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One thousand milligrams of calcium per day to prevent osteoporosis

In order to prevent osteoporosis, foods that provide one thousand milligrams of calcium per day should be consumed in general. The specialist José Zanchetta affirms that the epidemiological studies allow the understanding of this disease that weakens the bones and the awareness of the importance of the campaigns of prevention and diagnosis.

(CyTA Agency - Leloir Institute) -. The early care of our bones from childhood prevents the development of osteoporosis in adult life, a disease characterized by a decrease in the density and quality of bones.



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"Although the population's awareness of the measures that can prevent this disease is greater today, there are still many details that the population does not know," Dr. José Zanchetta, president of the Argentine Society of Health Sciences, told the CyTA Agency. Osteoporosis and member of the steering committee of the International Osteoporosis Foundation. He adds: "There is a lot that we can do daily to take care of our bones and those of our children. Care must start from early childhood. The proper diet in calcium, regular exercise, adequate sun exposure, healthy life without excessive tobacco and alcohol (both elements are toxic to the skeleton) favor the development, strengthening and maintenance of healthy and strong bones. On the other hand, the early detection of the disease plays a fundamental role in its future management ".

Calcium and vitamin D

When sufficient calcium is not supplied to the organism, the skeleton is decalcified and in the long term it becomes fragile in the face of minor traumas that can cause fractures, stresses Dr. Zanchetta who also works as a medical director of the Metabolic Research Institute.

Parallel vitamin D consumption is key to bone fortification. "This type of vitamin favors the absorption and utilization of calcium, and although it can be provided by some fortified foods, such as dairy products, the main source of vitamin D is our own body, since our skin exposed to the sun starts its production", explains Zanchetta. And he continues: "The main function of vitamin D is to help calcium to be absorbed in the intestine. In extreme situations of absolute lack of sun exposure in children, it can cause rickets, and malformation of the bones. It is recommended the solar exposure of 15 minutes in arms and legs per day (walks, shopping) avoiding the hours not recommended (11 to 16 hours). If there are contraindications for sun exposure (as in people with a history of skin cancer) it can also be easily replaced with medication droplets. "

According to the specialist, it is advisable to incorporate the calcium in the food and the most suitable are the dairy products. "The needs can vary in different moments of life but in general lines are 1000 milligrams (mg) of calcium per day," he says.

In this sense, Dr. Zanchetta states that it is useful to know how much calcium the different dairy products contain to make the daily menu. As an example, point out that a portion of semi-soft cheese provides 700 mg of calcium, a yogurt of 250 between 350-400 mg, a fortified yoghurt 450-500 mg, a glass of milk of 200 ml contains 200 mg and a glass of milk Fortified about 250-300 mg.

"If you can not meet the daily requirements for some reason such as intolerance can be supplemented with supplements in tablets," says the specialist.

Higher prevalence in women

Although osteoporosis is suffered by both sexes, this disease affects women more, especially after menopause. In order to know its prevalence in this population, Dr. Zanchetta and a team of colleagues conducted an epidemiological study in which 4 thousand Argentine postmenopausal women were evaluated.

The results of the work, presented at the 7th Congress of the Ibero-American Society of Osteology and Mineral Metabolism in 2007, showed that 35 percent of postmenopausal women over 50 have osteoporosis according to the classification set by the World Health Organization. According to Zanchetta, these results would be valid to date and can be extrapolated to the group of women of that age group in the country. And she says that at this stage in women's lives it is crucial to maintain optimal levels of calcium.

On the other hand, the specialist warns that in the case of the elderly where calcium levels tend to decrease it is critical to avoid falls to prevent fractures. "You have to take care of your eyesight, train your balance and muscular strength, wear comfortable footwear and free the house from obstacles that make it easier to get stuck, among many other measures," he says.

"Thanks to epidemiological studies we can have a more concrete idea of ​​this problem, which can help society in general to become aware of the importance of prevention and diagnosis campaigns and thus be able to identify patients at risk", Dr. Zanchetta emphasizes. And he concludes: "Prevention plays an important role, food, nutrition and exercise favor the development, strengthening and maintenance of healthy and strong bones and early detection of the disease plays a key role in its future management. Consultation with the doctor about bone health is fundamental. "

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Calcium overdose to have strong bones?

Increasing calcium intake does not prevent fractures, nor are supplements useful for bone remineralization .



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Tell me three truths about bone health:

• - It is necessary to take a lot of calcium to have strong bones.
• - Dairy products are essential and protect us from osteoporosis.
• - If, despite having a high consumption of dairy products (ergo, calcium), our bone density suffers, it will be fixed by taking calcium in supplements or calcium-fortified foods.

Many will think that these three statements are obvious, everyone knows them and you do not have to be a nutritionist ... These messages come to us continuously through advertising, food marketing and the advice of some experts. Nothing new. Dairy = calcium = strong bones.

Although the truth is that it may not be so true.

    It is encouraged not to leave the dairy products even if they are not tolerated, without much pausible evidence and with economic interests behind

Maybe the dairy industry has an interest in these messages and strives to reach us, especially when the trend indicates that sales fall. Maybe calcium intake is not directly proportional to bone mineralization . Perhaps there are preventive strategies for osteoporosis that are not prioritized because they do not report any economic benefit to any industry. Perhaps professional advice is often outdated or biased by interests, or poorly updated.

Yes, we started strong. Let's reduce the tension by talking a little about the recommended calcium intakes:

How much calcium?

Calcium intake recommendations are very variable among countries with similar conditions; we went from 900mg per day for adults in Spain to 1,000mg in the US or 700mg in the United Kingdom for the same age range. 30% less for the British than for the Americans, yes. The EFSA (European Food Safety Authority) for its part indicates a reference intake of 1,000 mg / day from 18 to 24 years and 950 mg / day for people over 25 ( PDF ). No changes in pregnancy or breastfeeding (Spain rises to 1,200mg in breastfeeding and the United Kingdom to 1,250mg) Do I need less calcium in London than in Madrid? If I breastfeed, do I increase my calcium intake by more than 60% as advised by the UK or do I keep it the same as the EFSA states? Or are the recommendations very dependent on other variables such as the type of diet, the bioavailability of the mineral and the interests of the person who formulates them? It is difficult to answer. But it is worth sowing the doubt and highlight that things are far from clear.

Do we take enough calcium?

Yes, we have enough, according to the Spanish Nutrition Foundation ( PDF ) and according to a study by Eduard Baladia, Julio Basulto and María Manera ( PDF ). Is media bombing with the issue needed then? Even if the intake is low ( as suggested by other sources ), is consuming more calcium the best strategy for good bone health? No: neither increase the intake prevents fractures , nor supplements are useful for bone remineralization . To these conclusions came two reviews published in the British Medical Journal in 2015.

It seems that the affirmations that opened the article begin to not be so clear.

The population is pressured to achieve a high calcium intake, especially in childhood and in postmenopausal women. All kinds of products focused on these objectives are designed: yogurts with twice as much calcium, milk enriched with even more calcium, children's products that outline in the package its content in such a heavy mineral ... It is encouraged not to leave dairy products even though they are not tolerated , because the industry gives solutions, launching government campaigns ... All without much pausible evidence and economic interests behind.

