Foods to fight osteoporosis

Foods to fight osteoporosis

Dietitian Sarah Ley has help for all of us on 

 osteoporosis, which affects half of women over 60.

Osteoporosis is a disease in which the bones deteriorate and become thin and brittle. This can be caused by poor bone development, poor maintenance of bone quality throughout life, or both.

It is a progressive disease, but often it’s not noticed until a major problem occurs in older people. This might be a hip or wrist fracture or weakness in the spine, pelvis or upper arm.

Osteoporosis is a major health issue in New Zealand as it affects more than half of women and nearly a third of men over the age of 60. It’s not just an older person’s problem though; bone loss can start in women from their mid-twenties.

Who does it affect – and what causes it?

Middle-aged or older people are at higher risk of osteoporosis although it can affect younger people too.

Certain medications taken long-term, such as corticosteroids, can reduce bone density. It is detected by a simple bone density scan of the areas most susceptible to fracture (hip and lumbar spine), which is compared to the average for a young woman or man who has achieved peak bone mass.

Bone mineral density progressively reduces with age; the denser our bones are the less risk of fractures we have.

If you’re worried about osteoporosis or have been diagnosed with the disease, discuss your results and your risk factors with your GP who can, if necessary, prescribe medications or supplements to slow bone loss. It’s important to remember that calcium in food is better absorbed than calcium taken in supplements.

Signs of osteoporosis

There are usually no recognisable outward symptoms of osteoporosis until the disease is well established. This is why it’s often called ‘the silent epidemic’.

The major risk factors for osteoporosis are:

• A diet lacking in calcium
• Lack of regular exposure to sunlight for vitamin D
• Poor intestinal absorption of dietary calcium
• Unnatural thinning of bones from medications
• Lack of regular, weight-bearing exercise, eg walking
• Smoking and excessive alcohol consumption
• Family history of osteoporosis

What do we need to eat for prevention?

Eating enough calcium-rich foods is vitally important for everyone. Almost all our body calcium is stored in our bones and teeth, where it helps to provide rigidity.

It is also important to get enough vitamin D as this helps our bodies absorb and use calcium. Here in New Zealand we get almost all of our vitamin D from exposure to sunlight. We also get a little vitamin D from oily foods.

If we eat a healthy, well-balanced diet we should get the protein and other nutrients essential for bone health.

How much calcium do we need?

Recommended dietary intakes (RDIs) of calcium are dependent on our age, growth patterns and likely requirements for keeping bones healthy. Here are the examples (Nutrient Reference Values for Australia and New Zealand 2006). Note that Adequate Intakes (AIs) are used where there is not enough information to determine a RDI.

Life stage	Age	Calcium recommendation
Infants	0-6 months 7-12 months	210mg (AI) 270mg (AI)
Children	1-3 years 4-8 years	500mg 700mg
Older children and teenagers	9-11 years 12-13 years 14-18 years	1000mg 1300mg 1300mg
Adults	Men and women 19-50 years	1,000mg
	Men 51-70 years	1000mg
	Women over 50	1300mg
	Men over 70	1300mg

Different life stages

Babies and children

Calcium for babies is supplied by breast milk or formula. Once babies reach 8-9 months old, some of their calcium needs can be supplied by other foods such as yoghurt, cheese or smooth peanut butter. Rapidly growing bones need good supplies of calcium every day. After 1 year, plain milk drinks or flavoured milks, custard, ice cream, flavoured milk jelly, yoghurt and cheese make good choices.

Teenagers

As teenagers experience growth spurts, calcium-rich foods as part of a healthy diet are vital for supplying the material for growing good strong bones. Young girls dieting to lose weight are at particular risk of having insufficient calcium intake if they choose low-calorie soft drinks in place of milk-based drinks. Easy ways to have calcium-rich snacks are in smoothies, low-fat ice cream, yoghurt, milk desserts, cereal and milk or cheese on toast.

Pregnancy and childbearing

Recommendations for calcium intake don’t change but pregnancy and breastfeeding do make extra demands on a woman’s body. The 1,000-1,300mg should be sufficient to meet those demands if mothers make sure they meet their recommended intakes daily. Ready-made liquid breakfasts, milk-based drinks, cheese and crackers and porridge made in the microwave with milk and added skim milk powder are just a few easy, fast ideas for busy mums.

Older age

Recent evidence suggests women need more calcium to reduce bone loss through the menopause and both older women and men also need more than was previously thought necessary. As a result, recommendations have increased for women from middle age and for men from 70 years old. Popular choices for older people are milk puddings (bread and butter pudding, rice pudding, creamed tapioca, custard), hot milk and Milo for supper, ice cream and custard for dessert, salmon or sardine sandwiches and cheese sauce with vegetables.

Where we get calcium in food

Dairy products or alternatives such as soy are our main source of calcium.

Tinned fish with bones, shellfish, nuts, dried beans, whole grains, eggs and some vegetables and fruit (particularly rhubarb, figs, broccoli, spinach and silver beet) also contribute worthwhile amounts of calcium to our diet.

Another way to increase calcium is to regularly add skim milk powder to foods such as mashed vegetables or in baking, puddings and soups.

How to get your daily calcium

Two to three serves of low-fat dairy products or replacement products such as soy, included as part of a balanced diet, can supply your daily calcium needs.

Here are some examples:

• Breakfast: 200ml calcium-fortified milk with a calcium-fortified breakfast cereal = 600mg
• Lunch: salmon and cheese sandwiches using whole grain bread = 450mg
• Supper: 200ml soy milk with Milo powder = 325mg
• For a tasty way to get your calcium, make this delicious Berry Smoothie.

Preserving bone health

There are things we can do in our daily lives to help preserve our bone health. These are:

• Eat a healthy, balanced diet that includes good sources of calcium and choose low-fat dairy products or soy products.
• Limit consumption of coffee, caffeinated beverages, salty snacks and alcohol as these cause more calcium to be taken from the bones and lost in urine.
• Stop smoking as nicotine increases your body’s requirements for calcium and other nutrients. It also changes hormone levels that regulate bone remodelling.
• Exercise regularly and in particular choose weight-bearing exercise for at least 30 minutes on most days of the week. Walking is the easiest for most people. Other good forms of weight-bearing exercise are lifting weights, running, dancing, golf, tennis, low-impact aerobics and rowing.
• Spend a little time outside (15-30 minutes) in the open air most days to get regular supplies of vitamin D from sunlight. Exposure to ultraviolet light on hands and face, even on cloudy days, is usually all you need.
• Eat a healthy, balanced diet to provide other important nutrients; protein, magnesium and zinc for bone health.

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