Dietary guidelines to maintain bone health

To achieve optimal bone health, it is recommended to maintain a balanced diet with a variety of foods, especially those rich in calcium.

Calcium can be obtained through supplements, but the best source is dietary, which we provide through food, since they contain other substances (lactose, amino acids, vitamin C, vitamin D) that favor its absorption. Nor should we despise foods enriched in calcium. There are products (calcium-enriched orange juice, calcium-enriched milk, calcium-enriched cereals) that contain significant amounts of calcium. Still, our ability to absorb calcium is limited, about 500mg in a single meal. For this reason it is recommended to eat foods rich in calcium spread throughout the day.

The typical Spanish diet, characterized by a high consumption of protein and sodium, causes a high loss of calcium in the urine. In the same way, different habits such as a high consumption of caffeine, tobacco and alcohol, are associated with a greater risk of suffering from osteoporosis.

The diet aimed at preventing osteoporosis is one that provides adequate calcium with a calcium / phosphorus ratio equal to or greater than

It must contain the same ratio between these two nutrients or a greater amount of calcium than phosphorus.

The key foods for bone health are milk and dairy products. They guarantee a high supply of calcium and an adequate calcium / phosphorus ratio. They also contain lactose and amino acids that promote calcium absorption and vitamins A and D that help fix calcium in the bone.

Dairy products provide more than 80% of the calcium in the diet and it is also easy to use. Studies carried out in people with lactose intolerance who suppress dairy consumption have shown an increased risk of suffering from osteoporosis.

Therefore, depending on the degree of intolerance, it is recommended to try to introduce yogurt or fermented milk. These dairy products are better tolerated because their ferments have transformed part of the lactose into lactic acid. Soy as an alternative to cow's milk is not a good source of calcium. Calcium added to soy shakes is absorbed less than that added in cow's milk.

Low-fat or skim dairy is the healthiest option. Thanks to these products, it is easier to increase calcium intake without increasing the amount of fat in the diet. Also low in fat does not mean low in calcium. Low-fat dairy contains even more calcium than their whole counterparts. A glass of whole milk provides approximately 290mg of calcium, while a glass of enriched skim milk provides 352mg.

To avoid nutritional deficiencies, especially when calcium demands are increased, it is advisable to follow a series of recommendations:

• Eat foods rich in calcium. A minimum of 2-3 servings of dairy is recommended daily. A portion of dairy is equivalent to: a glass of milk or 2 yogurts or 40 grams of cured cheese or 80 grams of fresh cheese. In special situations that increase calcium needs (growth, pregnancy, lactation, advanced age) it should be increased to 3-4 servings.
• Introduce foods rich in vitamin D to promote the fixation of calcium to the bones. This vitamin is found in the fat of certain foods: dairy (whole, semi-skimmed or skimmed milk enriched with vitamin D, cheeses, butter, cream), liver, oily fish, eggs.
• Fruits and vegetables provide vitamins A and C that help in the absorption of calcium. They also maintain the pH of alkaline urine, limiting the elimination of calcium through the urine.

It is recommended to consume 2-3 servings of fruit daily, being one serving (120-200gr) and 3-4 of vegetables that is equivalent to (200gr) per serving. It is preferable to consume the whole fruit to take better advantage of all the nutrients and take at least one piece a day rich in vitamin C (strawberries, kivi, citrus, ..). Cooking fruit and vegetables destroys part of the vitamin C, for this reason it is recommended not to abuse cooked vegetables and consume them raw. An excess of protein reduces the absorption of calcium and favors its elimination in the urine. Therefore, it is not recommended to abuse fatty meats (fatty beef, pork, duck, lamb, ...) or meat derivatives rich in saturated fat (sausages, hamburgers, delicatessen). In addition, an excess of saturated fat interferes with the absorption of calcium. Among proteins, the best choice is fish. If eaten whole, with the thorn (anchovies, sardines), it increases the amount of calcium.

Two daily servings are recommended, one serving being: meat (80-100gr), white or blue fish (150-200gr), chicken (100gr), egg (2 small units).

• Eliminate alcohol and tobacco, as they decrease bone mineral density.
• Limit cola soft drinks, because they contain phosphoric acid (phosphorus) that promotes bone decalcification
• Perform physical exercise on a regular basis to avoid bone demineralization and take a walk in the sun to synthesize vitamin D.