Meanwhile, one in four postmenopausal women have osteoporosis (according to the Spanish Society of Rheumatology in 2015 ), and the trend is increasing. It does not seem that the strategy is working at the level of population health.

Leaving aside economic interests, it can be said that insisting on increasing calcium intake lacks justification, from a health point of view. On the other hand, they are remarkably more effective indications to prevent osteoporosis and take care of bone health: recommend physical activity (especially strength exercises), an adequate protein intake (especially in the elderly), maintain a good level of vitamin D, moderate consumption of salt, get enough magnesium and vitamin K consuming vegetables, do not drink and do not smoke. And in the prevention of non-communicable diseases in general, incidentally.

But the message that the population receives is only to increase the calcium intake. And based on dairy, even if you do not like them or do not tolerate them. Dairy products that are frequently accompanied by huge amounts of sugar, especially those intended for children. You could even say that these sugary dairy products are a product to avoid and not to recommend.

Can economic interests have more weight in public health guidelines than the evidence itself? Maybe it's not just happening with dairy and calcium?

Lucía Martínez Argüelles , is a dietitian-nutritionist, master in nutrigenomics and personalized nutrition, TSD.

NUTRIR CON SCIENCIA is a section on nutrition based on scientific evidence and knowledge contrasted by specialists. Eating is much more than a pleasure and a necessity: diet and eating habits are now the public health factor that can most help us prevent many diseases, from many types of cancer to diabetes. A team of dieticians-nutritionists will help us to better understand the importance of food and to tear down, thanks to science, the myths that lead us to eat badly.

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The natural treatment of osteoporosis: Calcium

In Western culture, talking about the contribution of calcium is talking about milk and its derivatives. This is however another of the myths of modern nutrition promoted by the interests of the dairy industry.



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FIRST OF ALL SOME NOTIONS OF COMMON SENSE

• -We are the only mammal that continues to drink milk after teething.
• - We do not know of any other species within mammals that substitute breast milk for the milk of another species.
• -A calf is born and stands up as soon as possible, in the first year of life reaches a weight 180 Kg .; For this fabulous skeletal muscle development, nature has provided cow's milk with the appropriate nutrients: calcium and proteins in abundance. Precisely because of that, cow's milk has been exalted by modern nutrition; but human breeding does not need such a development in its first year of life, the priority is the maturation of its nervous system and its immune system, for this they are the mother's milk and lactation.

THE ADVANTAGES OF MILK AS A SOURCE OF CALCIUM

We can mention 3 reasons why milk has been exalted as a good source of calcium:

• 1) Milk contains important amounts of calcium: it provides 119mg per 100gr.
• 2) The calcium in the milk comes in the form of calcium salts (caseinates and phosphates) which makes it more absorbable.
• 3) Lactose (sugar) in milk improves the absorption of calcium.

For these reasons milk has been widely extolled as a good source of calcium. However, there are several evidences against this assertion.

THE DISADVANTAGES OF MILK AS A SOURCE OF CALCIUM

• 1) The calcium in milk is bound to its proteins, which makes it difficult to absorb it.
• 2) The milk protein generates blood acidification that must be neutralized by extracting alkalizing minerals from the bones, including calcium, which are then eliminated through the urine.
• 3) This process is regulated by the hormone thycalcalcin, which in turn inhibits the absorption of calcium.
• 4) Lactose in milk, in people with intestinal intolerance to it, generates intestinal irritation and absorption problems.
• 5) Calcium is best assimilated when the food containing it has a calcium / phosphorus ratio of 2: 1; milk and its derivatives have a relatively high phosphorus content in correlation with calcium: 119mg. of calcium / 93.4mg of phosphorus per 100gr.
• 6) Milk is poor in magnesium and vitamin C, which improves the absorption of calcium.

HIGH DAIRY CONSUMPTION AND HIGHER INCIDENCE OF OSTEOPOROSIS

The main effect of calcium deficiency in the diet is osteoporosis, but against all forecasts recent studies have shown that, paradoxically, osteoporosis is much more frequent among populations that have high milk and dairy consumption (and in general a high calcium intake in your diet).

For example, the Bantu, a South African ethnic group, which has a low protein diet and a discrete calcium intake (200/300 mg of calcium per day, about half or one third of what an average American consumes) does not They present almost osteoporosis, although women are usually multiparous and breastfeed for several years. But when these women migrate to the United States and adopt the American diet they develop osteoporosis, although not as much as Caucasian or Asian women.

Eskimos, on the other hand, have a diet rich in protein and calcium (2500mg per day) and yet have one of the highest levels of osteoporosis in the world.

lactros

Another well-known case is that of the Chinese: when the Chinese introduce milk into their diet, an increase in the incidence of osteoporosis is generated, this occurs even though Chinese people who drink milk have a higher calcium intake than those who drink milk. they do not drink milk

This paradox can be explained by the loss of calcium generated by the acidity produced by the intake of milk and meat proteins: the body counteracts the acidity by releasing minerals from the bones in the bloodstream and the kidney subsequently excretes them in the urine. This effect has been observed for all people who, without ever drinking milk, suddenly begin to drink it, as shown by the works of Drs Hsiu and Fun, from the universities of Taipei and Los Angeles.

On the other hand, studies with vegetarian populations have shown that meat consumers 65 years of age have 5 to 6 times more bone loss than vegetarians of that age. This may be due to both a high intake of animal protein (acidifier) ​​and a low intake of vegetables.

Dr. William Ellis, a North American physician, states based on the performance of more than 25,000 blood tests, that the lowest levels of calcium were found among those who consumed 4 or 5 glasses of milk per day.

Finally, let's say that babies fed with breast milk develop their bone structure better than those fed formulas based on cow's milk, although the diet of the latter is richer in calcium. The explanation lies in the calcium phosphorus ratio in human milk (2: 1), in comparison with that of cow's milk (2: 1.6), which makes absorption difficult, since phosphorus is linked to calcium and prevents the absorption of calcium.

The issue is therefore the metabolism of calcium and not simply the quantitative contribution of it. The concern for the contribution of calcium as a supposed determining vector for the prevention and / or treatment of osteoporosis, is a concept that has been applied in a mechanistic and erroneous way at present.

Currently, the real problem is not so much the contribution as the loss of calcium, that is, the modern diet provides calcium in abundance but it generates a poor absorption and a high loss of it .

THE ABSORPTION OF CALCIUM

Normally we absorb only 20 to 30% of the calcium in our food.

THE ABSORPTION OF CALCIUM IS DIFFICULTY WITH:

• -The antacids (inhibit stomach acid which decreases the absorption of calcium).
• - Excess fiber (fiber phytates trap calcium).
• -The phosphates of the chemical additives present in the sausages, melted cheeses, potato chips, cream of milk, canned fruits, carbonated drinks, etc. (The following additives contain phosphate: e-442, e450, e338 to e-343).
• -The carbonates (inhibit gastric acidity, which decreases the absorption of calcium).
• -The oxalates, present in some vegetables such as spinach, bind to calcium and prevent its absorption.
• -The prolonged use of laxatives worsens the absorption of calcium.

