Diet & Osteoporosis

Healthy bones are like banks, the more deposits you make, and the more withdrawals you can count on. Diet plays a major role in ensuring healthy bones. In particular, Calcium and Vitamin D need to be taken in the right amounts through life to build bone and slow down bone loss. Eating a healthy balanced diet, containing adequate calories, can help to improve your overall bone health not to mention your overall health.

Bone development
It is important to look after your bones no matter what your age. While 90% of adult bone is laid down by the age of 17, bone continues to grow in strength up until the mid-thirties. After this, it is natural to lose a small amount of bone each year. This is accelerated in women after the menopause when the protective effect of oestrogen is lost. However, calcium, Vitamin D and regular exercise help maintain bone strength and minimise bone loss.

The Department of Health and Children recommend that children, adults and older people include three servings of calcium rich foods per day

The easiest way to obtain this is through the regular consumption of milk, cheese and yogurt i.e. 3 servings each day from the milk group of foods. Teenagers and pregnant women need five servings each day.

A serving is equal to:

  • A glass of milk
  • An ounce {matchbox size} of cheese
  • A carton of yogurt

Teenagers in particular need 5 servings of calcium each day to meet the requirement for growth and development. Unfortunately, 75% of teenage girls do not meet their calcium needs. Other factors that may have a negative effect on bone health at this time include: lack of exercise, smoking, alcohol and lack of exercise, smoking, alcohol consumption, poor diet or some weight loss diets, and eating disorders such as anorexia and/or bulimia. Excessive consumption of fizzy drinks in teenagers means that healthier more nutritious drinks like milk and juices are often displaced in the diet leading to poor calcium intakes.

Tips to boost calcium intake
Dairy products are extremely versatile and can be included in the diet in many ways. Cooking does not destroy calcium, so it could not be easier to get your recommended number of servings each day. Serving suggestions include

  • A bowl of breakfast cereal with milk
  • Cheese on crackers or toasted cheese sandwich
  • Fruit salad with yogurt
  • A slice of pizza or lasagne
  • A fruit smoothie or milkshake
  • A frothy cappuccino or mug of hot chocolate
  • Baked potato with grated cheese
Calcium Recommendation (per day)* RDA (mg)
Adults  
Men 800
Women 800
Teenagers  
Boys 11-18 1200
Girls 11-18 1200
Children  
1-3 years 800
4-6 years 800
7-10 years 800
Pregnancy and Lactation  
Pregnant women
(second half of pregnancy)
1200
Breastfeeding women
(first six months of lactation)
1200
*Food Safety Authority of Ireland, Recommended Dietary Allowances for Ireland 1999

 

Calcium content of food
Food
Weight
Calcium content (mg)
Whole milk
190ml
224
Semi-skimmed milk
190ml
231
Skimmed milk
190ml
235
Soya milk
190ml
25
Goat's milk
190ml
190
Low-fat yogurt
150g
225
Ice cream
112g
134
Cheddar cheese
28g
202
Cottage cheese
112g
82
Boiled spinach
112g
179
Boiled broccoli
112g
45
Baked beans
112g
59
Large orange
1
58
Dried apricots
100g
92
Brazil nuts
100g
170
Whitebait (fried)
56g
482
Salmon (tinned)
56g
52
Tofu
100g
480
Milk chocolate
56g
123

I don’t like milk! What can I do?
If you do not like milk try the following to boost Calcium intake

  • Pancakes
  • Skimmed milk powder added to soups/smoothies/sauces
  • Porridge made on milk
  • Fortified milks

Other Sources of Calcium
Other foods in the diet contain less concentrated amounts of calcium, which is not as easily absorbed by the body as from dairy products. As a result, large quantities would need to be consumed in order to meet calcium requirements. For example, to match the calcium in one glass of milk, you would need to eat 10 servings of baked beans, 16 portions of spinach or 8 slices of white bread.

The importance of vitamin D
Another crucial nutrient for bone health is vitamin D also known as the sunshine vitamin. Vitamin D helps the body to absorb calcium. The best source of this vitamin is sunlight as the body makes vitamin D through the action of sunlight on the skin, however Ireland’s northerly latitude means we cannot rely on this source, especially in winter. Furthermore sun protection creams also prevent the production of Vitamin D and as a result dietary sources are becoming more important. Vitamin D is found in eggs, oily fish like salmon, mackerel, herring, sardines, fortified milks and spreads. Other foods high in Vitamin D are liver, and chicken liver pate, as well as some cereals. These should be included regularly, if one is at risk of low vitamin D and are particularly important for older people or those who are house-bound.

While Calcium and Vitamin D are extremely important for bone health other lifestyle factors are also important

Being a healthy weight.
Having a healthy BMI [Body mass index} can protect your bones. A healthy BMI is between 20 - 25.

Is you have a BMI less than 20 it may mean you are underweight and your bones have very little protection in the event of a fall. If you have a BMI in excess of 25 it may mean that you are overweight and this puts extra strain on your joints etc often preventing you from exercising. To calculate your BMI weight / (height x height)

If you want to lose weight
Do not cut out dairy products, more and more research shows us that dairy products can protect us from weight gain. Instead continue with the three a day message and choose lower fat options. Low fat or skimmed milk have the same amounts of calcium as full fat milk but may be lower in vitamin D so ensure that this is added back in.
Low fat yogurts are similar. Cheese with lower fat content includes Edam, Emmental and low fat cheddars.

Watch your Caffeine Intake
Caffeine is found in tea, coffee, energy drinks and colas and may cause us to excrete calcium in our urine. To prevent this from happening, limit your intake of these drinks to 4 /day. Try to include lattes and cappuccinos to boost milk intake.

Be Careful of your Alcohol Intake!
Excessive alcohol may increase your risk of Osteoporosis. The health promotion unit in Ireland recommends no more than 14 standard drinks/week for women and 21 standard drinks/week for men. A unit is equivalent to ½ pint beer/stout, 1 measure spirits, or a small glass of wine.

What if I am allergic to Dairy Products?
Allergy to the protein in cow’s milk is rare in adults and if present must be treated with a dairy free diet. Special attention must be given to other sources of calcium like fortified foods and soya products, which are fortified with calcium.

Lactose intolerance can occur in people following a severe gastroenteritis or after a chronic disease like coeliac disease. It is usually temporary lasting approx 6-8 weeks. During this period you do not need to completely omit dairy products but to limit them to 1 serving /meal. Cheese and yogurt are usually well tolerated but milk needs to be taken more cautiously. For more information contact your GP/Dietician.

A healthy balanced diet with adequate and appropriate exercise will ensure that all the nutrients for bone heath are provided. The food pyramid will help you to achieve a healthy diet.