Weekly Osteoporosis Menu: 7 Days with a Shopping List

Who is this menu for, and who is it not for?

It is intended for adults with osteopenia or osteoporosis, or anyone who wants to support their bone mass. It may suit people in perimenopause and postmenopause, and men over the age of fifty.

It is not intended for advanced chronic kidney disease, where the nephrology team adjusts phosphorus, potassium and calcium. It is also not intended for high blood calcium (hypercalcaemia) or recurrent calcium kidney stones. If any of these apply to you, discuss it with your doctor first.

The menu does not set a fixed calorie target. Portions are for an adult with moderate physical activity. If you need them adjusted to your weight or goals, we can work that out with you in a consultation.

The full week: breakfast, lunch and dinner

Day	Breakfast	Lunch	Dinner
Monday	Whole-milk plain yoghurt with rolled oats, ground sesame seeds, walnuts and sliced banana	Lentil stew with carrot, leek and paprika · mixed-leaf salad with feta and pumpkin seeds · one mandarin	Courgette and potato soup · two-egg omelette with sautéed mushrooms · plain yoghurt
Tuesday	Wholemeal toast with fresh cheese, sliced tomato and extra virgin olive oil · coffee or herbal tea	Chickpeas sautéed with steamed broccoli, garlic and paprika · pan-fried salmon fillet with lemon · one pear	Wholemeal noodle soup with homemade stock · canned small sardines, with their bones, on slices of boiled potato with paprika · plain yoghurt
Wednesday	Plain kefir with rolled oats, flaked almonds and diced apple with cinnamon	White beans stewed with pumpkin, leek and clams · tomato and cucumber salad with oregano · one orange	Pumpkin and leek purée · grilled chicken breast with oregano and lamb’s lettuce · cottage cheese with a touch of honey
Thursday	Wholemeal toast with sesame paste (tahini) and sliced banana · coffee or herbal tea	Brown rice with sautéed carrot, courgette and green beans · oven-baked hake with potato and onion · two dried figs	Seasonal vegetable soup · scrambled prawns and spring garlic with rocket salad · plain yoghurt
Friday	Plain yoghurt with muesli with no added sugar, chia seeds and fresh blueberries	Wholemeal macaroni with homemade tomato and onion sauce and diced sautéed tofu or light tuna · shredded cabbage salad with lemon · one kiwi	Steamed broccoli with extra virgin olive oil · grilled sea bream with garlic and parsley · cottage cheese or plain yoghurt
Saturday	Wholemeal toast with crushed tomato, extra virgin olive oil and a poached egg · one orange	Warm chickpea salad with roasted peppers, hard-boiled egg and sunflower seeds · oven-baked anchovies with garlic and parsley · a slice of melon or watermelon	Carrot and leek soup · turkey breast fillet with lamb’s lettuce, diced semi-cured cheese and walnuts · plain yoghurt
Sunday	Milk (or calcium- and vitamin D-fortified soy drink) with rolled oats, chopped hazelnuts and strawberries	Brothy rice with cuttlefish, mussels and vegetables (green beans and pepper) · watercress salad with lemon dressing · one apple	Boiled green beans and potato with extra virgin olive oil · plain omelette with semi-cured cheese · homemade apple compote with no added sugar

Each day, calcium and protein are spread across the three meals so they are supplied throughout the day rather than all at once.

Weekly shopping list

This list is for one person for seven days and is organised by market section. If you choose a soy drink instead of milk, make sure it is fortified with calcium and contains at least 3% protein. Bear in mind that soy is an allergen.

Vegetables

• 500 g broccoli
• 2 medium courgettes
• 400 g pumpkin
• 3 leeks
• 500 g carrots
• 1 kg potatoes
• 300 g green beans
• 6 tomatoes, for salad and for crushing
• 2 cucumbers
• 200 g fresh mushrooms
• 1 bunch spring garlic
• 3 red and green peppers
• 3 bags of mixed greens (lamb’s lettuce, rocket, watercress and cabbage)
• 1 net of garlic and 1 net of onions

Fruit

• 1 kg oranges and mandarins
• 4 bananas
• 4 apples
• 2 pears
• 2 kiwis
• 1 punnet of fresh blueberries and 1 punnet of strawberries
• 1 piece of melon or watermelon (500 g)
• 1 small packet of dried figs (100 g)

Legumes, grains and bread

• 2 glass jars of cooked chickpeas (800 g in total)
• 1 glass jar of cooked white beans (400 g)
• 400 g lentils, dried or cooked
• 500 g wholegrain rolled oats
• 1 small packet of muesli with no added sugar
• 500 g brown rice
• 500 g wholemeal pasta and noodles
• 1 wholemeal bakery loaf, to slice and freeze

Fish, meat and eggs

• 2 tins of small sardines in olive oil, with their bones
• 250 g cleaned fresh anchovies
• 1 fresh salmon fillet (150 g)
• 1 portion of hake fillets (150 g)
• 1 portion of cleaned sea bream fillets (150 g)
• 150 g cleaned cuttlefish
• 250 g clams and 250 g mussels
• 150 g peeled prawns
• 300 g chicken and turkey breast in total
• 1 block of firm tofu set with calcium salts (200 g)
• 1 dozen free-range eggs

