As we age, maintaining healthy bones becomes a vital necessity. Osteoporosis, a condition characterized by low bone mass and the breakdown of bone tissue, affects millions worldwide. When you have osteoporosis, your bones become weaker, increasing the risk of fractures. Fortunately, there are ways to improve bone mineral density and reduce fracture risk, including dietary changes. This article provides a comprehensive guide to osteoporosis diet recipes, offering insights into essential nutrients, meal plans, and lifestyle strategies to protect and preserve bone health.
Understanding Osteoporosis and the Importance of Diet
Osteoporosis is a condition in which the density and mass of the bones decrease, making them weaker and more prone to fractures. It's often called a "silent disease" because bone loss can occur without symptoms until a fracture happens. While more common in women and elderly people, it can affect anyone. A 2021 review reported that the worldwide prevalence of osteoporosis in women was 23.1%, while the prevalence of osteoporosis among men was found to be 11.7%. Additional risk factors include being smaller or thinner than average, smoking, excessive drinking, and having a family history of osteoporosis.
Because osteoporosis weakens the bones, those with osteoporosis are more at risk for fractures, including fractures of the vertebra, wrist, and hip. Healthy, strong bones are essential to long-term health and vitality. When an older adult has a hip, spine, or other fracture, it can signal the beginning of a serious decline and reduction in quality of life. Eating calcium and vitamin D-rich foods may help reduce the incidence of or slow the progression of osteoporosis. Calcium hardens and strengthens bones, while Vitamin D regulates the amount of calcium the body absorbs.
Key Nutrients for Bone Health
Not getting enough of certain vital nutrients could put you at risk for low bone mineral density and osteoporosis. A balanced, healthy diet for osteoporosis includes calcium-rich foods like low-fat dairy, leafy greens, and fortified alternatives. Vitamin D is just as critical, as it helps the body absorb calcium efficiently. Protein supports muscle mass, which in turn protects bones.
Here are the key nutrients to focus on:
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Calcium
Your body requires calcium to maintain healthy bones, which are constantly being remodeled. Calcium is needed to form new bone tissue. For this reason, it’s important to get recommended amounts of calcium in your diet when you’re living with osteoporosis. The recommended dietary allowance (RDA) for calcium is:
- Females 19 to 50 years of age: 1,000 milligrams (mg)
- Females 51 and older: 1,200 mg
- Males 19 to 70 years: 1,000 mg
- Males older than 71: 1,200 mg
Even though calcium is essential for bone health, it’s recommended to get your calcium through foods whenever possible. This is because some studies have linked high-dose calcium supplements to an increased risk of heart disease. While some people may require calcium supplements to treat osteoporosis, others may be able to get enough calcium through foods like yogurt, cheese, dark leafy greens, beans, nuts, and seeds. Animal-based calcium foods include dairy products and sardines, whereas plant-based options are fortified milk alternatives and juices, tofu, and legumes.
Vitamin D
Without enough vitamin D, your body can’t absorb calcium properly. Because of this, it’s critical to maintain optimal vitamin D levels. Unfortunately, vitamin D insufficiency and deficiency are extremely common. In fact, about 50% of the world’s population has insufficient vitamin D levels. Having low vitamin D levels can increase your risk of low bone mineral density and osteoporosis. For those with low or deficient vitamin D levels, supplementation may be necessary. This is because vitamin D is only concentrated in a few food sources, like fatty fish. The RDA for vitamin D is:
- Males and females 19 to 70 years: 15 micrograms (mcg) or 600 International Unites (IU)
- Males and females 71 and older: 20 mcg (800 IU)
Your skin normally makes vitamin D from sunlight. People with darker skin or who live in cities with intense air pollution absorb less vitamin D from sun, and may want to bump up their vitamin D, too. Salmon, sardines, egg yolks, and fortified breakfast cereals provide Vitamin D.
Protein
Protein makes up about 50% of your bone volume and ⅓ of your bone mass, so taking in optimal amounts of protein on a daily basis is incredibly important for bone health. Studies show that suboptimal protein intake increases the risk for low bone mineral density and that older adults following higher protein diets tend to have higher bone mineral density and lower fracture risk. Because of this, some osteoporosis experts recommend a protein intake between 1.0-1.2 grams per kg (.45-.54 grams per pound) per day, which is much higher than the current Recommended Dietary Allowance (RDA) of .8 grams per kg of body weight (0.36 grams per pound).
