Osteoporosis Diet: Foods To Eat And Avoid

Strong bones are essential for being able to stay active. 

Your bones make up about 15% of your body weight and play a vital role in your mobility and health. 

Your skeletal system, along with your muscles, tendons, and ligaments, allow you to walk, run, jump, and perform essential daily tasks.

Osteoporosis is a disease impacting your bone density and can lead to an increased risk for fracture. 

How can you support your bone health if you have osteoporosis? One of the first places to start is through your diet. 

Keep reading to learn what not to eat if you have osteoporosis and what foods you should include in your diet.

What is osteoporosis?

Osteoporosis is a disease where your body loses too much bone, doesn’t build enough new bone, or a combination of both. Osteo means “bone,” and porosis means “porous,” which describes how bones with osteoporosis look on the inside when examined.

Osteoporosis most commonly impacts women over 50, but it can also affect men. It’s estimated that osteoporosis will impact 20% of women over the age of 50. Some common osteoporosis symptoms include bone fractures, back pain, and loss of height.

Women tend to have osteoporosis more than men because they have smaller, less dense bones, and hormonal changes later in life can impact bone health. Women also tend to lose bone earlier in life than men and lose bone at a more rapid rate.

Osteoporosis and diet

Your diet and the foods you eat play an important role in the management of osteoporosis. Osteoporosis can be treated with prescription medications, but maintaining a healthy diet and practicing other healthy lifestyle habits is important to prevent further bone loss.

Foods to eat if you have osteoporosis

Calcium-rich foods

Calcium makes up a significant portion of bone tissue in the form of calcium phosphate, collagen, and other factors.

Calcium is one of the best-known dietary factors impacting bone health, especially since low calcium intake can increase your risk of bone loss later in life. 

It’s recommended to consume 1200 milligrams of calcium daily if you have postmenopausal osteoporosis, or 1000 milligrams daily otherwise.

Some of the best sources of calcium come from dairy products or calcium-fortified products. To help support bone health with osteoporosis, eat calcium-rich foods like:

  • Milk (cow’s milk or calcium-fortified dairy-free milk alternatives)
  • Cheese
  • Yogurt
  • Edamame (young soybeans)
  • Tofu
  • Canned sardines with bones
  • Leafy green vegetables like spinach, kale, and collard greens*
  • Calcium-fortified products like orange juice and cold cereals
  • Almonds
  • Broccoli
  • Tahini (made from sesame seeds)
  • Blackstrap molasses

*Some leafy greens like spinach are high in oxalates. Oxalates reduce calcium absorption, so you shouldn’t rely on high-oxalate calcium foods alone to meet your calcium needs.

Vitamin D

Like calcium, low vitamin D intake can increase your osteoporosis risk. If you already have osteoporosis, consuming enough vitamin D is important to help your body absorb calcium better.

Vitamin D isn’t found naturally in many foods, so you might need to take a supplement if you don’t eat enough from your diet. 

It’s recommended to consume 800 IU of vitamin D daily if for postmenopausal osteoporosis and 600 IU of vitamin D daily otherwise.

Some sources of vitamin D-rich foods include:

  • Fortified milk, both dairy and plant-based
  • Cod liver oil
  • Salmon
  • Swordfish
  • Tuna fish
  • Fortified products like cereals
  • Sardines
  • Beef liver
  • Egg yolks

Vitamin C

Collagen is a protein that builds the framework for the bone matrix, which is later filled with calcium and other minerals to make bones strong and dense.

With osteoporosis, your body needs vitamin C to build collagen and support bone growth and density. Vitamin C is an antioxidant helping to fight invaders that can be detrimental to bone health.

Researchers noted that very high doses of vitamin C can be detrimental to bone health, so try to obtain it from whole foods versus high-dose supplements.

Vitamin C-rich foods include:

  • Citrus fruits like oranges, kiwis, lemons, and grapefruits
  • Bell peppers
  • Strawberries
  • Tomatoes
  • Cruciferous vegetables like broccoli, Brussels sprouts, cabbage, and cauliflower
  • White potatoes

Magnesium

Magnesium is another mineral that plays a role in bone density. People with higher magnesium intakes tend to have higher bone mineral density, reducing your risk of bone fracture. Conversely, low magnesium intake can promote osteoporosis by negatively impacting bone crystal formation.

Some magnesium-rich foods to eat for osteoporosis include:

  • Pumpkin seeds
  • Almonds
  • Spinach
  • Cashews
  • Peanuts
  • Soymilk
  • Black beans
  • Edamame
  • Dark chocolate
  • Peanut butter
  • Whole wheat bread

Green tea

According to some studies, green tea leaves are especially high in compounds that may be beneficial for bone mass. 

A meta-analysis of 16 studies concluded that tea consumption could increase bone mineral density, yet its potential impact on osteoporosis-related fractures needs more research.

One thing to keep in mind is that all types of tea contain oxalates, which are compounds that can reduce calcium absorption. If you drink tea, avoid taking any calcium supplements with tea, and separate tea and calcium-rich meals.

Quality protein

A balanced diet with enough (but not excessive amounts of) protein, from animal and plant sources, can benefit bone health. The recommended daily protein allowance for adults over 70 ranges from 46-56 grams. 

You can get quality protein from sources like:

  • Red meat
  • Poultry
  • Fish
  • Eggs
  • Soybeans/soy products
  • Dairy products
  • Nuts and seeds
  • Legumes

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Foods to avoid if you have osteoporosis 

High-sodium foods

Sodium is one of the main minerals in sodium chloride, also known as table salt. Excessive sodium intake can reduce calcium levels by causing your body to lose calcium by releasing calcium in your urine.

