The Medicare Diet: Best Diet for Osteoporosis in Seniors

Do you trust your bones?

It’s a weird sentence, yes, but your bones are the literal foundation of your health: fragile bones can lead to fractures, hospital stays, and all sorts of complications. That’s why osteoporosis, a condition common in a number of older adults, especially postmenopausal women and older men, is so dangerous. 

Fortunately, following medical advice and eating a healthy diet can help prevent bone fractures, but the most helpful diet for osteoporosis is a bit more complicated than just drinking more milk.

The Bare Bones of Osteoporosis

Osteoporosis is a fairly self-explanatory disease: ‘Osteo-’ means ‘related to the bones’, while ‘-porosis’ is related to the term ‘porous’, meaning ‘having small spaces or holes’. So ‘osteoporosis’ is a disease characterized by porous bones. Or, more accurately, overly porous bones.

We tend to think of bones as being inert, like the skeleton on display in your high school biology classroom, but bones are actually quite active parts of our body. They consist of three layers:

• Compact bone: The tough, outer layer of bone that provides protection and support for our bodies.

• Spongy bone: Porous bone found at the ends of bones, and in joints, which allow marrow, nerves, and blood vessels to enter in and out of the bone. Despite the name, spongy bone is rigid, rather than soft.
• Bone marrow: The inner core of the bone. Bone marrow is best known for its role in the creation of blood cells, though only 50 percent of an adult’s bone marrow actually serves this function. The rest is simply responsible for maintaining the health of the bone.

Bones are made by cells called osteoblasts (‘-blast’ meaning ‘growth’ in this context). They pile bone around themselves for some time, before transforming into osteocytes, which exchange minerals and chemical signals through the bone. Some osteoblasts also become lining cells, forming the bone’s outer structure.

Bone growth is regulated by osteoclasts (“-clast” meaning ‘to break’), which break down and reshape bones. This is done in response to stress or injury, as well as when nerves or blood vessels need to be connected to the bone. The minerals in the bone are then released back into the blood in a process called resorption. 

It is this interplay between osteoblasts and osteoclasts that serves as the root cause of osteoporosis. In a healthy bone, these two cell groups are in equilibrium, with osteoblasts replacing bone at the same rate that osteoclasts break it down. 

However, if the rate of resorption exceeds the rate that new bone is developed, the overall density of the bone decreases. The end result is a fragile bone that, when examined under a microscope, looks more porous due to missing mass. 

A higher risk of osteoporosis is commonly associated with postmenopausal women because bone resorption is regulated by estrogen: the same hormone responsible for the menstrual cycle. During menopause, the ovaries dramatically reduce estrogen production in order to bring an end to the menstrual cycle. Because the body is accustomed to pre-menopausal levels of estrogen, it sees this reduction as a signal to increase bone resorption. 

This process only occurs in people who menstruate: typically cisgender women and people assigned female at birth who do not undergo gender affirming therapy. Cisgender men and people assigned male at birth do not undergo menopause as their estrogen levels do not fluctuate to the same extremes. Hormone replacement therapy, either as a gender affirming treatment or for other medical purposes, can also prevent the onset of menopause.

However, this does not mean that menopause is the only cause of osteoporosis in seniors and older adults or that osteoporosis only affect postmenopausal women. Other factors can result in a higher risk of osteoporosis or bone loss, including:

• Deficiencies in calcium and vitamin D
• Lower testosterone levels
• Increased inflammation due to certain medical conditions
• Certain medications, including treatments for prostate and breast cancer
• Alcohol consumption
• Smoking
• Low body weight
• Eating disorders that may result in a vitamin deficiency

Because there are no outward symptoms of osteoporosis, people with a higher risk factor should seek out bone density tests to catch any bone loss before a fracture occurs. 

The Osteoporosis Diet Plan

There are a variety of diets good for supporting bone and joint health out there, covering all sorts of dietary pattern needs. However, in order to understand what diets work, we need to understand why they work.

When we talk about the best foods for osteoporosis, our goal is to provide the nutrients needed for our osteoblasts to build new bones. As such, this works best as a preventative measure. Having a higher bone density overall reduces the risk of fracture, so the more we can build up before the onset of osteoporosis, the better. 

That’s not to say this isn’t helpful for people who already have osteoporosis: promoting bone health is just as, if not more essential at that stage. However, you may not see improvement from dietary changes alone. As always, these recommendations are not medical advice. Always consult with a doctor or professional healthcare provider before making major changes to your dietary pattern.

The most well known nutrient associated with bone health is calcium. You can find it in dairy products like milk and cheese, as well as in whole grain foods and vegetables like kale and broccoli. Many juices, as well as milk alternatives, are made with a calcium supplement (fortified), providing similar amounts of this vital nutrient. 

