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Q&A: How to Train with Low Bone Density

What should I look out for, or how can I train intelligently, if I’ve been diagnosed with low bone density? Should I eat more of certain foods to compensate?

First and foremost, when training for any sport or competition, it’s important to make sure you eat enough. This goes for all runners—athletes and weekend warriors alike. But when dealing with low bone density, there are a few things to keep in mind.

Excessive salt and caffeine intake could weaken bones over time, as do soft drinks. I’d recommend limiting or avoiding soft drinks, such as regular or diet sodas, altogether, and stick to salt and caffeine intake in moderation. Try to avoid overly processed foods and frozen foods, and be sure to rinse canned foods really well to reduce the amount of sodium. You can also try adding natural herbs, spices, and oils to add flavor to foods.

Excessive alcohol intake may also weaken bones, since it interferes with calcium absorption. Again, moderation is key. If your alcohol intake exceeds one drink per day as a woman or two per day as a man, and you already have low bone density, this is something you may want to reconsider and cut back a bit.

Calcium intake is a no-brainer. It’s one of the top bone health nutrients and an absolute must. Shoot for 1,200–1,500 mg per day through foods and supplements if needed. Top food sources of calcium include:

  • Dairy products like low-fat milk, Greek yogurt, cheese, and kefir

  • Fish canned with bones, like salmon and sardines

  • Tofu

  • White beans

  • Broccoli, kale, and other dark leafy greens

  • Almonds

  • Oatmeal

Vitamin D: This famous vitamin goes hand in hand with calcium. We can’t absorb calcium without vitamin D. The general recommendation is 800 IU per day—often the amount found in a multivitamin—but a supplement with 1,000–2,000 IU is absolutely acceptable and tends to be the norm. While it’s hard to get enough vitamin D through foods alone, here are the top sources:

  • Fatty fish like tuna, salmon, mackerel, and sardines

  • Beef liver, cheese, egg yolks

  • Fortified foods like dairy products, cereals, and soy and other alternative milks

  • Certain types of mushrooms in smaller amounts

Protein is essential for maintaining muscle strength, building muscle, and improving calcium absorption, all of which support bone strength. In combination with a healthy well-balanced diet (meaning lots of vegetables, fruit, whole grains, and healthy fats), protein is one of the most important nutrients out there to support healthy bones.

And lastly, muscle helps protect and support bone. In addition to running, it’s a great idea to include high-impact weight-bearing activity. Lift weights, take up boxing, take a HIIT (high-intensity interval training) class, or try barre, yoga, or Pilates. All of these activities help keep your muscles strong, and they also support a strong core and, obviously, stronger bones.


Dana Pitman

Dana Pitman is a Registered Dietitian/Nutritionist at Hospital for Special Surgery. She provides individual nutrition counseling and health coaching, and develops social media content for the official hospital channels. No stranger to an active lifestyle, Dana is an active runner and keeps a steady rotation of classes including spin, HIIT, boxing, and Pilates.

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