IMPROVES CALCIUM ABSORPTION:

• -Good heartburn that helps solubilize calcium.
• -The presence of vitamin D that helps absorb calcium (sunbathing improves vitamin D levels).
• -Vitamin C increases the absorption of calcium by 100%.
• -The magnesium improves the absorption of vitamin D, which in turn optimizes the absorption of calcium and its retention in the bones.
• -The consumption of calcium along with a wide range of minerals such as (magnesium, boron, manganese, fluoride, silica, copper, etc.) optimizes its absorption and use. To ensure an ample supply of minerals in the diet, the consumption of vegetables is fundamental.
• -The calcium supplements so usual now really do not solve the problem and can generate calcium deposits in the arteries, kidneys and other organs.

INCREASE THE EXCRETION OF CALCIUM BY RENAL AND OTHER ROUTES:

• -Foods containing refined (acidifying) sugar increase the urinary expulsion of calcium.
• - The acidifying diet (high consumption of animal proteins and low consumption of vegetables).
• -The elevated salt intake. The normal diet contains 10 to 20 times more sodium than necessary, which alters the calcium metabolism.

A study conducted with Dutch students, for example, observed that they eliminated 20% more calcium when they ate 6000mg. of sodium a day when they only ate 3000mg.

• -The high intake of phosphorus through bottled soft drinks, meats and agrochemicals hinders the intestinal absorption of calcium.
• -The coffee and alcoholic beverages: the consumption of alcoholic beverages hinders the absorption of calcium, and the excessive consumption of coffee (8 cups a day) generates loss of calcium.

WHAT TO DO THEN ABOUT CACIO TO AVOID AND / OR COMBAT OSTEOPOROSIS?

According to the above, it is clear that the common recommendation, currently dominant, to combat osteoporosis is wrong and harmful. In fact, consume many dairy products and take calcium supplements, not only does not solve the problem but can aggravate it, because as we saw a diet rich in dairy generates blood acidity and helps increase the expulsion of calcium and other minerals through the urine . For its part, the calcium in the supplements is poorly absorbed and can be fixed in the arteries or clog the kidneys.

The real issue is to understand calcium metabolism and act accordingly. The modern diet provides huge amounts of calcium but the osteoporosis epidemic continues to grow. Remember that milk provides 125mg of calcium per 100gr., And that in the long term the abundant consumption of dairy products generates a negative balance of calcium: the urinary loss of calcium generated by the blood acidification produced by dairy products is greater, than the contribution of calcium offered by them.

OTHER SOURCES OF CALCIUM

There are numerous sources of calcium, and many of them are better than milk:

The richest sources of calcium are seaweeds , which also contain little phosphorus, are rich in minerals, and contain almost all the trace elements that the body needs, which favors the absorption of calcium.

The hiziqui seaweed contains 1300mg of calcium, and the seaweed wakame 1250mg. per 100gr., which represents about 14 times more than milk. You can get them in stores selling Japanese products, and consume them soaked by adding them to salads, or cooked in soups or vegetable stews or other dishes.

Another interesting source of calcium are oilseeds :

The sesame contains 1000mg. of calcium per 100gr., almonds 266mg of calcium per 100gr. but they are rich in phosphorus which decreases the absorption of calcium.

Spirulina algae is also rich in calcium: 100 mg per 100 grams, although it is also rich in phosphorus. However, it also provides important amounts of magnesium, manganese, B complex and other valuable nutrients for bone health.

The other important source are green vegetables such as broccoli, parsley, watercress, nettle, dandelion, cabbage, all contain between 100 and 200 mg. of calcium per 100 grams and are rich in vitamin C and magnesium, which greatly improves the absorption of calcium (spinach and rhubarb because of their high content of oxalates hinder the absorption of calcium.)

On the other hand, green vegetables are the main nutritional source of vitamin K, of whose importance for bone health I spoke in a previous submission.

It is very important to point out that vitamin K does not have coagulant effects in people who do not have vitamin deficiency, that is, that you can consume important amounts of green vegetables without fearing that a high consumption of this vitamin will increase the risk of formation of blood clots.

Other sources of calcium (in parentheses its contribution of calcium x per 100gr.):

chard (119mg.), tortillas (175mg), beans (240mg), soybeans (277mg.), cane molasses (860mg), low-fat yogurt (199mg), sardines (240mg), camembert cheese (388mg), gruyere cheese ( 1.011mg).).

In this link, the previous installments of the series "The natural treatment of osteoporis", in addition to other collaborations of Andrés Sierra in Ecoofera.

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Vitamin D, calcium and bone health

Why is bone health important?

Bones are living tissues that constantly wear out and replace. Throughout life, the body seeks to compensate for the loss of bone tissue with the creation of new tissue. The highest bone mass (size and strength) is reached at approximately 30 years. Thereafter, bone mass begins to be lost.

Over time, the loss of bone tissue can cause osteopenia (lower bone mass) and then osteoporosis, a condition in which bones weaken and are more prone to breakage (fractures). Fractures can cause serious health problems, including disability and premature death. It is important to consume enough vitamin D and calcium to maintain healthy bones and reduce the risk of osteopenia or osteoporosis. Frequent exercise and the type in which weight is supported helps keep bones strong.



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Why is vitamin D and calcium important for bone health?

Vitamin D allows the body to absorb calcium. Calcium is necessary to have strong and healthy bones. Without enough vitamin D and calcium, bones may not form properly during childhood and may lose bone mass, weaken and break easily during adulthood. Even if you consume enough calcium in your diet, the body does not absorb that calcium if you do not consume enough vitamin D.

What is vitamin D?

Vitamin D is a fat-soluble vitamin, which means it is stored in the fatty tissue of the body. People normally get vitamin D when exposed to sunlight, which leads to the production of vitamin D in the skin.

Vitamin D is found naturally in very few foods. In the United States, it is added routinely to milk and baby formula. Other good food sources are egg yolks and some types of fish, such as salmon and mackerel. Vitamin D is also available in nutritional supplements.

Did you know?

Vitamin D is the only one that the body produces. Other vitamins such as A, B and C only come from food and supplements.

You probably do not get enough vitamin D if:

•     Spend little time in the sun or use a powerful sunscreen
•     He has very dark skin
•     is over 50 years of age, when the body has less capacity to produce and use vitamin D efficiently
•     have certain diseases of the digestive system that interfere with the absorption of fat and vitamin D
•     is overweight, because vitamin D can get "trapped" in body fat and be less available for the body's needs

Osteoporosis
What is calcium?

Calcium is a mineral with many functions. Most of the calcium in the body is stored in the bones and teeth, where it contributes to its structure. Calcium comes mainly from the foods you eat.

Among the good sources of calcium are dairy products (milk, cheese, yogurt); products fortified with calcium (foods and beverages with added calcium); fish canned with bones, and vegetables. Like vitamin D, calcium is also available in supplements.

