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
  • grapefruit 1/2
  • high fiber cereal (5-10 gm/serving)
  • banana 1/2 cup
  • whole wheat toast 2 slices
  • low saturated fat spread 2 tsp
  • jelly or jam 1 Tb
  • skim milk 1 cup
  • decaffeinated coffee/tea
  • vegetable soup 1 cup
  • lean hamburger patty 2 oz
  • the whole wheat hamburger bun
  • sliced tomato 2 oz
  • lettuce with dressing 1 Tb
  • fresh fruit salad 1/2 cup
  • oatmeal cookie 1
  • non-calorie beverage
  • tomato juice 1 cup
  • broiled chicken breast 2 oz
  • herbed brown rice 1/2 cup
  • broccoli spears 2
  • cheese sauce 1/4 cup
  • hard dinner roll 1
  • low saturated fat spread 1 tsp
  • carrot/raisin salad made with lite mayonnaise 1/2 cup
  • frozen strawberry yogurt 1/2 cup
  • skim milk 1 cup
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


  1. Porter JL, Varacallo M. Osteoporosis. StatPearls. Published online June 21, 2022. Accessed August 8, 2022. https://www.ncbi.nlm.nih.gov/books/NBK441901/
  2. 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
  3. Ding K, Hua F, Ding W. Gut Microbiome and Osteoporosis. Aging Dis. 2020;11(2):438. doi:10.14336/AD.2019.0523
  4. 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
  5. Garg M, Mahalle N. Calcium Supplementation: Why, Which, and How? Indian J Endocrinol Metab. 2019;23(4):387. doi:10.4103/2230-8210.268505

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