How could the recent trend of taking salt supplements affect your bone health?
How could the recent trend of taking salt supplements affect your bone health?
Related listening:
Should you be eating (way) more salt? (Nutrition Diva #755)
Does a High Protein Diet Weaken Your Bones? (Nutrition Diva #427)
How fiber builds strong bones (Nutrition Diva #632)
Mentioned in this episode:
Bone Health Workshop with Joanne Fagerstrom, PT, CFP
Hello and welcome to the Nutrition Diva podcast. Today’s episode, like so many of our episodes, was suggested by an email from a listener. Judy wrote to me in response to my recent episode on sodium.supplements. Some influencers claim that the current recommended intake for sodium is actually too low and that we’d be healthier if we got more sodium, not less.
After listening to that episode, Judy wrote:
“I’d love for you to address the connection between sodium intake and osteoporosis. Before my osteoporosis diagnosis, my diet was very high in both sodium and caffeine, so I was dismayed to learn that this probably contributed to my bone loss. No doctor had ever warned me about this.”
Judy’s right that sodium (and caffeine) can both impact calcium metabolism. However, there’s a lot more to this story.
A high sodium intake can increase the amount of calcium that is excreted in the urine. (Caffeine can do the same thing.) However, your body can compensate for these losses by increasing the amount of calcium that it absorbs from the foods you eat. As long as your diet contains enough calcium, a high sodium diet is likely to have little to no long-term effect on bone health. Of course, it’s not at all a sure thing that your diet contains enough calcium.
For women over 50, the recommended daily intake of calcium is around 1,200 mg. And it is possible to get that much from diet alone. Good food sources of calcium include dairy products, leafy greens, vegetables in the cabbage family, tofu, as well as calcium-fortified foods. Keep in mind that even foods that aren’t super high in calcium, such as grains, nuts, seeds, and other vegetables, still contribute to your overall intake. The typical American diet—which, as you know, doesn’t come anywhere close to the recommended amount of vegetables—still manages to provide an average of 250 milligrams of calcium a day, not counting dairy products.
Many women also take a calcium supplement. However, keep in mind that more is not necessarily better. Unfortunately, we cannot make up for the calcium we didn’t get earlier in life by taking more now. And when we load up our body with a lot more calcium than it can actually absorb, it can have unintended consequences. There have been studies linking high dose calcium supplementation with an increased risk of heart attacks or kidney stones, for example. For this reason, I recommend taking only as much calcium as needed to help you close the gap between the recommendation and your typical dietary intake.
To get a rough estimate of how much calcium you’re getting from foods, start with 250 milligrams as your baseline. Add 250 mg for each serving of dairy, canned fish, tofu, Chinese cabbage, or fortified orange juice. Give yourself another 100 for any other cabbage family vegetables. It’s not important that you get exactly the recommended amount of calcium every single day—if it’s averaging out to your recommended intake, you’re probably getting all the calcium you need. If your diet is falling short, you can add a supplement.
But, once again, you only want to take as much as you need to fill the gap between your dietary intake and your recommended intake. If you’re averaging 750 mg of calcium every day, for example, there’s no need to take 1,000 or 2,000 mg of supplemental calcium. A 250 mg supplement would do the trick.
Of course, calcium is not the only nutrient you need for strong bones.In particular, vitamins D and K are critical to strengthening bones. Vitamin D is actually more like a hormone than a nutrient. One of its key jobs is helping your body absorb and use calcium. Your body makes vitamin D when your skin is exposed to sunlight. Unfortunately, with clothes, roofs, and sunscreen, we don’t get as much sun on our skin as we used to. You can also get vitamin D from fish and from milk or soy milk that has vitamin D added to it.
Vitamin K is found in vegetables like spinach, kale, broccoli, and Brussels sprouts. Notice anything? Many of the vegetables that are high in vitamin K are also high in calcium. Perhaps that explains this mystery: Researchers noticed that people whose diets are high in vitamin K have a much lower incidence of bone fractures as they get older than people whose diets are low in vitamin K. “A-ha!,” we thought. “Vitamin K prevents osteoporosis.”
Later, we were disappointed to find that taking vitamin K supplements had no effect on fracture risk. But the folks with strong bones weren’t taking vitamin K supplements, they were eating foods rich in vitamin K. It just so happens that these foods are also rich in calcium, magnesium, potassium, and other bone-building nutrients. Even protein and fiber play a role here.
In other words, single nutrients don’t prevent bone loss. But a nutrient rich diet does. And finally, lifestyle factors also play a crucial role. Regular weight-bearing exercises, such as walking or jogging, as well as strength training help to keep bones strong.
And, by the same token, things like sodium or caffeine don’t cause osteoporosis all by themselves. However, if you’re not getting the nutrients needed to maintain strong bones, these can make a bad situation a bit worse.
Thanks to Judy for her timely question. And because I know that bone health is such a pressing concern for so many of my listeners, I am teaming up with Physical Therapist Joanne Fagerstrom to offer a Bone Health workshop on April 13th. Joanne specializes in osteoporosis prevention and management. We’re going to talk about (and then actually do!) the types of exercise that are best for strengthening bones, we’ll address nutritional considerations and leave plenty of time for your questions. If that sounds like something that you or anyone you know might be interested in, you can find out more and register at https://nutritionovereasy.com/healthybones
If you have a question you'd like me to answer, you can email me at nutrition@quickanddirtytips.com You can also leave me a message at 443-961-6206
Nutrition Diva is a Quick and Dirty Tips podcast and is supported by a fantastic team, which includes Brannan Goetschius, Nathan Semes, Davina Tomlin, Holly Hutchings, Morgan Christianson, and Kamryn Lacy.
That's all for this episode. Thanks for listening! I'll see you next week.