Osteoporosis literally means “porous bone.” Osteoporosis involves both the mineral (inorganic) and nonmineral (organic matrix, composed primarily of protein) components of bone. Bone is dynamic living tissue that is constantly being broken down and rebuilt, even in adults. Osteoporosis occurs when there is more bone breaking down than being formed.
Osteoporosis is usually without symptoms until severe backache or hip fracture occurs. Osteoporosis is best diagnosed by dual energy X-ray absorptiometry (DEXA) a technique that measures bone density.
What causes Osteoporosis?
Normal bone metabolism is dependent on an intricate interplay of many nutritional, lifestyle, and hormonal factors. Many dietary factors have been suggested as a cause of osteoporosis including: low-calcium-high-phosphorus intake, high-protein diet, high-acid-ash diet, high salt intake, and trace-mineral deficiencies, to name a few. Osteoporosis is most common in postmenopausal Asian and white women. Other risk factors for osteoporosis include: family history of osteoporosis; physical inactivity; short stature, low body mass, and/or small bones; and never having been pregnant.
What dietary factors are important in Osteoporosis?
A high-protein diet is associated with increased excretion of calcium in the urine and increased risk for osteoporosis, too. Raising daily protein intake from 47 to 142 grams doubles the excretion of calcium in the urine. However, too little protein is also associated with an increased risk for osteoporosis
In contrast, a vegetarian diet is associated with a lower risk of osteoporosis. Although bone mass in vegetarians does not differ significantly from that of omnivores in the third, fourth, and fifth decades of life, there are significant differences in the later decades. These findings indicate that the decreased incidence of osteoporosis among vegetarians is not due to increased initial bone mass, but rather to decreased bone loss.
A diet high in salt or acid ash also causes calcium removal from bones and increases calcium loss in the urine. Therefore, we recommend avoiding salt and eating an alkaline based diet. Basically, an alkaline diet is one that focuses on vegetables, fruit, nuts, and legumes while avoiding overconsumption of meat and dairy.
Soft drinks containing phosphates (phosphoric acid) are definitely linked to osteoporosis because they lead to lower calcium levels and higher phosphate levels in the blood. When phosphate levels are high and calcium levels are low, calcium is pulled out of the bones. The phosphate content of soft drinks, such as Coca-Cola and Pepsi, is very high, and they contain virtually no calcium. If you are concerned about developing or are at risk of developing osteoporosis you will want to eliminate soft drinks from your diet.
Refined sugar intake also increases the loss of calcium from the bone. Regular consumption of refined sugar increases loss of calcium from the blood through the urine. Calcium is then pulled from the bones to maintain blood calcium levels as foods containing refined sugar generally do not contain calcium.
Calcium is not the only nutrient that is important for bone formation. Many trace minerals such as copper, manganese, zinc and boron are also important. A deficiency in trace minerals can also predispose someone to osteoporosis.
Green leafy vegetables from the cabbage family, including broccoli, Brussels’s sprouts, kale, collards, and mustard greens, as well as green tea offer significant protection against osteoporosis. These foods are a rich source of a broad range of vitamins and minerals that are important to maintaining healthy bones, including calcium, vitamin K1, and boron. Vitamin K1 is the form of vitamin K that is found in plants. A function of vitamin K1 is to convert inactive osteocalcin to its active form. Osteocalcin is an important protein in bone. Its role is to anchor calcium molecules and hold them in place within the bone.
In addition, soy foods, such as tofu, soy milk, roasted soybeans and soy extract powders, may be beneficial in preventing osteoporosis. In several double-blind studies, taking 40 grams of soy protein powder containing 80-to-90 mg isoflavones increased bone mineral density of the spine and hips in post menopausal women. Alfalfa is another isoflavone and vitamin K rich food that can also be included in the diet.
However, while numerous clinical studies have demonstrated that calcium supplementation can help prevent bone loss, the data is inconclusive in regard to any link between a high dietary calcium intake from milk and prevention of osteoporosis and bone fractures. When reviewing the data from the Nurses’ Health Study, a study involving 77,761 women, researchers found no evidence that higher intakes of milk actually reduced fracture incidence. In fact, women who drank 2 or more glasses of milk per day had an increased relative risk of 45% for hip fracture compared to women consuming 1 glass or less per week. In other words, the more milk a woman consumed, the more likely she was to experience a hip fracture. This negative effect may turn out to be due to the vitamin A added to milk (at higher levels, vitamin A, but not beta-carotene may interfere with bone formation). Interestingly, if you look at the rate of osteoporosis worldwide, it is much higher in countries where milk intake is highest.
