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OSTEOPOROSIS: How huge our parents appeared to us when we were children, yet when we are grown, they seem so much smaller . It is not just that we have grown, very likely they are smaller now. This is because with age the body's frame can shrink as we lose cartilage, the padding between the bones of the spine. For some people this process remains within acceptable bounds, but for others it can become a major heath hazard as not only is the cartilage affected, but the bones themselves become brittle and start to erode . This bone loss happens to men as well as women, but is more common and a greater health risk in women.
Bone loss in women usually starts imperceptibly around the age of 30, increasing rapidly with the onset of menopause, then slowing down again about 5 years after the "change" to the earlier rate. The point is that the better the foundation of bone laid down in youth, the further you have to decline in age to be in trouble. As with so many health problems, prevention is so much easier than cure. Risks are higher for some women than for others, and the following factors are extremely relevant:
Step 1. Hormonal Balance is crucial to healthy bones. In Dr. John Lee's book, Natural Progesterone, The Multiple Roles of a Remarkable Hormone, he points out that if estrogen were the only hormone involved in the accelerated bone loss of the menopausal years, then there would be no bone loss when hormonal levels of estrogen are high, as is the case certainly after age 30 and even into the later childbearing years. The fact that the rate of bone loss accelerates when estrogen levels fall suggests a partial involvement, but the hormone that is lower during both these times in a woman's life is progesterone. The evidence we have at the moment suggests that estrogen's role in bone loss is limited to increased bone resorption in its absence.
On the other hand, there is evidence that such sites do exist for progesterone. In fact, Dr. Lee's studies show that untreated post menopausal women will lose bone mass, that estrogen supplementation will maintain bone mass, but that supplementing with natural progesterone will increase bone mass, effectively reversing the osteoporotic process. Remember, all hormones have cholesterol as a base, and the hormone-like vitamin D is also dependent on cholesterol. Regulation of cholesterol and LDL is dependent on the presence of the correct fatty acids. Because of the hormone connection to bone health, I urge you to balance your essential fatty acid intake to make sure you are getting a healthy ratio of Omega 3 to Omega 6. Think fish 3 times a week, or a supplemental source of Fish Liver Oil.
While estrogen use was not related to bone density, several other factors were:
were all associated with bone density. Interestingly, this study found that calcium and vitamin D supplements did
not improve bone density in these women either. I would be interested
to see a study investigating the connection between low stomach
enzyme levels and anorexia: lack of hydrochloric acid is
one cause of zinc deficiency, which has been linked to eating
disorders.
HCL is necessary for the absorption of both calcium and zinc.
Step 2 Proper diet. For women, this involves careful balancing of nutrients, heavy on the green leafy vegetables (such as kale, spinach, broccoli, cabbage), and low on animal fats. The Nurses' Health Study looked at this question of diet, and Dr. Diane Feshkanish, M.D. of Harvard Medical School found that the 20% of women who consumed less than 109 mcgs. of Vit. K (found primarily in your green leafies) had a 43% higher risk of hip fracture. There are numerous studies that show bone mass in vegetarians is much denser than that of meat-eaters when they reach their fifties, and the reason appears to be that high animal protein promotes the excretion of calcium. The main dietary enemies of proper calcium balance are sugar, caffeine and alcohol, all of which cause calcium to be lost from the body, and drinking carbonated pops, where the excess of phosphoric acid is thought to interfere with calcium uptake. I theorize it also causes an acid body pH, which affects calcium balances. I also recommend that women limit their dairy intake, except for yoghurt and kefir (see RESOURCES at right) and replace some dairy with soy products. As previously stated, studies are suggesting that soy promotes proper hormonal balance, essential for bone-building, and it is a fact that countries where dairy consumption is high tend to have higher levels of osteoporosis. Interestingly, tea (even caffeinated) is associated with higher bone density. This is probably because tea contains many positive elements, flavonoids such as catechins, and now research has discovered that an amino acid in Green Tea, called L-Theanine, counteracts the effects of caffeine giving the drinker the benefits of both relaxation and stimulation! A caveat here: if you cannot handle dairy, and/or are lactose intolerant, be very careful to supplement with enough calcium. See RESOURCES at right for a study connecting dairy intolerance with osteoporosis. Another reason diet is important is that calcium is very sensitive to acid conditions, and relies on a combination of the proper acid environment in the stomach - i.e. enough hydrochloric acid - and a more or less neutral pH in the blood for absorption. A diet high in veggies will take care of the latter part of this equation, but those of us who have digestive problems had better be SURE they are due to too MUCH acid before taking antacids!
High homocysteine levels are now suspect in osteoporosis, which is not a surprise, given the connection between pH, methylation and homocysteine.
Step 3 Exercise of almost any kind: including walking, swimming, yoga, jogging, but most effective is working out with light hand weights. One of our foremost holistic doctors has suggested, only half in jest, that we levy a tax on video games, television programs and other couch potato type occupations that keep our young people inactive, and set it aside in a fund for all the hips that will be fractured in the year 2030!