Read also: The Hoxsey Diet
Other Essential Nutrients
In addition to protein, calcium, and vitamin D, there are a number of nutrients needed to maintain healthy bones, which may play a role in reducing the risk of developing low bone mineral density and osteoporosis. You may need to supplement with some of the following nutrients if your diet doesn’t provide adequate amounts:
- Magnesium: Your body needs magnesium to maintain bone health, and not getting enough in your diet could increase your risk of developing osteoporosis. Studies show that magnesium supplements help increase bone mineral density and decrease fracture risk in older women. Avocados, legumes, pumpkin seeds, and chia seeds all contain magnesium.
- Vitamin K: Vitamin K is necessary for the function of proteins involved in bone formation and maintenance. Low dietary vitamin K intake is associated with higher fracture risk. Leafy greens like kale, spinach, and collard greens are rich in vitamin K and magnesium.
- Vitamin C: Vitamin C is an important antioxidant and may help prevent bone breakdown. Having low levels of vitamin C is linked to reduced bone mineral density, so consuming vitamin C-rich foods is important for those with osteoporosis. Foods rich in vitamin C include citrus fruits, berries, peppers, and broccoli.
- Zinc: Zinc is needed for proper bone growth and maintenance and also promotes bone regeneration. Low levels of zinc have been associated with post-menopausal osteoporosis. Sources of zinc include seafood, nuts, poultry, and lentils.
The minerals potassium, boron, silicon, selenium, iron, and manganese are also needed for bone health. Additionally, some research suggests that supplementing with omega-3s and collagen could be helpful for people with low bone mineral density and osteoporosis.
Foods to Incorporate into Your Diet
Grocery shelves are bursting with calcium-rich foods. The amount of calcium can vary wildly from one brand to another, so read food labels closely and compare different brands. Here are some foods to consider incorporating into your diet:
Breakfast Foods
Breakfast may be the best time to give your bone health a lift. Most of the foods and beverages now fortified with calcium are start-your-day kinds of tastes like orange juice, milk, and cereal. Some cereals, for instance, can give you half of the calcium you need all day. Have a cup of fortified cereal with milk and a glass of calcium-fortified orange juice, and you may satisfy your calcium needs before lunch.
Here are some calcium-rich breakfast food options:
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- Cereal, calcium-fortified: 100 - 1000 mg calcium per cup
- Soy milk, calcium-fortified: 80 - 500 mg calcium per 8 ounces
- Milk (nonfat, 2%, whole, or lactose-reduced): 300 mg calcium per cup
- Yogurt: 300 - 400 mg calcium per cup
- Orange juice, calcium-fortified: 200 - 340 mg calcium
Even if you're lactose-intolerant and don't digest milk well, you can find plenty of dairy products these days that are lactose-reduced or lactose-free. Just check the labels on milk, cheese, and yogurt, and try the health-food store if larger supermarkets don't carry enough choices.
Lunch, Dinner, and Snack Foods
If cereal's not your thing -- or you'd rather spread your calcium across the day for better absorption -- try adding a few calcium-rich foods to your dinner or lunch. Make an omelet with a bit of cheddar cheese, sautéed greens, and salmon. Or whip up a scrambled-egg stir-fry by adding Swiss cheese, broccoli, and sardines to your eggs, and you've got a lunch for strong bones. If you like soups and stews, try adding salmon, kale, or turnip greens to your other favorite recipes. Just as your bones store calcium, fish bones do, too. Those tiny bones in canned fish like sardines and salmon hold high levels of calcium, so be sure to eat those, too.
Here are some calcium-rich lunch, dinner, and snack food options:
- Canned sardines: 320 mg calcium per 3 ounces
- Swiss cheese: 270 mg calcium per 1 ounce
- Cheddar cheese: 200 mg calcium per 1 ounce
- Canned salmon: 200 mg calcium per 3 ounces
- Turnip greens: 200 mg calcium per 1 cup
- Kale cooked: 90 mg calcium per 1 cup
- Broccoli, raw: 90 mg calcium per 1 cup
Deciphering Food Labels
Try this trick to help you decipher the food labels and "Nutrition Facts" you now see on packaged foods. The calcium amounts you'll see listed are percentages, based on the standard of 1,000 milligrams of calcium a day. So to figure out how much calcium you're actually getting in each serving, it's easy. Just add a zero to the percentage of calcium you see on the label to convert it to actual milligrams (mg). So, for example, if a cereal box says "Calcium: 50%," then that cereal has 500 milligrams of calcium in each serving.
