You Ask, I Answer: Osteoporosis

I am a 56 year old woman diagnosed with osteoporosis.

I would like to know the best way to incorporate calcium [in]to my diet.

-- Maria Barbosa
Argentina

Before I answer your specific question, let's briefly discuss the larger issue.

Osteoporosis -- a condition in which bone tissue deteriorates and bone density decreases, thereby weakening the skeletal system (see accompanying illustration) -- is especially prevalent among women.

In the United States alone, it is estimated that approximately 10 million adults currently live with osteoporosis, and an astounding 75 percent of them are women.

In case you are wondering about the difference between these two groups, a decline in estrogen at menopause is associated with decreased bone density.

Men, meanwhile, are protected by testosterone. Although testosterone levels decrease with age, they are still at a sufficient range to guard against the onset of osteoporosis.

Since osteoporosis is “symptom free” (you don’t feel weak, bloated, tired, or get headaches), it is completely feasible to develop it and be completely unaware of this for years.

To discuss how osteoporosis starts – and how to make the necessary changes once diagnosed with it – let’s go back to the beginning.

Our bones are a vast storage unit for a handful of minerals, especially calcium.

It’s important to have a strong reserve of calcium because we lose it on a daily basis.

All bodily excretions (sweat, urine, and feces) contain calcium, and our nails require it for production and growth.

Calcium is also needed for a variety of bodily functions (i.e.: forming blood clots).

Consume adequate amounts of this mineral every day and you easily replenish any losses.

If calcium intake is insufficient, that’s where the problem begins.

The body, desperate for calcium, doesn’t find any circulating in the blood and goes to the trusted storage unit for some.

In turn, bones are demineralized and broken down.

Imagine this happening on a daily basis for ten, twenty, even thirty years!

By the time you hit the fifty or sixty year-old mark, your bones are -- not surprisingly -- quite fragile and acutely demineralized.

Although many people automatically equate osteoporosis with calcium, there are other factors to keep in mind.

A crucial one is Vitamin D, which helps our bodies absorb calcium (this is why you often see calcium supplements also containing Vitamin D).

As I have explained before, Vitamin D is not found in many foods (the best source is actually the sun).

If you live in an area of the world that does not receive much sunlight for five or so months of the year, or if your dermatologist has strongly recommended you always use UV-proof skin lotions, you run the risk of being significantly deficient.

The solution? Reach for a daily supplement! Aim for 1,000 International Units a day.

Protein also plays a role in preventing osteoporosis.

Both sides of the spectrum – not getting enough or getting too much – are problematic.

A lack of protein in the diet will hinder the body’s ability to repair and rebuild bone tissue.

An excess, meanwhile, results in urine outputs with higher calcium levels than normal.

Phosphoric acid is also worth paying attention to. Found in regular and diet sodas, it disturbs the body’s calcium balance mechanism, often resulting in calcium being leeched from bones.

Sodium – a mineral the majority of people in the United States overconsume– also plays a role in osteoporosis.

High sodium intakes increase calcium losses through the urine (a result of the body attempting to keep various mineral levels proportional).

With all that in mind, how can you be proactive about lowering your risk of developing osteoporisis (and maintaing what bone mass you do have at the time you are diagnosed with it)?

From a nutritional standpoint, make sure you get sufficient amounts of calcium and Vitamin D and that you do not surpass maximum recommendations for sodium and protein.

Aim for 800 – 1,200 milligrams of calcium a day.

To answer your question, all dairy products are a great source, as are tofu, almonds, oats, and any fortified products.

Spinach, however, is one food that gets way too much credit.

Although it offers substantial amounts of various nutrients, don’t put it in your osteoporosis defense kit.

Spinach offers significant amounts of calcium, but also contains high levels of oxalate, a compound that binds to calcium and greatly reduces its absorbability in our gastrointestinal tract.

The good news is that oxalates only affect calcium absorption of the food they are in.

So, if you’re having a spinach and tofu stirfry, only the dark leafy green vegetable's calcium will be practically rendered useless.

Aside from nutrition, one of the best things you can do to minimize your risk of developing osteoporosis (and prevent further bone demineralization if you have already been diagnosed) is weight-bearing exercises.

This does not mean you need to necessarily start lifting heavy weights or buildmuscles. It’s really just about performing physical activity in which the muscles have to resist weight.

Remember, bone strengthens up when stressed. Hence, challenging it with weights on a regular basis helps to maintain -- and even increase -- its density.

As you can see, there are helpful steps you can take at any stage of the game. There is no reason to give in to osteoporosis.