October 8th 2018 marks World Osteoporosis Day. While this health event may not be as widely recognized as others, it is of great importance. World Osteoporosis Day, which is sponsored by the International Osteoporosis Foundation, provides an all-important focal point for informing and educating the general public and policy makers about the prevention of osteoporosis which still suffers from poor general awareness.
Another related health observance this month is Bone and Joint Decade National Action Week (October 12 – 20). Similar to World Osteoporosis Day, National Action Week is designed to bring awareness to this condition that affects millions of women.
Are you getting the impression that public health officials and doctors are trying to tell us something?
In 2002, the President announced the next ten years to be known as the United States Bone and Joint Decade. The impetus behind this Decade was to bring awareness to the musculoskeletal diseases and disorders affecting millions of Americans. The mission is to improve the quality of life for those suffering from these conditions and to advance the understanding, prevention and treatment of musculoskeletal diseases and disorders.
A wide range of conditions fall under this category from arthritis, back pain, cerebral palsy, and spinal disorders to broken bones from sports injuries or automobile accidents. A major musculoskeletal condition that poses health risks is osteoporosis. The seriousness of osteoporosis was brought to light two years into the Bone and Joint Decade.
In 2004, the Surgeon General released the first-ever report on bone health in the United States. The findings included in the study were staggering. By 2020, it is estimated that half of all American citizens over the age of 50 will be at risk for fractures and low bone mass due to osteoporosis.
What is Osteoporosis?
The literal translation of osteoporosis is “porous bone”. The condition is characterized by the loss of normal bone density due to lack of calcium and other minerals. For example, a strong normal bone is dense like a brick; bone affected by osteoporosis is easily compressible, like a sponge. With osteoporosis, because the framework of the bone is weakened, bones are more susceptible to fractures and breaks. While bone fragility from osteoporosis leads to fractures mostly of the wrist, hip and spine, any bone can be affected.
Osteopenia is a condition where bone mineral density is lower than normal. It is considered by many doctors to be a precursor to osteoporosis. However, not every person diagnosed with osteopenia will develop osteoporosis.
According to the National Osteoporosis Foundation, an estimated 10 million people in the U.S. today have osteoporosis. Another 34 million people are estimated to have low bone mass, increasing their risk for developing osteoporosis. Women make up 80% of these statistics.
Other shocking statistics include: – Approximately 50% of women and 25% of men over the age of 50 will have an osteoporosis related fracture in their remaining lifetime. – An average of 24% of hip fracture patients over the age of 50 will die in the year following their fracture. – Women with a hip fracture are four times more likely to suffer from a second fracture. – Six months following a hip fracture, only 15% of patients can walk across a room unaided. – By 2025, experts predict the costs associated with osteoporosis-related fractures will rise to $25.3 billion.
Risk Factors with Osteoporosis
Many factors contribute to the development of osteoporosis. Some are unavoidable due to genetics such as being of Asian or Caucasian decent. Those with shorter statures and/or a smaller skeletal framework are also at a higher risk. And women, particularly post-menopausal women, are more susceptible to osteoporosis than men due to physiological, nutritional and hormonal differences between the sexes. However, men over the age of 50 are also at risk.
Lifestyle choices, such as poor diet and nutrition, lack of exercise, heavy alcohol consumption and cigarette smoking all increase the risk of osteoporosis. These, however, are all factors that are largely preventable and modifying them can decrease your risk of developing the disease.
When it comes to diet, a common misconception is that osteoporosis is caused solely by a dietary calcium deficiency. However, vitamins C, D, E and K as well as certain minerals such as magnesium, phosphorus, silicon, boron, zinc, manganese and copper all play a vital role in bone density and bone health. Hence the importance of eating a healthy and well-balanced diet. Some professionals even suggest what is being called the low-acid diet.
The Low-Acid Diet
According to a theory studied since the 1960s, the high acidity in the modern Western diet has contributed to an increase of osteoporosis in the U.S. Foods containing animal proteins (dairy and meat) are made up of amino acids, which are highly acidic on the pH scale. Sodium, sugar, caffeine and soft drinks, which are also highly acidic, are prevalent in the majority of processed and packaged foods – a staple of today’s American diet.
