Osteoporosis

The dietary treatment of osteoporosis aims to slow down or stop bones from becoming weaker. As we age we lose more calcium from our bones than is laid down and our bone density decreases. Although diet can’t reverse this process, by making a few simple changes to your diet, you can maximise the body’s ability to absorb and use calcium and limit the amount of calcium that is lost.

Calcium

An adequate intake of calcium every day is needed to maintain bone health. This can be achieved by consuming a moderate amount of dairy products, such as milk, all kinds of cheese, yoghurt, fromage frais, custard and milk puddings. Calcium-enriched soya milks also belong to this group. There is no official recommendation for the number of portions of dairy products that should be consumed each day, but a good rule of thumb is to include a source at each meal.

Do:
Choose low or reduced fat versions of dairy products. For example you could have semi-skimmed milk on your breakfast cereal, half fat cheddar in a sandwich or jacket potato and a low fat yoghurt as a pudding after a main meal.
Include plenty of other calcium-rich, non-dairy foods. Choose from fish with soft edible bones, eggs, shellfish, broccoli, soya products (tofu) and dried apricots.
Don’t:
X Rely solely on supplements and non-dairy sources of calcium. Calcium is best absorbed from dairy products. If you are taking calcium supplements, be aware that calcium absorption depends on the total amount of calcium consumed at one time and whether the calcium is taken with food or on an empty stomach. Absorption from supplements is best in doses of 500mg or less because the percent of calcium absorbed decreases as the amount of calcium in the supplement increases.

Vitamin D

Vitamin D is needed by the body for the absorption of calcium. The main source is via the action of sunlight on the skin.

Do:
Expose face, hands and forearms to at least 30 minutes of sunlight a day. You will still get enough exposure even on cloudy days.
Include dietary sources of vitamin D, such as oily fish, eggs, fortified margarines and breakfast cereals.
Don’t:
X Overdo it in the sun. Use a high sun protection factor when exposed for long periods and never allow your skin to burn.

Fruit, vegetables and other plant foods

A good intake of fruit and vegetables has found to be beneficial for people with osteoporosis. Studies have shown that a high intake can significantly reduce bone turnover.

Do:
Eat plenty of fruit and vegetables – aim for at least 5 portions a day.
Don’t:
X Rely on fruit and vegetables as a source of calcium. Phytic acid and oxalic acid, which are found naturally in some plants, binds to calcium and prevents it from being absorbed. These substances affect the absorption of calcium from the plant itself not the calcium found in other calcium-containing foods eaten at the same time. Examples of foods high in oxalic acid are spinach, sweet potatoes, rhubarb, and beans. Foods high in phytic acid include wholegrains, beans, seeds and nuts.
X Add bran to foods, its high phytate content can prevent calcium absorption from other foods.

Salt

High intakes of sodium or salt reduce calcium absorption.

Do:
Avoid adding salt at the table or during cooking. Use alternative flavours in cooking such as herbs, spices, chilli, garlic or lemon juice.
Check the labels of packaged foods to compare products and look for the green or amber traffic lights.
Don’t:
X Eat too many salty, smoked, cured or processed foods. Avoid foods that contain more than 1.5g of salt (0.6g sodium) per 100g.
X Eat more than 6g of salt a day.

Caffeine, alcohol and fizzy drinks

Excessive alcohol consumption reduces the absorption of calcium and it can stop the body from making vitamin D, which in turn reduces calcium absorption. Excess caffeine consumption and drinking large amounts of fizzy drinks also reduce calcium absorption.

Do:
Drink sensibly if you drink alcohol and keep within recommended guidelines.
Spread caffeine-containing drinks throughout the day, or try decaffeinated coffee and herbal teas instead.
Drink plenty of water.
Don’t:
X Binge drink alcohol.
X Drink too many high strength caffeine fizzy drinks.