Foods to Eat When You Have Osteoporosis

Hi, I’m Dr. Masha Livhits, endocrine surgeon at UCLA Health. If you’ve been diagnosed with osteoporosis, you might be wondering what you can do at home to help strengthen your bones. And one of the most important steps is making sure you’re getting the right nutrition—especially calcium and vitamin D.

As an endocrine surgeon, I take care of many patients with osteoporosis who have hyperparathyroidism, or an overactive parathyroid gland. We can cure hyperparathyroidism with surgery, and this has significant long-term benefits in terms of bone density and lowering the risk of fracture. But to achieve the best long-term bone health, we also need to focus on lifestyle factors including diet and weight bearing exercise.

Let’s start with the basics.

Calcium is a major building block of your bones, and vitamin D helps your body absorb calcium. When you’re not getting enough of either, your body can start pulling calcium out of your bones, which makes them weaker and more prone to fractures.

For most adults with osteoporosis, the general recommendation is to get about:

1,200 milligrams of calcium per day, and
800 to 1,000 international units (IU) of vitamin D per day

Ideally, we want to get as much of that calcium as we can from food, not just supplements, because it’s best absorbed in your diet. So what kinds of foods are rich in calcium?

Dairy products: milk, yogurt, and cheese are some of the most concentrated sources of calcium. One cup of milk has about 300 mg of calcium. Of course, some people have lactose intolerance or are worried about inflammation related to dairy.
Leafy greens: kale, bok choy, and collard greens are good choices. Just note that spinach has a lot of calcium, but your body doesn’t absorb it very well due to something called oxalates.
Calcium-fortified foods: many brands of orange juice, plant-based milks, cereals, and even tofu have added calcium. Always check the label and think about how much sugar you’re consuming as well.
Canned fish with bones, like sardines or salmon—you actually get calcium from the soft, edible bones.
Almonds, chia seeds, and white beans also contain some calcium, though in smaller amounts.

If you add it up, you want to aim for three to four servings of calcium-rich foods a day to get to that 1,200 mg goal.

Now let’s talk about vitamin D. This is a little harder to get from food alone. Some foods that have vitamin D include:

Fatty fish like salmon or mackerel
Egg yolks
Fortified milk and cereals
And mushrooms exposed to sunlight

But even with those, most people don’t get enough vitamin D just from their diet. And if you live in a place with limited sun exposure, especially in winter, your levels may be low. That’s why many people with osteoporosis need a vitamin D supplement, often taken daily or weekly depending on your levels and your doctor’s recommendation.

Now, I also want to mention a special group of patients—those with primary hyperparathyroidism. This is a condition where the parathyroid glands in the neck make too much hormone, which pulls calcium out of your bones and raises your blood calcium levels.

If you have primary hyperparathyroidism, you should not take calcium supplements before surgery, because your calcium levels are already too high and any calcium you ingest won’t really be absorbed. But after parathyroid surgery—when the source of the problem is removed—your bones start rebuilding, and that’s when your body may actually need more calcium. So at that point, we do recommend calcium supplements after surgery.

So, to summarize:

If you have osteoporosis:

Aim for 1,200 mg of calcium per day—mostly from foods
Include 3–4 servings of calcium-rich foods daily
Get 800–1,000 IU of vitamin D per day, through food, sun, or supplements
Talk to your doctor before starting any high-dose supplements

If you have primary hyperparathyroidism:

Avoid calcium supplements before surgery
But do take calcium after surgery, as your bones begin to rebuild

Nutrition is an important part of managing osteoporosis, and something that you can control. Combined with weight-bearing exercise, good bone health monitoring, and medications when needed, these can all make a difference in reducing your risk of bone fracture.

I’m Dr. Masha Livhits—endocrine surgeon at UCLA Health. Thanks for watching this video about dietary recommendations for osteoporosis.