You may need additional calcium if:

•     she is a postmenopausal woman
•     eat a few dairy products or do not eat them
•     have a digestive disease that interferes with the absorption of nutrients

Daily recommended level of vitamin D and calcium for adults

Vitamin D     Less than 50 years: 400 to 800 international units (UI)
More than 50 years: 800 to 1,000 IU


Calcium                  Less than 50 years old: At least 1,000 milligrams (mg)
More than 50 years: At least 1,200 mg

Questions to ask your doctor

•     How much calcium and vitamin D do I need?
•     How do I know if I am consuming enough?
•     Should I take a calcium or vitamin D supplement? How much should I take?
•     Should I have an analysis to determine if I have vitamin D deficiency?
•     What else can I do to keep my bones strong?

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Calcium and vitamin D: natural remedies to alleviate osteoporosis

The disease affects almost three million people in Spain
Adults up to 50 years, the population most affected, should ingest 1,000 milligrams of calcium daily .

Osteoporosis is a disease that causes a decrease in the density of bones , resulting in a worse resistance to shock and that, the same, fracture more easily. Almost three million people in Spain suffer from this disease, of which, in a few cases, the causes are known but it has a prevalence in the population over 50 years old; of 26.07% in women and 8.1% in men.



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To prevent a disorder that the World Health Organization (WHO) defines as: "a systemic disease , characterized by a decrease in bone mass and a deterioration of the microarchitecture of bone tissue that increases its fragility, with the consequent increase of fracture risk ", it is essential to consume calcium . In addition, it is also essential to take vitamin D , which improves the absorption of calcium for bone growth, delays the onset of disease and prevents fractures.

Why should calcium be consumed?

Calcium is essential for the blood to coagulate and the heart, muscles and nerves to function correctly. The insufficiency of this mineral contributes to the development of osteoporosis. Numerous studies have been published that indicate that inadequate calcium intake is directly related to a decrease in bone density and a high fracture rate.

Milk is the most traditional source of calcium. Its consumption is essential during the first years of life to ensure good development and growth, but that does not mean that, after this stage, you should stop taking it.

How much should be taken?

An article by Health.com , a magazine specializing in wellness, argues that adults up to 50 years old should consume 1,000 milligrams of calcium and 200 units of vitamin D per day . People who exceed this range would need 1,200 milligrams of calcium and 400 to 600 units of vitamin D. In adults it has been proven that those who follow a healthy diet have higher levels of bone mass than those who do not have healthy habits.

Children and adolescents must meet the recommendations of 1,300 milligrams daily to reach higher levels of bone mineral density.




Calcium, exercise and vitamin D, key factors in the prevention of osteoporosis

After 50 years of age, one in four women suffer from osteoporosis , three more than in the case of men. To prevent the disease, it is advisable to "maintain a diet that gives us the recommended amount of calcium , control vitamin D levels and, if necessary, take supplements," as indicated by Dr. Ángel Oteo, coordinator of the Unit Bone Fragility and Osteoporosis of the HM Madrid University Hospital.

Another key factor, according to this HM Hospitals specialist, is "to avoid a sedentary life that not only favors the appearance of osteoporosis, but also increases the risk of falls " . Therefore, it is advisable to perform physical exercise and maintain an active life, as well as correct visual and hearing problems, evaluate treatments that may cause sleep and eliminate barriers that pose an obstacle in the home.

It is necessary to take into account individual factors of each patient such as age, weight, the presence of previous fractures, the age of menopause in the case of women, the consumption of toxic substances such as alcohol or tobacco, diseases such as rheumatoid arthritis or treatment with corticosteroids.

Osteoporosis affects the entire skeleton , although the most frequent fractures occur in the vertebrae, hip, wrist, ribs and shoulder. The main problem of the pathology is that it does not give symptoms until the injury occurs and the fact of suffering the first fracture is associated with an increased risk of presenting new ones, as well as an increase in the mortality and a decrease in quality of the patient's life.

Mind acting before the first fracture

To avoid this first fracture and prevent the aggravation of the disease, it is necessary to make an early diagnosis . In this sense, Dr. Oteo recommends evaluations to discard osteoporosis "to all women and men between 50 and 70 years, according to whether or not they have risk factors, and also to all those who, above that age, They have suffered a fracture . "

The most common test is bone densitometry , although "complementary tests , such as imaging tests or laboratory tests are also performed , since the problem may appear as a consequence of other clinical situations , " says HM Hospitals specialist.

The evaluation is fundamental to be able to act before the first fracture occurs or to prevent future injuries, with the consequences that entail for the quality of life of the patient.

Once the disease is diagnosed, it is necessary to determine which patients need treatment . "According to the International Clinical Guidelines, those who have suffered a hip or vertebral fracture and those diagnosed with osteoporosis in the densitometry should receive it , " says Dr. Oteo . In case of osteopenia , bone loss less severe than that of osteoporosis, risk factors should be evaluated for whether it is necessary or not to receive treatment.

Currently there are treatments that allow both to prevent and treat osteoporosis in an optimal way. The Bone Fragility and Osteoporosis Unit of the HM Madrid University Hospital has clinical tools that allow calculating the risk of presenting a fracture if the patient does not receive treatment.

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Vitamin D and calcium prevent OSTEOPOROSIS

Osteoporosis, known as the silent epidemic, is considered one of the most common diseases in our country, as it affects women in a special way. It has emerged in recent years as a global public health problem that affects more than 200 million people in the world1. In Spain, it is estimated that osteoporosis affects 3.5 million people, which is why it is a public health problem of great magnitude due to its prevalence, the morbidity and mortality it causes and the consumption of health resources2.

The increase in life expectancy has led to the appearance of a series of bone disorders that have an important clinical impact, such as the development of osteoporosis. Factors such as aging, decreased sex hormones and inadequate lifestyle are the main risk factors that determine a low bone mass and, therefore, are in the genesis of a large part of osteoporotic fractures3. Physical inactivity, dietary changes and the hormonal changes that occur as you age lead, ultimately, to a marked reduction in bone mass2.



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In this sense, in order to prevent the appearance of this pathology and to minimize the associated complications, it is necessary to acquire a healthy lifestyle and carry out dietary measures, taking into account that the foods that are consumed usually contain a wide variety of foods. vitamins, minerals and other important nutrients for health.

In particular, and together with the treatment prescribed by the specialist, there are two essential nutrients in the management strategies of osteoporosis: calcium and vitamin D, since "an inadequate level of these two substances has serious consequences, such as bone loss, musculoskeletal pain, muscle weakness, falls and fractures, "says Dr. Manuel Díaz Curiel, of the Internal Medicine Service of the Jiménez Díaz Foundation in Madrid.

For that reason and with the objectives of facilitating the update on the global management of osteoporosis -which includes an adequate pharmacological treatment that helps the absorption of calcium that is acquired through the diet- and to present the role of the vitamin D and calcium for bone and general health, and insist on the importance of proper nutrition, Drs. Jose Manuel Quesada, Manuel Díaz Curiel and Gregorio Varela with the sponsorship of MSD, Danone and Grupo Ferrer have organized, in Madrid, the 'Symposium vitamin D and healthy life', aimed at health professionals, as primary care doctors, specialists in rheumatology , traumatology, rehabilitation, internal medicine, endocrinology and nutritionists.

