Nutritional Interventions in Osteoporosis

Susan J. Whiting, PhD; Hassanali Vatanparast, MD


Geriatrics and Aging. 2005;8(9):14-20. 

In This Article

Lifestyle Nutrients: Protein, Sodium, and Caffeine

Sufficient protein is needed for osteoporosis prevention and treatment.[1] There is, however, a debate about optimal protein intake. Experimentally, diets high in protein can induce a negative calcium balance by increasing urinary loss of calcium, which could lead to bone loss if calcium absorption is not up-regulated.[16] This overshadows the basic principle that protein is needed for bone formation. The OSC review was concluded prior to the publication of several studies which, taken together, show that many older men and women are not ingesting sufficient amounts of protein; animal as well as plant sources would improve bone health.[16]

Dietary sodium, primarily as salt, promotes calciuria. The amount of sodium that does not enhance urinary calcium loss, approximately 2,100mg/d, is similar to the UL for sodium that was set by the Institute of Medicine.[5] The recommended daily intake for sodium is 1,500mg,[5] an amount that can be achieved using unsalted versions of foods and avoiding processed/packaged foods.

Caffeine has only a small effect on bone health due to its effect on increasing urinary calcium excretion, which can promote bone loss when calcium or vitamin D intakes are too low to offset these losses. Because there is a greater risk of hip fracture with caffeine use,[17,18] and because new food products such as boutique coffees and energy drinks are already providing large amounts of caffeine, it is recommended that coffee intake (but not tea, necessarily, as it contains less caffeine per cup) should remain below four cups a day.[1]


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