Nutrition for Osteoporosis

Often called the "silent disease," the first symptom of osteoporosis is often a hip fracture or collapsed spinal vertebrae. Collapsed vertebrae may be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis (severely stooped posture). Fortunately, it is never too early or too late to start an osteoporosis prevention program which includes good nutrition.

What is Osteoporosis?

Osteoporosis, or low bone density, is characterized by low bone mass and deterioration of bone tissue, leading to fragile bones and potential for fractures. Complications of osteoporosis include fractures, disability, and chronic pain. Approximately 44 million people in the United States are affected. Osteoporosis is especially common in postmenopausal women, but the disease also affects men. One out of every two women and one in four men over 50 will have an osteoporosis-related fracture in their lifetime.

Osteoporosis is more likely to develop if optimal bone mass was not reached during the bone-building years.

Why use Nutrition for Osteoporosis?

Bone development continues throughout adulthood for repair of fractures and for remodeling to meet changing lifestyles. Nutrition is one of many elements that influence bone strength. Good nutrition lays a firm foundation for a healthy body and strong bones. Dietary intake can also play a significant role in protecting the skeleton by maintaining healthy tissues to cushion the force of a fall.

Who Can Use Nutrition for Osteoporosis?

Both men and women can benefit from dietary changes, which emphasize the following nutrients necessary for bone health:

Calcium: An inadequate supply of calcium over a lifetime contributes to the development of osteoporosis. Calcium needs change over a lifetime. The demand for calcium is greater during childhood and adolescence, when the skeleton is growing rapidly, and during pregnancy and breastfeeding.
Good sources of calcium include:
- low-fat dairy products, such as milk, yogurt, cheese, and ice cream
- dark green, leafy vegetables, such as broccoli, collard greens, bok choy, and spinach
- sardines and salmon with bones
- tofu
- almonds
- foods fortified with calcium, such as orange juice, cereals, and breads

Vitamin D: Vitamin D plays an important role in calcium absorption and in bone health. Vitamin D comes from two sources: through direct exposure to sunlight and from the diet. Vitamin D can also be obtained from fortified milk, egg yolks, saltwater fish, and liver. Persons following a vegan diet may need supplements. Vitamin D deficiency may be a problem among some elderly. Studies suggest that supplementation with calcium or calcium plus vitamin D, can reduce fracture incidence by about 30 to 50 percent in subjects with low calcium intake.

Protein: It is known that high protein intake increases the calcium requirement. However, the association between protein and osteoporotic bone fractures in individuals has not been fully explored.

Vitamin C: Vitamin C is essential for collagen formation and normal bone development. Study results suggest a possible protective role of vitamin C for bone health in older men. No benefit for women’s bone health was found in the same study, but getting enough vitamin C is good for overall health.

Who should not use Nutrition for Osteoporosis?

In some cases, diet and lifestyle modification is not enough to prevent osteoporosis or bone fractures. Those with a strong family history of osteoporosis or previous fractures should consult a physician.

What are the Risk Factors for Osteoporosis?

Many individuals with osteoporosis have several risk factors, while others who develop the disease have no known risk factors. Some of the risk factors can be reduced; other factors cannot be changed.

Osteoporosis risk factors that cannot be changed:

Gender: Women are at greater risk.
Age: Bones become thinner and weaker with age.
Body size: Small, thin-boned women are at greater risk.
Ethnicity: Caucasian and Asian women are at highest risk. African American and Hispanic women are at a lower, but still significant, risk.
Family history: People whose parents have a history of fractures also seem to have reduced bone mass and may be at risk for fractures.

Osteoporosis risk factors that can be changed:

Calcium and vitamin D intake: A diet low in calcium and vitamin D can lead to bone loss.
Alcohol intake: Excessive consumption increases the risk of bone loss and fractures.
Medication use: Long-term use of glucocorticoids and some anticonvulsants can lead to loss of bone density and fractures.
Lifestyle: An inactive lifestyle or extended bed rest may weaken bones.
Cigarette smoking: Tobacco use has been linked to an increased risk of osteoporosis.

In addition to the above risk factors, the following are associated with osteoporosis in men:

Prolonged exposure to certain medications, such as steroids used to treat asthma or arthritis, anticonvulsants, certain cancer treatments and aluminum-containing antacids
Chronic disease that affects the kidneys, lungs, stomach, and intestines and alters hormone levels
Low levels of the sex hormone testosterone

Special Considerations

Some drugs can contribute to decreased bone density. If you are concerned about osteoporosis, discuss the use of these drugs with your physician:

Long-term use of glucocorticoids (medications prescribed for a wide range of diseases, including arthritis, asthma, Crohn's disease, lupus, and other diseases of the lungs, kidneys, and liver)
Long-term treatment with certain antiseizure drugs - such as phenytoin (Dilantin) and barbiturates
Some drugs used to treat endometriosis
Excessive use of aluminum-containing antacids
Certain cancer treatments
Excessive thyroid hormone

Do not stop or change your medication dose without a doctor’s advice.