Why Osteoporosis Prevention Should Be a Priority – Even for Vegans
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It's National Osteoporosis Awareness Month, and our own Anya Todd RD explains all of us - vegans included - must make bone health a priority.
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May is National Osteoporosis Awareness Month. Ten million people (80% are women) in the US alone are affected by this disease characterized by a bone loss. This decrease can lead to fractures with debilitating results and, according to the National Institutes of Health, costs over $20 billion per year to treat. Many people do not realize our bones are in a constant state of remodeling every day of our lives – just because we physically stop growing in height does not mean our bones are done working. If you ask people which nutrient is essential for bone health, they will likely reply that it is calcium, along with the best source of that nutrient being dairy foods. Yet, building and maintaining strong, healthy bones is much more complex than ensuring you have a “milk mustache.”
I think we have all seen that frail elderly woman who looks as if she will crack a rib should she sneeze or laugh too hard. And I think we can all agree that none of us want to be “that” woman (or frail man) as we age. It is true that bone loss is a natural part of aging. We acquire what is known as our ‘peak bone mass’ by the time we are in our mid-30s. (At the age of 35, I am hoping I did right by my bones thus far!) Once we reach our mid-40s, bone loss is about 0.5% per year, which may not seem like much; however, when we are living decades beyond our 40s, this is a substantial loss. Add to it that menopausal women can lose up to 6 times that amount yearly, and the possibility of becoming the frail woman doesn’t seem as far-fetched. Yikes!
Taking care of our bones should be a priority – and it does not just involve your calcium intake, though that is a part of the picture. There are nearly twenty nutrients associated with bone health – calcium, vitamin D, vitamin K, magnesium, and protein are just a few of them, along with several lifestyle components. Speaking of protein, there has been a long held belief that excessive protein intake (especially of the meat and dairy variety) caused calcium to be leached from the bones & excreted through the urine. This was a health argument that many of us vegans held onto to support our idea of ditching animal protein in order to protect our bones; however, recent literature review by J. Calvez et al in the European Journal of Clinical Nutrition is not showing that to be the case – at least in those individuals consuming adequate amounts of calcium. For the sake of space, I will refrain from citing all the research on the issue, as I think Jack Norris RD does a wonderful job analyzing vegan bone health on his site, VeganHealth.org.
When it comes to vegans consuming enough calcium through the day, I am not sure we are doing such a great job at it. I think some of that may be due to the fact we have been led to believe “Since I am not eating animal protein, my bones aren’t in danger.” Many of us (vegans & non-vegans alike) fall short of that 1,000 mg/d recommendation for adults under the age of 50 years & 1,200 mg/d for those over 50, which essentially translates to roughly 3 cups of fortified non-dairy beverage. It is interesting to note that the UK recommendation is 700 mg/d, and I am personally comfortable with recommending that amount as well. It is easily attained by eating real food, like kale (which interestingly has a higher calcium absorption rate than cow’s milk), blackstrap molasses, tofu, and some fortified almond milk on your oatmeal – without having to rely on calcium supplements, which have been shown to be rather ineffective at preventing fractures and even dangerous to the cardiovascular system. Plus, eating food sources of calcium enables you to obtain so many more nutrients important to bone health (and your health in general) than if you were to depend upon pill supplementation.
I also need to briefly mention the importance of vitamin D intake in bone health as well – which again, isn’t a nutrient that only vegans are at risk of having low levels of. Now that spring is in the air and the sun is out, it should be easy for many of us to soak up some daily rays to meet our vitamin D needs of 600 IU. If you live in a climate with harsh, gloomy winters, you may need to consider a vitamin D supplement during that time of year if you are experiencing any symptoms of deficiency.
Decreasing our risk of osteoporosis isn’t just about the food we eat. Our genetics play a role as well as our lifestyle habits – smoking is bad news (no surprise there) while incorporating weight-bearing activity is a good thing. Avoiding too much sodium and caffeine shows to be beneficial as well. We are still learning about bone health, and what we do know encompasses a great deal more than I can address in this post. That being said, you don’t need that milk mustache from dairy to ensure calcium intake and bone health, but a little kale between your teeth can certainly help.
Photo credit: Lorraine Phelan via Flickr
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You bring up a good point about skin pigmentation affecting vitamin D absorption (ie the darker the pigmentation, the longer the exposure time to the sun that is needed). By no means did I want to come off as forgetting that point, but for the sake of space, I did not discuss in depth vitamin D. Cow’s milk is fortified with vitamin D – it is not innate to the product – and contains around 100 IUs per cup. Fortified non-dairy beverages contain about the same amount. Depending on fortified foods alone to meet the recommendation of at least 600 IU per day is not realistic for most people – nor would I encourage the consumption of 6+ cups of milk of any kind per day. Hence why sun exposure (& consumption of fortified foods and/or supplementation as needed) is recommended to maintain adequate levels of vitamin D.
you forgot about dark skin people i work in a nursery and do cross country i became vitamin d deficient just from giving up milk