We all know calcium builds strong bones, but did you know that it isn’t the only major participant when it comes to bone health? A balanced diet and good nutrition are essential for healthy bones. Calcium is a team player that acts best with other nutrients, like vitamin D, vitamin K, magnesium and potassium. And let’s not underestimate the importance of exercise—especially weight-bearing exercises. Weight training and cardio activities such as swimming, squats, taking the stairs, Tai Chi and walking will help to improve bone strength and prevent hip fractures. During Osteoporosis Prevention Month, I want to share some tips for preserving strong bones at any age!
What is Osteoporosis & What Are the Risk Factors?
Osteoporosis is a condition that makes your bones weak and, therefore, more likely to break. It’s known as the silent disease because you may not know you have it until you break a bone. Ouch! Approximately 10 million people over the age of 50 have osteoporosis, and another 34 million have low bone density, known as osteopenia, which puts them at high risk for developing osteoporosis. Anyone can develop osteoporosis, but there are certain factors that put you at higher risk:
- Getting older- Over 50 years of age and especially women after menopause
- Being a white or an Asian woman. Eighty percent of the people who have osteoporosis are women and women are four times more likely to get it than men
- Being small and thin
- Genetics- Having a family history of osteoporosis
- Taking certain medicines, such as steroids
- Excess fat around the belly- New research even suggests that excess liver and muscle fat, independent of BMI, age and exercise, is detrimental to the strength of the bones
The Nutrition Lowdown
1.) Eat it to beat it: Choose foods rich in calcium, not just dairy. Even though increased dairy consumption has been consistently associated with lower rates of osteoporosis and better bone health, you can get calcium from many other sources. The recommended calcium intake for adults is 1000-1200 mg per day, dependent on age. Estimate your average intake and fill in the gap with a supplement, if necessary. But remember, too much calcium is counterproductive!
- Fish, such as bone-in sardines, anchovies, salmon
- Leafy greens, like kale, collard greens, mustard greens, arugula, Bok Choy, broccoli rabe
- Low-fat to full-fat dairy products (preferably Organic or local), such as yogurt, milk, cheese, kefir
- Foods fortified with calcium, like orange juice, breakfast cereals, non-dairy milk alternatives (almond, rice, soy, coconut), breads or instant oatmeal
- Bone broth
2.) Check your vitamin D level. Vitamin D is hugely beneficial for bone health because it helps regulate calcium metabolism. Getting vitamin D from food or supplements is especially important if you are vitamin D deficient (<20ng/ml).
3.) Increase your intake of plant-based foods. As previously mentioned, bone health is a team effort. Include foods rich in the following nutrients:
- Vitamin K: Leafy greens such as kale, spinach and endives as well as any “green foods” such as celery, Brussels sprouts, broccoli and avocados are high in vitamin K.
- Magnesium: Dark leafy greens along with nuts, seeds, dried fruit, whole grains, beans and legumes are loaded with magnesium.
- Potassium: Bananas aren’t the only foods that have potassium! Baked potatoes, avocados, mushrooms, squash, and, you guessed it, leafy greens are full of it!
Bone Health Myth Busters
Myth: Once you turn 50 you have to supplement with calcium.
Fact: A 2012 analysis of NHANES data found that consuming a high intake of calcium beyond the recommended dietary allowance, typically from supplementation, provided no additional benefit. Multiple studies found that calcium supplements don’t reduce fracture rates in older women and may even increase the rate of hip fractures. Calcium supplements have also been associated with higher risk of cardiovascular disease, increased prostate cancer risk and an increase in kidney stones. More is not always better! Getting calcium in smaller amounts can increase proper absorption without overloading the arteries or kidneys.
Myth: Dairy contributes to poor bone health by “acidifying” our bodies. The “acid-alkaline” hypothesis theorizes that dairy increases acid in the blood and, therefore, blood needs to restore balance by stealing alkaline minerals (such as calcium) from the bones, decreasing bone density.
Fact: A diet including dairy does not affect our blood pH. Dairy and other acidic foods may affect our urine pH, which does change depending on what you eat, but that is eliminated when we urinate.
