Question: Does osteoporosis affect only older adults?
Answer: Osteoporosis affects mainly older adults, but it can strike at any age. What's more, the silent bone loss that may lead to osteoporosis can happen well before you hit your fifties.
It's especially important to take dietary action if you're at risk for the disease - if you're very thin, you've ever fractured a bone, you've gone through menopause at a relatively young age (in your late 30's or early 40's), you smoke, or you've been told you have low bone density. If you are at high risk for osteoporosis, you should have a bone mineral density test to find out whether or not you have osteoporosis and how likely you are to develop it in the future. Whether or not you're at high risk for osteoporosis, it's important to take steps to build and maintain strong bones. The good news: it's never too late -- or too early -- to make dietary and lifestyle changes to guard against osteoporosis.
Question: How much calcium do we need to prevent osteoporosis?
Answer: If your diet lacks calcium, the mineral will be moved from your bones into your bloodstream where it's needed to conduct nerve impulses, contract muscles, assist in blood clotting, and secrete hormones.
Children aged one to three years need 500 mg, kids aged four to eight need 800 mg and teenagers require 1,300 mg of calcium per day. Adults, aged 19 to 50, require 1,000 mg, while older adults need 1,500 mgeach day.
Get enough calcium. Here are some required intakes:
- Children, 1-3 years 500 mg
- Children, 4-8 years 800 mg
- Preteens and teens 1300 mg
- Adults, 19-50 years 1000 mg
- Adults, 50+ 1500 mg
Question: Can you get all that calcium from food alone?
Answer: In food terms, 1,000 mg of calcium translates into three cups of milk, yogurt or fortified soy milk. If you need 1,500 mg that means you need 5 cups of dairy or fortified soy beverage. One cup (250 ml) of milk or fortified soy beverage, � cup (175 ml) plain yogurt or 1.5 ounces (45 grams) of cheese delivers roughly 300 mg of calcium. Almonds, leafy green vegetables, canned salmon (with bones) and tofu also supply calcium.
Most people don't get what they need from diet and have to rely on supplements to make up the difference. If you need to take more than one calcium pill, divide your dose over the course of the day.
Question: What about vitamin D?
Answer: This nutrient maintains calcium balance in the bloodstream by enhancing calcium absorption from the foods you eat. Recent studies indicate that Canadians of all ages -- even children -- have insufficient levels of vitamin D thanks to our long winters and lack of sun exposure.
Osteoporosis Canada recommends adults aged 19-50 get 400 IU (international units) of vitamin D each day and adults over 50 consume 800 IU. (The Canadian Cancer Society advises adults consider talking 1000 IU of the nutrient in fall and winter to help reduce cancer risk.)
Foods fortified with vitamin D include fluid milk and soy and rice beverages (100 IU per 250 ml). Vitamin D is naturally present in oily fish, liver, egg yolks and butter. A 3.5 ounce (100 gram) serving of salmon has 360 IU of vitamin D; the same portion of sardines has 270 IU.
To get enough vitamin D, you'll need to reach for supplements. Add up what you're getting your multivitamin and calcium pills and then make up the difference with a separate vitamin D pill (e.g. 400, 800, or 1000 IU).
Question: What other foods should we be eating more of?
Answer: Magnesium. The fact that one-half of the body's magnesium is stored in our skeleton underscores its importance in bone health. In a recent study, older men and women who consumed more magnesium had significantly higher bone densities than those whose diets contained the least. A lack of magnesium is thought to impair the production of hormones involved in calcium balance.
The daily recommended intake for magnesium is 320 mg for women and 420 mg for men -- an amount that many people don't get from their diet. The best food sources include wheat germ, whole grain breads and cereals, almonds, sunflower seeds, black beans, soybeans, tofu, and figs.
Vitamin K. Best known for its ability to help the blood clot, Vitamin K also stimulates the production of osteoclacin, a protein that strengthens bone. Research suggests that an intake of 150 to 250 micrograms per day guards against hip fracture in women.
The recommended daily intake for vitamin K is 90 and 120 micrograms, for women and men respectively. (Scientists suspect it takes about 200 micrograms per day to protect the bones.) The best food sources include leafy green vegetables (kale, Swiss chard, spinach, Romaine lettuce), cabbage, and milk. Some multivitamins contain up to 120 micrograms per daily dose.
Question: What should we be eating less of to protect our bones?
Answer: It's not just what you eat that keeps your bones strong as you age. What you don't eat can also play a role in osteoporosis prevention.
Caffeine. Caffeine's bone depleting effects are likely most detrimental for people who don't get enough calcium. Limit your daily intake to no more than 400 mg of caffeine - about three small cups (8 ounces each) of brewed coffee or 9 cups of tea.
Sodium. Like caffeine, sodium also causes your kidneys to excrete calcium. Limit your daily intake to no more than 2300 mg. Eating potassium-rich foods such as fruits and vegetable can help offset the calcium-depleting effect of sodium.
Alcohol. Consuming alcohol acts directly on your bones and suppresses bone formation. Consuming alcohol also increases the risk of falls in post-menopausal women and is associated with an increased incidence of hip fractures
Vitamin A. While we need some vitamin A for bone health, too much may actually increase the risk of hip fracture. Studies show that consuming more than 5000 IU of retinol, the form of vitamin A in animal foods, fortified foods and supplements, increases the risk of hip fracture. Unless you eat liver regularly - or drink more than 5 cups of milk each day - it's unlikely you'll get too much vitamin A from foods. The concern rests with supplements. Make sure your multivitamin contains no more than 2500 IU of vitamin A (retinol). Beta-carotene (pro-vitamin A) is not thought to increase the risk of fracture.
