Your Body Has A Bone to Pick With You About Your Diet

By on July 12, 2018

Most people know that when you look for a house, you want a place with “good bones.” In other words, if the structure of the home is in good shape, most people feel they can fix up the rest. If a home doesn’t have good bones, the rest of it doesn’t matter. The same can be said of your body. If you don’t take care of your bones, the rest of your body will quickly fall into disrepair. Having a diet low in calcium and vitamin D is a major cause of weak bones or osteoporosis.

Osteoporosis and Fragility Fractures

Osteoporosis is a serious bone disease that occurs when you lose too much bone, make too little bone, or both. It progresses without symptoms or pain. As a result, bones become thin and weak and can break easily.

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Chronic back pain and loss of height may indicate thinning bones. With osteoporosis, the vertebrae weaken and collapse, causing the body to shrink. That also can cause curvature of the spine, back pain, and even trouble breathing. Unfortunately, many people are unaware that we have osteoporosis until they suffer a fragility fracture – a fracture sustained after falling from a standing height. 

Fragility fractures have can be very painful and disruptive to your life. Hip fracture are the worst. Within one year of fracturing a hip, 20 percent of patients over age 65 die, 20 percent end up in a nursing home, and another 30 percent drop one level in their ability to walk. So, if they didn’t need an assistive device to walk before their or walker hip fracture, afterwards they need a cane. Or if they already needed a cane, afterwards they need a walker. Only 30 percent of patients with hip fractures return to their same level of walking.

Risk Factors for Osteoporosis 

  • If you are a female over 65 or a male over 70 OR 
  • You’ve suffered a fracture from a standing height. 
  • You’ve lost 2 cm or more in height. 
  • You’ve been taking steroids for an extended time.  
  • You live an inactive lifestyle (less than 2.5 hours of exercise weekly). 
  • Your family member has had osteoporosis or hip fracture. 
  • You are a smoker or have more than two alcoholic beverages per day. 
  • You are not getting enough calcium or vitamin D in your diet. 

Prevention of Osteoporosis and Fragility Fracture

Taking care of your bones doesn’t require a lot of maintenance, but that doesn’t mean it should be overlooked. Just a little moderate exercise and eating some of the right food and drinks is all that is required. Two of the best bone-strengthening sources are calcium and vitamin D.  


Calcium is a mineral used for building and maintaining strong bones and teeth. Not made in the body, calcium must be absorbed from the foods you eat and is stored in your bones. Now, the body can only store calcium in the bones during youth—until age 21 in males and 26 in females. It’s like depositing money in the bank. The less calcium taken in when you’re young, the less calcium stored in your bones for future use for the rest of your life. So, at maturity, your bones are as strong as they will get. Bone strength can only decrease with age. 

Calcium is also essential for proper functioning of the heart, brain, and nerves. Adults need about 1,200 mg of calcium per day. A diet low in calcium will cause the body to steal calcium away from the bones to maintain normal blood calcium levels. Over time, this leads to weaker bones and eventually fragility fractures.  

Remember, though, your body will only absorb up to 1,500 mg of calcium per day. So, trying to “overload” on calcium to “make up for some loss time” only results in high calcium levels in the urine and stool, and increases the risk of constipation or kidney stones. 

I recommend getting calcium from your diet rather than in pill form. Some studies suggest that taking calcium in pill form may increase the risk of heart attacks and strokes. It is believed that in pill form, calcium is absorbed too rapidly. When the calcium blood level spikes, calcium sticks to the plaque in the blood vessels, increasing the chance of heart attacks and strokes. Calcium in food form is absorbed more slowly, thereby decreasing the chance of sticking to plaque. 

So, for strong bones, eat a well-balanced, healthy diet. Read food labels and choose foods and beverages that are high in calcium and vitamin D. Avoid sodas, since the phosphates in soda bind to calcium and deplete calcium. Look for calcium-fortified foods (foods that do not normally contain calcium but have added calcium). Examples include fortified orange juice and ready-to-eat cereals. 

