I was very fortunate to attend the Sylvia Escott-Stump Johannesburg CNE Workshop last week. Sylvia is the outgoing president of the American Academy of Nutrition and Dietetics and one of the editors of the very big text book that all us dietitians know so well. What an inspiring day! Sylvia, along with other speakers Prof. Beatriz Dykes, Prof Corinna Walsh and Prof Edelweiss Wentzel-Viljoen shared their knowledge and expertise, covering a variety of topics. The day left me inspired, motivated and excited about nutrition!
One of the talks present by Syliva, was “Better Bones: Osteoporosis Prevention”. This is a topic close to my heart as my late grandmother had osteoporosis. This is also a topic that I often receive questions about.
Here are some highlights from the talk and some practical advice to take away:
The Nation Osteoporosis Foundation recommends five simple steps to bone health and osteoporosis prevention:
Step 1: Get your daily recommended amounts of calcium and vitamin D.
Step 2: Engage in regular weight-bearing exercise.
Step 3: Avoid smoking and excessive alcohol.
Step 4: Talk to your doctor about bone health.
Step 5: Get a DXA scan and take medication if needed.
How much calcium do we need:
An easy way to meet calcium needs is consuming 3 cups of milk or equivalent milk products in combination with a healthy diet.
1 cup (250ml) milk = 30% daily requirement
1 cup (250ml) yoghurt = 30% daily requirement
45g natural or 60g processed cheese = 30% daily requirement
½ cup frozen yoghurt = 10% daily requirement
1 cup soya (calcium fortified) = varies, check the label. Not all soya milk is calcium fortified or contains vitamin D – check the labels. Part of the added calcium may be left in the contain when drinking some soya milks.
1 cup raw broccoli = 9% daily requirement
½ cup boiled turnip greens = 10% daily requirement
1 cup baked beans = 14% daily requirement
90g canned salmon with edible bones = 18% daily requirement
90g canned sardines, in oil, with edible bones = 32% daily requirement
1 cup cooked soya beans = 26%daily requirement
½ cup firm tofu (with calcium – check label) = 20% daily requirement
The body can best handle about 500mg calcium at one time from food and/or supplements. So, consume calcium sources split through the day instead of all at once. Note: food is best. There may be additional substances in foods that affect the body’s absorption and use of calcium. A balanced diet that promotes a healthy weight may provide additional benefits to protect against osteoporosis.
How much vitamin D do we need:
Dietary sources of vitamin D: fortified milk / margarines and cold water fish e.g. salmon, halibut, herring, tuna, oysters and shrimp.
Vitamin D is also manufactured in your skin following direct exposure to the sun. The amount made varies with time of day, season, where you are on the earth (latitude) and skin pigmentation. Ten – fifteen minutes of sun expose of the hands, arms and face 2 – 3 times a week should be sufficient (depending on skin sensitivity). Clothing, sunscreen, window glass and pollution reduce the amount produced.
Additional dietary considerations for bone health:
Vitamin K: is helpful especially with included with vitamin D
Fibre: excessive fibre intake could interfere with calcium absorption
Sodium: excessive sodium can increase calcium excretion
High protein: unbalanced, excessively high protein diets could increase calcium excretion
Some ideas for those who don’t like to drink milk:
Make porridge and cream-type soups with milk
Add milk to coffee
Add powdered milk to food (1 tablespoon = 50mg calcium)
Serve milk-based desserts e.g. frozen yoghurt, custard, tapioca – limit fat and sugar
Try low fat flavoured milks – average glass provides only 60 more calories than unflavoured milk
Top bakes potatoes with plain yoghurt
Make milk/yoghurt based smoothies
Try fruit parfaits
Take home message:
Support your bones, they support you.