Steps for strong bones: 3. Diet, supplements, and more
The foods we eat contain a variety of vitamins, minerals, and other important nutrients that help keep our bodies healthy. A balanced diet contains multiple nutrients which may help prevent bone loss, including calcium, magnesium, vitamin K, vitamin A, and isoflavones. The two nutrients we will focus the most on are calcium and vitamin D.
Calcium
Calcium is often thought of as being good for your bones, which it is. However, taking calcium does not necessarily make your bones stronger. Calcium is actually a needed nutrient for multiple organs in our bodies, including our heart, nervous system, and muscles. All of these organs get calcium from circulating calcium in our blood stream. It is such an important nutrient that our bodies have a very efficient way to ensure that our blood calcium levels stay normal, regardless of how much calcium we consume. If we do not get the calcium that our bodies need to maintain these body functions, our bodies “steal” calcium from our bones, and this can lead to osteoporosis if this occurs over a long period of time. Many published studies show that low calcium intake throughout life is associated with low bone mass and high fracture rates. National nutrition surveys have shown that most people are not getting the calcium they need to grow and maintain healthy bones. The purpose making sure that calcium intake is adequate is to ensure that your body does not have to take calcium out of your bones.
If you take an excess of calcium, the extra calcium is not stored away or mineralized in your bones. Kidneys filter out any excess calcium and dump it in your urine. This calcium can collect in your kidneys and form kidney stones. For this reason, calcium supplementation, especially when in excess, is associated with a higher risk of kidney stones.
Adequate calcium intake is all about getting just the right amount from all sources.
Recommended daily Calcium needed:
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Women 51 and older, and men 71 and older need 1200 mg of calcium per day from all sources (including diet and supplements)
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Adult women 50 and younger and men 70 and younger need 1000 mg of calcium per day from all sources (including diet and supplements)
Again, the amounts listed above are dietary calcium and supplemental calcium combined. Dietary calcium is likely best, as it is absorbed best. Supplements are meant to supplement what your diet does not provide. Very few people need to depend solely on supplements for their total calcium intake. However, when diet does not provide adequate calcium, supplements are needed.
Calcium SUpplementation
If you have trouble getting enough calcium in your diet, you may need to take a calcium supplement. The amount of calcium you will need from a supplement depends on how much calcium you obtain from food sources. There are several different calcium compounds from which to choose, such as calcium carbonate and calcium citrate, among others. Calcium citrate is generally recommended. It is best to get as much of the required calcium from your diet rather than from supplements. Calcium is absorbed in amounts of 500-600 mg at a time, so divide doses if you rely solely on calcium supplementation. Keep in mind that the recommended calcium intake amount includes what you get in your diet and in supplements combined.
Calcium Rich Foods
There are several calcium rich foods, even some that are not dairy. I would recommend checking out the calcium rich food guide from the National Osteoporosis Foundation:
https://www.nof.org/patients/treatment/calciumvitamin-d/a-guide-to-calcium-rich-foods/
Vitamim D
The body needs vitamin D to absorb and utilize calcium. Without enough vitamin D, you can’t absorb enough calcium from your diet. In this situation, the body must take calcium from its stores in the skeleton, which weakens existing bone and prevents the formation of strong, new bone. Even if you live in area with many sunny days, our skin's ability to use sunlight to produce vitamin D decreases as we age. In addition, although sunscreen should be used by everyone, it does block the vitamin D producing benefits. Also, nobody should be relying on the sun for vitamin D, as you should be wearing sunscreen and protecting yourself from prolonged sun exposure to prevent skin cancer. Vitamin D3 is the recommended form of vitamin D supplementation for most people.
Importance of Protein
Adequate protein intake helps minimize bone loss in patients who have suffered a hip fracture. In addition, other studies have shown that elderly people with a hip fracture who do not have enough protein in their diets are more likely to experience loss of independence, institutionalization, and even death after their fracture. People who get adequate amounts of protein are less likely to lose muscle mass as they age. The recommended daily intake for protein is 0.36 grams of protein per pound of weight, which is 56 grams for the average sedentary man and 46 grams for the average sedentary woman.
Moderation of Caffeine
Caffeine can keep you from absorbing calcium in your gastrointestinal tract and can cause calcium wasting from the kidneys. It is recommended that you have no more than 2 servings of caffeine per day (serving = 150 mg if caffeine, or 12 oz of coffee).
Limiting Alcohol
Alcohol can also inhibit calcium absorption and can cause calcium wasting in your kidneys. It can also make you more likely to fall. Keep alcohol intake in moderation, which is no more than 2 servings of alcohol per day for bone health.
Smoking Cessation
Smoking and chewing tobacco are bad for our health. Tobacco significantly affects your bone density and your bone quality. Tobacco cessation is a critical step for maintaining your bone health and decreasing your chances of a fracture. If you smoke, talk to your provider about strategies to help you stop using tobacco.
There are many resources to help you stop smoking. This website is a great place to start if you are interested in smoking cessation: