- Are a woman – especially if you’ve had a hysterectomy or are peri- or postmenopausal
- Are over 50 years old (although you start losing more bone than you create by age 30 or 35)
- Have an inactive lifestyle
- Have amenorrhea because of extreme exercise
- Are a heavy user of alcohol, tobacco, caffeine, sugar, or carbonated beverages
- Have a chronic health condition such as diabetes, malabsorption, celiac disease, or hyperthyroidism
- Are small-boned and consistently below normal weight for someone your size
- Are taking certain prescription medications long-term, such as steroids or anticonvulsants
- Are deficient in certain key nutrients, including vitamin D and vitamin K and the minerals calcium and magnesium*
- Don’t get enough exposure to the sun because you live in a high latitude, you don’t get outside enough, or your skin is always covered when you’re outside
- Have a low level of testosterone – even if you are a woman
- Are of Anglo-Saxon or Asian descent
- Have a family history of osteoporosis
Both osteopenia (characterized by low bone mineral density [BMD] that is not extreme enough to be called osteoporosis) and early-to-middle stages of osteoporosis are silent diseases because they have no symptoms.
Hence, low bone mineral density can go undetected until a bone is broken – often resulting from a situation that should not have caused a fracture. A diagnosis of osteoporosis is often found accidentally, such as when a bone is being x-rayed to determine the existence of a fracture.
On the other hand, advanced osteoporosis will usually present with symptoms such as bone pain, backache, curvature of the upper spine presenting as a hump, and loss of height from vertebral compression fractures.
- Green leafy vegetables like kale, bok choy, broccoli, and cabbage, which are sources of calcium, magnesium, and vitamin K (but avoid spinach as a source of calcium, because it is high in oxalates that bind calcium)
- Dairy products like milk, cheese, and yogurt, which are good sources of calcium, vitamin K, and vitamin D (most milk in the U.S. and all milk in Canada is fortified with vitamin D)
- Fish, such as sardines with small, edible bones that are a good source of calcium; oily fish, especially wild-caught salmon, which provide a good source of vitamin D
- Soy products, which are sources of calcium, magnesium, and vitamin K (fermented soy)
- Almonds and sesame seeds/sesame butter, which are good sources of calcium and magnesium
- Beans and other legumes, which are a good source of calcium and magnesium
- Avocadoes, which provide a good source of magnesium
- And, yes, dark chocolate, which is high in magnesium
Although eating bone-healthy foods that are high in vitamin D, vitamin K, calcium, and magnesium should be encouraged, it can be difficult to get the ideal amounts of these nutrients from your diet alone. Particularly because the amounts of these nutrients in foods can vary widely.
For example, a study of the vitamin D content of farmed salmon found they had only 25 percent of the amount of vitamin D as wild-caught salmon.1 The study found an average of 988 IU vitamin D3 in 3.5 ounces of wild-caught salmon compared to an average of 240 IU vitamin D3 in farm-raised salmon.