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Ask the RN: Kerri Zemko

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July 1, 2013

Kerri Zemko, R.N., B.S.N., O.C.N., is an oncology research nurse and PCRM Food for Life Instructor. She will be teaching a Cancer Project series this month in Portland and Northwest VEG members get $10 off! Click here for more information. You can also visit her Facebook page.
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Q: I am a healthy 70-year-old slim vegan woman who was recently diagnosed with osteoporosis (bone density of femoral neck is -2.9). My doctor is recommending that I take Fosamax or do a Reclast infusion but I would first like to try a nutritional and exercise plan. I am hoping to find out how I can incorporate more bone strengthening foods in to my diet.

A: Thank you for your important question! I admire your desire to use nutrition therapeutically and agree with your choice to follow a vegan diet for health. As you know, avoiding animal products can offer an advantage for bone health. Not only are higher dairy intakes associated with higher rates of bone fractures, but, additionally, many plant sources of calcium are better absorbed than animal sources. Naturally, there are exceptions (like spinach).

You may also know that the strength and density of our bones is largely determined when we are up to about 30 years old. After our mid 30ís, bone building (osteoblastic activity) slows down and bone re-absorption (osteoclastic activity) speeds up. Older age, female sex, post-menopausal status, use of any steroid medications, smoking, drinking, being thin, thyroid, kidney or adrenal diseases, and a variety of other factors may also lead to a faster rate of bone loss. The relevant nutrients to watch for possible deficiency are: vitamins D, K, magnesium, and the right level of vitamin A.

Unfortunately, your bone density has tested in the range which most doctors would treat medically. In addition to the dietary adjustments below, I would recommend seeing an exercise specialist for help finding the safest and most effective maneuvers for you. Ask your doctor to consider herbs that have some estrogen-like effects such as black cohosh and red clover. If you decide that taking medication is a wise move, then, thankfully, bisphosphonates like Fosamax have a very acceptable risk/benefit profile overall.

Foods that you should emphasize in your diet are broccoli, kale, collards and other greens (except spinach), beans, organic tofu, calcium-fortified orange juice, and fortified plant milks (should be shaken to avoid losing the calcium which settles to the bottom). Try to include magnesium-rich foods as well such as bananas, avocados, lima beans, cantaloupe, and potatoes. I would also strongly recommend you limit your salt and caffeine and refrain from smoking. Also, get sunlight as regularly as possible, and enjoy the active lifestyle a healthy diet supports, while being very conscious of protecting yourself from injury.

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