Furthermore, osteoporosis is linked with high blood pressure. Limiting your sodium intake is one of the most important aspects of promoting healthy blood pressure levels.

Sodium is the highest in processed foods since it acts as a preservative. Salt is an inexpensive flavor enhancer, so it’s often used in ready-to-eat foods such as fast food and other convenience foods.

Some of the highest sodium foods to avoid if you have osteoporosis are:

  • Deli and cured meats
  • Salty snacks (chips, pretzels, etc.)
  • Quick-bread mixes
  • Canned soups
  • Frozen entrees
  • Fast food like pizza, salted French fries, etc.

Foods high in phytates & oxalates (excessive amounts)

Phytates and oxalates can reduce your body’s absorption of calcium, which can worsen osteoporosis. Many phytate- and oxalate-rich foods are healthy and contain nutrients that can benefit osteoporosis, so you shouldn’t necessarily avoid them. Instead, aim to eat moderate amounts of high-phytate foods in an overall balanced diet. 

Some foods rich in phytates and oxalates include:

  • Whole grains, especially wheat bran
  • Nuts and seeds
  • Legumes
  • Spinach
  • Rhubarb
  • Rice bran

Caffeine

“Heavy” caffeine intakes can increase the urinary excretion of calcium and interfere with the formation of cells that build bone tissue. “Moderate” coffee consumption, or the equivalent of 1-2 cups a day, doesn’t appear to significantly impact calcium levels in postmenopausal women.

While light- to moderate-caffeine intake is likely safe when balanced with healthy lifestyle habits for osteoporosis, you may want to avoid excessive consumption of caffeine products like:

  • Strong espresso drinks 
  • Energy drinks or “shots”
  • Caffeinated sodas
  • Black teas

Colas and other drinks with phosphorus

Consumption of colas, but not other carbonated drinks, is associated with lower bone density in older women. Contrary to a popular myth, carbonation has not been found to cause bone damage.

The ingredient in cola that is thought to contribute to lower bone mineral density is phosphorus. Phosphoric acid, a common ingredient in dark colas, can cause an imbalance between phosphorus and calcium, leading to decreased bone density, fractures, and osteoporosis. This is especially true if calcium intake is low.

Alcohol

Chronic and heavy alcohol consumption is associated with an increased risk of osteoporosis by negatively impacting bone health. 

Heavy alcohol use weakens bones, so aim to keep your alcohol intake within the recommended guidelines. This means one drink or fewer per day for women and two drinks or fewer per day for men.

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Other tips to help osteoporosis

Exercise

Weight-bearing exercises can help increase bone density. Walking, dancing, low-impact aerobic exercises, and using exercise equipment like the elliptical trainer and stair stepping machine.

While swimming and biking are also beneficial, you don’t bear weight as you do with the other types of exercise, so they aren’t as helpful for osteoporosis. Weight-bearing exercise causes your muscles and tendons to stimulate your bones to make more bone tissue. 

Weight lifting and resistance training can also help build bone tissue. Strength training can also help your muscles better support your skeletal system and reduce your fall risk, which could lead to fractures if you have osteoporosis.

Don’t smoke 

Tobacco use, such as smoking, is associated with an increased risk of bone fracture and osteoporosis. Smoking can also inhibit bone healing if you’ve experienced a fracture.

Conclusion

Osteoporosis is a disease that reduces bone mass and strength, increasing your risk for bone fracture. Osteoporosis is most common in older women but can also impact men.

Foods to eat to support bone health with osteoporosis include those rich in calcium, vitamin D, vitamin C, and magnesium.

If you have osteoporosis, avoid consuming large amounts of sodium, caffeine, alcohol, and excessive intakes of foods that can reduce calcium absorption, like phytates and oxalates.

Other ways to support bone health if you have osteoporosis are engaging in weight-bearing exercise and not smoking.

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Sources

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  3. Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients. 2013 Jul 31;5(8):3022-33. 
  4. Shen CL, Yeh JK, Cao JJ, Wang JS. Green tea and bone metabolism. Nutr Res. 2009 Jul;29(7):437-56. 
  5. Guo M, Qu H, Xu L, Shi DZ. Tea consumption may decrease the risk of osteoporosis: an updated meta-analysis of observational studies. Nutr Res. 2017 Jun;42:1-10.
  6. Carbone L, Johnson KC, Huang Y, Pettinger M, Thomas F, Cauley J, Crandall C, Tinker L, LeBoff MS, Wactawski-Wende J, Bethel M, Li W, Prentice R. Sodium Intake and Osteoporosis. Findings From the Women’s Health Initiative. J Clin Endocrinol Metab. 2016 Apr.
  7. Luciana Do Carmo, David G. Harrison, Hypertension and osteoporosis: Common pathophysiological mechanisms, Medicine in Novel Technology and Devices, Volume 8, 2020, 100047, ISSN 2590-0935.
  8. Coronado-Zarco R, Olascoaga-Gómez de León A. Reply on “Coffee consumption and bone health: A risk assessment”. Osteoporos Sarcopenia. 2020 Mar;6(1):34-35. 
  9. Tucker KL, Morita K, Qiao N, Hannan MT, Cupples LA, Kiel DP. Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study. Am J Clin Nutr. 2006 Oct.
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