Osteoporosis (also known as brittle bone disease) is a disease characterised by low bone mass and deterioration in the structure of the bone which ultimately causes the bones to become fragile and more likely to fracture. Yet it is largely preventable – how we eat, live and exercise has an enormous impact on how healthy are bones are.

By Jane Clarke

March 20, 2017

Fresh ricotta

Building healthy bones
Who is at risk
Healthy bone diet
Osteoporosis and saturated fat
Salt and calcium absorption
Alcohol and bone health
Caffeine and low calcium
Frequently asked questions on osteoporosis

Osteoporosis (also known as brittle bone disease) is a disease characterised by low bone mass and deterioration in the structure of the bone which ultimately causes the bones to become fragile and more likely to fracture. It can cause a great deal of pain and discomfort, especially when fractures happen, most commonly of the hips, wrists and spine. Yet it is largely preventable – how we eat, live and exercise has an enormous impact on how healthy our bones are.

Building healthy bones
The foundation of strong bones are set in our younger years. If they have a good and continuous supply of calcium and vitamin D, bones continue to grow in density until our late teens and early 20s. Optimising bone health early in our lives can reduce the rate and impact of bone diseases such as osteoporosis later on. If you suffer a fracture in your middle years, or are thought to be at risk, your doctor may suggest a bone scan to assess bone density and assess for osteoporosis.

Who is at risk
Osteoporosis affects more than three million people in the UK, with 500,000 people having hospital treatment for fragility fractures every year as a result of the disease. Women are more at risk then men but there are other factors that can increase osteoporosis risk in both men and women:

• long-term use of high dose corticosteroids or anticonvulsant medication
• inflammatory conditions and hormone-related conditions
• hormonal treatments given as part of cancer therapy
• bowel, digestive or kidney problems
• family history of osteoporosis
• low body mass index (BMI)
• heavy drinking and smoking
• too much caffeine
• high salt intake
• lack of weight-bearing exercise.

Homemade custard

Healthy bone diet
Osteoporosis is largely preventable. Eating and living well can reduce risk of the disease, and reduce its impact and severity.

Foods to eat for healthy bones
Dairy products (unless you are vegan or dairy free, link)
Oily fish and vegetable oils
Small-boned fish, such as sardines
Green leafy vegetables
Soya products
Nut milks, such as almond milk
Dried fruits

Click here for delicious bone-friendly recipes.

Foods to avoid for healthy bones
Too much alcohol
Too much salt
Too much caffeine

Berry butter

Osteoporosis and saturated fat
It can be a juggling act to balance eating enough calcium-rich foods to keep up our bone density without having too much dairy food that’s high in saturated fat, which can increase level of LDL cholesterol. Lower-fat dairy foods can be helpful, especially as low-fat milks contain slightly more calcium than full-fat versions.

I’m generally not a lover of low-fat products, as I don’t think they taste good and they’re often filled with sugar. To get the right balance, choose a dairy food that tastes good, such as a natural yoghurt or fromage frais. The fat content of yoghurt varies a lot – from the runny no-fat variety, which I find disappointing, to the Greek-style yoghurts which can be up to 12 per cent fat. Although they’re higher in fat I tend to go for the latter, as they’re more satisfying, so you don’t feel the need to eat so much. The best solution would be to find something in the middle that you enjoy.

Low-fat cheeses include Gouda, Emmental, Parmesan, fromage frais, fresh feta, ricotta and cottage cheese. The fat content of sheep’s milk and goat’s milk varies, but is harder to find lower-fat versions of these milks.

Although studies don’t yet tell us why, it’s thought that the fatty acids within oily fish and the vegetable-derived oils help to support good bone health.

Salt and calcium absorption
High salt intakes have been associated with an increase in the amount of calcium we lose in our urine. If we bear in mind that too much salt also has a negative effect on our heart health, it’s a good idea to keep your intake down.

For more on salt and heart disease, see Be Salt Savvy and Heart Disease.

Alcohol and bone health
Bones don’t like too much alcohol. Chronic alcohol abuse tends to damage the cells that manufacture new bone and also interferes with the way our livers behave, which can have a profound impact on the metabolism of key nutrients such as calcium and vitamin D.

Caffeine and low calcium
Too much caffeine can interfere with the amount of calcium we absorb, so enjoy a cup of really good coffee or tea, rather than drinking litres of inferior brews, or change to a caffeine-free alternative. Some people I see in my clinic who are diagnosed with low bone density or osteoporosis, or who really want to maximise the amount of calcium their body can absorb, prefer to give up caffeine altogether. But equally, studies don’t show that a couple of caffeine drinks a day will do any harm to your bones.

Smoked trout pate

Frequently asked questions on osteoporosis
Q Why are women more at risk of osteoporosis?
A When women reach the menopause, usually around age 50, our bone density rapidly decreases. We lose an average of about 2 to 3 per cent over the next five to 10 years, with the loss at its greatest in the early post-menopausal years.

Q Does osteoporosis run in families?
A There’s a strong genetic link that can put us more at risk of developing osteoporosis, so it’s worth looking at your family history to see if your mother, grandmother or another close female family member developed the disease.

Q Will HRT protect me from osteoporosis?
A One of the benefits of hormone replacement therapy (HRT) is bone protection, but taking this is such a personal decision so discuss the pros and the cons of taking HRT with your doctor.

Q How can I boost my calcium if I don’t eat dairy foods?
A There are lots of foods that will provide you with easily absorbed calcium. Small fish like sardines and anchovies that you eat whole, including the calcium-rich bones. Green, leafy vegetables like cabbage and kale are rich in calcium, as are nuts, seeds and dried fruit. For lots more ideas, see Reduced Bone Mass and Osteoporosis.

Q Should I take a calcium supplement?
A Even with a diet packed with calcium-rich foods, you may find it difficult to eat enough bone-friendly calcium, as well as essential magnesium and vitamins K and D, if you don’t eat dairy products, if you have low bone density or strong risk factors for developing osteoporosis. In these cases, you may want to consider adding a daily combined calcium, magnesium and vitamin D supplement to your diet.

Q Are fortified foods helpful?
A You can buy calcium-fortified breads and even orange juice, although I think it’s much better to get your calcium from natural sources if possible. There are so many tasy calcium-rich foods out there, even if you don’t eat dairy products, that you really don’t need to look for processed alternatives.