making dairy more accessible to those who might have trouble digesting it.

• Egg yolks: While eggs—particularly yolks—have been shunned on and off due to their cholesterol content, many large studies have proven that eggs and egg yolks have little impact on cholesterol levels. Egg yolks are an excellent source of vitamin D (two eggs gets you about 10 percent of your daily need), as well as a good source of protein, folate, and vitamin B12.

• Tofu/ Soy products: Despite getting a bad rap, tofu and soy products can be beneficial to your health. Some of the best calcium sources include tofu (up to 680 milligrams per 100 grams!), edamame (98 milligrams per 1 cup cooked), tempeh (184 milligrams per cup), and soy milk (450 milligrams per cup). And, for menopausal women, the phytoestrogens found in soy-based foods can be helpful in mitigating symptoms associated with estrogen loss. Just choose organic where possible, as conventional soybeans are heavily treated with pesticides.

• Almonds: Another excellent non-dairy source of calcium is almonds, which contain 367 milligrams of calcium per cup. They’re also rich in heart-healthy mono- and poly-unsaturated fats, as well as bone-health supporting magnesium and phosphorous.

• Fortified plant milks: In addition to soy milk, other plant-based options like almond and oat, are often enriched with calcium and vitamin D, making them good alternatives for those who don’t eat, or can’t tolerate, dairy. Many options can exceed the calcium content of cow milk, with some brands reaching up to 450 milligrams per cup! Be sure to choose the unsweetened option to avoid any unnecessary added sugar.

• Prunes: Daily prune consumption may be particularly helpful for postmenopausal women, as studies show it can slow the progression of age-related bone loss and reduce the risk of fracture. One cup of dried prunes contains 104 micrograms of vitamin K–more than the 90-microgram recommended daily intake for women. Vitamin K is crucial for bone remodeling and mineralization, and can increase bone mineral density in those with osteopenia and osteoporosis.  

Foods to Avoid

While there are plenty of foods you can add to your plate to boost your bone health, there are a few things you should avoid:

• High sodium foods: While you don’t have to cut out salt entirely, the more salt you eat, the more calcium you lose through urine, so keep your sodium intake low.

• Alcohol: Avoid or limit alcohol as it may inhibit the absorption of important nutrients for bone health, including vitamin D, magnesium, and calcium.

• Soda: Soda has a negative impact on many aspects of health, including bones. Research has shown a link between soda consumption and decreased bone density, though the “why” is not fully understood.

• Caffeine: Like salt, a moderate consumption of caffeine is considered safe, though more than 400 milligrams per day may interfere with calcium absorption.

• Oxalates & Phytates: Oxalates, found in foods such as spinach, peas, and lentils, are plant compounds that bind to calcium as they leave the body. Phytates are another plant compound (found in whole grains, legumes, nuts, and seeds) that can inhibit calcium absorption. These nutritious foods shouldn’t be eliminated; rather you can minimize their anti-nutrient properties by soaking and cooking them or using sprouted versions instead.  

Supporting Healthy Bones Through Exercise and Supplements

In addition to eating a bone healthy diet, weight-bearing exercise is an absolute must. Walking, hiking, yoga, Pilates, and strength training with weights, bands or even your own body weight are all great ways to building and maintaining strong bones.

Supplements may be necessary for those who can’t get enough calcium through diet alone. Quality matters when choosing the proper supplements. The drugstore brands simply don’t cut it.

If you need help navigating an osteopenia diagnosis—or want to learn more about how you can prevent it, please contact me. We’ll assess your needs and make sure you maintain healthy bones for years to come!