Osteoporosis

NUTRITION

• A healthy nutrient rich diet (3)

• Adequate vitamin D (women: 800 IU/day) and calcium intake (women: 1200mg/day from diet or supplements) for maintaining good bone health (1, 6). However there is mixed evidence for vitamin D and calcium supplementation reducing fracture risk (1)

• Avoid heavy alcohol intake (5). Alcohol intake is a risk factor for osteoporosis (3)

• Compared to abstainers, persons consuming 0.5-1 drinks a day have 1.38 times the risk of developing osteoporosis (4)

• Protein intake: There is mixed evidence on a high protein intake and bone density. Some studies show that increased protein intake reduces the risk of hip fractures, while other studies suggest that a high protein intake may increase bone resorption and calcium excretion (5)

PHYSICAL ACTIVITY

• Regular exercise, preferrably weight bearing, which help maintain good bone health (1, 5)

• Balance training reduces the risk of falling (1)

• Exercises that increase muscular strength and improve balance may be the most beneficial (5)

• Exercise improve bone mineral density of the lumbar spine. There is however uncertainty about the recommended dose, frequency and type of activity (1)

• Exercise reduces the risk of (osteoporotic) fractures (5)

• Prevention: Regular exercise plays a role in prevention of osteoporosis in people over 65 years of age, improving BMD of the lumbar spine and hip (2) 

• Excessive exercise in premenopausal women may cause amenorrhea and weight loss leading to osteoporosis (5)

SMOKING

• Smoking cessation reduces the risk of fractures (3)

• Smoking one pack of cigarettes per day throughout life is associated with 5-10% reduction in bone density (5)

• Smoking may also reduce the effectiveness of estrogen therapy (5)

WEIGHT

• Maintaining optimal body weight (3)

Prevention

• Recomended intake of calcium: 1000mg/day (men) and 1200mg (women). Vitamin D: 800-1000 IU/day (2, 5). Higher vitamin D doses in some people may be necessary (2)

• A diet high in high in fruit and vegetables, fish, poultry and whole grains reduces the risk of low BMD and hip fractures (3)

• A typical western dietary pattern high in processed and red meat, animal fat, refined sugar and soft drinks may increase the risk of low BMD and hip fractures (3)

• A vegan diet is associated with increased risk of fractures (3)