Dietary Patterns for Bone Health
Research suggests that while certain diets may increase the risk of osteoporosis, other dietary patterns could help protect against osteoporosis development and improve bone mineral density and overall health in people living with osteoporosis.
The Mediterranean Diet
The Mediterranean diet is a way of eating that’s rich in whole foods like vegetables, fruits, beans, nuts, and fish. Studies show that a Mediterranean-style diet could help protect against fracture and osteoporosis risk and help maintain healthy bone and muscle mass. The Mediterranean diet is high in bone-protective compounds like polyphenol antioxidants as well as bone-supportive nutrients like magnesium and calcium.
High-Protein Diets
Maintaining sufficient protein could also be helpful for people living with osteoporosis and those who want to support overall bone health. For example, a 2021 study in 2,160 older adults found that those with the highest dietary protein intake had up to 6% higher bone mineral density in their hips and lower spine compared to older adults with low protein intake. Plus, the older adults who ate the most protein had a reduced risk of vertebral fractures compared to the low protein group.
Other dietary patterns, including well-planned Asian or all-vegetarian diets, may be effective in helping to prevent osteoporosis or fractures.
Foods to Limit or Avoid
Diets high in ultra-processed foods, added sugar, and excessive salt could harm bone health and increase the risk of bone diseases like osteoporosis. The Western diet is a dietary pattern characterized by high intakes of ultra-processed foods, sweetened beverages, fried foods, processed meats, and refined grains. This way of eating is linked to lower bone mineral density and a higher risk of osteoporosis and fractures. The high fat and sodium content of the Western diet can reduce calcium absorption and increase bone loss. What’s more, the Western diet causes an acidic environment in the body, which may cause bone breakdown. A high intake of added sugar from sugary foods and beverages like ice cream and soda can also contribute to osteoporosis by increasing calcium loss through the urine and interfering with calcium homeostasis. Consuming sugary soda is especially harmful to bone health because soda is high in sugar and phosphoric acid additives, which can inhibit bone mineralization.
Although some study findings suggest caffeine consumption may be harmful to bone health, not all studies have found a negative association. Therefore, more research is needed.
Sample 5-Day Meal Plan for Osteoporosis
Here is a 5-day healthy eating plan for people with osteoporosis. This menu is high in protein and nutrient-rich foods like vegetables, beans, and seeds, which help promote bone health. Keep in mind that this meal plan only covers basic meals and doesn’t list serving sizes. This is because your calorie needs depend on your activity level, body size, gender, age, and more. If you’re unsure of how many calories you should be consuming, consider making an appointment with a registered dietitian. They can help you develop an eating plan that’s specific to your health needs and weight goals.
Day 1
- Breakfast: Whole eggs scrambled with spinach and zucchini served with sliced avocado and a cup of mixed berries
- Lunch: A Mediterranean quinoa bowl made with chickpeas, roasted red peppers, feta, cucumbers, olives, tomatoes, artichokes, and red onions
- Dinner: Roasted salmon served with mashed sweet potatoes and garlicky broccoli
Day 2
- Breakfast: A parfait made with full-fat unsweetened Greek yogurt, diced apples, pumpkin seeds, and unsweetened almond butter sprinkled with cinnamon
- Lunch: Lentil soup served with a large green salad topped with an olive oil and lemon juice-based vinaigrette
- Dinner: Turkey burgers served with a Greek salad made with cucumber, feta, cherry tomatoes, and red onion and roasted herbed potato wedges
Day 3
- Breakfast: Cottage cheese topped with almond butter, chia seeds, and blueberries
- Lunch: Veggie and grilled shrimp kabobs served over quinoa
- Dinner: Burrito bowl made with chicken, sautéed vegetables, salsa, guacamole, shredded cheese, black beans, and brown rice
Day 4
- Breakfast: A smoothie made with unsweetened milk of choice, frozen berries, ground flax, unsweetened peanut butter, and unsweetened vanilla protein powder
- Lunch: A large salad made with mixed greens, sunflower seeds, goat cheese, chopped vegetables of your choice, and grilled chicken or grilled shrimp served with whole grain crackers and hummus
- Dinner: Sweet potato and lentil coconut curry served over brown rice
Day 5
- Breakfast: Roasted vegetable buddha bowl topped with jammy eggs
- Lunch: Creamy sesame brown rice noodles topped with chopped peanuts and fresh herbs
- Dinner: Chicken chili topped with a dollop of Greek yogurt and sliced avocado plus a green salad
The Importance of Vitamin D
The experts all agree: Don't forget your vitamin D. You need it to absorb the calcium from all those calcium-rich foods. Your skin normally makes vitamin D from sunlight. And he advises even higher doses -- up to 1,200 IU of vitamin D a day -- if you have bone thinning and live in a climate without much sun. People with darker skin or who live in cities with intense air pollution absorb less vitamin D from sun, and may want to bump up their vitamin D, too. Calcium-rich foods are often high in vitamin D. Sardines, herring, and salmon have high levels of vitamin D, and many calcium-enriched foods have vitamin D added. And it's an easy vitamin to supplement. "Vitamin D is a little bit easier to absorb, so you can usually get away with taking supplements once a day," says Mystkowski.