The thought behind the low-acid diet and its effect on osteoporosis development stems from the pH balance in the human body. Dr. Bart Clarke, an endocrinologist specializing in osteoporosis and an associate professor of medicine at the Mayo Clinic in Rochester, MN said, “There’s good evidence to suggest that pH in diet can make a difference (when it comes to bone health).”
Human blood maintains a pH level typically just above 7, which is slightly alkaline. Diets high in acidity can throw the blood’s pH level out of balance. In order to maintain homeostasis, nutrients are sourced from other parts of the body, in this case the bones, to maintain an alkaline pH level. Calcium is the key nutrient extracted from the bone and used to neutralize the pH in the blood.
Lower Your Risk with Diet & Lifestyle
To help combat osteoporosis, it’s beneficial to add low-acidic foods such as fruits, vegetables and whole grains to your diet. Foods such as broccoli, dark green leafy vegetables, kale, oats, oysters, salmon, sardines, sesame seeds and shrimp naturally add calcium and vitamins C, D, E and K to your diet.
Eating more soy-based foods and flax which include soy beans, tofu, soy milk and miso can help fight osteoporosis as well. Plant compounds called phytoestrogens are found in these foods and can mimic estrogen, resulting in a decrease of bone density loss.
Along with a balanced diet, strength training and aerobic exercises are also beneficial for overall health and wellness and are thought to help reduce the risks of osteoporosis as well. While exercise doesn’t have a direct link to increasing bone density, it does play a part in strengthening the surrounding muscles. By improving balance and mobility the risk of fracture-causing falls is decreased.
According to The National Institutes of Health Consensus Conference on Osteoporosis, below are the daily recommended values of calcium intake for those with or without osteoporosis:
– Children ages 1 to 10: 800 mg/day
– Teenagers and young adults ages 11 to 24: 1,200 mg/day
– Men, premenopausal women and postmenopausal women taking estrogen: 1,200 mg/day
– Pregnant and nursing mothers: 1,200 mg to 1,500 mg/day
– Postmenopausal women not taking estrogen: 1,500 mg/day
– The total daily intake of calcium should not exceed 2,000 mg
There are two main forms of calcium found in supplements, calcium citrate and calcium carbonate. A difference between these two compounds is the percentage of elemental calcium present. A greater percentage of elemental calcium means that fewer tablets need to be taken. In the calcium carbonate form, calcium accounts for 40% of the compound; in the calcium citrate form, calcium accounts for just 24%. Chelation, a technology that combines a mineral with an amino acid to facilitate absorption of the mineral, has shown to improve calcium absorption. Brands like VitaMedica, use chelated minerals in all of their products to help with the absorption and assimilation of the minerals.
Calcium carbonate is more readily available, inexpensive, and requires fewer pills to obtain a desired calcium dosage than the calcium citrate. While calcium citrate requires taking more pills, it also has a better absorption rate. Whatever the form, calcium supplements are better absorbed when taken with food. Additionally, taking calcium with meals may reduce the risk of developing kidney stones.
Supplementing calcium in the evening appears better for osteoporosis prevention than taking calcium in the morning, based on the circadian rhythm of bone loss. VitaMedica’s Multi-Vitamin & Mineral uses chronotherapy or the use of daytime and nighttime dosing, to provide the right nutrients at the right time of day. The PM formulation is formulated with 750 mg of calcium plus other vitamins & minerals to support bone health.
Although the risk for developing osteoporosis is highest in the elderly, it is important to take the precautions to prevent bone density loss early on in life. According to the National Osteoporosis Foundation, about 85-90% of adult bone mass is acquired by age 19 in girls and age 20 in boys. Taking the initiative to make sure your children are building strong bones in childhood and adolescence through healthy lifestyle and diet choices can help to prevent osteoporosis later in life.
Last updated May 4, 2018
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.