Is your diet affecting your bones?

The best osteoporosis diet is not just about eating calcium-rich foods. It's also about avoiding certain foods that can impact your bone health when eaten in large quantities. Follow the advice of dietitian Maggie Yap from the Department of Dietetics at Singapore General Hospital (SGH) on what you should not eat too much of.

For strong, healthy bones, go easy on…

1. Salt

Salt is present in nearly all fresh and processed foods, including condiments, preserved vegetables, chips and even whole grain breads. The Singaporeans' go-to for fast food, hawker fare, is also usually laden with salt.

This is a concern because a "high sodium intake increases the amount of calcium eliminated in the urine, hence increasing calcium loss from bone," says Yap.

The Health Promotion Board recommends that adults get no more than 2,000 mg of sodium a day (equivalent to a teaspoon of salt). The average Singaporean, shockingly, consumes 3,257 mg of sodium a day.

Related article: Curious to know what questions people like you have asked regarding osteoporosis? Read Health Xchange's recent doctor Q&A on the topic.

2. Alcohol

Stick to the recommended daily limit of three standard drinks for men and two for women, and booze shouldn't pose a risk. A standard drink is equivalent to:

• 2/3 can (220ml) of regular beer

• 1 glass (100ml) of wine

• 1 nip (30ml) of spirit

Any more could interfere with the absorption and use of calcium, vitamin D and other bone nutrients, ultimately leading to an increased risk of osteoporosis.

"This would result in adverse effects on bone-forming cells (osteoblast) and hormones that regulate calcium metabolism," says Yap.

"Chronic and heavy alcohol consumption is also associated with malnutrition (a risk factor of osteoporosis) due to prolonged inadequate food intake."

Additionally, getting a little tipsy affects balance and gait, upping the risk of falls and fractures.

Related article: Want to slow down osteoporosis? Find out what you should eat

3. Caffeine

Some studies have suggested that drinking more than two to three cups of coffee a day could increase bone loss in post-menopausal women, says Yap.

In these studies, caffeine was shown to increase urinary calcium excretion as well as reduce calcium absorption, she explains.

Fortunately, there's no need to cut out java completely.

According to Yap, recent studies suggest that moderation of caffeine consumption with adequate intake of calcium (about 800 mg a day) does not cause any damaging effects on bones.

Thus, if you're a coffee lover, just be on the safe side by ensuring an adequate intake of calcium, with moderate caffeine intake.

Related article: Caffeine: What women should know

4. High-protein diets

Bones are about 50 per cent protein, and research shows that sufficient protein intake is important for maintaining bone mass density and skeletal metabolism. However, some studies caution that prolonged, over-consumption of "acidic" foods such as protein could lead to bone loss.

Everyday bodily functions such as digestion produce chemicals (acidic, neutral, or alkaline) that change the acid-base balance in the body. As a buffering system, kidneys play a major role in ensuring the blood stays at optimum balanced levels.

So if a person's diet is too high in protein and lacking in more alkaline food like fruits and vegetables, alkaline minerals such as potassium, calcium and magnesium could theoretically be withdrawn from bone reserves to ensure an optimal acid-base balance.

Definitive studies have yet to be carried out, but in the meantime, strive for a balanced diet to stave off osteoporosis and a host of other diseases. The recommended intake of protein is two to three servings a day.

One serving could be five medium prawns, or a palm-sized piece of meat, fish or poultry, two glasses of milk, ¾ cup cooked pulses or lentils, or two small blocks of soft beancurd (170g).

This article was written by Lydia Ng for Health Xchange, with expert input from the Department of Dietetics, Singapore General Hospital.

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Health Xchange's articles are meant for informational purposes only and cannot replace professional surgical, medical or health advice, examination, diagnosis, or treatment.