"It has been shown that vitamin D and calcium supplements reduce the appearance of osteoporosis by up to 40%, which is why we must encourage healthy diets supplemented with calcium," says Dr. Díaz Curiel.

To this, adds Dr. José Manuel Quesada, of the Endocrinology and Nutrition Service of the Reina Sofía University Hospital of Córdoba, belonging to the Thematic Network of Salud , Farmacia , Psicología , Belleza, Medicamentos Cooperative Research on Aging and Fragility (RETICEF) and scientific coordinator of the Symposium, "that in order to have a good absorption of calcium, a good gastric function is also essential, since only in this way is it possible to dissociate calcium from its salts and that this calcium is absorbed correctly. Also, for a good absorption to take place, it is necessary that there be at least 20 nanograms per milliliter of vitamin D, which is very complicated to achieve ".

The sun, source of obtaining vitamin D
It is known that vitamin D, Achilles' heel in the approach to osteoporosis, is key in the prevention of fractures due to this disease, even more so if one takes into account that there is a deficit of this hormone in the elderly population and that associated to calcium decreases the risk of fracture4. Vitamin D is essential for the maintenance of muscle function, facilitating the absorption of calcium and phosphorus.

The main problem is that vitamin D present in food is scarce, so it must be obtained through other sources, such as solar energy. Once the sun comes into contact with the skin, the formation of vitamin D begins.

"90% of vitamin D should be synthesized by the skin through the sun. However, there is an inadequate level of vitamin D throughout the world, including in Spain. It is estimated that practically 70% of the population has an inadequate level of vitamin D and it has been shown that the levels in our country are even lower than those of the inhabitants of Nordic countries, such as Sweden, Finland and Norway "5, states Dr. Quesada.

Foods beneficial for obtaining calcium
Specialists stress the importance of supplementing the diet with a diet rich in calcium. "There are foods that help to present higher levels of this substance. These foods are mainly dairy products - milk cheese and yogurt - and others such as margarine, "says Dr. Díaz Curiel. In turn, Dr. Quesada states that "it is necessary to supplement vitamin D through drugs, while calcium can be acquired relatively easily through diet."

Additional benefits of vitamin D
"Currently, vitamin D is conceived as a true hormone, since it improves bone and mineral metabolism, and is also the calcium manager, keeps the bone compact and strong and reduces up to 49% the risk of falling and improves neuromuscular performance, "says Dr. Diaz Curiel.

But, beyond providing benefits in the management of osteoporosis and avoiding the risk of falls and fractures, it has been shown that "in light of the available evidence, it is critical to maintain optimal levels of vitamin D, since low vitamin levels D, are associated with a higher risk of developing cancer, of suffering from infections, autoimmune, cardiovascular diseases, such as acute myocardial infarction, metabolic syndrome and arterial hypertension, among others. The treatment with vitamin D, by its specific actions, diminishes those risks and that of death as a whole. These data, of great scientific importance, make that maintaining adequate levels of vitamin D is a public health objective "6, says Dr. Quesada.

For its part, Carmen Sánchez, president of the Spanish Association against Osteoporosis (AECOS), insists that "it is essential that women ask their doctor about the health of their bones, since among all it is possible to fight against osteoporosis" .

Update of Recommended Vitamin D Intakes
As indicated by Prof. Gregorio Varela, member of the Department of Nutrition, Bromatology and Food Technology of the Faculty of Pharmacy, University CEU San Pablo, "the intake of vitamin D is lower than recommended in a very high percentage of individuals, ranging between 50 and 100% of the cases studied. Of the entire population, the elderly are the group most at risk of having vitamin D deficiencies. "

Vitamin D plays a key role in the maintenance of bone mass and mineral metabolism, since it regulates the intestinal absorption of calcium. "Taking into account that one of the main consequences of presenting inadequate levels of vitamin D is the appearance of rickets and osteomalacia, it is necessary to redefine the reference values ​​of vitamin D," says Prof. Varela.

Therefore, "it is essential to call for the public health authorities to update the Recommended Intakes, which lead to improve nutritional status," concludes Prof. Varela.

Proper treatment
As explained by Dr. Diaz Curiel, it is essential to detect early those patients with risk factors for osteoporosis. "Preventive work is the best therapy, especially in those people who have
n risk factors. "

"Only half of patients suffering from osteoporosis have been diagnosed, and of this percentage, only 19% have been correctly treated. For this reason, and to ensure an adequate diagnosis, it is also important to know the risk factors of each person ", explains Dr. Díaz Curiel," there are factors that can and should be corrected, such as diet, lack of exercise , the abuse of tobacco and the consumption of alcohol, which can modify the peak of bone mass ".

For this reason, it is essential that "a treatment against osteoporosis be instituted, and that this be enhanced through an adequate and continuous supply of vitamin D, which avoids breaches in indicated supply8, enhancing the calcium intake through the diet ", concludes Dr. Quesada.

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Calcium and vitamin D prevent osteoporosis: how to increase your levels

Nutrition in osteoporosis
We give you the appropriate dietary guidelines that help change the modifiable risk factors of osteoporosis, in order to prevent or control your symptoms, especially with the intake of calcium or vitamin D.



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The main objective of the treatment of osteoporosis is to avoid bone fractures. For this, before the diagnosis of the disease, it is advisable to increase the calcium intake and adapt the vitamin D :

Increase calcium intake

For this, it will be necessary to increase the consumption of foods rich in calcium , such as dairy products and their derivatives . Other interesting foods to consider for their contribution in calcium are almonds, chickpeas, bivalve molluscs and green leafy vegetables such as Swiss chard and spinach. It is likely that the doctor also advises the use of calcium supplements, such as calcium carbonate or calcium citrate. Although the recommended intake of calcium in adulthood is between 800 and 1000 mg of calcium per day, it is advised that the postmenopausal woman consume between 1000 and 1300 mg of calcium daily.

The absorption of calcium can be altered in a positive way by a low intestinal pH, the intake of fats and lactose or an increase in calcitriol in the blood. Calcitriol is the active form in which vitamin D is found in the body, and is also used in the form of a drug to treat low calcium levels.

However, there are factors that can reduce the absorption of calcium, such as certain types of gastritis , vitamin D deficiency, high intestinal pH, excessive consumption of dietary fiber , presence of oxalates and phytates in the diet and excess phosphorus , among others. . For this, the consumption of between 2 and 4 daily servings of dairy products and derivatives (better skimmed) is basic.

Adequate intake of vitamin D

Vitamin D is essential in the absorption of dietary calcium. The recommended intake of vitamin D for the general population is between 400 and 800 IU daily. When it comes to people over 65, this recommendation increases to 800 IU. Food sources of vitamin D are scarce: whole milk products and blue fish are the main dietary sources to obtain it, along with eggs (yolk) and supplemented foods such as breakfast cereals, margarine and soy drinks.
Boquerones, pescado azul Blue fish is a rich source of vitamin D, essential for the absorption of dietary calcium.

However, this vitamin is able to form on our skin during sun exposure, so sun walks in older people with osteoporosis are fundamental to their bone health.