Check your bone health by testing your bone mineral density, especially if you have any of the above-mentioned risk factors. Keep your bones healthy at every age!
Written by Alanna Cabrero, MS, RD, CDN
Originally posted on NYHRC Tumblr
The name “Greek yogurt” currently references how the yogurt is made rather than the country where it originated. Greek yogurt is made by straining out the whey (watery liquid part) of the yogurt. This process creates a thicker, creamier yogurt, reduces the liquid content, and increases the nutritional density.
Nutritionally, Greek yogurt rocks! Compared to traditional unsweetened yogurt, Greek yogurt has:
- Almost triple the protein content (15-20 grams per 6 oz serving), leaving you feeling fuller longer
- Half the sugar, about 5-8 grams per serving
- Up to 95% of the lactose (sugar in milk) removed, making it a better option for the lactose intolerant
- Healthy bacteria! Live bacteria have been shown to help the immune system and promote regular digestion. Make sure to look for the National Yogurt Association seal of approval. “Live & Active Cultures“
- Proven to keep age-related weight gain at bay, according to a study published in the New England Journal of Medicine focusing on one serving of low-fat, plain yogurt per day
- Greek yogurt naturally has more fat content so beware of the saturated fat content, which can raise the “bad” cholesterol (LDL). When going Greek, stick to nonfat or low fat.
- Greek yogurt has less calcium than regular yogurt as some calcium is lost in the liquid whey. However, one serving still has 200mg or 20% of your daily recommendation.
- Compared to natural yogurts, the flavor can be tart. Add fruit or spices, such as cinnamon to naturally sweeten.
- Environmental experts are concerned that acid whey, a byproduct of the Greek yogurt straining process, may become harmful to aquatic life if improperly handled. Currently, acid whey is used mostly as fertilizer or as a protein supplement for animal feed, but as the popularity of Greek yogurt increases – Greek yogurt comprises 35% of all yogurts on the market – the issue of proper byproduct handling will become crucial.
Note: acid whey differs from sweet whey, which is a byproduct of making cheese.
Healthy Ways of Going Greek
- Opt for nonfat, unflavored Greek yogurt and DIY toppings toavoid added sugars and calories. Use fresh or frozen fruit and for extra flavor add vanilla, lemon or 1 tsp of natural sweetener such as honey, agave nectar, or molasses.
- A recent study showed that breakfast is the meal lowest in protein content. What better way to start your day than with protein-rich Greek yogurt for breakfast? Add healthy fat such as nuts (almonds, walnuts), seeds (flax, chia, sunflower) or homemade granola and you have a complete, balanced meal.
- Greek yogurt is very versatile. Use plain Greek yogurt as a cooking substitute for sour cream, mayonnaise, cream cheese, sauces, dressings or toppings. Tzatziki is one of my favorite sauces. All you need is yogurt, cucumber, garlic, lemon, parsley and mint.
Brands I like
- Chobani 0% Nonfat Plain
- Dannon Oikos Fat Free
- Fage Total 0% Plain
- Stonyfield 0% Organic Plain
- Yoplait Greek Plain
- 365 Nonfat Plain
- Fage Total 0% Strawberry Goji, Raspberry or Strawberry
- Stonyfield Oikos Organic with Superfruits or Vanilla
- Trader Joe’s Greek Style Nonfat Pomegranate
- Wallaby Organic Lowfat with cherries
- Wallaby Organic Nonfat with Mixed Berries
Edited and photographed by TCabrarr
Here’s the Scoop on Greek Yogurt. Environmental Nutrition. June 2013.
Not All Yogurts Are Created Equal. Environmental Nutrition. June 2011.
Whey-ing Greek yogurts environmental impact. Eatocracy. June 2013.
Giles-Smith, K. Milk Proteins: Packing a Powerful Nutritional Punch. Today’s Dietitian.
Greek Yogurt vs. Regular Yogurt. US News. September 2011.
