Preventing Osteoporosis and Promoting Your Bone Health
by Dr. Louise Gagné

Osteoporosis is a skeletal disorder. It is characterized by compromised bone strength that predisposes individuals to a higher risk of fracture.

You can use many strategies to strengthen your bones and reduce your risk of osteoporosis. These include an anti-inflammatory diet, stress reduction, supplements, and regular exercise.

Your bone mass peaks at approximately 30 years of age. However, repair and renewal of bone continues throughout your life. About 15% of your bone mass turns over each year. 

Eat an Anti-Inflammatory Diet

• Reducing chronic inflammation will help you promote bone density and strength. An anti-inflammatory diet with abundant fruits and vegetables of many colours and kinds, legumes, whole grains, nuts and seeds, and healthy fats is critically important to your bone health. 
  
• Foods rich in phytonutrients have significant anti-inflammatory properties. Examples include peppermint, parsley, green and black tea, blueberries, cocoa, kale, berries, broccoli, onions, sweet potatoes, carrots, spinach and soybeans. Ginger, garlic, turmeric, omega-3 fatty acids, vitamins A, C, D, and E also have helpful anti-inflammatory properties. So do magnesium and zinc, and significant intakes of fibre.

Maintain a Healthy Microbiome

To maintain your overall health, as well as your bone health, nourish a healthy gut microbiome. To do so, choose a plant-based, unprocessed, high-fibre diet that includes a variety of cultured and fermented foods. Good choices are kefir, traditionally made sauerkraut, and miso.

Adequate Calcium and Vitamin D Intake

Calcium is a very important component of your bones and teeth. It is also necessary for muscle and nerve formation. Several studies have found that women with low calcium intake are at increased risk of osteoporosis and fractures. I recommended a daily allowance of calcium for adults of 1035mg/day.

Vitamin D is essential for your skeletal health. Persistent deficiency can increase your risk of fractures. The recommended daily allowance of Vitamin D for adults ages 51 to 70 is 600 IU/day. If you are over 70, it is 800 IU/day. 

To reduce your risk of osteoporosis or to treat it, it is important that deficiencies of both calcium and Vitamin D be addressed together.

Get Adequate Magnesium

Magnesium is a major component of your bones. It is an essential mineral involved in hundreds of enzymatic reactions in your body. Magnesium deficiency is common. Adequate magnesium intake is important. Your best way to obtain it is by eating an unprocessed, plant-based diet. Good dietary sources include:

• dark green leafy vegetables 
• nuts and seeds 
  
• legumes
• avocados
• whole grains.

Adequate Vitamin K

Vitamin K works with Vitamin D to stimulate bone mineralization. I recommend Vitamin K intake of at least 90mcg for women and 120mcg for men. (Be sure to consult a doctor if you are on Warfarin.) Excellent sources of Vitamin K are 

• green leafy vegetables such as lettuce, collards, spinach and kale
  
• broccoli and green tea.

Adequate Vitamin C

Several studies have shown that higher dietary intake of vitamin C is strongly correlated with a lower risk of hip fracture. Fruits and vegetables offer good sources of Vitamin C. For example, eat: 

• papaya, pineapple, oranges, kiwifruit
  
• broccoli, and red peppers.

Achieve the Right Balance of Essential Fatty Acids

It is important to achieve a balanced ratio of omega-6 to omega-3 fatty acids. Our western diets are usually high in omega-6 fats and low in omega-3 fats. I advise increasing intake of omega-3 rich foods such as walnuts, dark leafy greens, hemp hearts, flaxseed, chia seed, and fatty ocean fish. You can also choose foods fortified with omega-3 fats such as omega-3 eggs. Omega-3 fatty acids have anti-inflammatory effects. They also have beneficial effects on bone.

Soy 

To help maintain good bone health, I suggest eating one to two servings per day of traditional soy foods. Good choices are: tofu, tempeh and edamame.

Other Nutritional Recommendations for Good Bone Health

• Take a good quality multivitamin and mineral supplement
  
• Ensure adequate protein intake. Aim for protein intake of 0.8g/kg or slightly higher. In doing so, take account of your fish and vegetarian protein sources.
  
• Tea is rich in polyphenols and contains trace minerals, vitamin C and vitamin K. It has a wide range of health-promoting effects.

Movement/Exercise

Exercise training programs for women have been found to prevent or reverse bone loss in both the spine and the neck. Exercise will also reduce your fracture risk. Moreover, it will increase cerebral blood flow, elevate your mood and offer beneficial effects for your heart, lungs and digestive system.

Examples of the kind of activities that are preventive in nature include 

• walking, gentle and vigourous aerobic exercise
  
• running and jumping 
  
• racquet sports
  
• weight training. 

Aim for at least 30 minutes of exercise most days of the week. I recommend doing weight training on alternate days. You could also try Tai Chi to improve your balance and help reduce the risk of falls.
If you already have osteoporosis, be sure to consult with a health professional to plan a safe exercise program. 

Mind−Body Work

Several mental health conditions are associated with a higher risk of osteoporosis. Stress reduction by using mind–body practices such as yoga, meditation, self-hypnosis, guided imagery, and breath work is often helpful and can be done while at home.

Practices to Avoid

• Smoking harms your bone health. It can cause lower Bone Mineral Density and increased rate of fracture.
  
• To maintain good bone health and reduce the risk of osteoporosis limit your sodium to 2300 mg/day or less. Limit your coffee consumption to 4 cups or less each day. Avoid excessive alcohol consumption. Evidence increasingly points to the health benefits of keeping alcohol consumption at a low level. 
  
• Minimize or avoid soda and soft drink consumption. Studies repeatedly link these drinks to a higher risk of fracture. 

The material in this article was written by Dr. Louise Gagné. She practiced medicine in Saskatoon for over 35 years and completed a Fellowship in Integrative Medicine at the University of Arizona with Dr. Andrew Weil. She taught nutrition and integrative medicine at the University of Saskatchewan for 15 years. Louise passed away in April of 2023. This submission was made by her husband Peter Prebble so the public can continue to benefit from the expert knowledge that Louise shared with so many patients.