Collaborative Healthcare Network
5–3405 South Millway
Mississauga, ON L5L 3R1
We’ve all seen the commercials on TV telling us to drink milk to keep our bones strong. We know that we hit peak bone mass before the age of 30, and as we age, our bone mass starts to decline. Depending on our genetics and lifestyle, some of us may decline faster than others. Osteoporosis is the age-related decline in bone density that men and women may experience after 50 years old. Progression into osteoporosis is marked by a weakening of bone tissue that increases the risk of easy fractures, specifically in the hip, spine, and wrist. It is important to note that osteoporosis is an entirely preventable condition, and is associated with poor nutritional and lifestyle habits throughout life. There are many dietary and nutritional approaches that can significantly reduce progression and are of utmost importance for those at high risk.
How Do We Lose Bone Mass?
Most people think that bones are very static structures and we have the same ones for life. In reality, our skeletons are incredibly active and dynamic structures, constantly breaking down in some areas and rebuilding in others depending on the forces that we place on them. Bones act as reserves for many micronutrients, especially calcium,
zinc, magnesium, and phosphorus. Diets
that are highly processed are devoid
of nutrients and require that the body
compensate for the lack of nutrients.
These diets are also highly acidic and
require buffering from the bone to balance
out the pH of the body. Compound this
over many years, and the bone tissue can
become very weak, especially if we are
lacking physical activity.
Why Do Women Develop Osteoporosis Earlier Than Men?
Women have higher levels of estrogen than men, and estrogen is protective for bone
structure. Once a woman becomes perimenopausal, her estrogen levels start to decline,
which means she doesn’t have the same hormonal protection for her bones. The earlier
a woman goes into menopause, the earlier her bone mass will start to decrease, and the
higher her risk of osteoporosis and fractures. For men, things are a little different, and
the decline in bone mass is simply a result of age. However, because our average life
expectancy has increased over the last few decades, more men will live to experience
the progression into osteoporosis.
So, if your genetics are not on your side and early menopause is in store for you, what
can you do to keep your bones as strong as possible?
Education Is a Key Piece of the Osteoporotic Puzzle
The more knowledge there is around bone loss, the more conscious one can be about
their sources of nutrients and in what ways they might be losing bone mass. Remember
those old milk commercials claiming to keep your bones strong? Well, evidence exists
to prove and refute this point. Studies carried out over many years showed that people
who consumed milk in their childhood had higher peak bone mass, and tended to have
fewer fractures later in life. The earlier the exposure to milk, the better for preventing
fracture. So what do you do if you’re lactose intolerant or have a dairy allergy? Well, this
same study showed that dietary calcium intake had similar benefits to milk. Whether
you chose to supplement calcium or fortify your diet with high-calcium vegetables,
vitamin D, and other micronutrients, your bone structure can be maintained.
Know If You Are at Risk
According to the American Association of Family Physicians, those at risk for osteoporosis
include those with a family history of osteoporosis, white race, dementia, poor nutrition,
cigarette smoking, alcoholism, low body weight, estrogen deficiency, inadequate
physical activity, and early menopause. Additionally, individuals with certain health
conditions are at high risk for bone loss before the age of 50. These people are often
on high doses of corticosteroids or hormone therapies; or they have been diagnosed
with rheumatoid arthritis, Cushing’s disease, hyperthyroidism, hyperparathyroidism,
malabsorption syndrome, or other chronic inflammatory disease.
Knowing where you stand can be a
motivating factor to either get your act
together, or know that you’re on the right
track. If you have strong risk factors for
osteoporosis, it might be a good idea to
raise your concerns with your physician
and talk about how early they recommend
you having a bone mineral density test
done. It is often not recommended unless
you are in early menopause, have one of
the chronic inflammatory conditions that
cause bone loss, or are over the age of
65; however, many private clinics offer
testing. The test itself is called a “DEXA scan,” and does involve a small amount of
radiation in order to see through the layers of your spine.
According to the US guidelines for osteoporosis treatment and management, a thorough
workup of a patient should include the following blood tests:
serum creatinine (a measure of kidney function);
thyroid stimulating hormone (low TSH has been associated with low bone mineral
parathyroid hormone; and
alkaline phosphatase (a marker of bone and liver health).
Many professionals consider osteoporosis to be an end-stage disease, meaning the
process began 20–30 years ago and has been steadily progressing over the years.
By the time a diagnosis is given, bone loss and nutrient levels have gone so low that
symptoms such as fractures become more of a risk. While osteoporosis can be difficult
to manage, strengthening the bones and fortifying the diet can do a lot to increase
numbers and slow progression.
Alkalinize Your Diet
As mentioned previously, highly processed foods as well as diets high in protein and
low in fruits and vegetables are very acidic and will leach nutrients out of the bone
tissue. Other highly acidic foods include grains, buckwheat, refined sugar, cheese, and
coffee. The solution? Reduce consumption of these foods and increase alkaline foods
in the diet, such as leafy green vegetables, almonds, coconut, bananas, avocados, and
The primary strategy for prevention of fractures stresses the importance of maintaining a
healthy body weight through regular exercise. There is absolutely no medication on the
face of the planet that can replicate what exercise does for us, and the most important
thing that anyone can do to strengthen their bones is weight-bearing exercise. Whether
you enjoy yoga, dancing, weight training, or playing a sport, getting your body moving
will activate different muscle groups, strengthen the bones in those areas, and improve
your circulation. All good things!
Fortify with Supplements
Vitamin D: I believe in individualized medicine, but this is one thing I put every patient
on across the board. No matter how much time you spend outside, our Canadian sun
is limited and definitely not strong enough to penetrate the skin and provide the right
dose of vitamin D all year round. The ability to use and convert vitamin D from the
skin is also a very individual thing, and some people are more efficient converters than
others. Either way, there is no point in supplementing with calcium if you don’t have the
adequate vitamin D to absorb it, so make sure you add this to your plan.
Magnesium: Another very important nutrient that is often low in Canadians is
magnesium. Our soil levels are low, which means our vegetables that grow from the
soil are not as strong of a source of magnesium as they used to be. Magnesium and
calcium work together in the maintenance of strong bones and healthy muscles. Get
more of this, especially if you have higher levels of inflammation in the body and suffer
from a lot of aches and pains.
Combination Formulas: Research has allowed supplement and nutraceutical
companies to put together some really great formulas for bone health. The unfortunate
thing is most of these formulas require taking anywhere from 6 to 10 capsules per day in
order to reach the recommended doses. Needless to say, this can be overwhelming for
a lot of people, but the alternative of consuming all the nutrients in individual capsules
can be even more overwhelming. In order to chose the best combination formula for
your bones, consider products that contain the following:
Optional: Microcrystalline hydroxyapatite (MCHC) is essentially bone meal from another animal that comprises the full spectrum of nutrients for bone health. It has conflicting evidence but is commonly found in combination formulas as a more bioavailable source of nutrients. Strontium ranelate is a bit harder to find in Canada, and has insufficient evidence to prove its safety and efficacy. However, the few studies that have been done show an increase in bone mineral density for the more extreme cases of osteoporosis.
As you can see from this article, the management of osteoporosis encompasses a whole bunch of things that everyone should be doing regardless of their risk factors. Don’t wait until your bone mineral density is low before you start making changes to your diet and exercise plan. Awareness is half the battle, and most people are not motivated to make a change unless someone close to them is affected by a disease. Be the exception! Get your diet on track with alkaline foods, drink plenty of water, and just keep moving!