Jessica T. Wei MD, FACOG
As we age, we are at increased risk for low bone mass (formerly called osteopenia) and osteoporosis, which makes us more susceptible to fractures, decreased mobility, pain, and even death, after complications of having a hip fracture. Low bone mass and osteoporosis are increasingly more common, with an estimated 10.2 million adults diagnosed with osteoporosis and 43.4 million with low bone mass in the United States in 2010. So what can we do to keep our bones strong and healthy?
- Eat a high alkaline, anti-inflammatory diet. This generally means a largely plant-based diet with an emphasis on whole fruits and vegetables, raw foods, green juices, beans, and nuts, and avoidance of high-sodium foods, processed grains, too much meat and animal protein, and added sugar.
- Avoid gluten. Gluten is a strong trigger for leaky gut and inflammation which can lead to increased bone loss.
- Support healthy gut bacteria and gut function which help to influence bone remodeling by eating prebiotic and probiotic foods, as well as bone broth. Supporting gut health also allows the best digestion of food and absorption of nutrients needed for bone health such as calcium, magnesium, Vitamin D and Vitamin K.
- Limit the prolonged use of medications which decrease stomach acid such as proton-pump inhibitors, which can lead to decreased absorption of calcium.
- Consider having your Vitamin D level checked. A level below 30 ng/dL is considered to be a deficiency. Sun exposure is the best form of Vitamin D supplementation. Taking a Vitamin D supplement if you must limit your sun exposure may be recommended. Opinion about what constitutes an optimal Vitamin D level varies (depending on calcium and parathyroid hormone levels), and optimal vitamin D levels for individuals vary.
- Optimize Vitamin K2 intake (100 mcg/day) through supplementation or through diet (animal foods and fermented plant foods). Vitamin K2 directs calcium to bones and teeth, and keeps it away from the kidney and blood vessels.
- Calcium (1000-1200 mg/day)is best obtained through food rather than supplementation. Best food sources: dairy products, sardines, salmon, dark leafy greens and blackstrap molasses. If used, calcium citrate supplementation should be accompanied by adequate Vitamin K2, Vitamin D, and magnesium.
- Magnesium (400 -800 mg/day) is also critically important for bone health as it aids in the conversion of Vitamin D to its active form and allows adequate absorption of calcium. Best food sources: nuts, seeds, legumes, green leafy vegetables like kale and collards, whole grains and avocados. The most easily absorbed forms of magnesium are magnesium glycinate, taurate, malate, threonate, and citrate.
- Engage in weight-bearing exercise such as tai-chi, yoga, brisk walking, dancing, hiking, and strength-training.
- Practice relaxation and meditation to reduce stress and excessive production and release of cortisol which over time leads to excessive bone breakdown.
These are just the beginning of many things to consider when aspiring to maintain good bone strength and health; nevertheless, it’s a great start!