Hot Nutrition Topics - Osteoporosis

Prevention of Osteoporosis

Sabrina W.S. Mok, Accredited Practicing Dietitian (Australia)

 

We often see in TV commercials menopausal women with stooped posture having difficulty walking down the stairs due to the development of osteoporosis. How can we actually prevent osteoporosis?

Our bones progressively lose calcium as we age. Osteoporosis occurs in both men and women and it often starts silently without any noticeable symptoms. Therefore, we should start preventing osteoporosis at young age by adopting a health lifestyle and having a balanced diet. For more information about the causes and risk factors of osteoporosis, please refer to the article about osteoporosis under “Disease Related Nutrition” from our website:

http://www.hkda.com.hk/index.php?_a=viewDoc&parent_id=&docId=125


Adequate consumption of calcium and vitamin D daily, along with a healthy balanced diet, helps promote bone health:

Calcium:

·        Function: for building and maintaining strong bones and teeth

·        Calcium requirement varies with age

·        Calcium in milk and milk products are easier to absorb than that in other sources

 

Vitamin D:

·        Function: promotes absorption and use of calcium by the body

·        It is found in very few food sources, e.g. oily fish (salmon, tuna, mackerel), oysters, fish oil capsules, egg yolk, most of which are high in fat and cholesterol

·        Exposure to sunlight promotes the synthesis of vitamin D

·        Sunlight exposure for 15-20 minutes daily without sunscreen is recommended. Avoid midday sun (10am to 2pm) to minimize damage from UV light.

 

Recommended Daily Intake (RDI) of Calcium for Adults

Age Group

Male

Female

19-50

1000mg

1000mg

51-70

1000mg

1300mg

>70

1300mg

1300mg

 

Adequate Intake (AI) of Vitamin D for Adults

Age Group

Male

Female

19-50

5.0 μg

5.0 μg

51-70

10.0 μg

10.0 μg

>70

15.0 μg

15.0 μg

(Source of Information: Nutrient Reference Values, National Health and Medical Reference Council, 2006)

Are there any other calcium-containing foods and drinks to consume besides drinking milk?

Item

Calcium (mg)

1 glass Hi-calcium low-fat milk (250 ml)

300

1 small tub low-fat yoghurt (200g)

250

2 slices low-fat cheese (40g)

230

½ cup ricotta cheese

280

4 scoops low-fat milk powder

300

1 cup calcium-fortified soy milk (250 ml)

275

100g firm tofu

300

1 can sardines (with bones)

300

20g small dried fish

440

20g dried shrimps

215

1 bowl kan lan/choy sum/bukchoy/spinach (cooked)

100

Baked Beans(200g)

80

Papaya(300g)

84

1 orange

60

1oz unsalted almonds(28克)

60

2 slices whole wheat bread

60

 

Small tips to increase calcium intake

·        Add High calcium, low fat milk/ calcium-fortified soy milk and sesame/ sesame powder to oatmeal for breakfast

·        Have low-fat cheese/baked beans/sesame paste on toasts for breakfast

·        Have low fat yoghurt, orange or almonds as snacks

·        Consume more green-leaf vegetables (e.g. kan lan, choy sum, bakchoy, spinach) at meals

·        Consume more dishes with soybean products and fish (with bones), e.g. steamed tofu with dried scallops, fried eggs with small dried fish, stir-fried bean and meat shreds

 

One-day Suggested Meal Plan

 

 

Calcium content (mg)

Breakfast

2 slices whole wheat bread + margarine

1 glass Hi Calcium, Low Fat Milk/ Calcium-fortified soy milk

60

300

Lunch

Red cargo rice (1 bowl)

Stir-fried choy sum (3/4 bowl)

Stir-fried zucchini and beef

50

75

4

Snacks

1 small tub low fat yoghurt

300

Dinner

Red cargo rice (1 bowl)

Pan-fried chicken with tofu

Stir-fried kai lan in ginger sauce (3/4 bowl)

50

300

75

Snacks

1 orange

60

Total

 

1270

 

Frequently Asked Questions (FAQs)

 

What if I have lactose intolerance?

The ability to digest lactose varies among individuals but you do not need to eliminate dairy foods completely from your diet even when you are lactose intolerant. Scientific evidence shows that most people with lactose intolerance can consume one glass of milk (240 ml, containing about 12g lactose) a day without experiencing any related symptoms. Yoghurt contains about 9.6g lactose per serve and other diary sources, such as cheese, cream and ice cream, contain less than 1g lactose per serve.

Always consume other non-dairy calcium-containing foods to ensure adequate calcium intake.

 

I am a strict vegetarian (avoid egg and dairy products). Are there any other good sources of calcium that I can consume?

Calcium in plant-based foods is often harder to absorb and the oxalate and phytate inside these foods reduce absorption of calcium.

Ensure you consume adequate amount of high-calcium plant-based foods , such as calcium-fortified soy milk, firm tofu, unsalted almond, dried beans and lentils, green leafy vegetables (broccoli, bok choy, cauliflower, cabbage and spinach), sweet potato, and fish with bones.

 

Do I need any calcium supplements?

Dietary intake of calcium is the best source to meet the requirement. These calcium-containing food sources also provide the body with other essential nutrients.

For those who cannot obtain enough calcium from diet, e.g. older people, strict vegetarians, are recommended to take calcium supplements. Calcium supplements should not substitute dietary intake of calcium. Please consult a registered dietitian or doctor before taking any calcium supplements.

 

References:

Diet Sheet: Three Serves of Dairy Every Day, Dairy Australia (2008)

Diet Sheet: Lactose Intolerance, Dairy Australia (2011)

Nutrient Reference Values, National Health and Medical Reference Council (2006)