Dairy and plant-based alternatives

• 8 whole-milk plain yoghurts with no added sugar
• 1 bottle of plain kefir (500 ml)
• 1 litre whole or semi-skimmed milk, or soy drink fortified with calcium and vitamin D
• 250 g fresh Burgos-style cheese
• 250 g cottage cheese
• 100 g semi-cured cheese and 100 g feta

Pantry, nuts and seeds

• 150 g shelled walnuts
• 150 g raw almonds
• 100 g unsalted roasted hazelnuts
• 1 bag of raw or toasted sesame seeds (150 g)
• 1 assorted pack of pumpkin, sunflower and chia seeds
• 1 small jar of tahini (sesame paste)
• 1 bottle of extra virgin olive oil
• Sweet paprika, cinnamon, oregano and black pepper

How can you cook to get more from calcium?

The body does not absorb all the calcium in food. How much it absorbs depends on what else is on the plate and how the food is cooked.

• Oxalates. Spinach, chard and beetroot contain oxalates, substances that bind to the calcium in those foods in the gut and leave very little available for absorption. Broccoli, cabbage, cauliflower, kale and watercress contain very little, so their calcium is absorbed much more effectively.
• Soft bones. Most of the calcium in small sardines, anchovies and canned anchovies is in the bones. Eat them and chew them well.
• Ground sesame. Whole seeds often pass through the gut without being broken down. Toast them lightly and grind them before adding them to yoghurt or salad, or use tahini.
• Short cooking times. Steaming, baking, cooking en papillote and quick stir-frying lose fewer minerals into cooking water. If you boil vegetables or legumes, use the cooking liquid in soups and stews.

What does this menu leave out, and why?

There is no alcohol during the week. Alcohol slows the formation of new bone and increases the risk of falls.

It also leaves out cola and sugar-sweetened drinks, which displace milk and water. In addition, the phosphoric acid in cola does not support bone health.

Salt, ultra-processed foods, processed meats and salty snacks are kept to a minimum. Excess sodium increases calcium loss in urine.

Coffee appears at two breakfasts. Drinking a lot of coffee slightly increases calcium loss in urine, so if you have several cups a day, have them with milk.

Why does this menu support muscle as well as bone?

We tend to think of bone as calcium, but inside it has a protein framework, mainly collagen, on which the mineral is deposited. If protein is lacking, both this framework and the muscle that protects the bone can be affected.

European guidance on nutrition in older people and osteoporosis recommends at least 1 g of protein per kilogram of body weight per day [2] [3]. The Spanish osteoporosis guideline sets the intake at 1 to 1.5 g per kilogram [1]. For someone weighing 60 kilos, that is at least 60 g a day, spread across three meals with eggs, poultry, fish, dairy and legumes.

Bone also responds to loading. Regular exercise is recommended, for example walking for at least 30 minutes a day [1], along with weight-bearing activity and measures to prevent falls [3]. Strength training builds muscle, and stronger muscles reduce the risk of falling. We cover this in our guide to sarcopenia and our guide to eating for longevity.

How does calcium from food differ from supplements?

EFSA sets the general reference for adults from age 25 at 950 mg of calcium a day. For osteoporosis, the Spanish guideline recommends 1,000 to 1,200 mg of calcium a day [1]. The European guideline recommends 800 to 1,200 mg, preferably from food and especially dairy [3]. Food is the first source to consider. You can have up to 3 servings of dairy a day, preferably plain and unsweetened. Calcium is supplied throughout the day, alongside protein and other nutrients.

First work out how much calcium you get from your food; if you need a supplement, your doctor or dietitian-nutritionist will recommend it.

Calcium supplements are reserved for when the diet provides less than 800 mg a day [3]. If needed, your doctor or dietitian-nutritionist will recommend them after reviewing what you eat. Taking them on your own does not protect your bones more and may cause constipation or digestive discomfort.

Vitamin D is different because few foods contain it. For adults, the dietary reference is 15 micrograms a day (600 IU), calculated for when the skin produces very little [4]. For osteoporosis, the Spanish guideline advises keeping blood vitamin D above 20-25 ng/ml, and preferably above 30 ng/ml [1].

If you need a vitamin D supplement, your doctor or dietitian-nutritionist will recommend it after assessing your situation. The full clinical guidance is in our guide to eating with osteoporosis.

What mistakes do we see in consultations?

Relying on spinach for calcium. People add it to everything for bone health, but very little of its calcium is absorbed. Eat it for its fibre and folate, and get calcium from dairy, fish eaten with the bones or broccoli.

Starting at the pharmacy. People buy calcium tablets before checking how much they already get from food.

Cutting out whole food groups without a replacement. Dairy is removed without replacing it, or a crash diet is followed. This kind of restriction can leave you short of nutrients, and a severe calorie deficit reduces muscle and bone at the same time.

Looking after the plate and forgetting movement. Without loading and movement, bone density falls, however well you eat.