I was an all-state runner in high school, and I had no idea my body needed extra support for my bones. I rarely ate foods with calcium or vitamin D. My freshman year, I developed stress fractures that were slow to heal.
Once they healed, I made yogurt or a drinkable yogurt a daily staple, plus cheese. Even so, I had osteopenia, which means bone density lower than normal but not low enough to be osteoporosis. I’ve made bone health a priority ever since, and I saw nutrition, along with the right weight-bearing exercise, make a difference.
Years later, my bone density was monitored while I took Lupron as part of fertility treatment. My numbers started dropping during the second round, and I knew I shouldn’t do another. Today I keep an eye on my bone density, my vitamin D levels, and how much I get from food.
About 1 in 5 women 50 and older has osteoporosis, and about half have osteopenia. If you just heard the word osteopenia after a bone scan, or recently went through menopause with declining estrogen levels (which lower bone density), you were probably told to get more calcium. Calcium matters, and research also points to your overall eating pattern. An osteoporosis diet works alongside strength and weight-bearing exercise, fall prevention, and medical care. In this article, we will cover the foods with the best research for your bones, what to limit, and how much calcium and vitamin D you need.
Download the free Bone Health Food List
Osteoporosis by the Numbers
Osteoporosis becomes more common as you age. Among US women, the CDC reports:
| Women | Osteoporosis | Low bone mass (osteopenia) |
| 50 to 64 | 13.1% | 50.3% |
| 65 and older | 27.1% | 52.9% |
Osteoporosis in women 50 and older also rose from 14.0% to 19.6%, from 2007 to 2018, the most recent national data.
The habits you build when you’re younger matter. Lifestyle choices shape 20 to 40% of your peak bone mass, the most bone you’ll have as an adult, and building more of it lowers your risk of osteoporosis later.
Bone loss starts during perimenopause, speeding up about a year before your final period, and slows, but doesn’t stop, about two years after. That roughly three-year window is when bone changes fastest, which makes midlife a good time to look at how you eat. I cover the other changes after menopause in my menopause diet article.
Estrogen helps keep bone breakdown and rebuilding in balance, and it also affects inflammation. As estrogen falls, bone breakdown speeds up. Researchers are also studying how chronic inflammation and the foods you eat may add to that bone loss.
Can an Anti-Inflammatory Diet Help Osteoporosis?
Most research on diet and bone comes from large observational studies. Some measure bone density, and others follow people’s eating habits for years and track who breaks a bone. These studies show links, not proof that changing your diet will lower your risk. The table sums up what researchers found.
| Eating pattern | What researchers observed | Type of research | What we can conclude |
| Mediterranean-style eating | People who ate this way most closely had 29% fewer hip fractures, and about 5% fewer for each point on the diet score. | 15 studies, 503,174 people | A consistent link, though people who eat this way differ in other ways (they’re often more physically active, for example). |
| A more inflammatory diet | People with the most inflammatory diets had 19 to 28% more fractures and 31% more osteoporosis. | Reviews of observational studies | A consistent link, not proof of cause. |
| A more inflammatory diet, midlife women | 28% more fractures for each step up in diet inflammation, even after accounting for bone density. | SWAN, 1,559 women followed up to 20 years | The strongest midlife evidence, still observational. |
| More fruit and vegetables | 8% fewer hip fractures with one more serving a day. | Review of observational studies | The strongest evidence of 34 dietary factors reviewed, though still low certainty. |
| Lower-calorie Mediterranean diet plus exercise | Women in the weight-loss group kept more spine density over 3 years than women told to follow a regular Mediterranean diet. | Randomized trial, 924 adults 55 to 75 with metabolic syndrome | Losing weight with food and movement together protected bone in women. |
| DASH diet | No link to osteoporosis | Review of observational studies | Good for blood pressure, with no bone evidence yet. |
The midlife finding stands out. Women whose diets were more inflammatory before or early in perimenopause had more fractures over the next two decades, even after accounting for their bone density. Inflammation may weaken bone in ways a bone scan doesn’t show. I also cover this study in my perimenopause article.
No single food explains these results. In a review of 34 dietary factors and hip fracture, fruit and vegetables were the only one with evidence rated above “very low.” An overall pattern that includes these foods across your week matters more than any single food or a perfect “bone health” diet. Even one extra serving of produce a day is a small change linked to 8% fewer hip fractures.