Calcium intake is the foundation of bone health, and getting enough calcium is essential. However, you should be careful not to consume too much, as calcium deposits can also form kidney stones. Magnesium, another electrolyte, also plays a major role in bone health, and can be found in beans and vegetables.

Calcium intake is often paired with vitamin D intake, which your body needs to process calcium in the first place. If you’re deficient in vitamin D, the calcium you consume will just be passed through your body, never reaching your bones! Vitamin D is found in eggs, fatty fish like salmon and tuna, and in Portobello and cremini mushrooms. Most dairy products and other calcium fortified foods are also fortified with vitamin D. Other vitamins linked to bone health include vitamins C, K, and Zinc. 

Finally, protein makes up a surprising portion of our bones: roughly 1/3rd of our overall bone mass. It also promotes healthy muscles, which can prevent falls and injury. 

Foods to avoid include anything high in sugar and sodium, as well as anything high in phosphoric acid. This includes soda, ice cream, fried foods, and processed meats. 

For those of you looking for a delicious dinner idea, here’s a pair of recipes that are great for bone health.

• One Pan Chicken Parmesan Pasta by Hillary Meyer
• Sautéed Broccoli and Kale with Toasted Garlic Butter by Lia Huber

Ingredients

For the Chicken Parmesan Pasta

• 2 tbsp extra virgin olive oil, divided.
• ¼ cup whole-wheat panko breadcrumbs
• 1 tbsp + 1 tsp minced garlic, divided
• 1 lb. boneless, skinless chicken breast, cut into ½ pieces.
• 1 tsp Italian seasoning
• ¼ tsp salt
• 3 cups low-sodium chicken broth
• 1 ½ cups crushed tomatoes
• 8 oz. whole-wheat penne
• ½ cup shredded Parmesan cheese.
• ¼ cup chopped fresh basil.

For the Kale and Broccoli

• 1 ½ lbs kale (about 2 bunches.)
• 1 cup water, divided in half.
• 2 large broccoli heads, cut into florets (12 cups)
• 2 tbsp extra-virgin olive oil
• 4 tbsp unsalted butter
• 5 cloves garlic, thinly sliced
• ¼ tsp crushed red pepper, plus more for garnish
• ¾ tsp fine sea salt, plus more for garnish

Directions

Directions

1. Remove stems and ribs from kale, and coarsely chop. Cook covered in ½ cup water in a large skillet over medium-high heat, until slightly tender. Transfer to a colander to drain. Repeat the process with broccoli, using the other ½ cup water. Set aside, and wipe out the pan. Be sure to keep the broccoli and kale separate at this stage.
2. In a separate large, broiler safe skillet, heat 1 tbsp oil over medium high heat. Add panko and 1 tsp minced garlic. Cook, stirring constantly, until golden brown (about 2 minutes). Set aside, and wipe out the pan.
3. Heat 1 tsp oil in the pan over medium high heat. Add chicken, italian seasoning, ¼ tsp salt, and 1 tbsp minced garlic. Cook, stirring frequently, until chicken is no longer pink on the outside. Don’t worry about the inside yet, as we’ll be finishing the cooking in the oven. Add the broth, crushed tomatoes, and penne, and bring to a boil. Cook uncovered, stirring frequently, for about 15-20 minutes. The penne should be cooked, and the sauce reduced and thickened.
4. While cooking your pasta, set an oven rack in the upper third of your oven, and set the broiler to high. When the pasta is cooked, sprinkle mozzarella over the mixture and place under the broiler for one minute, until mozzarella is bubbling and beginning to brown. At this point, turn off the broiler, but allow the pan to remain in the oven with the door slightly ajar.
5. In your original skillet, heat 1 tbsp oil at medium high heat, then add the kale and cook, stirring often, until tender and slightly browned (4-6 minutes). Transfer to a bowl, then repeat with the broccoli.
6. Heat butter, garlic, and crushed red pepper to the pan over medium heat until butter is melted. Cook, stirring constantly, until the garlic is light brown, (1-2 minutes). Drizzle the mixture over the vegetables, and sprinkle ¾ teaspoons of salt. Gently toss, then garnish with additional salt and red pepper flakes.
7. Retrieve pasta from the oven and top with basil, parmesan, and panko mixture. Plate with vegetables. Serve.

If you’re looking for more ways to manage your osteoporosis, Medicare can help. Our licensed agents can connect you with a Medicare Advantage plan that fits your needs, including bone density tests and assistance paying for groceries. Call one of our agents at (800) 950-0608, or try our free comparison tool to begin your search.