As a Dietitian I Learned the Hard Way Not to Ignore Your Bone Health

November 3, 2023

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Did you know that one in five women will develop osteoporosis by age 70 and one in two of those will break a bone due to osteoporosis? When thinking about all the prevalent health concerns in our society including heart disease, diabetes, and cancer, how often do our bones top the list? As a dietitian, I learned the hard way not to ignore your bone health and I’m going to share my journey so you can avoid my mistakes and help prevent bone loss at any stage of the lifecycle.

As a woman in my early 40’s, my bones were not top of mind. I was working and raising a family while attempting to simultaneously exercise and eat well. Growing up with overweight and obesity, I chronically dieted my way through childhood and adolescence (at the advice of my pediatrician) and after losing 40 to 50 pounds just before graduating high school, the following decades were painstakingly spent trying to maintain that weight loss. It did not occur to me at the time that chronic calorie restriction is hazardous to bone health, I mean, dieting was a badge of honor in the 80s and 90s. I cringe now at the thought.

The results of my bone-health screening was not what I expected.

Everything changed nearly ten years ago when I attended what dietitians affectionally refer to as our “Superbowl of Nutrition,” the Food and Nutrition Conference and Expo (FNCE); we call it “fency.” Already aware that dried plums/prunes possess bone health benefits supported by a body of scientific research, I was excited to receive an invitation to the Sunsweet brand expo booth to participate in a bone health screening. I trotted in and curiously placed my hand into what reminded me of a gel manicure UV nail dryer. What happened next changed everything I thought about bone health.

“You should probably call your doctor to discuss these results”, said the kind person who handed me the printed results of the scan. “You might need a DEXA scan for more thorough results.” I was simultaneously shocked, worried, and craving more information. How can this be? I eat so healthy. I do weight-bearing exercise. I’m not a tiny person and I’m only 43 years old, circled in my head. Immediately after returning home, I called my endocrinologist and told him what happened. He sounded surprised and hesitant but acquiesced.

Sure enough, my DEXA bone scan results indicated I did indeed have osteopenia in my hip and spine. Now what?

What are osteopenia and osteoporosis?

According to the Bone Health and Osteoporosis Foundation, osteoporosis is a disease of the bone that makes a person’s bones weak and more likely to break. Approximately 10 million Americans have osteoporosis and another 44 million have low bone density (osteopenia), placing them at increased risk.

I was shocked to learn women can lose up to 20% of their bone density within five to seven years after menopause. By the age of 70, one in five women will develop osteoporosis and of those, one in two will break a bone as a result.

In my experience with clients over 25+ years, people never ask me about maintaining their bone health until after they receive a diagnosis of osteopenia or osteoporosis. It’s very important that we as a population begin paying more attention while time allows us to maximize our bone health before problems arise.

How to best support bone health through diet

People believe that simply taking calcium or eating foods with calcium is all that is needed to support bone health and that’s only one piece of the puzzle. Forming bone requires an adequate supply of nutrients, such as calcium, protein, magnesium, phosphorus, vitamin D, potassium, and fluoride. In addition, vitamins and minerals needed for metabolic processes related to bone include manganese, copper, boron, iron, zinc, vitamin A, vitamin K, vitamin C, and the B vitamins.

Calcium itself is not nearly enough to build or maintain bone. We need a diet full of fruit, veggies, nuts, beans, seeds, whole grains, lean proteins, and dairy products or calcium/vitamin D-fortified nondairy alternatives to fulfill these nutrient requirements. And in some cases, supplements will be necessary to fill in any shortfalls.

How do prunes fit into the bone health protection plan?

Remember I mentioned that the only reason I discovered my low bone density was because of a screening offered by Sunsweet? That’s because an extensive body of research shows that the combination of many different nutrients in prunes helps to protect our bones throughout the aging process. Adding 5 to 6 prunes per day to your meals and snacks can help to prevent bone loss in perimenopause and beyond. I personally eat them every day as part of my bone-supporting regimen. My #1 tip is to freeze prunes right in the bag and take out your chosen portion when ready to snack. They are amazing with a sweet, chewy bite that isn’t icy at all because of the lack of water content in the dried fruit.

Protecting your bone health involves more than a healthy diet.

Peak bone mass is achieved in our late teens or early 20s, with the start of bone loss beginning around age 30. Children and adolescents who achieve a higher peak bone mass decrease their risk of osteoporosis later in life. This is why it’s so important to begin healthy bone-building lifestyle habits during childhood and continue them throughout our lifespan.

These key interventions include:

Adequate consumption of calcium and vitamin D through a balanced, varied diet and supplements if needed.
Appropriate physical activity including weight bearing and strength training exercises.
Avoidance of smoking and alcohol consumption for minors with limited alcohol intake for adults.
Wearing seat belts and protective equipment during activities like bike riding and sports. And taking care to avoid hazards both in the home and outside that could cause falls.

I am happy to report that since my osteopenia diagnosis approximately nine years ago, the combination of my supplement regimen, nutrient-rich diet, consistent exercise, and daily prunes has helped to minimize additional bone loss.

Remember that each person is unique, and I recommend speaking with your doctor and registered dietitian about the best way to protect your bone health through diet and lifestyle as early as possible.