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10 tips to fight osteoporosis: even if you're at an elevated risk, EN's nutrition and lifestyle strategies can help push back the inevitable.

Because 70 percent of our bone destiny is due to heredity, you're at greater risk for osteoporosis if you have a family history of the disease--but that doesn't mean you can't help shape the health of your bones.

We actively build bone until our mid-20s, then we start to slowly lose bone mass. One in 2 women, and 1 in 4 men, age 50 or older will break a bone due to osteoporosis. Until they break that wrist, hip, or vertebrae in the spine, odds are they will have no idea they have osteoporosis. In women, that risk of bone loss temporarily speeds up for about 5 years post-menopause. While it's best to develop bone-healthy habits in childhood, you can take action at any age to improve both bone and muscle health, even if your genes may be working against you. Why is muscle important? Maintaining muscle as you age makes it more likely that you can stop a fall--and prevent a fracture--if you lose your balance.

1 Don't Fear Calcium. You know that calcium is important for strong bones--but you may also be concerned that calcium supplements increase the risk of cardiovascular disease. Andrea Singer, MD, FACP, CCD, National Osteoporosis Foundation (NOF) trustee and clinical director, says that calcium intake from food and supplements that doesn't exceed 2000-2500 milligrams (mg) per day should be considered safe from a cardiovascular standpoint, based on a recent rigorous review of the evidence by the NOF and the American Society of Preventative Cardiology.

2 Supplement Calcium Smartly. The NOF recommends that women under age 50 get 1,000 mg of calcium per day and women 50 and older get 1,200 mg. Men age 70 and younger need 1,000 mg per day, those 71 and older need 1,200 mg. "Obtaining calcium from food sources is preferred," Singer says. "Supplemental calcium can be safely used to make up any shortfalls in your diet."

3 Look Beyond the Obvious. Calcium-rich foods beyond dairy products include canned sardines and salmon that still have their bones, tofu made with calcium, tempeh, calcium-fortified soymilk, and some dark leafy vegetables. Collard greens, broccoli rabe, turnip greens and kale are the best of the bunch.

4 Don't Block Calcium. Spinach and beet greens contain oxalic acid, which makes their calcium unavailable to us. Cooking greatly reduces oxalic acid, and eating a food with oxalic acid does not affect absorption of calcium from other foods you eat during the same meal. One food that will block calcium absorption is wheat bran--if you eat wheat bran cereal with milk, you will only absorb some of the milk's calcium.

Load Up on Produce. A diet rich in fruits and vegetables creates an environment in the body that prevents bone and muscle breakdown. Antioxidants and other nutrients, like potassium, in produce help prevent calcium loss. Produce and plant foods include still more nutrients that Singer says are good for bone health, including magnesium, and vitamins K and C.

6 Stock Up on Vitamin D. Vitamin D is essential for absorbing calcium, but it also helps build muscle. When exposed to the sun, your skin produces vitamin D. However, most of us protect our skin from the sun. Food sources include fatty fish, and fortified foods such as milk and most soymilks. Mushrooms contain variable amounts. Taking 800-1,000 IUs of supplemental vitamin D with food is recommended for osteoporosis prevention if you don't get enough through diet, especially if you live in northern states where vitamin D production from sunshine exposure may be limited.

7 Power Up with Protein. Adequate--but not excessive--protein is good for both muscle and bone. Divide your weight in pounds in half to estimate your protein goal in grams. So, if you weigh 150 pounds, aim for about 75 grams of protein per day.

8 Calm Inflammation. Omega-3 fatty acids, both EPA and DHA from fatty fish and ALA from walnuts and flax seed, can help reduce inflammation in the body--important, because inflammation can accelerate bone loss.

9 Get-and Stay-Active. Weight-bearing exercise--walking, running, strength training--stimulates bone-building activity and builds and maintains muscles. Exercises that help improve balance can also help avoid falls.

10 Avoid "Bad to the Bone" Behaviors. These include smoking, and excessive intake of alcohol, caffeine and sodium, all of which can increase calcium loss. Yo-yo dieting has also been shown to reduce bone density.
Salmon and White Bean Salad

1 6-oz can salmon with     3 Tbsp sesame seeds
bones, drained             3 Tbsp capers, rinsed
1 15-oz can white beans,   2 Tbsp extra-virgin olive oil
drained and rinsed         2 Tbsp fresh lemon juice
3 c destemmed, chopped     Salt and pepper to taste
1. Place salmon in a medium bowl and break up
with a fork. Add beans, kale, sesame seeds and
capers, and gently toss.
2. In a small bowl, whisk olive oil and lemon juice
together and toss into salad.
3. Add salt and pepper to taste, toss gently, and serve.
Makes 3 servings
Nutrition Information Per Serving: 408 calories, 17 grams (g) fat,
39 g carbohydrate, 28 g protein, 11 g dietary fiber, 452 mg sodium.
Recipe by Carrie Dennett, MPH, RDN

--Carrie Dennett, MPH, RDN

Caption: Dairy products, kale, and tofu are rich in bone-loving nutrients.
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Author:Dennett, Carrie
Publication:Environmental Nutrition
Date:Feb 1, 2017
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