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Eating Right When You Have Osteoporosis

by Deborah McInerney, MS, RD, CDN

So you have osteoporosis. You’re not alone. Today in the United States there are an estimated 10 million people with osteoporosis and another 34 million who are at risk for it. Osteoporosis, which disproportionately affects women and people over 50, weakens bones and increases the risk that they will fracture. Treatment for osteoporosis usually focuses on medicines and vitamin and mineral supplementation. Often overlooked is nutrition, even though what you eat affects both your bones and the soft tissues that protect and cushion them.

This article will look at the nutrient needs of people who have osteoporosis — or want to prevent it — and at how they can meet these needs. Please keep in mind that your specific needs might vary, depending on your overall state of health.

A healthy diet

What does “a healthy diet” mean exactly? Practicing good nutrition and “eating right” can be very confusing, especially when you hear conflicting advice from family and friends, news sources, and even health-care professionals. Throw in the fact that you may have medical conditions, such as high cholesterol or high blood pressure, and it’s no wonder you’re not quite sure where to start — or whether you’re even headed in the right direction.

One of the problems is that the word “diet” has taken on an entirely new meaning, often referring exclusively to a weight-loss plan. But “diet” simply refers to what you eat every day, so don’t be put off by the word. A good guide to diet is the food guide pyramid called ChooseMyPlate, from the U.S. Department of Agriculture (USDA). MyPlate breaks down food into groups and gives daily recommendations for each group. (See "Your Daily Diet" for more on the recommendations.)

The recommendations might seem overwhelming, but they are simply meant as a reference to help you better understand your current diet and portions. Notice that there is no food group labeled “sweets”? That’s because candy, cookies, baked goods, and ice cream should play a limited role in your diet. These foods contain “empty” calories that lack nutritive value.

To make sure you are eating a complete diet, try keeping a food journal for a few days, writing down everything you eat and drink. Keeping a journal and consulting the food guide pyramid can help you determine whether you’re getting enough of all types of nutrients in your daily diet.

Calcium and vitamin D

Calcium and vitamin D are very important nutrients. Calcium is a major part of bone, and vitamin D helps the body absorb calcium. The recommended daily intake of calcium and vitamin D varies depending on your age, gender, and medical condition. You will find basic calcium and vitamin D recommendations by age group in "Calcium and Vitamin D."

Calcium up close. Food is the best source of calcium for the body, and dairy foods are at the top of the high-calcium list. Dairy foods naturally rich in calcium include milk, cheese, and yogurt. If you drink milk and eat yogurt and cheese every day, you may be getting just enough calcium from food. One thing to remember is that all types of milk (skim, 1%, 2%, and whole) have the same amount of calcium; they vary only in calorie and fat content. For a better idea of the calcium content of common dairy products, consider that 1 cup of yogurt or milk has 300 milligrams (mg) of calcium, 1 ounce of cheese has 200 mg, and 1/2 cup of milk pudding or frozen yogurt has 100 mg. If you eat cottage cheese, you should know that although it is a dairy product, it contains very little calcium naturally, so make sure you choose a brand that has calcium added.

Some people are lactose intolerant, meaning they are unable to fully digest the milk sugar (lactose) found in dairy products. Luckily, there are many alternatives to choose from: lactose-free milk, lactose-reduced milk, and soy or rice milk. Just make sure the soy or rice milk is calcium-fortified, since on their own these products are naturally low in calcium. You also might find that you have less of a lactose problem with cultured and aged dairy foods like yogurt and hard cheeses. Experiment to discover the degree of your intolerance. For example, try smaller portions of dairy or have it with other foods for better digestion, such as cheese on a turkey sandwich.

Perhaps you are a vegan or a vegetarian who does not eat dairy. Or perhaps you have a milk allergy or simply do not like dairy products. You also have options. Choose nondairy calcium foods and calcium-fortified soy and rice milk products. Consider this: One ounce of almonds has 70 mg of calcium; a 3-ounce serving of salmon has 180 mg, a 3-ounce serving of sardines has 320 mg; a cup of broccoli has 90 mg, a cup of soybeans has 260 mg, and 1⁄2 cup of collard greens has 90 mg. It may be difficult to rely on these nondairy foods for ample calcium, but they are well worth eating. People who do rely on them may also need a calcium supplement to meet daily recommendations. (See “Calcium and vitamin D supplements” below.)

Last Reviewed on June 18, 2010

Deborah McInerney is a Clinical Nutritionist at Hospital for Special Surgery in New York City.

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