Below is the calcium and vitamin D content of some of the foods to be included in the diet for the prevention and treatment of osteoporosis:
   
     Calcium(mg)             Vitamin D(UI)

• 1 glass of milk (250ml)     282.5     traces
• 1 glass of milk enriched with calcium and vitamin D (250ml)     400     8
• 1 yogurt     171.25     traces
• 125g of cottage cheese     748.75     traces
• 40g semi-cheese     306     4.48
• 1 tablespoon of milk powder (10g)     94.3     one
• 20g of butter         10.4
• 20g of margarine         64
• Small blue fish        
• Canned anchovies (4-5 steaks)     54     112
• Herring (1 unit of 60g aprox)     30     456
• Sardines in tin (100g)     407     220
• Egg yolk (1 unit)     27.4     36
• Veal liver         9.6

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The role of Vitamin D prevent osteoporosis

We tell you how important it is for your bone health and how to acquire it

When it comes to bone health , most of us are aware of the importance of calcium intake, and we are not wrong. Calcium is essential to have strong bones, although it should be noted that there are other nutrients involved, and without a good contribution of all of them we can not enjoy good bone health and prevent a disease as widespread and silent as osteoporosis .



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Nutrients needed to prevent osteoporosis
On the one hand, calcium, phosphorus and vitamin D are necessary for bone development at a structural and functional level . On the other hand, magnesium, vitamin K and zinc are involved in its formation . Consuming sufficient amounts of all of them is important throughout life, both in the growing season, when the bone is developing, and in adulthood, to avoid excessive loss of bone mass that can end in osteoporosis .

The importance of Vitamin D for our bone health
After calcium, the most important nutrient for bone health is Vitamin D. This vitamin, which is found in the fat fraction of foods, has the function of facilitating the absorption of calcium and phosphorus from the diet , that is, consuming calcium along with Vitamin D favors the calcium that we are ingesting into the bloodstream .

For this reason, the calcium that dairy products contain is so good, because when accompanied by Vitamin D we can take better advantage of it. In addition, Vitamin D also causes less calcium to be eliminated and therefore also decreases its loss.

How can I get Vitamin D?
Vitamin D can be obtained through food , by eating fatty animal foods such as blue fish, mushrooms, egg yolks, fortified foods and dairy (if you take skimmed you will be losing part of this vitamin) .

There is another way to obtain Vitamin D without food intake, an alternative that is also our main source of this nutrient: the sun. The contact of sunlight with our skin stimulates the synthesis of Vitamin D. For this reason deficiencies of this type of vitamin usually occur in the winter months or in countries where they have fewer hours of sunshine.

It is estimated that in winter we would need around 130 daily minutes of sun exposure, with at least 10% of the body uncovered and in the central hours of the day and with 25% of the body exposed, to synthesize enough Vitamin D. Instead, in summer with 10 minutes (without protective cream) we would have enough.

Keep in mind that as we get older, our ability to synthesize Vitamin D through sunlight is lost and we will require more contact, in addition to strengthening our diet .
In summary, to provide a sufficient amount of Vitamin D, we advise you to take:

•     3 times a week blue fish (salmon, tuna, sardine, trout, bonito, jack mackerel, anchovy, mackerel, carp, anchovy, turbot ...).
•     2 or 3 times a serving of eggs.
•     Dairy daily or enriched vegetable drinks.

And do not forget to take a daily walk to facilitate sun exposure!






How can I prevent osteoporosis?

What is osteoporosis?

Osteoporosis is an alteration in the bone density that usually appears during the Third Age, but its origin is usually the cause of nutritional deficiencies that can begin in childhood. It is considered a silent disease, because it does not cause symptoms until fractures appear.

Characteristics of osteoporosis

By definition, osteoporosis is a decrease and deterioration of the bone mass , that is, the mineral density of the bone is reduced and a change in its structure is produced, converting it into a more porous tissue. The bone with osteoporosis , therefore, is more fragile and more susceptible to injury due to not being able to withstand normal stresses.

The incidence of osteoporosis is very high in women from the age of 50 , doubling between 50 and 60 years, and tripling from 60. In fact, it is estimated that half of women 50 years will suffer a fracture due to osteoporosis at some point in his life. The most frequent fractures are those of the ulna, vertebrae and ribs.

Classification

    Primary osteoporosis . It is due to physiological factors, without any associated disease . There are two kinds:

•     a) Due to low estrogen levels , especially in postmenopausal women.
•     b) Because of advanced age , both in men and women, from 70 years old.

    Secondary osteoporosis . There is a pathology or external cause that originates it . Four causes:

•     a) For diseases of the endocrine system.
•     b) For drugs.
•     c) For digestive diseases.
•     d) Due to nutritional deficit.

How does the formation and maintenance of bones work?

99% of calcium is stored in the bones, and only the remaining 1% circulates through the blood. The calcium in the blood will fulfill different functions, such as muscle contraction, coagulation or bone mineralization.

The body is responsible for maintaining the concentration of calcium in regular blood, controlling the absorption of calcium from the diet and its elimination from the body. If the body detects that the concentration of calcium in blood is low, activate mechanisms to increase it. These mechanisms involve, among others, obtaining the calcium from the bones, so that if it is not corrected, the mineral density of the bone decreases.

Bone remodeling is the process by which bone is formed and destroyed. During the growth the balance is positive (more is created than the one that is destroyed), during the adult phase there is usually a 0 balance and, after 40 years, the regulation mechanisms begin to fail and a negative balance is produced, that is, the bone is destroyed.

It is important to understand that with our habits we can improve the calcium accumulation and avoid excessive loss.

How to improve bone health?

To enjoy good bone health, we must begin to take care of young people and continue to do so throughout our lives. In the stages of bone formation we can achieve the maximum possible mineralization and in the adult phase minimize losses.

The factors most involved in bone health are:

Calcium

It is essential for the structural and functional development of bone. The best source of calcium that we have in the diet is that from dairy products. Throughout life is recommended to take between 2 and 4 servings of dairy every day to meet the needs of calcium. A dairy serving equals 1 glass of milk, 2 yogurts or 40 g of cheese.

Calcium also contributes pulses, nuts, broccoli or cabbage , and some enriched vegetable drinks, although its use is less.

The stages of life in which the requirements are greatest are childhood and adolescence, pregnancy and lactation, and also during the Third Age.

Vitamin D

Along with calcium, Vitamin D is essential for bone formation. Its role is to help the calcium in the diet absorb better. We can synthesize it when the sun hits us on the skin (10 minutes a day) or food: blue fish, mushrooms, cow's milk or eggs.

Physical activity

It has been observed that exercise has a protective role of bone health. The tensions that the skeleton receives when we practice exercise favor the quality of the bone. Exercises with impact are most stimulating and are especially important during puberty. In addition, there is a direct relationship between muscle mass and bone mass, so that maintaining a good muscle mass is preventive for bone health.

In summary, both to prevent and treat osteoporosis a balanced diet is recommended that covers all the needs of nutrients, especially calcium and vitamin D, and exercise on a regular basis.

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A diet rich in calcium prevents osteoporosis

The benefits that it contracts to suppress harmful habits, in order to build a strong and resistant bone, and prevent its loss of bone mass to prevent fractures in future stages.

