Beautiful Bones!

World Osteoporosis Day is October 20. Health experts have good reason to shine the spotlight on this crippling disease—approximately one-third of Australians over 65 fall each year, and around six per cent result in a fracture.

Osteoporosis 101

Osteoporosis is a largely preventable condition. The first step in prevention is learning all you can about the disease and the lifestyle factors that influence its development.

Bone is not a static material—it’s dynamic, living tissue that is always changing. Throughout our lives, our bones go through a continual process of losing old bone and making new bone material to replace it. When we’re young, our bodies keep up with this process and make new bone faster than it breaks down old bone, so bone mass increases.

However, after we reach our “peak bone mass”—typically around the early twenties—the cells responsible for building new bone, osteoblasts, are less efficient, so slightly more bone is lost than is gained. If too much bone is lost, osteoporosis occurs. There are several factors that influence this deleterious scenario, and many are completely within our control.

Risk factors

While men can and do get the disease, women are much more susceptible to it. A woman’s bones are generally smaller than a man’s, so she has much less bone mass to lose to begin with. And during menopause, declining estrogen levels can cause women to lose bone at an alarming rate. Estrogen helps bones absorb and keep calcium—a mineral essential for bone building. If a woman hasn’t accrued a healthy bone mass in her youth, this rapid withdrawal from the “bone bank” can lead to osteoporosis.

In addition to being female, other innate risk factors for osteoporosis include having a thin frame, being Caucasian or Asian and having a family history of osteoporosis. Several lifestyle factors also increase our chances of developing the condition. These include smoking, consuming too much alcohol, lack of exercise, certain medications and nutritional deficiencies.

Having high blood levels of homocysteine—a factor implicated in cardiovascular disease—has also been shown to be a factor in the development of osteoporosis. You may lower your homocysteine levels by optimising your intake of folic acid and other B vitamins (check with your health care practitioner first).

Nutritional help: not just calcium

Calcium is perhaps the most renowned bone nutrient—it has long been hailed as an essential building block for strong bones. And indeed several studies have shown that calcium deficiency is associated with an increased risk of osteoporosis.

However, increasing calcium alone will not ward off osteoporosis or prevent fractures. Calcium requires a team of nutrients to do its job, and the major players are vitamin D, vitamin K, magnesium and, to a lesser extent, boron and silicon. While these members of the “bone-building team” have not always garnered the attention they deserve for their role in bone health, recent research is showing just how critical they are in the fight against osteoporosis.

Vitamin D

In the last decade there have been a plethora of studies indicating vitamin D can lower the risk of osteoporotic fractures. That’s not surprising when we consider that without sufficient vitamin D our bodies can only absorb 10 to 15 per cent of the calcium we get from our food.

Vitamin K

It’s important to note that there are two types of naturally occurring vitamin K: K1 and K2. Although vitamin K is famous for its role in facilitating blood clotting, recent research has applauded vitamin K2 for its role in promoting bone health. Studies suggest that it may reduce the risk of vertebral fractures and improve bone strength.

Magnesium

Magnesium’s role in bone health is equally important. It acts as a structural part of bone, and low blood magnesium levels can lead to low blood calcium levels.

Boron

The trace mineral boron is no slouch when it comes to bone strengthening either. Boron not only extends the half-life of vitamin D, but it may also help our bodies absorb calcium.

Silicon

The last trace mineral on the “team”, silicon is thought to promote bone health by aiding in the mineralisation process. Epidemiological studies report that dietary silicon intake of more than 40 mg per day correlates with increased bone density.

Supplements

Obtaining the recommended amounts of the nutrients discussed above from food sources alone (see sidebar for examples of food sources) can sometimes be challenging. Thankfully, we can look to supplements for a helping hand.

Please keep in mind that these are general guidelines only; always check with your health care practitioner to determine if a supplement is right for you.

Calcium

If, like many Australians, you don’t consume the recommended 1000 to 1300 mg of calcium per day (depending on your age and gender) from dietary sources, you may need to add a supplement to your regimen. There are many types of calcium supplements available, but calcium citrate is well known for its bioavailability.

Vitamin D

It’s virtually impossible to meet our needs for vitamin D through diet alone. For most Australians, the main source of vitamin D is from exposure to sunlight. But, according to Osteoporosis Australia, more than 30 per cent of adults have a Vitamin D deficiency. Health experts recommend supplementing with 800 to 2000 IU per day of vitamin D.

Vitamin K

Vitamin K (including K2) is available at many health food stores; however, keep in mind that it is contraindicated for those taking warfarin (Coumadin). Ask your health care practitioner for advice on dosage.

Magnesium

The recommended dietary intake of magnesium is 320 mg per day for women and 420 mg for men. If you consider your magnesium intake is inadequate, supplements are widely available and come in a variety of forms.

Boron

A recent review recommended a daily supplemental dose of 1 to 3 mg of boron for bone health.

Silicon

The same review suggested 20 to 30 mg per day of silicon for those who don’t obtain enough in their diets. Silicon is often found in supplement form as silica.

Exercise

While any regular physical activity is healthy, weight-bearing exercises are some of the most effective at building bone. Engaging in regular strength training can yield great bone-building benefits, as can weight-bearing aerobic activities such as hiking or dancing.

Even gentle exercises such as certain stretches and yoga can be effective for strengthening bone. Not surprisingly, a recent German study showed that exercise could reduce bone loss and back pain in postmenopausal women with osteopenia (reduced bone mineral density that is not as severe as osteoporosis).

Ask your health care practitioner which exercises are appropriate for you.

Osteoporosis by the numbers

• Osteoporosis affects more than 1 million Australians.
• Men make up around one quarter of all those with osteoporosis; women, the other three quarters.
• Although osteoporosis can strike at any age, its effects are not usually seen until age 60. Men and women over 50 with risk factors may need a bone check up.

Bone foods