Humans actively build bone until reaching our mid-20s, then we begin to slowly lose bone mass. Over the age of 50, 1 in 2 women and 1 in 4 men will break a bone due to osteoporosis, or “brittle bones”. Since 70% of our bone density relates to heredity, we face greater risk of skeletal problems if our family history is positive for the disease; this does not mean; however, that lifestyle choices don’t play a role.
Behaviors which favor maintaining optimal bone mass during the aging process include getting regular weight-bearing exercise, eating a well-balanced diet which includes nutrients known to support skeletal health, and avoidance of “Bad to the Bone” behaviors, all of which negatively impact bone health. These include smoking, excessive intake of alcohol, caffeine, and sodium, all of which deplete the body’s calcium stores. This article focuses on dietary factors which promote strong, healthy bones.
Calcium is the mineral most commonly associated with our bones; it is also needed for muscles, nerves, veins, arteries, enzymes, and hormones to function properly. If dietary calcium intake is too low to support these crucial metabolic processes, calcium is drawn from reserves stored in bones, leading to depletion and eventual fracture. The Institute of Medicine (IOM) recommends that most adults should get 1,000 milligrams (mg) daily; women over 50 and men over 70 need 1,200 mg.
While the media has stirred up some controversy during the past couple of years regarding the safety and efficacy of calcium supplements, calcium is not to be feared. Andrea Singer, MD, FACP, CCD, National Osteoporosis Foundation (NOF) trustee and clinical director, maintains that calcium intake from food and supplements which does not exceed 2,000-2,500 mg per day should be considered safe. Be aware that calcium is absorbed most readily from food sources (as opposed to supplement forms). Rich sources include milk (skim contains more calcium than whole!), buttermilk, yogurt, cheese, calcium enriched orange juice, sardines containing bones, tofu (prepared with calcium sulfate), tempeh, calcium-fortified soymilk and certain dark, leafy greens (collards, broccoli rabe, turnip greens, and kale are the best of the bunch).
Spinach and beet greens contain a substance called oxalic acid, which binds calcium and renders it unavailable. Cooking greatly reduces oxalic acid, and consuming a food with oxalic acid does not affect absorption of calcium from other foods eaten during the same meal. Wheat bran will block calcium absorption, however; eating wheat bran cereal with milk will allow only some of the milk’s calcium to get into the bloodstream to positively impact bone health.
Vitamin D is essential for optimal calcium absorption. A 2012 meta-analysis from the New England Journal of Medicine found that supplementing with at least 800 International Units (IU) of vitamin D daily lowered the risk of hip and non-vertebral fractures significantly. Without vitamin D, less than 10 percent of the calcium people ingest is absorbed. Dietary sources of this fat-soluble vitamin include Sockeye salmon, fortified milk, swordfish, canned tuna, fortified orange juice, and eggs. Getting 15 minutes of (unprotected) sun exposure two or three times each week also helps the body make more of its own vitamin D.
Up to 60% of the body’s magnesium is stored in the bones, making this mineral highly important to bone formation and maintenance. Providing resiliency and protection from fractures, it is also essential for converting vitamin D to its active form in the body. A 2014 study in the American Journal of Clinical Nutrition found that lower magnesium intake is associated with lower bone mineral density (BMD); many Americans are deficient in dietary magnesium. Sources to include in the diet are almonds, spinach, pumpkin and squash seeds, Brazil nuts, black beans, edamame, peanut butter, avocado, whole-wheat bread, and kidney beans.
Getting adequate-but not excessive-dietary protein promotes both muscle and bone health. Maintaining good muscle reserves during the aging process provides the strength required to prevent falls and subsequent fractures. To determine your protein goal in grams, divide your weight in pounds in half. Most women need 20-25 grams/meal, while men require closer to around 30-35 grams at each meal. Select lean sources of animal protein to control fat/caloric intake, and choose plant-based choices like tofu and pea protein powder as well.
Vitamin K is found in two main forms in food, K1 and K2; both play a role in blood clotting. The K2 version prevents calcium from being deposited in arteries (the process of atherosclerosis), instead directing it to the bones. K2 is found in cheese, grass-fed beef, liver and natto (fermented soybeans).
Helping to lower levels of homocysteine, a compound which stimulates the breakdown of bone, folate and vitamin B12 support bone health as well. Find B12 in meat, fish and other animal foods, along with fortified cereals and nutritional yeast. Folate is provided by green leafy vegetables, broccoli, asparagus, and legumes.
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