Best Foods for Bone Health
The best foods for bone health give you calcium, protein, or the produce linked to fewer fractures, and most of them already fit an anti-inflammatory eating pattern. Calcium amounts below come from the National Institutes of Health and the USDA.
| Food | What the research found | Calcium per serving | Try it |
| Fruits and vegetables overall | One more serving a day was linked with 8% fewer hip fractures | From about 10 mg in a medium apple to 99 mg in ½ cup cooked turnip greens | Sautéed greens, Berry Powerful Smoothie |
| Yogurt | 15% fewer hip fractures for each cup a day | 415 mg in 1 cup plain low-fat yogurt; about 230 mg in a 7-oz container of plain low-fat Greek yogurt; about 316 mg in 1 cup plain low-fat kefir | Yogurt bowl |
| Cheese | 19% fewer hip fractures for each 1.5-ounce serving | 333 mg in 1.5 oz part-skim mozzarella; about 210 mg in 1.5 oz feta | Mediterranean chickpea salad |
| Milk and fortified plant milks | People who ate more dairy overall had neither more nor fewer hip fractures (more in the FAQ) | 299 mg in 1 cup nonfat milk; 276 mg in 1 cup whole milk; 299 mg in 1 cup fortified soy milk | |
| Fish | Eating more fish was linked to fewer hip fractures | 325 mg in 3 oz canned sardines with bones; 181 mg in 3 oz canned salmon with bones | Budget plate method |
| Tofu and soybeans | In trials, soy protein and animal protein had similar effects on bone density. | 253 mg in ½ cup firm tofu made with calcium sulfate; 131 mg in ½ cup cooked soybeans | |
| Beans | Calcium plus plant protein and fiber, though oxalates in beans lower how much calcium your body absorbs. | About 161 mg in 1 cup cooked white beans; about 126 mg in 1 cup cooked navy beans; about 80 mg in 1 cup chickpeas | Mediterranean chickpea salad |
| Leafy greens: collards, turnip greens, kale, bok choy | Good plant sources of calcium | About 268 mg in 1 cup cooked collard greens, though oxalates in collards lower how much your body absorbs; 99 mg in ½ cup cooked turnip greens; 94 mg in 1 cup cooked kale; 74 mg in 1 cup raw bok choy | Sautéed greens |
| Seeds and nuts: chia, sesame, almonds | A small calcium boost you can add to many meals | 76 mg in 1 tablespoon chia seeds; about 88 mg in 1 tablespoon whole sesame seeds; about 76 mg in 1 ounce almonds | Yogurt bowl, energy bites, oatmeal |
| Prunes | 5 to 6 a day held hip bone density steady for a year in one trial | About 22 mg in 5 to 6 prunes |
Download the free Bone Health Food List
- How calcium adds up: A cup of yogurt, a serving of sardines and a cup of fortified soy milk give you about 1,040 mg. That’s one example of how quickly calcium-rich foods add up toward the 1,200 mg women 51 and older need.
- Spinach: How much calcium a food has and how much your body absorbs aren’t the same. Spinach has calcium, but your body absorbs only about 5% of it, compared with 27% from milk. Count spinach toward your vegetables and get your calcium from the foods above.
- Tofu: Check the label for calcium sulfate. Tofu made without a calcium salt has very little calcium.
- Tea: Tea drinkers had 19% fewer fractures in observational studies, so tea is a nice addition, not a foundation. My anti-inflammatory drinks article has options I make at home.
- Protein: Protein matters for bone, and it doesn’t pull calcium from your bones. More on that in the FAQ.
Calcium and Vitamin D: Food First
Calcium builds bone, and vitamin D helps your body absorb it. The National Institutes of Health sets these daily targets for women, counting food and supplements together:
| Women | Calcium | Vitamin D |
| 19 to 50 | 1,000 mg | 600 IU |
| 51 to 70 | 1,200 mg | 600 IU |
| 71 and older | 1,200 mg | 800 IU |
| Upper limit | 2,500 mg through age 50; 2,000 mg after | 4,000 IU |
The foods in the table above make calcium the easier of the two to get from food. Vitamin D is harder, because few foods have much of it. Fatty fish and fortified milk or soy milk are the main sources.
Supplements help some women more than others:
- Healthy women after menopause: Routine calcium and vitamin D pills haven’t lowered fractures in healthy postmenopausal women living at home.
- Kidney stones: In the large Women’s Health Initiative trial, women taking calcium plus vitamin D had more kidney stones.
- More vitamin D isn’t better: The Endocrine Society advises against taking more than the daily target without a medical reason if you’re under 75.
- When a supplement fits: If you have osteoporosis, don’t get enough from food, or have low vitamin D, your doctor may recommend a supplement made for you.
- Pair them with exercise: Calcium and vitamin D worked better alongside exercise than the supplements alone.
Osteoporosis Foods to Avoid
Searches for “osteoporosis foods to avoid” turn up long lists, but research points to a few things worth limiting. Each one has a simple swap.
| Limit | Why? | Swap it for… |
| Alcohol | 6% more fractures for each daily drink | Tea or one of my anti-inflammatory drinks |
| An unhealthy eating pattern heavy in sweets and refined grains | People with the highest scores on an unhealthy plant-based diet index had 37% higher odds of osteoporosis, a finding about the whole eating pattern rather than any one food. These foods can also crowd out the produce, beans and dairy that support your bones. | Fruit, oats, or one of my favorite snacks to buy |
| More than a couple of cups of coffee a day | In women, 2 cups a day was linked to 2% more fractures and 8 cups to 54% more, though other reviews found no link. | Tea for some of your cups |
Milk isn’t on this list. Find out more in the FAQ. For a longer list of foods to limit and enjoy, download my printable anti-inflammatory food lists.
