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What
is Osteoporosis?
By definition, osteoporosis is simply a decrease in bone
density. This occurs when bone loss is greater than
bone formation. Media, pharmaceutical and natural
health companies have lead the public to believe that
osteoporosis is simply a question of calcium or vitamin
D levels, grossly oversimplifying a disease that is
rooted strongly in our diets and lifestyles.
Supplements are Not the Answer.
Many
of us are lulled into a false sense of security by
taking calcium supplements. There are many pitfalls to
this approach. First, many cheaper commercial bone
supplements lack important nutrients that are as
essential to bone health as is calcium. In addition to
calcium the process of health bone modeling requires
magnesium, vitamin D, zinc, manganese, copper, vitamin
C, vitamin B1, strontium and vitamin K. Furthermore,
ingesting abnormally high levels of calcium hold their
own set of risks such as the development of kidney
stones, exacerbation of arterial disease whose plaques
include calcium deposits, or acquisition of nutritional
imbalances of other competing nutrients. For example, I
find many of my patients complaining of leg cramps which
are caused by excessive calcium which acts to contract
muscles in the absence of enough magnesium which acts to
relax muscles. Also we must realize that on average even
for a good quality supplement we only absorb about 30%
of the calcium, for example, and this is if our
digestion is optimal. Having said all that, the bottom
line is that supplements should be supplements and not
replacements. If you cannot come close to meeting your
mineral needs through your diet it must be very
imbalanced and this will increase your risk of all major
chronic disease today such as cancer, diabetes and heart
disease. If you doctor is asking you to supplement
with calcium in the range of 1000mg the assumption is
you are getting none from your diet.
Excess Loss is the Real Problem.
In reality, poor Intake of bone nutrients has far less
of an effect on bone health than does high losses of
nutrients. In fact, in North America, where we have
amongst the highest rates of osteoporosis in the world,
we consume more calcium than most other countries.
There are three primary dietary factors that contribute
to abnormal losses of calcium and other key bone
nutrients. First, our excessive consumption of animal
based foods causes our bodies to be overly acidic. The
body compensates by leaching out alkaline minerals from
the bones such as calcium and magnesium. Secondly, a
significant amount of calcium and other nutrients are
lost from the diuretic effects of coffee and soft
drinks. Lastly, high salt intake from processed and
canned foods results in urinary loss of calcium. Other
contributing factors are antibiotics, fluoride intake,
alcohol abuse, thyroid imbalance, inflammatory or
autoimmune disease, medications, and hormone
imbalances.
Sunshine for your Bones.
Vitamin D is essential to bone health. Recent studies
show much of the Canadian population is deficient in
vitamin D due to our long winters compounded by overuse
of sun blocks during the summer months. In fact,
anything from SPF 8+ prevents vitamin D synthesis! For
your daily requirements of vitamin D light skinned
persons need about 10-15 minutes sunlight on face, hands
and forearms. However for those with very dark skin
they may need from 30 minutes up to 3 hours. Luckily
we can store some vitamin D in the summer months to use
during times of sunlight deficiency; however infants
will not have stores. Beware that our ability to
convert sunlight declines up to 50% as we age. Bottom
line is that many of us might need to supplement with
vitamin D during the winter months.
Osteoporosis is Not a Disease of Menopause and Estrogen
Deficiency.
Osteoporosis can begin years before menopause.
Furthermore, estrogen only temporarily retards
progression but does not reverse osteoporosis. In
contrast, the hormone progesterone actually helps
rebuild bone. Progesterone deficiencies can occur years
before menopause. Progesterone levels drop much more
than estrogen levels do at menopause. If we compare
ourselves to China where their population on average has
a longer period of menopause and lower blood levels of
estrogen (related to diet) we still have far more
osteoporosis.
How
helpful are Bone Density Scans?
Studies show that bone density scans may not always be a
good predictor of future fractures. For example,
genetics determines maximum bone density by ages 25-30.
Bone scans years later may be misleading when assuming
that low density measurements indicate that bone loss
has occurred. Furthermore, while density scans are great
at showing us bone QUANTITY, they do not reflect the
QUALITY of bone. There is growing evidence that
fluoride as well as some osteoporosis medications
prevent the normal remodeling of bone (breakdown and
rebuilding). This means that the bone grows thicker but
is brittle and poorly structured. In the long run this
may lead to increase fracture rates.
Risk
Factors for Osteoporosis.
There are a number of risk factors that must be
considered in the case of each person when deciding how
to treat osteoporosis: family history of osteoporosis,
low body weight or small frame, sedentary lifestyle
and/or lack of weight bearing activities, poor diet, old
age, suboptimal thyroid functioning, hormone imbalances
and medications that cause mineral deficiencies.
Treatment of Osteoporosis.
As with most prevalent chronic diseases in North
America, osteoporosis is primarily caused by lifestyle
factors, our poor diets and sedentary lifestyles. There
are no easy solutions and medications and/or supplements
will not have a significant impact in the absence of
seriously evaluation our lifestyle choices. However, if
you choose to supplement with bone minerals here are
some pointers: take supplements offering smaller amounts
of minerals in divided doses as you will absorb little
in one giant daily dose of anything. Try find a
supplement covering a broad range of bone minerals.
Look for supplements that contain better quality forms
of minerals such as vitamin D3 instead of D2, magnesium
citrate or malate instead of oxide, and the like.
Dosing if very individual but try to rely more on foods
than pills. If you are vegetarian, vegan or simply must
avoid dairy for any reason do not believe the myth that
you cannot meet your mineral needs with diet alone.
Well balanced plant food diets contain everything we
need for healthy bones, well, that is, everything short
of our sunshine vitamin D. |