In Canada, more than two million people are living with osteoporosis. In the United States, about one in ten people aged 50 and older have osteoporosis. Fractures caused by osteoporosis lead to an increased risk of morbidity and mortality, a decrease in quality of life and a loss of autonomy. Although osteoporosis is often thought of as a disease affecting older women, men are remarkably undervalued and undertreated for this condition.
Osteoporosis is defined as a bone mineral density (BMD) of 2.5 standard deviations or more below peak bone mass. Osteoporosis is an indicator of an increased risk of fractures. A clinical diagnosis of osteoporosis may be made in people aged 50 years and older if they have suffered a mild fracture of the hip, vertebrae, humerus or pelvis after the age of 40, or if they have an absolute risk of fracture of 20% or more in the next 10 years, using a fracture risk assessment tool.
The clinical practice guidelines for the management of osteoporosis and the prevention of fractures in Canada were updated in 2023. Below are the top recommendations on exercise and nutrition for the prevention of falls and fractures in postmenopausal women and men aged 50 years and older.
Adequate calcium intake can slow down the process of bone loss and decrease the risk of fractures. The daily calcium requirement is 1000mg for adults aged 19 to 50 and 1200mg for people over 50 years of age. The need is not higher for people with osteoporosis. It is best to meet the recommended dietary allowance of calcium by eating a variety of calcium-rich foods. A calcium supplement is recommended only for people who cannot meet their needs through diet alone. The highest sources of calcium include dairy products, fortified plant-based beverages, almonds, molasses, salmon and canned sardines including their bones, legumes and tofu. For more detailed information on calcium-rich foods and serving sizes, you can consult this list available on the Osteoporosis Canada website. You will also find a calcium calculator.
Vitamin D is mainly synthesized by the skin if it is sufficiently exposed to the sun. It is found naturally in very few foods. It contributes to strong bones by promoting calcium absorption. In Canada, sun exposure is limited and often does not allow one to produce enough vitamin D. In addition, the skin’s ability to produce vitamin D decreases with age. Osteoporosis Canada recommends that Canadian adults over the age of 50 take a daily vitamin D supplement year round. People over the age of 50 and young adults at high risk (with osteoporosis, multiple fractures, or living with a disease that inhibits vitamin D absorption) should take a supplement containing between 800 and 2,000 IU of vitamin D per day.