Anti-Inflammatory Doesn’t Mean Vegan
Plant-based eating can support your bones, but it takes some careful planning, because many of the easiest sources of calcium and protein are dairy, fish, and meat. In studies of vegan eaters, fractures were more common, though the evidence is of low certainty.
If you eat mostly plants, soy can help meet your goals:
- Protein: In trials, soy protein and animal protein had similar effects on bone density.
- Calcium: Calcium-set tofu and fortified soy milk are great calcium sources (see the food table above).
- Expectations: Choose soy for its protein and calcium. Isoflavones, the plant compounds in soy, didn’t clearly change blood tests of bone breakdown and buildup in trials with postmenopausal women, so soy won’t treat bone loss on its own.
Losing Weight Without Losing Bone
If you’re working on weight loss in midlife, protect your bones by adding exercise. In trials of dieting alone, hip bone density dropped about 2%. Adding exercise reduced that loss in some studies, though not all, and in the Mediterranean diet trial, women who cut calories and exercised kept more spine bone density.
Muscle matters, too. In SWAN, women who lost more muscle during the menopause transition had more fractures later, even after accounting for bone density. Food and movement work together here:
- Strength training: In adults 65 and older, progressive strength training raised hip bone density by 2.8%.
- Impact training: In one trial, women with low bone mass who did supervised strength and jumping training twice a week raised their spine bone density. Ask your doctor or a physical therapist what’s safe for you before you start jumping.
- Weight-bearing exercise: Walking and other weight-bearing exercises are part of osteoporosis guidelines alongside strength training.
- Protein: Protein helps you keep muscle, and it doesn’t harm your bones. More on that in the FAQ.
I do a low-impact strength program at home three days a week with dumbbells and a kettlebell, and I walk most days. I have no cartilage left in my knees, so I skip high-repetition squats and jumping and choose deadlifts or isometric lifts instead.
Weight loss and exercise also improve blood sugar and liver fat. I cover how much they help in my articles on type 2 diabetes, fatty liver disease and insulin resistance in midlife.
For more on how weight changes in midlife, see my article on belly fat in midlife.
Free Printable: Bone Health Food List
My free Bone Health Food List puts this article on one page for your fridge or grocery list. The Eat More side lists bone-friendly foods with their calcium counts, and the Limit side shows what to cut back on, with a swap for each.
Frequently Asked Questions
Does Protein Pull Calcium From Your Bones?
No. A review of 127 papers found no sign of harm to bone from usual protein intakes, and another review found a small benefit at the spine. Protein also helps you keep muscle, and losing muscle during menopause was linked to more fractures.
Is Milk Bad For Your Bones?
No. In a study of nearly 487,000 adults, total dairy showed no link to hip fractures. Yogurt and cheese were linked to fewer hip fractures and milk to slightly more, but these were observational findings. Milk is still one of the easiest calcium sources if you enjoy it.
Do Prunes Really Help Bones?
They might. In one year-long trial funded by the California Prune Board, women who ate 5 to 6 prunes a day kept their hip bone density steady, while the comparison group lost 1.1%. One trial makes prunes promising rather than proven.
Prunes also have about 3.6 grams of fiber per serving, and a constipation trial found they improved bowel movements. Start with a few, since some women in the bone trial had trouble tolerating them.
Can Diet Reverse Osteoporosis?
No food reverses osteoporosis. A healthy eating pattern gives your body what it needs to maintain bone, and the habits you build while you’re younger and still building bone matter most. Diet doesn’t replace medication when treatment is needed, so if you’ve been diagnosed, talk with your doctor.
Is Coffee Bad For Your Bones?
Probably not in moderate amounts. In one review, women who drank 2 cups a day had about 2% more fractures, while 8 cups a day was linked to 54% more, and another review found no link at all. If you’re at risk for fractures, keep coffee to a cup or two and try tea for the rest. My article on coffee and the Mediterranean diet covers more.
Takeaways
- Build meals around bone-friendly foods. Yogurt, cheese, canned fish with bones, calcium-set tofu, leafy greens, and plenty of fruits and vegetables all support your bones.
- Get calcium and vitamin D from food first. Women 51 and older need 1,200 mg of calcium a day, and 600 IU of vitamin D through age 70, rising to 800 IU after.
- Limit alcohol, sweets, and refined grains. Each one has an easy swap.
- Pair food with movement and medical care. Strength and weight-bearing exercise protect bone, and your doctor can talk with you about bone density testing and treatment.
Let’s get UNstuck and stay UNstuck!