Osteoporosis is the most common bone disease in Australia. With over 1 million Australians diagnosed with osteoporosis and a further 5.5 million Australians diagnosed with low bone density, it is the fastest growing bone disease in our country.
Did you know that one in every two women over the age of 70 suffers a fracture related to osteoporosis? (7) That is a pretty scary statistic. So what can you do to keep your bones strong and healthy?
Let’s take a closer look at what osteoporosis is and what natural treatment options are available for you.
What is Osteoporosis?
Osteoporosis is a condition where the bones lose strength and become fragile and brittle causing them to break (fracture) easily. The word osteoporosis actually means ‘porous bones’. It commonly affects postmenopausal women but can also affect men.
Don’t think that just because you are young you won’t be affected, more and more young people both men and women are being diagnosed with osteoporosis. The hips, spine, wrists, ribs, pelvis and upper arm are the most common areas affected.
What causes Osteoporosis?
The leading cause of osteoporosis is the loss of calcium from the bones. There are many reasons as to why calcium doesn’t stay in the bones. The leading reasons are:
• High animal protein intake -animal protein has a high phosphate content which increases urinary excretion of calcium and may promote bone breakdown. (6)
• Low Estrogen or Testosterone - Estrogen plays an important role in vitamin D activation, helping to keep calcium in the bones. Before menopause, estrogen preserves bone density by protecting the cells in charge of building up bones. Without estrogen as your bone bodyguard, you end up losing bone. Low testosterone can also reduce bone density as testosterone converts to estrogen so low testosterone can cause low estrogen leading to lower bone density. (6)
• Certain medications such as corticosteroids, anticonvulsants, heparin and aluminium antacids can reduce calcium in the bones. (4)
• Certain health conditions such as Cushing’s syndrome, cancer, malabsorption issues, rheumatoid arthritis and chronic renal failure can all increase your risk of developing osteoporosis.
Other causes for Osteoporosis include
• Having a family history of osteoporosis can predispose a person to developing the disease later in life.
• Lifestyle choices have a big impact on bone health, drinking large amounts of alcohol, smoking and leading a sedentary lifestyle can all have a detrimental effect on bone health.
Now we are aware of what causes our bones to become porous let look at what we can do to keep our bones strong.
We have all heard that you need calcium to keep your bones strong. Studies have shown that Calcium alone or with vitamin D, is effective in the preventative treatment of osteoporosis fracture.
Studies have also shown with calcium supplementation there is a minimum of 12% reduction in fractures of all types and an overall reduction of bone loss of the hip and spine (1)
Most forms of supplemental calcium are acceptable; calcium citrate appears to be better absorbed especially in older adults. (4) To ensure maximum absorption, take with meals and limit to 500 mg per dosage. Magnesium is also an important mineral in the bone matrix, and is usually provided with calcium to offset some of its constipating effects.
Recommended dosage is age dependant, as your need will increase as you get older and is dependent on your gender. Women require a higher dose of calcium from 50 years of age due to menopause and the loss of estrogen. Men generally don’t require a higher dose of calcium until they reach the age of 70.
Adults over 19 years of age - 1000mg per day
Women over 50 years of age - 1300mg per day
Men over 70 years of age - 1300mg per day
Vitamin D has an essential role in bone health; there are several reasons for this. Vitamin D improves the absorption of calcium from the intestines; it helps to regulate the levels of calcium in the blood and also helps to support the growth of the skeleton. (4)
We have an epidemic of vitamin D deficiency in Australia. Most people assume that living in the sunburnt country means we get plenty of vitamin D from the sun, but with the slip slop slap message well and truly getting through to people the amount of time spent in the sun unprotected (without sunscreen) is less than in years gone by. The end result of this is many people are not getting enough safe sun exposure leading to vitamin D deficiency.
Did you know the amount of sun exposure to get adequate amounts of vitamin D is actually relatively low, take a look below at the current recommendations from Osteoporosis Australia for sun exposure to see how much you should be getting? (3)
For those who are unable to get sufficient sun exposure or who have been tested to be deficient in vitamin D, taking a vitamin D supplement is essential. The amount of vitamin D you will need to take will be dependent on how low your levels are.
The current recommendations for vitamin D supplementation is as follows: (3)
Vitamin D is readily available in capsules and liquid form from your local health food shop.
Vitamin K is a fat soluble vitamin primarily involved in blood clotting. What many people are unaware of is that vitamin K plays an integral part in bone mineralisation and remodelling. Several proteins responsible for the building of bone are dependent on vitamin K.
Vitamin K is produced in the intestines by the gut flora, but the gut flora only makes approximately 50% of what our body needs so the remainder needs to be obtained by food or by supplementation.
Currently there is no recommended daily intake (RDI) for Vitamin K but it is estimated that intakes between 75 and 150 micrograms are adequate for most adults (5). Currently you are unable to purchase vitamin K on its own in Australia without first speaking to a healthcare professional but you will find vitamin K in most calcium and bone supporting supplements.
It is also important to know that some medications interact with vitamin K. Warfarin, aspirin and salicylate containing medications inhibit the action of vitamin K.
Many trace minerals such as copper, manganese, zinc and boron are also important. A deficiency in trace minerals can also predispose someone to osteoporosis. It is important to ensure you are getting these trace nutrients either via the diet or by supplementation. (2)
Osteoporosis is a disease that can be in the most part prevented by good nutrition and leading a healthy lifestyle. The general recommendation is for anyone over the age of 35 to be taking some sort of calcium supplement as the bones start to breakdown after the age of 35.
When looking for a good calcium supplement to take to help keep your bones nice and strong ensure it has at least 250mg of calcium and 125mg of magnesium. A good supplement will also have vitamin D, K and trace minerals in it too. You may need to take 2-4 tablets a day in divided doses to reach your minimum of 1000mg of calcium a day.
Ensure you eat a balanced diet rich in fresh fruits and vegetables and quality proteins. Reduce your intake of caffeine, processed foods, alcohol and tobacco. Partake in regular exercise particularly weight bearing exercise as this helps to increase bone density.
Osteoporosis can be a debilitating disease, but by making a few lifestyle changes and taking good quality supplements, you can reduce your chances of being affected by Australia’s most common bone disorder.
Written by Lea McIntyre - Naturopath - ND BHSc
Lea has had many years of professional experience as a naturopath working with her patients and clients both in her clinic and as a senior retail naturopathic adviser. When Lea is not helping people stay well and enjoy a healthy lifestyle, she is busy caring for and nurturing her two young children.
1. Tang BM, Eslick GD, Nowson C et al. Use of calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet; 2007;370 (9588): 657-66
2. A Prentice, Diet, nutrition and the prevention of osteoporosis, MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK. Public Health Nutrition: 7(1A), 227–243
3. http://www.osteoporosis.org.au/about/about-osteoporosis/vitamin-d. Accessed 25/01/2014
4. Jefferay, K. Vitamins and vitamin like substances. 2nd edition. 2001.
5. Jefferay, K. Minerals, The macro and micro minerals, trace elements and heavy metals. 2nd edition. 2001
6. Osiecki, H. The physicians handbook of clinical nutrition. 6th edition. bioconcepts publishing, Aust , 2001.
7. Holford, P. The optimum nutrition bible.Little brown book group, London.2004.
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