September is Blood Cancer Awareness Month. Maintaining bone health can be a serious challenge for those living with blood cancer. Both blood cancer, especially myeloma, and treatments for blood cancer can lead to bone disease. If you or someone you love is a blood cancer survivor, bone health may be on your mind.
Proper nutrition gives your bones the strength to support your body and overall well-being. Choose food first as the source of bone-building nutrients. Ask your treatment team if you need dietary supplements. Always ask your doctor before taking a new supplement as some can interfere with cancer treatment.
Grab your plate and let’s dish on the foods that support bone health!
Protein is the foundation of building strong bones. Adequate protein intake provides the necessary building blocks (amino acids) for bones to grow during development. It also repairs and preserves bone mass as we age. Protein needs vary based on age, sex, health conditions, and activity level. You may need additional protein during cancer treatment, as well as after age 65.
Sources of protein: legumes or beans, nuts, seeds, tofu, fatty fish, poultry, meat, yogurt, cheese, and cow or soy milk
How much protein do I need? The Recommended Daily Allowance (RDA) for protein is 0.36 grams (gm) per pound of body weight for adults. For example, a person weighing 150# would require approximately 54gm protein per day (0.36gm x 150# = 54gm protein per day1.) Protein requirements can vary greatly depending on activity level and medical condition.
To learn how much protein is in a serving of food, check the Nutrition Facts label.
Tip: Sprinkle chia seeds, ground flax seed, hemp seeds, wheat germ or sunflower seeds on salads, bowls, toast, yogurt, or oatmeal for crunchy texture and a protein and nutrient boost!
Calcium is well known for its role in giving bones their strength. Calcium is responsible for building the scaffolding to provide the rigid structure of bones2. It is important to note that the calcium levels often shown on routine blood work are not necessarily reflective of adequate intake and/or bone health.
Sources of calcium: dairy products, leafy greens, fortified orange juice, fortified plant-based milk, almonds, tofu, and canned sardines or salmon with bones
Some people may benefit from a calcium supplement. However, do not start taking a calcium supplement without first speaking to your doctor.
How much calcium do I need? Most adults need 1,000-1,200mg per day.3 Calcium is best absorbed in divided doses of 500mg or less per sitting.4 Make sure to include a high-calcium food at least twice daily to meet your daily goal.
To learn how much calcium is in a serving of food, check the Nutrition Facts label.
Tip: Challenge yourself to eat one high-calcium snack per day. Keep it simple: grab a serving of almonds, cheese sticks, yogurt, kefir, hummus and broccoli florets, kale chips, or cottage cheese!
Vitamin D helps your bones absorb calcium. While sunlight helps your body make vitamin D, you may not be getting enough vitamin D this way, and ultraviolet radiation from the sun can cause skin cancer, so it’s important to protect your skin from the sun. While only a few foods contain vitamin D naturally, many foods in the United States (for example, milk and breakfast cereals) are fortified with vitamin D. Vitamin D can come from a supplement. However, talk to your doctor before beginning a supplement.
Sources of vitamin D from food: fatty fish, beef liver, egg yolks, some mushrooms, fortified dairy products, and fortified ready-to-eat breakfast cereals and orange juice.
How much vitamin D do I need? The RDA for persons 1-70 years of age is 15mcg per day and those persons older than 70 years of age is 20mcg per day.5
To learn how much vitamin D is in a serving of food, check the Nutrition Facts label.
Tip: Ask your doctor if you should get your vitamin D level checked. The results can help you and your doctor decide if you need a vitamin D supplement.
Magnesium doesn’t get the attention it deserves compared to calcium and vitamin D; however, it plays an important role. Magnesium helps your bones to absorb calcium and helps to activate vitamin D.
Sources of magnesium: whole grains, nuts, seeds, dark green leafy vegetables.
How much magnesium do I need? Most adults need 310-420mg per day.6
Visit the National Institutes of Health to learn more about Magnesium.
Tip: Aim to consume all the magnesium you need from plant-based foods. Plant-based foods contain fiber, antioxidants, vitamins, and minerals. Fill 2/3 of your plate with plant-based foods.7
Vitamin K potentially plays many roles in supporting strong bones. Low intake of vitamin K is associated with weaker bones and an increased likelihood of a fracture. Note: If you are taking the blood thinning medication warfarin (Coumadin®), please talk to your doctor before making any changes to your vitamin K intake.
Sources of vitamin K to add to your plate: green leafy vegetables such as broccoli, kale, Swiss chard, endive, spinach, and collard greens
How much vitamin K do I need? Most adults need 90-120mcg per day.8
Visit the National Institutes of Health to learn more about Vitamin K.
Tip: Try adding washed and torn leafy greens to soup at the end of cooking. Leafy greens shrink down and take on the taste of the soup. You may not even notice them in your bowl!
Beyond the Plate
Weight-bearing exercises, resistance training, and balance training can help to improve your bone health. Make sure to consult with your doctor before making any changes to your exercise routine. If mobility or balance is an issue, ask for a referral to a physical therapist for a personalized exercise plan.
Talk to Members of Your Healthcare Team
If you have specific questions about what amounts of nutrients you require to support good bone health or are wondering if you need to add a nutrition supplement, ask your doctor for a referral to a registered dietitian to best assess your individual needs. Aiming to meet your nutrient needs from whole foods is best. Fueling your body with proper nutrition can contribute to stronger bones and a better quality of life. Bon Appetit!
- Institute of Medicine. (2005) Dietary Reference Intakes for Energy, Carbohydrates, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. National Academy Press. https://nap.nationalacademies.org/read/10490/chapter/1.
- Vannucci L, Fossi C, Quattrini S, Guasti L, Pampaloni B, Gronchi G, Giusti F, Romagnoli C, Cianferotti L, Marcucci G, Brandi ML. Calcium Intake in Bone Health: A Focus on Calcium-Rich Mineral Waters. Nutrients. 2018 Dec 5;10(12):1930. doi: 10.3390/nu10121930. PMID: 30563174; PMCID: PMC6316542.
- National Institute of Health. (2022, October) Calcium Fact Sheet for Health Professionals.S. Department of Health & Human Services, National Institutes of Health. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/.
- Wacker M, Holick MF. Sunlight and Vitamin D: A global perspective for health. Dermatoendocrinol. 2013 Jan 1;5(1):51-108. doi: 10.4161/derm.24494. PMID: 24494042; PMCID: PMC3897598.
- National Institute of Health. (2022, August) Vitamin D Fact Sheet for Health Professionals.S. Department of Health & Human Services, National Institutes of Health. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#h3.
- National Institute of Health. (2022, July) Magnesium Fact Sheet for Health Professionals.S. Department of Health & Human Services, National Institutes of Health. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/.
- American Institute for Cancer Research. (2023) Setting Your Table to Prevent Cancer. https://www.aicr.org/cancer-prevention/healthy-eating/new-american-plate/.
- National Institute of Health. (2021, March) Vitamin K Fact Sheet for Health Professionals.S. Department of Health & Human Services, National Institutes of Health. https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/.
Through LLS’s Nutrition Education Services Center patients and caregivers of all cancer types can receive a free nutrition consultation with a registered dietitian who has expertise in oncology nutrition.