My father had osteoporosis for several years before his death in 2001. My 83 year old mother also has it. She's a tiny person with a large bulge on her upper back. She has of course, shrunk in stature over the past 10 years. She's broken a bone or two in the past, but has luckily avoided that catastrophe in recent years although the risk is high. On the other hand, she has suffered terrible back pain due to compression fractures that appear to occur for almost no reason due to the condition of her bones. She took oral medication and nasal inhalers to control pain and increase her calcium intake, but the advance of the disease has continued. Now she takes annual Reclast injections.

My doctor warned me years ago, that I am at high risk for osteoporosis as well. I have a slender build, a family history, I'm white, and female. Now as I approach menopause, my concerns turn to myself and how I can thwart what seems to be inevitable. I've decided to do what I can to increase my calcium, Vitamin D, and maintain my activity level to control what I can.

(photo by patrix)

The good news is that I do have a few things on my side and, if they aren't on yours, you can change them if you want.

I don't smoke or drink alcohol (except on rare occasion).

I seldom consume caffeine; either soft drinks or coffee which can reduce calcium absorption.

I have a good level of physical activity, including weight bearing. I walk, hike, or bicycle regularly. Daily in fact. I'm planning on adding some simple weight lifting to my morning activities as well.

My sugar intake is reasonable.

Obviously, the best nutritional defense against osteoporosis starts in your early years. When your bones are forming, having a calcium rich diet and getting enough weight bearing exercise helps your bones to develop in to strong ones. Maintaining this throughout your lifetime is also important. How much calcium your body needs to build and maintain strong bones varies with age and so forth. However, in my case as a woman who will soon be post menopausal, I've found that I need a minimum of 1,200mg of calcium per day.

Certainly, anyone with concerns about osteoporosis should consult with their physician and discuss their diet, perhaps receive a bone scan to check the condition of their bones, and then discuss any supplements if necessary. It can be important not to take in too much Vitamin D or calcium, so physican approval can be critical although exceeding the allowable amount would require you to consume more than twice the recommended level. I'll be having my physician consultation in a few months, but for the past several years, I've been planning ahead.

I began taking a calcium supplement when I turned 40 years old. I don't personally like the idea of taking pills and I'm not convinced that it's the best form of calcium or any other mineral or vitamin. However, as a precaution, I began taking one 600mg pill per day and hope that it's being absorbed.

I also made some adjustments in my diet to try to get more calcium via the foods I'm eating as I feel this is the best way to assure the calcium is properly absorbed and used by my body. I found that there are a number of foods I enjoy which are rich in calcium. I try to eat a minimum of three of these a day.

These calcium rich foods include:

- A cup of milk
- A cup of yogurt
- A cup of cottage cheese
- An ounce and a half of cheese (parmesan, Edam, cheddar, or mozzarella are good choices)
- A small can of salmon with bones
- A serving of broccoli
- A handful of sesame seeds (on a salad or alone)
- A handful of almonds
- Green leafy vegetables (not spinach)

Dishes like an egg and cheese quiche, lasagna, macaroni and cheese, or a salad dressed with several of these ingredients made it easy to get at least half of this in a single meal. Even simple desserts like custard made with milk helps. Obviously, if your fat intake is too high, either low fat versions of the dairy products or placing more weight on the appropriate vegetables is important. Figs, kale, and even Tofu are known to be great sources of calcium although they aren't ones that I've made use of very often.

Another tactic I use is to double the calcium I get from the milk I drink. I've always been a 2% milk drinker but was never able to make the leap to skim or fat free milk. However, when I learned that the non-fat powdered milk gave me nearly 30% of the calcium I needed for the day, I began combining it with the skim milk (rather than water) which made it richer and more acceptable to me. This doubled the calcium I was getting in a single serving. The calories are a bit high, but that's why I switched to skim milk. The powdered milk doesn't even add any fat which is another reason I like it. Despite lower fat and calories, skim milk has even more calcium than whole milk. I wouldn't really drink this on it's own, but I will use it on cereal and so forth which I eat routinely.

Then of course, there are the calcium fortified or enriched foods which can play a role in increasing your calcium intake. There are breads and cereals that have added calcium, but I don't really use those. What I do use however, is the calcium fortified orange juice. I'm not a big juice drinker, but OJ is something I enjoy.

My research on the internet has taught me that Vitamin D is another important part of the diet for anyone who wants strong bones. It apparently helps your body absorb the calcium it needs. Luckily the salmon and full dairy products listed above as calcium rich options, are also good sources of Vitamin D. So too, are many other kinds of fish and eggs as well as fortified orange juice, milk, and the powdered milk mentioned above.The other great thing about vitamin D is that getting out in the sunshine helps to provide it as well.