The lack of daily exercise, the deficiency of vitamin D and calcium consumption (milk and derivatives), as well as smoking and alcoholism, are risk factors for osteoporosis, as reported by the person in charge of the State Program of Aging of the services of Health of Oaxaca (SSO), Carlos Castellanos.



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Who explained that fractures are the symptom and the main consequence of this disease, since the skeleton becomes porous, increasing the number and size of the cavities, and consequently is more fragile.

He warned that women are the most vulnerable population group, since the maximum amount of bone mass is usually lower than the male and the cessation of production of female sex hormones by the ovary, some may suffer a faster and faster loss of bone, which can lead to post-menopausal osteoporosis.

Therefore, he stressed the importance of raising awareness among the young population, especially the Oaxacans, that they should ingest an adequate amount of calcium in adolescence and youth, that they should carry out correct and constant physical exercise.

He also emphasized the benefits of suppressing harmful habits, in order to build a strong and resistant bone, and prevent its loss of bone mass to prevent fractures in future stages.

Since he mentioned that the complications associated with fractures include an increase in mortality and an increase in the risk of suffering new falls, causing partial disability or require special care.

In this regard, he stressed that during the administration of the governor, Gabino Cué Monteagudo, and the holder of the SSO, Germán Tenorio Vasconcelos, prevention strategies have been promoted for a healthy life that helps to take care of the bones, strengthen them and reduce the damages that put the health of the Oaxacans at risk.

He added that working on the factors that can improve the prognosis is key to prevent the incidence of this condition increases, "healthy bones require good habits," he concluded.





Osteoporosis: what it is, symptoms, diagnosis and treatment

What is it

Osteoporosis is a skeletal disease in which there is a decrease in the density of bone mass. Thus, the bones become more porous, increases the number and size of the cavities or cells that exist inside them, they are more fragile, they resist the blows worse and they break more easily.

Causes

Many metabolic changes occur throughout life, alternating phases of destruction and bone formation. These phases are regulated by different hormones, physical activity, diet, toxic habits and vitamin D, among other factors.

Under normal conditions, a person reaches 30-35 years a maximum amount of bone mass ("peak bone mass"). From that moment, there is a natural loss of bone mass .

Women have more frequent osteoporosis for several reasons: their peak of bone mass is usually lower than that of men and with menopause bone loss is accelerated (postmenopausal osteoporosis).

There are many other causes of osteoporosis: alcoholism, drugs (glucocorticoids, hormone treatment used for the treatment of breast and prostate cancer ...), rheumatic inflammatory diseases , endocrine, liver, kidney failure, among others

symptom

Osteoporosis is called a silent epidemic because it does not manifest symptoms until the loss of bone is so important that fractures appear. The most frequent fractures are the vertebral, hip and wrist fractures (Colles fracture or distal end of the radius). Hip fracture is especially important because it is considered a serious event because it requires surgical intervention, hospital admission and a loss of quality of life for the patient, even for a short period of time.

Prevalence

This disease mainly affects women after menopause, although it can also do so earlier or affect men, adolescents and even children. Specifically, in Spain, approximately 2 million women suffer from osteoporosis , with a prevalence in the postmenopausal population of 25% (1 in 4). It is estimated that this disease is responsible for about 25,000 fractures every year. Approximately 1 in 3 women and 1 in 5 men over 50 will suffer an osteoporotic fracture in their lifetime.

Diagnosis

Although it is a silent disease, currently rheumatologists have a wide range of tools for early diagnosis and thus adapt the treatment, either to prevent the loss of bone mass or to combat osteoporosis.

There are life habits that can help improve bone quality such as: adequate calcium intake, physical exercise and no smoking. The specific amount of calcium varies with age, but many adults will need 1,000 to 1,500 mg per day. This intake can be made with natural foods rich in calcium (especially milk and its derivatives) or as supplements in the form of medicines (calcium salts). In this last case there should be a control of your doctor about the amount and the administration schedule.

In the same way, vitamin D is a fundamental substance for bone . Their daily needs are mainly achieved by the formation of it on the skin when it receives the effect of solar irradiation.

Treatment

The goal of osteoporosis treatment is to reduce the number of fragility fractures.

As a generalized measure, it is recommended to maintain healthy lifestyle habits, such as a balanced diet rich in calcium , quitting tobacco and excessive consumption of alcohol, as well as exercising daily with control to avoid falls. In addition, some people may require calcium and vitamin D supplements.

The antiresorptive treatment is one that prevents the loss of bone mass. This group includes drugs such as bisphosphonates (alendronate, risedronate, zoledronate ...), denosumab, selective modulators of estrogen receptors (raloxifene, bazedoxifene) and estrogens. The osteoformador treatment , as the name suggests, stimulates the formation of new bone and within this group is included teriparatide. Finally, the drug that has a mixed mechanism of action (antiresorptive and osteoformer) is strontium ranelate.

However, the rheumatologist will assess the characteristics of the patient, their pathological background and risk factors for osteoporosis and decide in each situation which is the most appropriate drug in each case.

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Calcium : Osteoporosis and its prevention

Osteoporosis is a disease characterized by asymptomatic reduction of bone mass. When this happens, that is, when the bone mass decreases, the structure of the bone deteriorates; there is no more mechanical support and fractures with minimal traumas occur.

This disease appears more frequently in postmenopausal women and in elderly people of both sexes.



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The alternatives for an appropriate intake of calcium in the daily diet and that therefore does not involve a consumption of calories and excess fat are:

•     Dairy products and their derivatives. Because it is low-fat, its fat content (and therefore caloric content) is lower, without its calcium dose being lower. It usually happens that its calcium content is equal or greater.
•     Fish (sardines with their skeleton), dried fruits, legumes and broccoli are important sources of calcium.
•     Add skim cheeses (white spreads or soft cheeses) to salads, steamed vegetables, soups, purees, matches, etc,
•     Use skim milk as a cooking medium for cornmeal, rice, baked fish, white sauces, soups, etc.

The 10 tips to prevent osteoporosis:

1.     Ingest enough calcium with a balanced diet
2.     Ingest enough vitamin D ,
3.     Do not perform "starvation diets",
4.     Exercise periodically,
5.     No Smoking,
6.     Control caffeine intake , excess salt , protein and phosphorus ,
7.     Do not eat foods with excess plant fibers ,
8.     Limit the consumption of cola beverages,
9.     Moderate the consumption of alcohol ,
10.     Avoid medications that decrease bone mass.

Calcium deficiency

Studies on animals showed that diets low in calcium or high in phosphorus produce a generalized decrease in bone mass.

On the other hand, it is advisable to ingest 800 mg of Calcium per day in women between 25 and 45 years of age ( see table ), and up to 1200 mg / day between 10 and 25 years may be required to achieve peak bone mass. . These amounts can be reached with appropriate diets, which will prevent osteoporosis through proper nutrition.

The risk factors, also known as decalcifying factors, that exist and that must be taken into account because they do not allow the correct assimilation or use of calcium in the body are:

•     The consumption of alcohol ,
•     The exaggerated consumption of proteins ,
•     Zinc supplements,
•     Oxalic acid / phytic acid,
•     Exaggerated fiber consumption,
•     Ingesting excess salt,
•     Caffeine ,
•     The consumption of tobacco and
•     The sedentarismo.

