If you have Osteopenia (thinning bones; T-score between -1 and -2.5), Osteoporosis (brittle bones; T-score ≤-2.5) or even normal bones, you can always benefit from implementing lifestyle and nutritional changes to help!
Make sure you eat enough and avoid malnutrition—eating enough is not a problem for most of us, but eating the right things often is the tricky part! A diet rich in calcium and vitamin D is important. There has been some controversy surrounding Calcium supplementation, so generally Calcium of 1000mg a day is what I recommend now (this is total in a day from supplements and diet). I recommend Vitamin D supplementation of 1000 I.U. to 2000 I.U. daily. If you have Osteopenia or Osteoporosis, then I recommend that you have your blood Vitamin D levels checked and your goal should be in the 40 to 50 range.
Vitamin K: Vitamin K is a useful co-factor in bone metabolism. Most studies for Vitamin K have been done on Japanese women and Vitamin K is widely used in Japan to help prevent bone loss and fractures. Experts do warn caution when deciding to use Vitamin K because most studies were done on the Japanese population and testing on Caucasian population did not show similar reductions in fracture risk or increase in bone density.
Isoflavones: Foods high in isoflavones (a type of ‘phytoestrogens’—plant estrogen) have been shown to help bones. Examples of such foods are: soybeans, chick peas and lentils.
Exercising at least 30 mins three times a week has been shown to reduce risk of hip fractures in older women. Exercise also helps improve your bone density, although this may not be reflective in your actual T-score, but we know that it does help improve the actual mass—we think the effects are likely more by changing architecture of the bone and improving muscle strength as well. Exercising to include walking, jumping, jogging, and resistance training are all excellent to help with your bone health.
I often tell my patients; “there is NOTHING good that comes out of smoking” so might as well just stop and save the money! Here is another reason to quit—help your bones! As quoted from an UpToDate article, “Smoking one pack per day during adult life was associated with a 5 to 10 percent reduction in bone density.”
AVOID MEDICINES THAT CAN CAUSE BONE LOSS
Certain medicines like steroids, seizure medicines, antacids (especially Proton Pump Inhibitors like Nexium, Protonix, Prevacid, Prilosec) can cause bone loss so you should try to either avoid taking these medicines for a prolonged period of time OR speak with your physicians about alternatives. Of course there are situations where you have to take these medicines (like the seizure medicines) so I often tell my patients to make sure they are good with their Vitamin D supplementation when they are on these medicines. If you have to be on prolonged steroids to treat health problems like Autoimmune Rheumatoid Arthritis, Lupus, or Psoriasis, I would recommend speaking with your doctor about doing a Bone Density Scan (DEXA) after 6 months of being on the medicine to make sure there is no extensive bone loss occurring.