I recently counseled a young client that reminded me of my twenty-year-old self.  Twenty years ago, I sat in a dietitian’s office seeking help for an eating disorder, too.  While no one’s history with an eating disorder is the same, I empathized with this motivated and driven young girl.  Even though I have thankfully recovered, I occasionally feel the consequences from this time in my life. Ten years ago it was fertility issues, and today I face bone health concerns. Like many who have eating disorders, they often occur during the precious bone building years. My body was doing its best to lay down the foundation for a strong skeleton and my eating patterns sold it short.  As I enter my forties, I recognize that there was some long-term damage. I am empowered to know there is MUCH I can do to support this area of my health.

If you haven’t thought much about your own bone health, there might be good reason to consider the fact that ½ of women and ¼ men over the age of 50 will break a bone because of osteoporosis. Risk factors for poor bone health include:

  • Age: Bone density peaks around the age of 30. Women over the age of 50 are the most likely to develop osteoporosis.
  • Gender: While many men suffer from osteoporosis, the condition is 4x more likely in women.
  • Family history: Mom got a history of osteopenia? That increases your likelihood of the condition as well.
  • Bone structure/body weight:  Being petite or “thin” increases your chances
  • History of broken bones: That stress fracture I had during my 3rd pregnancy? Yep, that gives you a clue your bones aren’t as strong as they should be.
  • Ethnicity: Caucasian and Asian women are at higher risk than women of other ethnic backgrounds
  • Medical conditions: Inflammatory related conditions like arthritis and inflammatory bowel disease increase your odds
  • Smoking & heaving drinking: Increase your odds

I often hear people make light of their recent fracture or poor results from a bone density test. Perhaps they accept it as a fact of getting older or as the norm for a runner who trains a lot.  However, we should not accept that it is normal or that there is little we can do. Many bone building medications can have unintended consequences and a fall during exercise could leave you with an aggravating injury that never quite heals correctly.

Knowledge is power, so if you do have concerns, speak with your physician and get the proper tests and lab work performed. In addition, support your skeleton with the following dietary habits:

Foods trump supplements.  Choose foods over supplements that contain bone-building nutrients.  Top bone-building nutrients include calcium, vitamin D, magnesium, and vitamin K. While supplements compared to whole foods are a convenient option, researchers show it is the synergy of nutrients in food that offer the best protection. In addition, whole foods don’t carry the risk of side effects like supplements can. This doesn’t mean that supplements can’t play a supportive role; however, it is important not to get a false sense of security from supplements.

Food sources of bone nutrients:

Dairy foods: Milk, yogurt, and cheese have many of the bone-building nutrients we need in ONE food.  Aiming for three servings per day like a cup of yogurt in the morning, 1 oz. of shredded cheese in a black bean quesadilla and a cup of kefir/soy/cow’s milk after a workout would meet your quota.

While “milks” like almond, rice, coconut and hemp drinks are trendy beverages, we need to ensure they are the right option.  Remember two things:

1. Read labels to compare micronutrients content – like calcium and vitamin D. Plant-based milks can fall short in calcium and vitamin D.

2. Consider the protein content. (See protein section below). Many plant-based drinks have only 1 or 2 grams of protein compared to the 12 grams of protein found in cow or soy milk.

Salmon: Salmon is one of the highest food sources of vitamin D.  Aim for two, 3-4 oz. servings of fatty fish like salmon each week. Because it is challenging to meet vitamin D needs through food, the majority of us benefit from a supplement.  Have your vitamin D status assessed at LEAST once a year.

Fruits and Vegetables:  Eating fruits and vegetables create what we call an “alkaline” environment. Reducing the acidity in our body appears to be protective for bones.  Vegetables like bok choy, broccoli and other leafy greens are rich in bone building nutrients like calcium. Lycopene-rich produce, such as watermelon, tomatoes, pink grapefruit, and bell peppers may protect against fractures. Aim for at least 4.5 cups of produce per day.

Protein-rich foods: Bone building nutrients, like calcium, are better absorbed in the presence of protein.  The recommended amount of protein is 0.8 g/kg of body weight: 60 g/protein/150 pound female. Researchers have shown that more protein is necessary for bone protection.  Aiming for 1.2-1.3 grams (80-90 g/ protein/150 pound female) may be more optimal for bone health. The source of protein (animal vs. plant) does not appear to impact bone mass density.  Also beneficial is protein timing. Instead of eating the majority of protein at dinner, it is more effective to spread protein throughout all meals and snacks.

Activity: All types of exercise can help protect the bone. A well-rounded exercise program should include balance, coordination, fall prevention and functional strength. Ideally, weight bearing exercise like jogging/running, if feasible, is of value. I was happy to see a smaller recent study that showed yoga was able to increase hip and spine density. Plus, yoga’s “side effects” include better posture, balance, and strength – all important factors to support our aging structure.

Eating for optimal bone health is valuable at any age.  Children and teenagers can maximize the bone mass they lay down for their future. Those of us finished building bone can eat to maintain and optimize the bone mass we have accumulated.  It is never too late to do something now that our future self will thank us for later.

Jennifer McDaniel

Jennifer McDaniel is a Registered Dietitian, Media Spokesperson, and co-author of Prevention's Mediterranean Table Cookbook. She and her team of Registered Dietitians aim to help their clients go further, make change last, and unlock their potential. She lives in St. Louis, MO with her husband, and three young sons. If you are interested in working with Jennifer, please visit our contact page.