The 10 best foods to prevent osteoporosis

Diet and sedentary lifestyle favor the appearance of osteoporosis. But the key is not to increase the consumption of dairy, as is often recommended.

Our bones are a living tissue that constantly absorbs or releases calcium, as the body needs. Osteoporosis arises when the body is not able to produce enough bone or reabsorbs too much, and this is heavily influenced by diet.

Basically our bones are formed by calcium , proteins, including collagen, water and other minerals such as magnesium and phosphorus. Certain vitamins such as K2 and D help fix calcium in the bone.

On the other hand, excess sugar and protein, refined foods, coffee, alcohol and salt can cause bone loss.

10 foods rich in calcium to prevent or stop osteoporosis

Traditionally we have been told that to strengthen our bones we have to increase our consumption of dairy products. The problem with dairy products is that in addition to calcium, they have a lot of phosphorus. This is essential, but in excess it competes with calcium and prevents it from being properly fixed in the bones. That is, dairy products are not only dispensable, but can also be counterproductive.

But calcium is not only in dairy. The vegetable diet is ideal for osteoporosis. There are plant sources of calcium that are better assimilated than dairy products.

1. Black sesame

These seeds are rich in antioxidants and calcium , the mineral most needed for bones.

Ideally, 2 tablespoons a day. You can make tahini and use it in countless sweet and salty preparations.

2. Kombu seaweed

It has abundant vitamins and minerals, like most sea vegetables, and is ideal for enriching soups and broths. You can also cook cereals and legumes with a slice to make them more digestive.

Add a dry piece, about 2 fingers, to all your broths and cooking cereals and legumes.

3. Almonds

Nuts contain high levels of calcium , especially almonds. You will take more advantage of its nutrients if you activate them by previously soaking them in water.

Take 1 handful a day, preferably with a pre-soak of 8-12 hours in water to activate them.

4. Azuki beans

Traditional Chinese Medicine advises them together with black soybeans to strengthen bones , for their proteins and antioxidants. Well cooked they are very digestive and introduce variety in the diet.

Take them 2-3 days a week, boiled with vegetables or in the form of pate.

5. Col kale

Cabbages in general are especially rich in high availability calcium . The kale, in addition, is very versatile: you can make it steamed, marinated in salad or in the form of dehydrated chips, for example.

We recommend that you take 4-5 leaves every day, in broths, salads, chips or any other variation.


6. Orange

Taking frequently foods rich in vitamin C, such as orange, favors the formation of collagen, necessary for the formation of bone .

Take one or two oranges, 5-6 days a week.

7. Walnuts
They are a good source of omega-3. These fatty acids influence the activity of bone-forming cells, which can reduce the risk of fractures .

1 handful of nuts a day, raw as is or with a previous soak to make them more digestive.

8. Dates

They are very nutritious. Eat two a day, for example of the tasty variety Medjoul, provides minerals, proteins and vitamins that favor the formation of bone tissue and the proper functioning of the body. They also satisfy the need for candy at any time.

Taking 2-3 a day will help prevent osteoporosis.

9. Whole grains

They are much more nutritious than the refined versions. Some provide more protein than others, and all will be more digestive if soaked in mineral water for 8 hours and cooked with kombu seaweed.

Take them 3 times a week, introducing variety.

10. Spinach

They are rich in vitamin K2, another vitamin that is involved in the formation of bone . In addition, green leaves in general contain a large amount of calcium and minerals necessary for bone tissue .

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Does taking more calcium during menopause prevent osteoporosis and fractures?

That is not enough, there are other important ways to achieve it

The estrogen lowering characteristic of menopause can affect a woman's bone health. Therefore, during this stage of life is essential to maintain a healthy diet and include in the diet foods that strengthen and prevent the occurrence of osteoporosis , especially those rich in calcium.



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But, it is also necessary to acquire other nutrients and meet certain recommendations. 

Osteoporosis implies a decrease and deterioration of the bone mass that causes a greater fragility of the bones and, therefore, the increased risk of fractures.

This disease develops slowly, is asymptomatic and occurs in 80% of women , usually 10 years after menopause.

To prevent it, there is to know, through a bone densitometry, what is the state of the bones. It is also convenient to do an analytical to evaluate calcium and vitamin D levels.

BONES

To prevent the risk of osteoporosis, it is necessary to maintain some guidelines

1. Balanced diet through: 

•     Foods rich in calcium, which can be of animal origin such as dairy products and edible soft-bodied fish such as sardines or salmon, and those of vegetable origin.
•     Adequate protein intake, since an excess produces an increase in calcium requirements, which being excessive causes hypercalciuria (loss of calcium in the urine). 
•     Get enough magnesium and vitamin K through green leafy vegetables, as well as phosphorus, an essential mineral for bone formation. 

2. Exercise:
Perform physical activity and exercises (mainly strength as weights) on a regular basis for at least 40 minutes 3 times a week to reduce the risk of fractures and slow down the osteoporosis process.

3. Vitamin D:
It is necessary to achieve an adequate absorption of calcium, since this mineral does not fix itself.   To obtain this vitamin the main way is through exposure of the skin to the sun, there are also other limited sources such as fatty fish, egg, viscera. More information:
It may interest you:
Eat more vitamin D

4. Moderate sodium consumption , since an excess causes an increase in calcium excretion through urine.

5. Avoid alcoholic beverages, smoking, moderate caffeine consumption.

Foods rich in calcium not only dairy

Calcium is one of the minerals that we must try to obtain through an adequate intake of food since its deficit can cause the decalcification of bones. 

For this, dairy products can be selected, which are the main source of calcium with the greatest bioavailability, and can be consumed provided that the person does not present alterations in the absorption of lactose, allergies or other symptomatology.

Of the dairy products we can choose : natural yogurt, kefir, milk, cheeses of low fat content such as cottage cheese.

But there are also other sources of calcium of vegetable origin (of lower absorption).

Of vegetable origin: pulses, especially cooked chickpeas, green leafy vegetables, nuts such as almonds, whole grains, sesame seeds, chia, hemp, ground or broken flax to absorb their nutrients, sesame paste or tahini spreads or enrich purées or soups and marine algae such as wakame and hiziki.

Although recommendations for calcium intake vary greatly between countries, for example, the EFSA (European Food Safety Authority) indicates a reference intake of 950 mg / day for people over 25, in the United States for adults is 1,000mg.

It may interest you:

How to improve bone health with our eating habits?

Example to cover calcium needs in the day:

•     50 grams a day of low-fat cottage cheese 295 mg of calcium
•     1 glass of natural yogurt 200 ml 240 mg calcium
•     2 canned sardines 244 mg calcium
•     150 grams of cooked spinach 204 mg calcium

Total: 983 mg calcium / day

Food, exercise and sun exposure throughout life are the best insurance against osteoporosis and consequently fractures. 

Your time is now, take care of yourself and plan to lead a healthy life, doing the relevant exams and feeding yourself consciously.