As we work to put wholesome, healthy food into our bodies and consume a balanced diet, one thing we may overlook is bone health. Is what we eat feeding our bones?
Good bone health may not be a big concern to young adults, but it becomes more critical with age. For adults younger than 50, 1,000 milligrams a day of calcium is recommended for good bone health. If you're older than 50, that number increases to 1,200 milligrams per day.
However, Kim Kramer, registered dietitian for Ingalls Memorial Hospital, notes that it’s not all about the calcium. “As far as food goes, one of the main things is going to be calcium and making sure we have enough calcium for bone health,” she said. “You also need vitamin D. It goes hand-in-hand with the calcium. If you don’t have enough vitamin D, you are not going to be able to absorb the calcium properly.”
Sunlight is a major source of vitamin D. In the winter, when reduced hours of sunlight combine with less time spent outside, getting vitamin D from what we eat becomes more critical. “The problem with vitamin D is there are not high levels in food naturally. In egg yolks, there’s some, and there’s a little in sardines, tuna, liver,” Kramer said. But foods such as tuna and liver generally aren’t eaten regularly enough to supply needed vitamin D. Kramer suggests consuming low-fat fortified products, such as milk, yogurt, cereals and orange juice.
Also, keep in mind that it’s never too late to start improving bone health. “The food you eat may help the drugs used to treat osteoporosis, a form of bone disease, work better,” said Althea Reid, manager of clinical nutrition at Methodist Hospitals.
Diet also goes hand in hand with exercise for good bone health. “Exercise is a big component, too, and it’s recommended to do resistance training with light weights,” said Kramer. “A higher repetition of lighter weights can help build muscle for optimal bone health.”
Beyond calcium and vitamin D, Reid stresses the importance of eating 5 to 6 ounces of lean meat or beans each day to feed bones as well as five or more servings of fruit and vegetables. Those fruits and vegetables supply vitamin C, magnesium, vitamin K and potassium, which are also all needed to strengthen bones.
Kramer says proper calcium absorption also requires limiting or avoiding some things. Less caffeinated coffee, soda, tea and energy drinks can go a long way to keeping your bones strong. Smoking also should be avoided as it reduces calcium absorption.
Watching sodium intake is also important, according to Reid. “A diet low in sodium helps the body keep calcium instead of flushing it in urine,” she said.
Calcium and vitamin D deficiencies are common, according to Kramer. Though she says calcium levels are often checked in routine lab testing, vitamin D is not, so patients should ask about having their levels checked, especially if they know their diet is lacking in fortified foods and exposure to sunlight is limited. Deficiencies can usually be remedied with supplements taken in consultation with doctors.
“What can happen with a toxicity is a buildup of calcium in blood,” said Kramer. “It can cause kidney problems, vomiting and poor appetite. It’s rare, but it’s serious.”
Kramer says the group most at risk for calcium and vitamin D deficiencies is post-menopausal women. She suggests they eat two to three servings a day of milk, yogurt or other calcium-rich, fortified foods.
Also be mindful of what makes up a serving to ensure you're maximizing your calcium and vitamin D intake. Reid said a serving is 1 ounce of Swiss cheese, 8 ounces of yogurt, one-half cup of cottage cheese, one medium orange, one medium corn tortilla, one-half cup of white beans, 1 ounce of almonds, one-half cup of kale, two calcium-fortified graham crackers or one packet of calcium-fortified instant oatmeal.
Kramer and Reid emphasize that while diet is an important component to good bone health, physical activity is also key in retaining bone strength.