Written by Kelsey Schaffstall Young MS, RDN, LDN

A person’s peak bone mass is achieved by age 30.^1,8 Then, the rate of bone mineral density decreases with age.⁵ However, diet and lifestyle can be a valuable tool in supporting bone mineral density maintenance and the prevention of osteoporosis as you age.

Risk factors for Osteoporosis

A person’s risk for osteoporosis increases with physical inactivity, cigarette smoking, and excessive alcohol use.⁹ The long-term use of certain medications such as corticosteroids, anti-seizure drugs, or proton pump inhibitors can also increase the risk of osteoporosis. Hormonal shifts, such as low levels of estrogen in women and testosterone in men are also responsible for bone losses.⁵ Finally, osteoporosis can be caused by a dietary pattern low in calcium, vitamin D, potassium, and protein such as a vegan diet, an eating disorder.⁹ The malabsorption of these vitamins and minerals caused by Celiac disease or bariatric surgery can also increase the risk of osteoporosis.

Strategies to maintain bone mineral density

Optimize calcium intake – aim for 1,000 mg daily for women up to 50 years old and men up to 70 years old and 1,200 mg/day for women over 50 and men over 70.⁵ Choose foods such as milk, yogurt, cheese, canned sardines and salmon with bones, kale, broccoli, bok choy, and fortified juices and cereals to increase calcium intake.⁵

Ensure adequate vitamin D intake to promote calcium absorption in the gut.⁶ Aim for a minimum of 600 IU daily for people aged 50-70 and 800 IU daily for those over 70 years old to achieve vitamin D levels > 50 nmol/L and > 20 ng/mL, which are generally considered adequate to support bone health and overall health.⁶ The best source of vitamin D is sunlight, so aim for 15-30 minutes of mid-day sun exposure on the head, neck, arms, and legs to ensure adequate vitamin D production. Food sources of vitamin D include fatty fish such as trout, salmon, tuna, and mackerel and fortified foods like milk, orange juice, and yogurt.⁶ Vitamin D supplementation may be necessary to maintain adequate levels, especially in certain geographic areas that don’t receive adequate sunlight year-round.

Potassium intake should also be optimized as it can help to prevent bone breakdown.⁴ The best food sources include dried fruit, lentils, beans, squash, potatoes, orange juice, bananas, milk, and yogurt.⁴

Finally, consume adequate protein to support healthy bone and muscle mass, which also plays a major role in preventing fracture by promoting calcium absorption, supporting bone density, and reducing fracture risk.^2,3

Other strategies to maintain bone mineral density include consuming adequate dietary magnesium from foods such as pumpkin seeds, chia seeds, almonds, peanuts, soy milk, and beans.⁸ It’s also important to include foods rich in vitamin K in your diet like collard greens, spinach, kale, broccoli, soybeans.⁷ Perform weight bearing exercise such as walking, hiking, climbing stairs, and strength training regularly to stimulate bone regeneration.^8,9 Finally, don’t smoke and limit alcohol consumption to prevent excess bone losses.

If you would like to develop a routine to maximize your both health, reach out to a Registered Dietitian who can help you form healthy habits to support bone health as you age.

References

1. “Bone Health in Depth.” Linus Pauling Institute, 3 Jan. 2023, https://lpi.oregonstate.edu/mic/health-disease/bone-health.
2. Hannan, M.T., Tucker, K.L., Dawson-Hughes, B., Cupples, L.A., Felson, D.T. and Kiel, D.P. (2000), Effect of Dietary Protein on Bone Loss in Elderly Men and Women: The Framingham Osteoporosis Study. J Bone Miner Res, 15: 2504-2512. https://doi.org/10.1359/jbmr.2000.15.12.2504
3. Marissa M Shams-White, Mei Chung, Mengxi Du, Zhuxuan Fu, Karl L Insogna, Micaela C Karlsen, Meryl S LeBoff, Sue A Shapses, Joachim Sackey, Taylor C Wallace, Connie M Weaver, Dietary protein and bone health: a systematic review and meta-analysis from the National Osteoporosis Foundation, The American Journal of Clinical Nutrition, Volume 105, Issue 6, June 2017, Pages 1528–1543, https://doi.org/10.3945/ajcn.116.145110
4. Muñoz-Garach, Araceli et al. “Nutrients and Dietary Patterns Related to Osteoporosis.” Nutrients 12,7 1986. 3 Jul. 2020, doi:10.3390/nu12071986
5. National Institutes of Health. “Calcium-Fact Sheet for Health Professionals.” Office of Dietary Supplements National Institutes of Health (2020).
6. National Institutes of Health. “Vitamin D-Fact Sheet for Health Professionals.” Office of Dietary Supplements National Institutes of Health (2020).
7. National Institutes of Health. “Vitamin K-Fact Sheet for Health Professionals.” Office of Dietary Supplements National Institutes of Health (2020).
8. Price, Charles T et al. “Essential Nutrients for Bone Health and a Review of their Availability in the Average North American Diet.” The open orthopaedics journal 6 (2012): 143-9. doi:10.2174/1874325001206010143
9. Spritzler, Franziska. “10 Natural Ways to Build Healthy Bones.” Healthline, Healthline Media, 18 Jan. 2017, https://www.healthline.com/nutrition/build-healthy-bones#TOC_TITLE_HDR_11.