Additional Tips for Bone Health
- Weight-bearing Exercise: Calcium also amplifies the benefits of weight-bearing exercise in building strong bones. Combine resistance training and weight-bearing exercises to quickly increase bone density with a calcium- and vitamin D-rich diet.
- Lifestyle Changes: Lifestyle changes such as quitting smoking, limiting alcohol, and getting regular sunlight also support bone health.
- Consultation with Healthcare Professionals: A healthcare provider like your doctor who manages your osteoporosis can perform testing to identify potential insufficiencies and deficiencies in certain nutrients and can recommend appropriate treatment if needed. A dietitian can also recommend helpful supplements and dietary patterns to support your health and improve your bone mineral density.
Recipes for Bone Health
Here are some recipes that can be incorporated into an osteoporosis-friendly diet:
- Tandoori Trout: Oily fish such as trout is a great source of vitamin D.
- Gingery Broccoli-Fry with Cashews: A healthy veggie dinner with antioxidant-rich broccoli.
- Halloumi Pasta: Add the punchy flavors of halloumi to pasta along with olives, courgette, and tomato.
- Pasta Arrabbiata with Aubergine: A healthy pasta supper that's low in fat and calories but packed with flavor, calcium, and fiber.
- Cinnamon Porridge with Baked Bananas: Add fiber-rich bananas and live yogurt to your breakfast porridge.
- Healthy Porridge Bowl: Start your day right with this filling bowl of oats, berries, banana, and seeds.
- Chickpea, Coconut & Broccoli Stew: Serve this light yet comforting stew for a low-fat plant-based dinner.
- Peanut Butter & Date Oat Pots: Try these make-ahead overnight oats for a healthy start to your day.
- Roasted Carrot, Rocket & Lentil Salad: A vibrant and substantial salad that's rich in calcium and fiber.
- Tofu Scramble: Try vegan spiced tofu with cherry tomatoes for an egg-free take on scramble on toast.
- Parmesan Pork with Tomato & Olive Spaghetti: A healthy, balanced dinner that is packed with lean protein, fiber, calcium, vitamin C, and iron.
- Caponata Bake: This healthy, comforting veggie bake is topped with cheesy potato slices.
- Curried Tofu Wraps: This spicy, easy-to-make vegan supper is big on taste and nutrition, offering calcium, iron, and vitamin C.
- Kidney Bean Curry: A rescue recipe for when there's nothing in the fridge or when you fancy something cheap.
- Chilli Paneer: Enjoy this flavor-packed chili paneer with rice and your favorite vegetarian sides.
- Sardine Pasta with Crunchy Parsley Crumbs: An affordable way to include oily fish in your diet.
- Indian Chickpeas with Poached Eggs: This quick, fiber-rich veggie supper is filling and good for you too.
- Sardine Tomato Pasta with Gremolata: Enjoy this crowd-pleasing pasta with sardines and gremolata.
- Breakfast Egg Wraps: Enjoy these protein-rich egg wraps filled with mushrooms and tomatoes.
- Herby Broccoli & Pea Soup: This vibrant broccoli and pea soup delivers three of your 5-a-day.
- Overnight Oats: Adapt this recipe for easy overnight oats to suit your tastes.
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