What nutritional supplements should I take for Osteoporosis?
Health Bones Plus from Natural Factors is based on the latest research to promote bone health. It provides a comprehensive formula to augment the high nutrient levels in the MultiStart for Women formulas to provide an effective bone health strategy. This combination provides the therapeutic dosages given below for each of the discussed nutrients. OsteoSense provides calcium in the form of tricalcium phosphate. Here is why:
- Provides 1,000 mg of highly absorbable forms of calcium and 500 mg of magnesium.
- Contains BioSil – the clinically proven bioavailable form of silicon that increases the collagen matrix of bone.
- Provides other nutrients critical to both the collagen and mineral matrix of bone.
- For more information go to www.healthybonesplus.com.
Calcium supplementation alone has shown little benefit in treating or preventing osteoporosis. But, combined with vitamin D, calcium supplementation can slow the rate of bone loss by as much as thirty percent and it offers significant protection against hip fractures. The recommended dosage for calcium is 1,000 mg daily.
Vitamin D supplementation is associated with increased bone density and studies that combined vitamin D with calcium produced better results than either nutrient alone. Vitamin D supplementation is especially helpful for elderly people who don’t get sufficient exposure to sunlight (which stimulates the body’s manufacture of vitamin D)-those who live in nursing homes or farther away from the equator, or those who do not regularly get outside. The daily dosage recommendation for vitamin D for prevention is now 2,000 IU. For those with existing osteoporosis I recommend 5,000 IU daily.
Magnesium supplementation is thought by some experts to be as important as calcium supplementation in the prevention and treatment of osteoporosis. Women with osteoporosis have lower bone magnesium content and other indicators of magnesium deficiency than people without osteoporosis.The recommended dosage is 250 to 500 mg daily.
Vitamin B6, folic acid, and vitamin B12 are important in the conversion of the amino acid methionine to cysteine. If a person is deficient in these vitamins, there will be an increase in homocysteine level. Homocysteine has been implicated in a variety of conditions, including atherosclerosis and osteoporosis. Combinations of these vitamins will produce better results than any one of them. The recommended daily dosages are 25 to 100 mg for vitamin B6, and 400 to 800 mcg for folic acid and vitamin B12.
Biosil is a highly bioavailable from of silica that has shown clinical effects in improving bone density and the collagen content of the bone. By increasing the collagen content of the bone by 22% within one year of use, BioSil increases the number of bone mineral binding sites. Supplementing at a dosage of 6 mg per day increased bone mineral density by 2% within one year – safely and without side effect.
Boron is a trace mineral that has gained attention as a protective factor against osteoporosis. It appears that boron is required to activate certain hormones, including estrogen and vitamin D. In order to guarantee adequate boron levels, supplementing the diet with a daily dose of 3 to 5 mg of boron is recommended.
Ipriflavone is a semi-synthetic flavonoid (isoflavone) derived from the soy compound daidzein. Ipriflavone promotes the incorporation of calcium into bone. It also inhibits bone breakdown. Many clinical studies, including numerous double-blind studies, clearly show long-term treatment with ipriflavone (along with 1,000 mg supplemental calcium) is both safe and effective in halting bone loss in post-menopausal women or women who have had their ovaries removed as well as improving bone density in cases of osteoporosis. The typical dosage of ipriflavone is 600 mg daily.
Although nutritional factors are important, I cannot stress enough that the best thing a person can do to strengthen their bones is to get physical activity. Physical exercise, consisting of one hour of moderate activity (e.g., walking, weight lifting, dancing, etc.) three times a week, has been shown to prevent bone loss and actually increase bone mass in postmenopausal women. In contrast to exercise, lack of physical activity doubles the rate of calcium lost from the system.
How do I know if the recommendations are working?
If you are female, attention to bone health must be a lifetime goal. I recommend getting a baseline bone density assessment such as a DEXA scan. It can provide valuable information on your bone density and can also be used as a long-term monitor.