Maintaining a healthful diet with the recommended amounts of calcium, vitamin D, protein, and other nutrients is critical to supporting good bone health. What Is the Osteoporosis Diet?

Published on December 13, 2022

Medically reviewed by Anita C. Chandrasekaran, MD

While medication is often prescribed to treat osteoporosis, maintaining a healthful diet with the recommended amounts of calcium, vitamin D, protein, and other nutrients is critical to supporting good bone health. Avoiding ultra-processed foods, added sugars, and excess alcohol can also help.

This article looks at the best foods for bone health and foods to avoid to help with osteoporosis.

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Benefits

A balanced diet that includes nutrients such as calcium, vitamin D, and protein, helps prevent further bone loss and reduces the risk of fractures. This eating pattern can also help prevent osteoporosis in those without the condition.¹

Calcium

Calcium for Osteoporosis diet

Calcium is vital for building and maintaining strong bones. Inadequate calcium intake throughout life is associated with low bone density and high fracture rates.² When you don’t consume enough calcium in your diet, your body pulls calcium from your bones, which can contribute to bone loss.³

Though some individuals require a calcium supplement, they should be used with caution and under the supervision of a healthcare provider. Studies have linked calcium supplements to an increased risk of kidney stones, colon polyps (small growths in the large intestine), and heart disease.⁴⁵

Foods high in calcium include:⁶

Milk
Cheese
Yogurt
Dark, leafy green vegetables, such as kale, spinach, and collard greens
Tofu
Nuts and seeds
Legumes
Canned salmon and sardines with bones

Daily Recommended Calcium Intake

Females who are 51 years and older require 1,200 milligrams of calcium daily, while males need 1,000 milligrams. Beginning at age 70, men and women require 1,200 milligrams daily.²

Vitamin D

Your body needs vitamin D to absorb calcium and keep muscles strong. Low vitamin D levels are associated with decreased bone density, which can lead to osteoporosis and broken bones.⁷⁸

You can get vitamin D from the sunlight and from eating vitamin D–rich foods. However, few foods are naturally rich in vitamin D. The best sources are the flesh of oily fish such as trout, salmon, or tuna and fish liver oils.⁹

Other dietary sources of vitamin D include:

Orange juice fortified with vitamin D
Beef liver
Mushrooms
Egg yolks
Sardines
Plant-based milk fortified with vitamin D
Cheddar cheese

Daily Recommended Vitamin D Intake

Individuals 70 and younger should consume 600 IU (international units) of vitamin D daily. People over 70 should increase their consumption to 800 IU daily.²

Protein

Around 50% of your total bone volume and about one-third of bone mass is made of proteins. Dietary protein affects the secretion and action of insulin-like growth factor I (IGF-I), a hormone essential for bone formation.¹⁰

While it was once believed that too much protein might cause a negative calcium balance and bone loss, some studies suggest that a protein-rich diet, combined with adequate dietary calcium intake, is essential for bone health.¹⁰

Good dietary sources of protein include:

Lean meat
Seafood
Eggs
Beans
Legumes
Nuts and seeds

How Much Protein Do I Need?

Many experts recommend a dietary protein intake of 1.0–1.2 grams per kilogram of body weight per day, including around 20–25 grams of high-quality protein at each meal.¹⁰

Other Nutrients

Dietary patterns rich in fruit and vegetables are associated with higher bone mineral density.¹¹

Vitamins and minerals commonly found in fruits and vegetables that play a role in bone health include:¹¹

Magnesium
Potassium
Vitamin K
Vitamin C
Carotenoids

How It Works

A good diet for osteoporosis incorporates various nutrients that support bone health. There are no special rules, but try to eat more nutrient-dense foods to ensure optimal amounts of vitamins, minerals, protein, and other vital nutrients daily.

Studies suggest that a calcium intake that meets the current recommended daily allowance and a Mediterranean-style diet may be effective in maintaining good bone health and preventing osteoporosis.¹²

High intakes of fruits, vegetables, legumes, nuts, whole grains, fish, seafood, and extra virgin olive oil are included in the Mediterranean diet. It is generally low in red meat.¹³

What If I Am Lactose Intolerant or Follow a Vegan Diet?

