Bone density and diet in post-menopausal women

Osteoporosis is a long-term condition that affects bone density, making your bones more fragile and prone to breaking. It affects roughly three million people in the UK.¹ One in two women, and one in five men over 50 in the UK are likely to suffer osteoporosis fractures.²

But there are steps you can take to help maintain your bone density after the menopause, including eating a healthy diet, taking weight-bearing and muscle-strengthening exercise and topping up with dietary supplements if needed.

What to eat for strong bones

There's no specific 'bone-building' diet, but it's recommended you follow standard healthy eating guidelines, eating foods from the four main food groups:

• Fruit and vegetables
• Dairy foods
• Carbohydrates including pasta, bread and potatoes
• Protein including fish, eggs and pulses/beans³

Although calcium is needed for bone health, you don't have to eat additional calcium-rich foods after the menopause, but the recommended nutritional intake (RNI) is 700mg of calcium a day. If you've been diagnosed with osteoporosis though and are on medication, your doctor may recommend a higher daily calcium intake. Higher-dose calcium supplements are available.

Good dietary sources containing a 200mg dose of calcium include:

• 200ml of milk
• 30g of cheddar cheese
• A 125g pot of yogurt
• 50g of sardines
• 120mg of tofu

Calcium³ is also found in dried fruits, pulses, rice pudding, soya milk, in fortified products such as orange juice and breakfast cereals, and to a lesser extent in baked beans and cottage cheese.

If you eat a vegan diet, get your calcium from green leafy vegetables, pulses, tofu, fortified soya yogurt and milk. Although spinach contains calcium it also contains oxalic acid which reduces calcium absorption, so it's not a good source.⁴ Calcium supplements are also available.

Vitamin D is also important for bone health as it's needed to absorb calcium; you get it mainly from exposure to sunshine, but dietary sources include eggs and oily fish. As sunshine can be in short supply in the UK, the National Institute for Health and Care Excellence (NICE) recommends that all adults take a 10mcg a day supplement all year round.

Other vitamins and minerals needed for healthy bones

Although calcium and vitamin D are the better-known bone-friendly nutrients, many others play a role in bone health too.

• Vitamin K switches on a protein called osteocalcin⁵ needed for building new bone; it's found in a variety of commonly-eaten foods including meat and fish, or it's available as a supplement.
• B vitamins are also needed for bone health. The National Osteoporosis Society says vitamin B12 is important for bone-building cells.⁵ B12 is found in lamb, liver salmon, shellfish, cheese and eggs. Sources for vegans include yeast extract, soya drinks and fortified breakfast cereals.
• Magnesium helps reduce bone loss and is needed for mineralisation, as well as metabolism of calcium and vitamin D.⁵ It's found in milk, green vegetables, fish and nuts and available as a supplement.

Look out for supplements which combine vital bone-friendly nutrients in one capsule.

Exercise to keep your bones strong

To build strong bones you need to do a combination of exercises where you bear weight on your feet and work your muscles harder than normal to strengthen them.⁶

Bone is living tissue and when you bear weight on it, it gets stronger. Try brisk walking, running, dancing, jumping and stair-climbing to help your bone health.

Use resistance to build muscle and bone strength, exercising with weights, resistance bands, or doing heavy gardening, and even carrying shopping will help.

If you have been diagnosed with osteoporosis, exercise is still important but you are at higher risk of fractures if you fall, so your doctor will advise you to stick to low-impact exercise such as swimming, yoga and tai chi, rather than high-impact running or racquet sports.