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Spotlight on Bone Health


Good nutrition is critical in osteoporosis prevention and treatment. 


bonehealthaug2016Americans young and old know that calcium makes bones strong. Dairy producers have supplemented our third grade food pyramid knowledge through copious advertising — (remember those “Milk, It Does A Body Good!” commercials?). But who is out there to advocate for lowly vitamin D, an equally important player in the bone health game?

Touro dietitian Julie Fortenberry, RD, LDN, says that vitamin D is a huge factor in helping the body absorb the calcium it needs to strengthen bones and prevent and treat osteoporosis. You can drink all the milk you want and eat cheese until you’re ill, but your body is not going to hold onto calcium without vitamin D to assist. “Vitamin D is the real hero,” Fortenberry says.

Focus First on Vitamin D
Our main source of vitamin D has always been sunshine. “But most people are highly deficient because of the ways we protect ourselves from the sun these days,” Fortenberry says. Even though she knows dermatologists cringe, she recommends about 10 minutes of sunshine early in the day on sunscreen-free legs and arms.
It’s also important to note that in the winter months, when vitamin D levels are likely to be lower, people with osteoporosis are at a higher risk for bone injury, making nutrition an even bigger factor in treatment.

Alternative Vitamin D Sources
Sunshine is the best source of vitamin D, but there are a few food sources too:

Salmon has the highest vitamin D levels, followed by fatty fish like tuna and sardines
Egg yolks offer a small source of vitamin D
Vitamin D is available in an oral drops supplement
Fortified vitamin D in juices and foods is not well absorbed, so stick to food and sun

Your required dosage of vitamin D depends on your current deficiency. Fortenberry recommends discussing your individual needs with your doctor.

Eat Leafy Greens for Calcium
The most popular form of calcium is dairy products. “People are kind of wishy washy about it right now, but the research is still very solid,” Fortenberry says. However, lactose-intolerant, vegans and other milk avoiders have options, and, in many cases, she says, dark leafy greens, though lower in calcium levels, are better absorbed by the body than dairy sources:

One glass of milk: 300 mg of calcium
1.5 ounces of chia seeds: 300 mg of calcium
Leafy greens (like kale, collards and bok choy), almonds, cheese, beans and tofu: between 100 and 200 mg depending on serving size
Researchers recommend 1,200 mg of calcium per day for seniors, women over 51 and pregnant women.

Nutrients as a Reservoir
It’s not just your bones but different parts of your body that need calcium, Fortenberry says. So if your body is not being fed calcium, it will take it from your bones.

The calcium in your bones is like water in a reservoir, she says. Your body will draw from the bones whenever it needs it. If you don’t refill it, your reservoir will be empty. Someone young, with good bone health, can quickly lose that advantage if they don’t continue to keep up a steady supply of calcium and Vitamin D.

General Health for Best Absorption
“You can consume tons of these nutrient sources, but, if you aren’t absorbing them, it won’t be beneficial,” Fortenberry says. Try this checklist for best health results:

Are your gut and digestion systems healthy? (Poor digestion means nutrients are more likely to flush out of your body.)
Are you consuming a balance of nutrients throughout the day? (Too much and at just one meal means you are less likely to optimize your absorption rates.)
Are you too focused on one or just a few nutrients? (You might be neglecting your body’s other needs.)
Are you exercising? (Your bones can’t rely on nutrients alone, and exercise can help thicken and strengthen bones.)
When it comes to patients with osteoporosis, Fortenberry shares the same advice that she gives to all of her patients. “Eat from the earth as much as possible,” she says. “Eat fruits, vegetables and good fats. The more colors, the better for the best variety of nutrients. Shop for greens, purples, oranges — a rainbow plate — and focus on overall wellness.”

Julie Fortenberry, RD, LDN is a registered dietitian at Touro Infirmary. She earned a Bachelor of Science degree in Nutrition and Dietetics from the University of Southern Mississippi. Fortenberry believes that lifestyle changes and wholesome nutrition are obtainable, and she brings real-life understanding to wellness and nutritional counseling.