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How To Have Healthy Bones on a Plant-based Diet

I’m Kayli Anderson, dietitian and natural foods chef. PBM is your headquarters for empowering, woman-centered plant-based nutrition and lifestyle guidance. 

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A common concern I hear from women: “Can I have healthy, strong bones if I’m plant-based?” It makes sense that bone health is on womens’ minds since osteoporosis rates are 4x higher in women than in men. And since we’ve been taught to associate bone health with calcium, and calcium with dairy, plant-women are often especially worried about building and maintaining strong bones. If you’ve ever had this fear, not to worry! It is very much possible to build strong bones and eat all or mostly plants. In fact, plant-based foods can actually protect your bones. Also, many women don’t realize that skeletal health is about more than just the food you eat. In addition to sharing nutrition musts for healthy bones, I’ll also share lifestyle steps you can take to protect the health of your bones.

bone health on a plant-based diet

Do you need dairy for strong bones?

Calcium has become synonymous with dairy, so what about dairy? Do we need it in order to have healthy bones? Here’s the truth about milk and dairy from a 2020 review paper:

  • Evidence does not support the use of high dairy consumption for reducing the risk of fractures. 
  • Countries with the highest intakes of milk and calcium tend to have the highest rates of hip fractures
  • 60-80% of estrogens in Western Diets come from milk and dairy products
  • Dairy products have been associated with estrogen-related cancers (endometrial, ovarian)

In other words, diary and milk are not necessary for strong bones. The primary bone-supporting nutrients that milk provides – calcium and vitamin D – can easily (and less expensively) be obtained from other foods and vitamin D supplements.

How can plant-based women take care of their bone health?

Your bones are constantly breaking down and re-building. Early in life, the balance is more heavily focused on building. As you get older, the balance shifts more toward breaking down. The key to healthy bones later in life is to slow bone loss and give your body the nourishment it needs to support re-building. 

Related:  Are There Foods You Shouldn’t Eat?

If you’re a predominantly plant-based woman, the good news is that as long as you’re eating healthfully and getting enough calcium, vitamin D, protein, and overall calories, then there’s no evidence that you are at higher risk for osteoporosis than other women. Other keys to healthy bones: weight-bearing exercise, and avoiding alcohol and tobacco.

Your Bone Health Checklist

Eat more plants

You read that right – a plant-based diet made up of whole foods is actually supportive of your skeletal health! Healthy bones require many of the nutrients abundant in plant foods like calcium, vitamin A, magnesium, potassium, fiber, and vitamin C. A plant-based eating pattern has been associated with lower hip fracture risk. 

Make sure you’re eating enough calories

This one is so key! Under-nourishing yourself means your body is missing the nutrients and energy (calories) it needs to support skeletal health. Low weight is associated with poorer bone health, so be sure you’re eating enough everyday.

Get your daily servings of calcium

Most women are surprised to know that so many plants contain calcium, and that you absolutely don’t need dairy to meet your needs. Aim for about 6 mini servings of high-calcium foods each day to get enough. This includes dark leafy greens, beans, nuts, dried fruit, and fortified plant-based milks. Women ages 19-50 and those who are pregnant or breastfeeding should aim for 1,000mg per day. Women over 50 should aim for 1,200mg per day.

Check vitamin D levels

Vitamin D plays an important role in healthy bones, but deficiency or low levels are incredibly common since we mainly get this vitamin from sun exposure (and most of us spend our days indoors). Get your levels checked to determine if you might benefit from a vitamin D3 supplement (hint: most women need one).

Find movement you love

Regular exercise has been shown to reduce bone loss that happens as we age, so find physical movement that you enjoy enough to do on most days. The best kind of exercise for your bones is weight-bearing movement like walking, jogging, weight training, dancing, or pilates.

Limit alcohol

High alcohol intake (more than 1-3 glasses per day) has negative effects on bone health, so it’s best to limit how much you drink.

Ditch tobacco

Smoking significantly increases osteoporosis risk, so kick a smoking habit as early in life as possible.  

Healthy bones are not only possible on a plant-based diet, they can be a wonderful side effect of this way of eating.

Willett, W.C. and Ludwig, D.S., 2020. Milk and health. New England Journal of Medicine, 382(7), pp.644-654.

Related:  5 Plant-based Meal Planning Tips

Alswat KA. Gender Disparities in Osteoporosis. J Clin Med Res. 2017;9(5):382-387. doi:10.14740/jocmr2970w

“Office of Dietary Supplements – Calcium.” NIH Office of Dietary Supplements, U.S. Department of Health and Human Services, 17 Aug. 2021, ods.od.nih.gov/factsheets/calcium-healthprofessional/. 

Tollefson, Michelle, Nancy Eriksen, and Neha Pathak, eds. Improving Women’s Health Across the Lifespan. CRC Press, 2021.

Hsu E. Plant-based diets and bone health: sorting through the evidence. Curr Opin Endocrinol Diabetes Obes. 2020;27(4):248-252. doi:10.1097/MED.0000000000000552

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