It's estimated that nearly two million Canadians live with osteoporosis, a disease that causes bones to become weak and brittle, increasing the risk of fracture. In fact, one in six women will suffer a hip fracture during her lifetime – greater than her lifetime risk of developing breast cancer (one in nine).
But it's not only women who get osteoporosis – at least one in eight men over 50 have the condition. It affects mainly older adults, but it can strike at any age, even well before you hit your 50s.
Because you can't feel the bone loss caused by osteoporosis, it's hard to imagine that what you are eating, or not, is hurting your bones.
And there's more to the story than calcium. In addition to this bone builder, there are a number of other foods and nutrients that defend against osteoporosis.
Risk factors for osteoporosis include older age, suffering a bone fracture after age 40, family history, low bone mass, cigarette smoking, inactivity, excessive alcohol consumption and long-term use of corticosteroid medications such as prednisone and cortisone.
Whether or not you're at high risk for osteoporosis, it's never too late to make dietary changes that help keep bones healthy throughout life.
Get enough calcium Adults aged 19 to 50 need 1,000 milligrams of calcium each day, and older adults require 1,200 mg. Teenagers need 1,300 mg of the mineral daily and children aged 4 to 8 should get 800 mg.
One cup of milk, 3/4 cup of plain yogurt and 1.5 ounces of cheese each contain roughly 300 mg of easily absorbed calcium. Other sources include fortified soy beverages (300 mg per 1 cup), sardines with bones (3 ounces has 325 mg), canned salmon with bones (3 ounces has 188 mg), cooked Swiss chard (1 cup has 102 mg), cooked broccoli (1 cup has 62 mg) and almonds (1/4 cup has 92 mg).
If you can't get enough calcium from food, take a supplement. Calcium carbonate pills typically offer 500 mg of calcium and are best absorbed when taken with or immediately after a meal. Calcium citrate supplements provide 250 to 350 mg per tablet and are well absorbed at any time.
Most multivitamins do not contain enough calcium to suffice as a supplement.
Take vitamin D This nutrient enhances calcium absorption from foods and is essential to preventing osteoporosis. While exposure to sunlight provides vitamin D, from October to April the sun isn't strong enough to produce vitamin D in the skin.
Osteoporosis Canada recommends a daily vitamin D3 supplement of 400 to 1,000 IU for adults under 50 who don't have osteoporosis. After 50, a daily supplement of 800 to 2,000 IU is recommended. If you're over 50 – or have osteoporosis – take vitamin D year round.
Eat leafy greens Spinach, Swiss chard, beet greens, kale, rapini and arugula are rich in vitamin K, a nutrient needed to build bone. Studies have linked higher vitamin K intakes with a significantly lower risk of hip fracture.
Scientists speculate it takes a daily intake of 200 micrograms of vitamin K to protect bones from thinning – an amount that can easily be obtained by eating 1/2 a cup of cooked greens each day.
Reduce salt Excess salt causes calcium to be excreted from the body. Keep your daily sodium intake under 2,300 mg. Adults require no more than 1,500 mg of sodium per day.
Read labels to choose packaged foods that are lower in sodium. Eat more meals prepared at home rather than in restaurants.
Curb caffeine Caffeine, too, can increase calcium excretion – especially if you're not meeting your daily requirement for the mineral.
Limit your caffeine intake to 450 mg per day (1 cup of coffee has 100 to 175 mg; 1 cup of black tea has 45 mg). If you have osteoporosis, aim for no more than 200 mg.
Avoid soft drinks Many soft drinks – diet and regular – contain phosphoric acid, a flavour additive and preservative. Consuming too much may cause bones to lose calcium, making them weaker.
Limit alcohol Consuming more than two drinks per day can reduce bone formation and interfere with calcium absorption. If you drink, limit your intake to seven drinks per week (women) and nine per week (men).
Lose weight sensibly Crash dieting for an extended period – consuming 1,000 calories or fewer per day – can cause bone loss. Experts suggest a threshold of at least 1,200 calories per day is needed to maintain bones.
Aim to lose weight at a safe rate of one to two pounds per week while meeting you daily calcium needs.
Exercise regularly Weight-bearing exercises – walking, jogging, stair climbing, hiking – help maintain bone density in your legs, hips and lower spine. Strength training helps strengthen muscles and bone in your arms and upper spine.
Exercise can also improve posture and balance and, as a result, reduce the risk of falling and breaking a bone.
Leslie Beck, a Toronto-based dietitian at the Medcan Clinic, is on CTV's Canada AM every Wednesday. Her website is lesliebeck.com.