However, if you don’t get enough calcium from your diet, take no more than 500 mg of calcium at one time. Choose calcium citrate for better absorption and ensure it contains vitamin D.

Vitamin D

Sunshine is our greatest source of vitamin D. Vitamin D is important for the absorption of calcium and aids in improving muscle strength and balance. Vitamin D deficiency is associated with depression, Parkinson’s disease, and seizures. It is estimated that 10 percent of the American population is vitamin D deficient. Recent studies have shown that 40 percent of patients who visit an orthopaedist’s office are vitamin D deficient. 

In my Chicago office, where we have the fewest number of sunny days than any other major city in the U.S., 80 percent of my patients with fractures are vitamin D insufficient or deficient. So, I start them on a prescription dose of vitamin D. The FDA’s official dietary recommendations are 600 IUs (International Units) daily to age 70, and 800 IUs over 70.  However, many experts believe that these recommendations are far too low to maintain healthful vitamin D levels. One study shows that only 90 percent of patients who take 4,000 IU of vitamin D are within normal levels. That’s 10 percent who are still deficient. I recommend most patients to take 5,000 IU per day. Taking up to 10,000 IU of vitamin D a day is safe. You get 10,000 IU from being in the sun for 10 minutes, but that’s in the middle of the summer at noon with shorts and a T-shirt on. Vitamin D3 is the best form of vitamin D to take.  

Again, sunshine is considered the best source for vitamin D, and 10 minutes a day will do it— depending on where you’re located. In July in Cape Cod, for instance, 10 minutes in the sun in shorts and a T-shirt will give you plenty of vitamin D. But north of Atlanta, the sun is not high enough from October to May to produce that much vitamin D. Despite what dermatologists warn against, spend 10 minutes in the sun, then put on sunscreen and a hat.  

Get ample exercise. 

Incorporate weight-bearing activities into your daily routine. This can help preserve bone density and maintain muscle strength. Consider activities like weight training, walking, hiking, running, elliptical, stationary bike, or even dancing. Resistive exercises including working out with bands, push-ups, and pull-ups also can help. Physical therapy including using a vibrating plate is another way to stimulate bone strength. 

In addition, Tai chi, swimming and stretching exercises can improve your balance to prevent falls. 

Prevent falls. 

Preventing falls inside and outside the home can help prevent fragility fractures.  

Inside the home, keep the floors smooth (but not slippery) and clean of clutter. Don’t walk around in socks or floppy slippers. Use no-slip rugs on floors, and rubber mats in the shower or tub. Install railings on both sides of the stairs and in the shower and tub. Use nightlights. And move the washer and dryer out of the basement.  

Outside the home, take care with curbs before stepping up or down. Watch out for the potholes in streets and sidewalks. Use the railings on stairs. In wet weather, take extra care to avoid slipping in water on the floor. In winter, wear shoes with good traction and coats with adequate padding. And in bad weather, ask for help or consider using a cane or walker. (People are nicer to you when you have a cane.) 

Don’t smoke! 

Besides causing heart and lung disease, smoking is toxic to bones, leading to osteoporosis and fragility fractures. If you do get a fracture, smoking will delay healing and increase the risk of deep vein thrombosis (a blood clot) and stroke after a fracture. It also increases the risk of complications such as infections, pneumonia, heart attacks, and death after surgery for a fracture.  

Limit alcohol intake. 

Heavy drinking can increase bone loss and increase the risk of fracture after a fall. The National Osteoporosis Foundation states that three or more drinks per day is detrimental to your health. 


About Dr. Victor Romano

Dr. Victor Romano ( is an orthopedic surgeon in Oak Park, Ill., and the author ofFinding The Source: Maximizing Your Results – With and Without Orthopaedic Surgery. He is board-certified in orthopedics and sports medicine with over 25 years of experience in the field. He graduated cum laude from the University of Notre Dame and completed medical school at the University of Loyola-Chicago.


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Your Body Has A Bone to Pick With You About Your Diet