Osteoporosis is a condition that affects the bones in our body as we age. Osteoporosis is a Latin word meaning "porous bones." Small spaces inside a healthy bone increase osteoporosis, leading to loss of bone strength and density.1 Osteoporosis occurs at old age and approximately 53 million people are either suffering from osteoporosis or are at high risk of it.
Risk Factors for Osteoporosis and Osteopenia
The following risk factors can cause osteoporosis2:
- Non-Hispanic, Caucasian, and Asian ethnicity
- Small bones – i.e., females
- Family history of osteoporosis or osteopenia
- Cigarette smoking
- Poor nutrition
- Physical inactivity
- Older age and menopause
- Long-term estrogen hormone use
- Alcohol abuse
- Sedentary lifestyle
- Low vitamin D blood level
- Low calcium intake
- Certain medications such as prednisone, Dilantin, excess thyroid, etc.
Gut Bacteria and Calcium
Colon bacteria play an important role in the absorption of calcium. Two thousand species of bacteria reside in the human colon and play an important role in calcium regulation.3 Vegetables and a diet rich in fiber increase colon bacteria growth.
Soluble Prebiotic Fiber
All fiber comes into the colon unchanged, and colon bacteria will use the soluble fiber to absorb calcium from the large intestine.
Vitamin D
Vitamin D plays an essential role in the absorption of calcium. Caucasian and light-skinned people can absorb vitamin D from the sun easily. Dark-skinned people often require vitamin D supplementation.
The following foods are high in vitamin D:
- Cod liver oil
- Salmon, mackerel, tuna, sardines
- Vitamin D enriched milk, yogurt, and juices
What are the good things we can do?
- Consume 1000–1500 mg of calcium daily in food or from supplements.
- Adopt an active lifestyle like walking, bicycling, going to the gym, and regular workouts.
- Eat soluble plants and take prebiotic supplements like Prebiotin-Bone Health.
- Avoid smoking.
- Moderate alcohol use only.
- Consult a physician to discuss medications.
- Reduce caffeine intake.
Osteoporosis Treatment
Osteoporosis treatment requires lifestyle changes along with the possibility of medication. The doctor may also recommend calcium intake along with vitamin D supplementation.
Calcium intake
It is important to get adequate amounts of calcium daily. On average, 1000–1500 mg of calcium intake daily is sufficient, even with high needs like pregnancy, bone fractures, and increased athletic activity.4 The following table gives detailed information about good sources of calcium in foods. Along with a diet rich in vitamins and nutrients, protein and zinc levels should also be examined for optimal bone health.
| Calcium Content of Foods | ||
|---|---|---|
| Foods | Serving Size | mg of calcium |
| Yogurt, low-fat | 1 cup | 450 |
| Cheese, Grilled Sandwich | 1 | 371 |
| Cheese, Ricotta | 1/2 cup | 337 |
| Sardines | 7 | 322 |
| Yogurt, Fruit | 1 cup | 315 |
| Cheese, Cheddar | 1 1/2 oz | 305 |
| Milk, Skim or 2% | 1 cup | 300 |
| Orange Juice with calcium | 1 cup | 300 |
| Soy Beverage with calcium | 1 cup | 250-300 |
| Cheese, Gruyere | 1 cup | 287 |
| Salmon | 5 oz | 278 |
| Tofu, Firm | 1/2 cup | 240 |
| Cheese, Mozzarella | 1 ounce | 207 |
| Tofu with calcium | 1/2 cup | 204 |
| Macaroni and cheese | 1/2 cup | 179 |
| Waffle, Homemade | 1 | 179 |
| Collard Greens, frozen/boiled | 1/2 cup | 179 |
| Ice Cream, Vanilla | 1 cup | 176 |
| English Muffins, Whole Wheat | 1 | 175 |
| Cheese, American | 1 oz | 174 |
| Rhubarb, cooked | 1/2 cup | 167 |
| Oatmeal, instant | 3/4 cup | 163 |
| Cottage Cheese, 2% | 1 cup | 163 |
| Rice Beverage with calcium | 1 cup | 150-300 |
| Pudding made with milk | 1/2 cup | 147-160 |
| Custard, baked | 1/2 cup | 149 |
| Pizza, Cheese | 1 slice | 111-147 |
| Molasses, Blackstrap | 1 Tb | 137 |
| Spinach, cooked or frozen | 1/2 cup | 122 |
| Tofu, regular | 1/2 cup | 108 |
| Yogurt, Frozen (fat-free/low-fat) | 1/2 cup | 105 |
| Milk, instant (dry/nonfat) | 2 Tb | 105 |
| Almonds | 1/4 cup | 94 |
| Broccoli, cooked or fresh | 1 cup | 90 |
| Kale, cooked | 1/2 cup | 90 |
| Sesame Seeds, dried | 1 Tb | 88 |
| Taco, Chicken | 1 | 87 |
| Bok Choy, cooked or fresh | 1/2 cup | 80 |
| Mustard Greens, cooked | 1/2 cup | 75 |
| Bread, White | 2 slices | 70 |
| French Toast | 1 slice | 65 |
| Hot Dog, Turkey | 1 | 58 |
| Orange, medium | 1 | 52 |
| Halibut, baked | 3 oz | 51 |
| Fig Bar Cookie | 4 | 40 |
| Bread, Whole Wheat | 2 slices | 40 |
| Cream Cheese | 2 Tb | 23 |
| Cream, Half and Half | 1 Tb | 16 |
| Chicken Breast, baked | 3 oz | 14 |
| Apple, medium | 1 | 10 |
| Pasta, cooked | 1 cup | 10 |
| Beef, Lean Ground | 3 oz | 9 |
| Banana, medium | 1 | 7 |
| Sample Menu | ||
|---|---|---|
| Breakfast | Lunch | Dinner |
|
|
|
| This sample diet provides the following: | |||
|---|---|---|---|
| Calories | 1,200 mg | Fat | 54 gm |
| Protein | 2,120 Kcal | Sodium | 326 g |
| Carbohydrates | 84 g | Potassium | 3,130 mg |
Calcium Supplements
Calcium is available in different preparations. To get the best form of natural calcium, eat foods including dairy products such as milk, yogurt, some cheeses, and fish. Other formulations are available when calcium from the diet isn’t enough.5
- Calcium carbonate
- Calcium citrate
- Calcium gluconate
- Calcium lactate
References
- Porter JL, Varacallo M. Osteoporosis. StatPearls. Published online June 21, 2022. Accessed August 8, 2022. https://www.ncbi.nlm.nih.gov/books/NBK441901/
- Hyassat D, Alyan T, Jaddou H, Ajlouni KM. Prevalence and Risk Factors of Osteoporosis Among Jordanian Postmenopausal Women Attending the National Center for Diabetes, Endocrinology and Genetics in Jordan. Biores Open Access. 2017;6(1):85. doi:10.1089/BIORES.2016.0045
- Ding K, Hua F, Ding W. Gut Microbiome and Osteoporosis. Aging Dis. 2020;11(2):438. doi:10.14336/AD.2019.0523
- Sunyecz JA. The use of calcium and vitamin D in the management of osteoporosis. Ther Clin Risk Manag. 2008;4(4):827. doi:10.2147/TCRM.S3552
- Garg M, Mahalle N. Calcium Supplementation: Why, Which, and How? Indian J Endocrinol Metab. 2019;23(4):387. doi:10.4103/2230-8210.268505
