NCPAD:Health Promotion: More Vegetables for Healthy Bones?

More Vegetables for Healthy Bones?

Valerie Lawson - Exercise Physiologist

Osteoporosis is considered a progressive reduction in bone density, which creates brittle and porous bones. About 28 million Americans have osteoporosis, and 80% of them are women (www.osteo.org/osteo.html). Persons with osteoporosis have an increased risk of fractures, particularly those at the hip and wrist.

Research is still being conducted to determine exactly why fruits and vegetables may affect bone health, but some suggest it may be the alkalizing effect of fruit and vegetable consumption on acid-base balance, as well as the dietary effects of vitamin K, phytoestrogens, and other unidentified dietary components they contain. So aim for at least 5 to 7 servings of fruits and vegetables per day. A few journals have cited that a higher intake of fruits and vegetables can play a crucial role in maintaining and/or increasing bone density in adults (American Journal of Clinical Nutrition, July 2002, 76, 245-252, and June 2006, 83(6), 1420-1428). Therefore, if you are easily achieving 5 servings, aim for 9 servings a day to receive the most benefits, including prevention of osteoporosis.

Risk factors associated with osteoporosis include, but are not limited to:

Excessive use of alcohol or cigarette smoking
Postmenopausal women with a history of diabetes
Female gender
Family history
Slender frame, low muscle mass
Caucasians, especially women of Northern European extraction, and Asian women
Advancing aging
Pre-menopause: amenorrhea, low estrogen in women, and low testosterone in men
Lifetime diet low in calcium and vitamin D (including low intake of fruits and vegetables)
Sedentary lifestyle

Dietary recommendations for osteoporosis include an adequate intake of calcium, which is at least 1,000 to 1,200 mg daily. For those in menopause or over age 65, at least 1,500 mg daily is recommended. A quart of milk per day could meet this recommendation. (See the list below for additional ideas on calcium sources.) There is ongoing research on the benefits of an increased intake in soy, as the isoflavens found in soy may be beneficial for bone health, and the current recommendation is 2 to 3 servings of soy daily. Vitamin D is also an important factor when dealing with osteoporosis, with the recommended intake being 200 to 400 International Units (IU) daily. This can be achieved with 4 to 6 cups of milk a day, as each cup contains 100 IU of vitamin D. Additional vitamins and minerals that are important for osteoporosis prevention can be found in fruits and vegetables, such as vitamins C and K, potassium, and magnesium. Another recommendation is to decrease sodium and sugar intake. Some research has indicated that a 50% decrease in sodium may be as effective as an 800 mg increase in daily calcium intake (Nutrition and Diagnosis-Related Care, 5th Edition, 2002). Foods with added sugar and salt (sodium) should be avoided.

Increasing daily intake of fruits and vegetables is another excellent way to reduce the risk of osteoporosis. Research has demonstrated some benefits for bone density from a healthy diet that includes vegetables and fruits. Intake of calcium and vitamin D is important for bone density, as well as intake of magnesium and potassium.

Magnesium: The recommended daily intake is 400 mg, and good sources include soymilk (1 cup = 46 mg), cooked spinach (½ cup = 75 mg), bran cereal (1 cup = 69 mg), black beans (½ cup = 60 mg), avocado (½ cup = 45 mg), and cooked Swiss chard (1 cup = 151 mg).

Potassium: The recommended daily intake is 3,500 mg, and good sources include baked potatoes (medium = 477 mg), lima beans (½ cup cooked = 398 mg), banana (medium = 467 mg), honeydew melon (1 wedge = 434 mg), milk (1 cup = 383 mg), dry roasted soybeans (½ cup = 1173 mg), mashed winter squash (1 cup = 1070 mg), cooked tomatoes (cooked from raw 1 cup = 670 mg), and chopped dates (1 cup = 1160 mg).

Note that processing foods usually reduces the amount of potassium while increasing the sodium content, so read the labels.

The glut of information on recommendations for the prevention of multiple chronic conditions, secondary conditions, diseases, and the reduction of progression and/or complications can obscure the key take-home message: the intake of fruits and vegetables can make a positive impact on our health at many levels and benefit our quality of life.

Food-Based Calcium Sources

Please note that this list is an estimate of actual calcium content. Fruits and vegetables are in bold type.

FOOD	Portion	Calcium (mg)
Parmesan cheese	1 cup grated	1,376
Cheddar natural	1 cup shredded	815
Cheddar natural	1 ounce	204
Yogurt low-fat plain	8 ounces	415
Broccoli, boiled, drained	1 cup chopped	205
Oatmeal, instant, fortified, flavored	1 packet	168
American natural cheese	1 ounce	174
Brick natural cheese	1 ounce	191
Edam cheese (natural)	1 ounce	207
Gruyere natural cheese	1 ounce	287
Ricotta, part skim	½ cup	337
Romano	1 ounce	302
Swiss natural cheese	1 ounce	272
Cod, dried, salted	3 ounces	189
Sardines, canned in oil	3 ounces	371
Skim milk	1 cup	302
Buttermilk	1 cup	285
Chocolate milk	1 cup	280
Cocoa, homemade	1 cup	298
Cocoa, (mix/water)	1 cup	90
Eggnog, nonalcoholic	1 cup	330
Evaporated milk, skim	1 cup	738
Milkshake, vanilla	10 ounces	413
Pudding, tapioca	½ cup	131
Chocolate pudding, mix	½ cup	146
Spinach, frozen, boiled	½ cup	139
Spinach soufflé	½ cup	165
Turnip greens, boiled, drained	½ cup chopped	99
Collard greens	1 cup	335
Bok choy	1 cup	250
Soy beans	1 cup	180
Mustard greens	1 cup	150
Okra	1 cup	90
Acorn squash	1 cup	90
Great Northern beans	1 cup	140
Kidney beans	1 cup	115
Tofu	1 cup	130

Additional food choices include fresh fruits, dried and unsweetened fruit (apricots, prunes, and dates), low-fat tomato sauces, tomato salsas, sweet potatoes, sesame seeds, grape juice, red grapes, and pink grapefruit.

For questions about supplements, please discuss options with your physician.

Please send your comments and feedback to Valerie Lawson at vlawson@uic.edu.

Low-Fat and Healthy Cream of Broccoli Soup

2 cups chopped broccoli

3 cups chicken broth (low sodium)

½ cup chopped onion

2 cups skim milk

1 cup non-fat dry milk

1 teaspoon of black pepper

2 tablespoons of cornstarch

A few broccoli florets to top each bowl of soup
Cook broccoli and onion in a sauce pan with chicken broth until soft.
Puree in blender or food processor.
Then add skim milk, dry milk, and pepper. Cook about 15 more minutes.
Thicken with cornstarch dissolved in skim milk. Continue cooking until soup is slightly thickened.
Top each serving with broccoli florets. Serves 4 to 6.

This recipe is a healthy choice to prevent bone loss because it contains alpha-carotene, beta-carotene, calcium, magnesium, potassium, inositol, chromium, zinc, iron, folic acid, vitamin A, vitamin D, vitamin C, vitamin K, and the B vitamins.

This fact sheet was last updated on 09-29-2006.