The importance of
exercise is high-lighted by a 2002 study at the University
of Connecticut (Ilich-Ernst, et al) that showed pretty conclusively a
direct connection between lean body mass (LBM) and bone mineral
density (BMD): Step 4 Supplementing: this is a complex subject , certainly not as simple as just taking Tums, made from calcium carbonate, an inefficiently absorbed form of calcium to start with, and one that ironically requires the stomach acid it is designed to suppress to be absorbed at all! In fact, Max Motyka, who holds an MS in Pharmacy, wrote in an article in October 1999 that clinicians are reporting a rise in a problem called Milk-Alkali Syndrome. Sufferers present with irritability, nausea, headache, vertigo, weariness, hypercalcemia, metabolic alkalosis and renal failure. All of the cases were attributable to the use of a popular calcium carbonate antacid formula as a calcium supplement. Unfortunately, too, whatever calcium is absorbed from Tums , when combined with the highly alkaline carbonate, greatly increases the risk of kidney stones. This is what I suggest you look for in a calcium supplement, together with some of the reasons: Calcium in an absorbable form, such as citrate, or there are studies suggesting MCHA calcium, from actual (organic bovine) bone is also a very positive choice for absorbable supplementation. If you have an acidic pH, consider adding Coral Calcium as part of your calcium supplementation. I aim for between 500 and 1500 mg depending on the individual’s dietary level of calcium. A recent NIH study makes it clear that starting in childhood, reserves need to be built up and that this early approach to bone building pays off in later life. Yet the figures are far from encouraging:
Magnesium - at least 50% of the calcium level, perhaps more. Many people (women in particular) are seriously deficient. Boron - a trace mineral that has an estrogenic effect on calcium absorption. L-Lysine - important in calcium absorption and connective tissue strength. Vitamin D - Essential for calcium uptake. Look for D3, calciferol, and consider doses of up to 2000 i.u. Vitamin K - essential for bone formation, and found chiefly in green leafy vegetables. A Japanese food called Natto is an excellent source of Vitamin K. Silicon/Silica - difficult to find enough in the diet, and a nutrient found in high concentrations anywhere bone is being built.
Melatonin -interesting new research is linking age-related Melatonin deficiencies to osteoporosis. For some, this might be a helpful addition, but I recommend measuring the level of the hormone through a saliva test before supplementing . It is also really important to take your calcium in divided doses throughout the day, with some being taken last thing at night. Measurements of uptake show 29% efficiency for 500 mg taken once a day, versus 40% efficiency for 500 mg divided into three daily doses with an all time low of 14% uptake for 2000 mg taken in one dose! Strontium - here is an expert opinion. Strontium is demonstrably present in bone when it is actively building. Recently, some extremely encouraging research has been done on a supplement called Ipriflavone, which shows promise for restoring bone mass: it was first discovered back in the 1930s, but has recently been reintroduced along with new evidence of its benefits. This substance, which is found naturally in Alfalfa and Bee Propolis, has been shown not only to prevent bone loss ( even in patients with Paget's disease and thyroid problems) but to either maintain, or improve, bone density in post-menopausal women. The interesting thing about Ipriflavone is that it achieves this by exerting an estrogen-like influence on the body, but absolutely without affecting hormonal levels at all: in other words, it appears to carry with it none of the risks of Hormone Replacement Therapy, even for women susceptible to estrogen-induced forms of cancer. (Source: Osteoporosis Int (1997) 7: 119-125)
Recent research at the Universities of Purdue and Indiana has turned up a connection between bone health and Vitamin E. Working with chickens, Drs. Watkins and Seifert found that supplementing the birds' feed with natural D-Alpha Tocopherol along with the naturally occurring companion mixed tocopherols not only resulted in leg bones that grew longer, stronger and denser, but also inhibited the effects of free radicals on existing bone, shielding the bone-forming cells (osteoclasts) and allowing them to continue with their job of producing new bone. This has definite implications for osteoporosis, say the two doctors. Let me point out here that I have been saying for many years how inferior the activity of synthetic Vitamin E is to the natural: now comes a study in the American Journal of Clinical Nutrition that unequivocally show the rate of absorption of synthetic is far less than that of natural, perhaps as little as one half as much. On another interesting note, studies in Sweden suggest that women ingesting more than 1.5 mg of Vitamin A daily had almost twice the risk of hip fractures. Some experts have data that suggests making sure you are getting enough vitamin D mitigates this risk. What this translates to is that if a woman is drinking 5 glasses of milk per day, or the equivalent in other dairy foods and foods high in Vitamin A, she should make sure she is not taking a multivitamin with Vitamin A. Even 5000 i.u. is enough in combination with a diet high in A to increase risk for bone density loss. Beta carotene is NOT a villain here, since it is only converted to Vitamin A if the body needs it.
A study by Dr. Schurch (with WHO in Geneva) has demonstrated that protein plays an important role in proper bone growth: his double blind, randomized study showed that not only did it slow bone loss and help heal existing fractures, but it also supported immune function. (Ann Intern Med1998 / 128 (10) / 801-809.) Confirmation of this information comes from an Australian study published in the Am. Journal of Clinical Nutrition (vol 81, no 6, pp1423-1428) in 2005: results showed a positive correlation between protein intake and both heel and hip bone mineral density, even after adjusting for age, body mass index, and other nutrients. Levels of protein below 66gms per day were problematic, over 87 gms protective. This would seem to give double validity for the regular daily use of soy or whey protein shakes, particularly for women who not only are at greater risk for bone loss and consequent fractures, but who also benefit in other ways from the beneficial phytoestrogens in soy. I have used a shake made from soy protein for breakfast for nearly 20 years now, and every day it appears I find out a new reason why! See RESOURCES at right for the connection between protein and Osteoporosis. This is part of the pH Factor, without which calcium cannot be absorbed. As is so often the case, balance is the key.
Now let's look at other factors, all of which are well within our own control. I proved this last week when my dog (all 140 lbs of him) barreled into me (all 63 years of me) when I was running, and knocked me down two flights of concrete steps. I landed on my arm, and thought I had broken it - an X-ray showed that I had only bruised it badly. Now, if I can just control my dog as well as I control my bones ...
To recap: we can keep our bones strong through a combination of exercise, diet, supplementation, and hormonal balance. The sooner in life we start, the better: but it's never too late to start building stronger bones!
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