Nutrition & bone health

Healthy bones are like banks, the more deposits you make, the more withdrawals you can count on. Diet plays a major role in ensuring healthy bones. Calcium and Vitamin D need to be taken in the right amounts throughout life, to help keep your bones healthy. Eating a healthy balanced diet, containing adequate calories and items from all food groups, can help 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 can help to minimise bone loss.

The Department of Health and Children recommend that children, adults, and senior citizens include three servings of foods with calcium per day

The easiest way to obtain this is through the regular consumption of milk, cheese, and yogurt i.e. three servings each day from the milk group of foods. Teenagers need five servings of calcium each day to meet the requirement for growth and development. Pregnant women need three unless they are expecting twins when five servings are recommended.

A serving is equal to:

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

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, fad diets or constant dieting, eating disorders such as anorexia and/or bulimia, or excessive exercise on its own or combined with an eating disorder. 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 is easy 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 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 do not 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 with water and Chia seeds
Did you know how 1 glass of milk compares to other foods in calcium content?

Other foods in the diet contain less concentrated amounts of calcium, which is not as easily absorbed by the body as those from dairy products. As a result, large quantities would need to be consumed 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, 8 slices of white bread or 16 portions of spinach, which spinach is not recommended for those with bone loss.

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 which is essential for healthy bones. The best source of this vitamin is sunlight, as the body makes vitamin D through the action of sunlight on the skin. However, due to Ireland’s northerly latitude this means we cannot rely on this source, especially in winter. When we are lucky enough to have a sunny day, 15 minutes of exposed skin, which can be broken up into 3 sets of 5 minutes and then put sunblock on. Those who burn easily should not try to get their Vitamin D from the sun and young babies should be given Vitamin d drops and should not be exposed to the sun.

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 in your diet regularly, if you are at risk of low vitamin D. This is particularly important for senior citizens 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 you are underweight and your bones have very little protection in the event of a fall. If you have a BMI of more than 25 it may mean that you are overweight. This puts extra strain on your joints often preventing you from exercising. To calculate your BMI weight / (height x weight)

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 some may be lower or have no Vitamin D, so make sure it contains Vitamin D.
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 fizzy drinks and may cause us to excrete calcium in our urine. To prevent this from happening, limit your intake of these drinks to 3 a 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 11 units per week for women and 17 units per week for men. A unit is equivalent to ½ pint beer or stout, 1 measure of 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.

A healthy balanced diet with adequate calories can help not only your bones, but your overall health.

 

Some suggestions to replace dairy

  • Pancakes
  • Skimmed milk powder added to soups/smoothies/sauces
  • Porridge made with water and Chia seeds

Foods that can help to reduce a person’s risk of bone loss

Calcium sources from food

  • Yoghurt
  • Milk
  • Cheese
  • Bread
  • Nuts
  • Any oily fish (e.g. sardines and tuna)
  • Some dark green vegetables.
  • Some brands of orange juice
  • Some breakfast cereals have calcium.

Vitamin D sources from food

  • Yogurts, if fortified
  • Fortified milks
  • Oily fish
  • Eggs
  • Chicken livers
  • Breakfast cereals – Check labels

Protein sources from food

  • Yogurt
  • Milk
  • Cheese
  • White poultry meat
  • Eggs
  • Fish

Calcium and Vitamin D3 supplements

If you are unable to get the recommended amounts of Calcium and Vitamin D3 through food, supplementation may be necessary. You need to be careful that you are not taking calcium and vitamin D from both food and supplements, which results in you taking far too much of either of them, which can have a negative effect on your health.

Protein Supplements
There may be inadequate amounts of protein in a person’s diet and supplementation is necessary when dietary intake of protein is inadequate.

Fibre
More than 30 grams of fibre a day may affect absorption of nutrients, so make sure not to take too much fibre.

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