Calcium is extremely important to promote bone health and prevent osteoporosis. About 99% of the calcium in our body is stored in our teeth and bone, while the other 1% helps with muscle contraction, nerve conduction and formation of cell membranes. Other vitamins and minerals are also important for bone mass and the absorption of calcium, such as vitamin D, vitamin K, and magnesium.
Recent research suggests that consuming calcium in pill form rather than in food is not as effective and can increase certain health risks, such as:
- Ineffectiveness at preventing bone loss
- Slight increase in kidney stone formation
- Associations to added heart risks
The great news is that getting enough calcium from food is relatively easy! Common sources are dairy products like milk or yogurt, but dairy products can be high in saturated fat and calories, so make sure to choose fat-free/low-fat versions. Some sources of calcium that are naturally low in saturated fat and good sources of healthy fat include broccoli, tofu, almonds, sardines, and collard greens. See below for a more detailed list.
What if you are lactose intolerant, strict vegetarian, or simply don’t like milk? Luckily, there are many other “milk alternatives” such as soy, almond, or rice milk that can provide up to 300mg of calcium per 8-oz cup. Read on for more ideas!
Isn’t getting calcium from food the same as supplements? Actually, no. The form of calcium used in fortification versus supplements can vary (usually carbonate or citrate). Additionally, the ability to absorb calcium changes. Calcium is better absorbed “little by little.” If you need to take a supplement to make for any calcium deficits in the diet, avoid taking more than 500 mg at a time.
Age Adequate Intake (mg) Upper Level (mg)
4-8 years 800 2500
9-18 years 1300 2500
19- 49 years 1000 2500
50 and up 1200 2500
From the Institute of Medicine (IOM), 2011.
Promoters of calcium absorption?Vitamin D & potassium found in bananas, beets, apricots, raisins to mention a few.
Inhibitors of calcium absorption?Oxalic & phytic acid bind to calcium and inhibit absorption. These are found in spinach, beet greens, okra, peppers and wheat bran, flax seed, soybeans respectively, which is why calcium from dairy sources are better absorbed (for the most part!). High intake of sodium, caffeine, and protein increase calcium excretion from the body.
Healthy Sources of Calcium:
Food Portion Calcium in mg
Plain, low fat yogurt 8 oz 415
Sardines w/bones 3 oz 372
Collards, cooked 1 cup 357
Fruit, low fat yogurt 8 oz 343
Ricotta cheese 4 oz 335
Skim milk 8 oz 302
Almond milk 8 oz 300
Rice milk (fortified) 8 oz 300
Soymilk, fortified 1 cup 200-300
Tofu 1 ⁄ 2 cup 120-350
Figs, dried 5 pieces 258
Mozzarella Cheese 1 oz 207
Cheddar/Muenster Cheese 1 oz 203
Blackstrap molasses 1 TBS 187
Sesame seeds 2 TBS 176
Kelp 3.5 oz 168
Salmon, canned w/bones 3 oz 167
Turnip greens, cooked 1/2 cup 126
Soy nuts 1 ⁄ 4 cup 126
Swiss chard 1 cup 102
Broccoli, cooked 1 cup 100
Cottage cheese, fat free 4 oz 100
Kale, cooked 1 ⁄ 2 cup 90
Almond butter 2 TBS 86
Bok Choy , cooked 1 ⁄ 2 cup 79
Tempeh 1 ⁄2 cup 77
Mustard greens, cooked 1 ⁄ 2 cup 75
Navy/black beans, cooked 1/2 cup 64
Brussels sprouts 8 sprouts 56
Black beans, cooked ½ cup 52
Almonds or brazil nuts 2 TBS 50
Soybeans, cooked 1/2 cup 44
Chickpeas, cooked ½ cup 40
Raisins 1/3 cup 27
Inspiration & Resources:
- All You Need to Know About Calcium. Integrative Therapies Program Nutrition Resources. August 2011.
- Higher Doses of Vitamin D Requires to Protect Your Bones. September 2012, Vol. 30, Number 7.
- Boning Up On Calcium. Tufts University Health & Nutrition Letter. October 2012, Vol. 30, Number 8.
Edited by Tcabrarr