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By Carla Centola, RD and Kyle Stunden, DC

Osteoporosis is a condition in which bones slowly deteriorate due to progressive bone loss, which reduces their strength and makes them more likely to break. By the time fractures occur, the disease is quite advanced and thus harder to treat. That’s why, according to Osteoporosis Canada, this disease is also called ‘the silent killer’ – it develops slowly in the background over the course of many years.

Who is at risk?

Here are some interesting statistics to consider about osteoporosis:

  1. Osteoporosis affects everyone but it is most common in women after menopause
  2. 2 million Canadians are affected by osteoporosis, and it is most common among Canadians 50 years of age or older
  3. At least one in three women and one in five men will break a bone due to osteoporosis in their lifetime, and though fewer men are affected, the risk of mortality after a hip fracture is higher in men
  4. Fragility fractures represent 80% of fractures in menopausal women over the age of 50
  5. Fractures from osteoporosis are more common than heart attacks, strokes and breast cancer combined

By now you’re probably wondering what you can do to reduce your risk of osteoporosis and keep bones strong. Here you go:

Make sure you include calcium-rich foods in your diet

Calcium is essential for the maintenance of normal bone health. Your calcium requirements depend on your age, gender and whether or not you are pregnant or nursing. A dietitian can tell you more about your current calcium requirements.

Ideally, you should get your calcium from food, but this may not always be possible. In that case, you can use supplements such as calcium carbonate or calcium citrate.

As a rule of thumb, if you aim for one serving of a calcium-rich food with each meal, you are likely to meet your daily calcium requirements.

For example: you can drink a glass of milk (dairy, or a calcium-fortified milk alternative), opt for soup made with milk, dairy or alternative (think cream of mushroom soup, chowder), or main courses made with cheese or cheese alternatives. Tofu is a great source of protein, and is rich in calcium, though the amount of calcium in each serving of tofu can vary by brand. Always read the label! Snack on calcium-rich foods such as hummus made with tahini (sesame butter,) nuts (especially almonds) or add dark leafy greens to a smoothie.

No dairy? No problem!

If you are intolerant to dairy products or prefer to avoid them, here are calcium-rich alternatives:

  • Calcium-fortified soy, almond, oat and rice beverages (check the nutrition labels)
  • Calcium-fortified orange juice (check the nutrition labels) and consider this an occasional treat – juice contains a lot of sugar, and since the fiber is removed through the juicing process, this sugar is absorbed and digested very quickly by the body
  • Canned salmon or canned sardines, bones included. (Fish bones are softened during the canning process, which makes these foods excellent sources of calcium!).

As a dietitian, I strongly recommend you obtain your calcium through diet. If that is not possible, you will need to consider supplements. However, because sometimes calcium supplements can interact with other nutrients and affect their absorption, or lead to constipation, discuss your supplementation plan with your health practitioner or dietitian beforehand.

What happens if I get too much calcium?

This is a rare occurrence from diet alone, but when supplementing with calcium it’s easy to exceed your needs. When your consumption of calcium consistently exceeds your requirements, you increase your risk of kidney stones, and cardiovascular disease. Your iron levels can drop since calcium can inhibit iron absorption.

Try a calcium calculator or talk to your dietitian about how to increase calcium naturally through foods over supplements.

The sunshine vitamin

Vitamin D (also known as the “sunshine vitamin”) is essential for bone development because it helps the body absorb calcium.

Vitamin D can be made in the skin after exposure to UVB rays from the sun, but keep in mind that sunscreen, older age, winter season and extensive coverage of skin by clothing can get in the way.

Get out in the sun for 15 to 30 minutes a day, depending on where you live and also on the time of day. Avoid overexposure in the hottest midday summer sun though – you’ll burn your skin and increase your risk of skin cancer over time.

So where else can you get vitamin D?

In Canada, there is a requirement for cows’ milk and margarine to be fortified with vitamin D. Some milk alternatives such as almond or soy can be fortified with vitamin D, so check the label! Vitamin D can be found naturally in a few foods, such as fatty fish, fish liver oils, and egg yolk.

However, if you don’t consume these foods regularly, you may benefit from a supplement. Health Canada currently recommends everyone over the age of 50 to take a supplement of 400 IU daily, in addition to dietary sources of Vitamin D.


What about exercise?

Exercise is an important factor in preventing osteoporosis, and an important addition to everyday life in general. When you exercise regularly, you help prevent bone loss, increase physical strength and improve your balance.

An ideal exercise regimen includes strength training, balance activities and aerobic exercises! Good balance means a lesser risk of falls, the main cause of injury in older adults.

Strength training consists of body weight or weighted exercises, for arms, legs and chest. Balance activities can include Thai chi, yoga or dancing, and aerobic activity includes activities such as walking, running, hiking or biking.

Aim for at least 150 minutes of physical activity per week, which is equivalent to almost 30 minutes about 5 days per week.

When and where do I start?

What better time than now? Talk to your health practitioner about the changes you can make today. You can also make an appointment with a dietitian to help design a diet plan that will help maintain healthy bones. A chiropractor or physiotherapist can help you put together an adequate physical activity regimen and off you go! Come see us, we can help you make your best health possible!

See you soon!

Here are some additional resources for you to consult:

Bone Health During Covid-19

Calcium and Vitamin D

Exercises for Healthy Bones

Osteoporosis Canada

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