Eating dark, leafy greens, colorful veggies, beans, and nuts, as well as spending a moderate amount of time in the sunshine, are good ways to meet your daily protein, calcium, and vitamin D requirements without dairy or meat products.

Foods to Avoid, Limit, or Replace

The overconsumption of certain foods, such as added sugar, salt, ultra-processed foods, caffeine, and alcohol, may lead to bone loss and increase your risk for osteoporosis.

Ultra-Processed Foods

One study found that diets rich in red and processed meat, refined grains, and sweets were linked to a lower bone mineral density and a higher fracture risk.¹⁰

Another study linked diets high in ultra-processed foods, such as cheese, french fries, processed meat, pastries, pizza, snacks, and refined grains, with a lower bone mineral density when compared to other diets.¹¹

A high fat intake mainly derived from processed foods directly interferes with calcium absorption in the gut. It also places you at a greater risk for obesity, which can also negatively affect bone health.¹⁰ Replacing high-fat processed foods with healthy fats, such as avocado and olive oil, can also help you maintain a healthy weight.

Salt and Sugar

Too much salt may increase the amount of calcium your body excretes with urination. Aim to consume less than 2,300 milligrams per day, equal to about 1 teaspoon of table salt.²

Overconsumption of added sugars may increase the risk of osteoporosis by reducing calcium absorption in the gut, increasing the urinary excretion of calcium and magnesium, and impairing bone formation.¹⁴

Reduce your salt intake by swapping prepackaged snacks for whole foods, chicken broth for low-sodium chicken broth, and processed meats for fresh proteins flavored with herbs and spices. Moreover, many sodas are high in sugar and phosphoric acid additives, which can prevent bone mineralization.

Caffeine

Caffeine may interfere with calcium absorption. However, evidence to support its effects on bone health remains limited.

One study found that the consumption of 800 milligrams of caffeine resulted in a 77% increase in calcium eliminated by the kidneys compared to a placebo (a substance containing no caffeine) over nine hours.¹⁵ Another study found that people who regularly drank coffee had higher bone mineral density than non-coffee drinkers.¹⁶

If you’re a coffee drinker, aim for two to three cups daily, as long as you eat enough calcium-rich foods.¹⁷ One 8 ounce cup of coffee has around 96 grams of caffeine. Swap caffeinated beverages for flavored water or decaffeinated coffee or tea to reduce caffeine intake.

Alcohol

Excessive alcohol consumption interferes with calcium balance, and the body’s natural production of vitamin D.¹⁸ Individuals with alcoholism also tend to have high levels of cortisol, which can increase bone breakdown and decrease bone formation.

Excess drinking can cause hormone deficiencies in both men and women. Males may produce lower amounts of testosterone, a hormone linked to bone formation. Females may experience irregular menstrual cycles, which can reduce estrogen levels and increase the risk of osteoporosis.

Summary

Osteoporosis diet

A balanced diet rich in bone-supporting nutrients like protein, calcium, and vitamin D and low in ultra-processed foods, alcohol, added sugar, and sodium is best to support bone health. You may also want to limit your daily caffeine intake. If you’d like to develop an osteoporosis meal plan tailored to your health needs and dietary preferences, consider working with a registered dietitian.

By Lindsey DeSoto, RD, LD
Lindsey Desoto is a registered dietitian with experience working with clients to improve their diet for health-related reasons. She enjoys staying up to date on the latest research and translating nutrition science into practical eating advice to help others live healthier lives.

Conclusion

Osteoporosis is a common condition that can be treated with healthy lifestyle habits and, sometimes, medications. Many people can achieve healthy calcium and vitamin D levels by following a balanced, nutrient-dense diet, while others may still require supplementation. Work closely with your healthcare provider to determine the best osteoporosis treatment plan for you.

FREQUENTLY ASKED QUESTIONS

Do certain foods make osteoporosis worse?

Foods with a lot of added sugar and salt, such as processed foods, can increase the amount of calcium your body loses through urination. Excessive alcohol consumption can also interfere with the balance of calcium in the body and vitamin D production.

Does diet directly affect osteoporosis?

Yes. A diet chronically low in calcium and vitamin D is associated with low bone density, which can contribute to the development of osteoporosis.

What are other natural ways to increase body density?

In addition to eating a healthy diet, performing weight-bearing and resistance exercises can help you improve bone health.

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Sources

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