So sorry to hear that you’re dealing with this problem at this young age. I’m going to share what I’m doing (and why) to help preserve bone density in the hope that it can help others. I’m looking at some of my friends who are older than me and I know I don’t want to become so frail. I’ll fight it with everything that science has to offer. This post is more about what needs to be taken out rather than added to the diet to maintain healthier bones. For a reference, I’m less than a year older than Cathe and I’ve been using her workouts for over 30 years. I figured as long as she can do it, I can do at least some, if not all of it. I give her full credit for keeping us going with more challenging workout over the years.
Apologies for the long message. The subject is complicated and this is a summary.
This is what I'm doing to maintain bone density:
Reduce Sodium: I knew that controlling salt intake is the most important factor to reducing calcium and magnesium loss (doctor's advice). The body can’t store much sodium and it ends up losing potassium, Ca and Mg in the process of eliminating excess table salt. The process varies in different people. We’ve been on a low salt diet (maximum of 2 gr a day) for about 10 years now. We had to give up eating out except on rare occasions and we cook everything from scratch. No packaged food. So far reducing salt has worked very well.
Reduce oxalates from food: Recently, I started reading about oxalate and the stress they cause to the entire body. I realized by trying to eat healthy I’ve been overloading on oxalates. Oxalic acid is present in many of the healthy foods we eat. It is also produced in the body as a waste product and is removed by the kidneys in the urine. It binds with high affinity to minerals like Ca and Mg in the intestinal tract and in the kidneys and removes them from circulation. It can lead to kidney stones in some people. Excess oxalates that are left in the body get stored in all the tissues with 68% ending up in our bones.
Our bones hold most of our Ca/Mg which are used to help maintain the osmolarity of the blood (balance of ion concentration). Think of them as a 24hr ATM for Ca and Mg. The only problem is that it is much easier to take CA/Mg out (break down bone tissue) than it is to replenish them (rebuild bone tissues). Both processes happen at the same time all the time, but the breakdown happens much faster and much more frequently. Over a lifetime, it leaves us with depleted weaker bones. This seems the best explanation for why people who are doing everything right are still having problems with bone density.
Oxalates are very high in many healthy foods like spinach, beet greens, swiss chard, parsley, chives, celery, various beans, soy, sesame, almonds, cashews, etc. Even food that are considered moderate in oxalates are still very high. I realized that my family’s diet is very high in oxalate as we eat a Mediterranean diet, heavy on vegetarian food. I was eating more than a gram of oxalate a day, more than 10X the recommended amount for a healthy diet. Even with supplementing with Ca/Mg, vitamins D and K2, I was doing a lot of damage to my body and I was starting to feel it. The oxalates had to go. I'm changing the way I eat and the way I cook to reduce daily oxalate load.
I’ve also increased my water intake even though I’ve always drank plenty of water and I started adding electrolytes. I don’t buy prepacked electrolytes because I don’t want any of the additives and flavorings. I use potassium citrate powder with a small amount of calcium carbonate (5:1 ratio) and a splash of lemon juice. Our bodies need about 5 gr of potassium (K) and 1 gr of calcium per day. I add 1.5 gr of K from the citrate powder. The main reason for the electrolytes is to add citrates and carbonates which are the body’s main buffering system. The goal is to increase urine pH to ~6.5 to make it easier for the kidneys to get rid of toxins including oxalates. This is only needed by people who have more acidic urine (below 6.0). I also started to take a low dose Ca/Mg supplement with every meal. The logic here is if oxalic acid binds to Ca/Mg in the GI track, its absorption into the bloodstream is reduced. If it has access to supplemental Ca, the hope is it may use a little less of the endogenous minerals, less stress on the bones.
Now the bad news: there is no reliable oxalate data for most foods. Even PubMed searches don’t give much data. There is a list of oxalates in food from Harvard medical school and another from the University of Chicago that seem to have some real-world data to support them. This is what I'm using. There are many conflicting lists on the internet. It’s been a guessing game on some of the food I eat. I’m aiming to limit oxalate from food to 200mg per day.
Oxalates are something to consider if you’re trying to preserve bone density.
