News | Published May 29, 2012 | Written by Bonnie Lepro, MS, RD, LDN, chief clinical dietitian, nutrition & culinary services, Mount Nittany Medical Center

Osteoporosis and Diet: The Calcium Connection

Osteoporosis is a bone disease that leads to an increased risk of fractures. In osteoporosis, the bone mineral density (BMD) is reduced, and this results in less bone strength.

Unfortunately, there are no symptoms in the early stages of osteoporosis. As the disease progresses, one or more fractures may occur. In addition, a person with osteoporosis may experience back pain or neck pain, tenderness over fracture sites, loss of height, as well as the common clinical feature of stooped posture.

Treatment options do exist for osteoporosis. The goals of osteoporosis treatment are to control pain, slow or halt bone loss, prevent fractures and minimize risk of falls that might contribute to fractures. Methods of accomplishing these goals include: medications, physical activity/exercise and diet. A diet that includes the recommended amount of calcium not only plays a role in the treatment of osteoporosis, but also helps prevent the disease.

The majority (99%) of the body's calcium is stored in the bones. Calcium also plays a crucial part in the health of teeth and proper function of the nervous system, muscle contraction, metabolism, blood clotting and hormone secretion. When there is an insufficient amount of calcium available in the bloodstream to meet these needs, the body withdraws calcium from the bones. Calcium can only be returned to bones when the dietary intake from foods and supplements is sufficient to meet all of the body's needs. The body's ability to absorb calcium depends on an adequate intake of vitamin D, a sufficient amount of hydrochloric acid for digestion, the presence of parathyroid hormones as well as exercise. In the absence of these factors, even a high dietary intake of calcium will not allow for proper bone retention of calcium.

So, what are good food sources of calcium? Dairy foods, such as milk, yogurt and cheese, are considered the richest sources. Spinach and cruciferous vegetables, including broccoli, cabbage, and arugula, are also good sources, particularly for people who are lactose intolerant. Salmon, sardines and blackstrap molasses are also good sources. In addition, there are a number of foods that have been fortified with calcium, including some brands of orange juice, ready-to-eat cereals and soy beverages. To help you find additional sources of calcium, see Appendix 14 in the reference below:

How much calcium is recommended each day? The amount depends on both age and gender. See Appendix 5 in the same reference for the specific recommendations for all age and gender groups listed in the Dietary Guidelines for Americans, 2010, published by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture.

For more information on the importance of calcium in the prevention of osteoporosis, or for more ways to prevent the disease, visit