Osteoporosis and Bone Health
Healthy bones are dependent on an intricate interplay of many nutritional and hormonal factors. In the human body, there is a constant process of breaking down and remaking of bones. When the rate of breakdown exceeds that of bone manufacture, it can result in Osteoporosis. Osteoporosis affects more than 20 million people in the United States including one out of four postmenopausal women.(1)
The Cause
Osteoporosis involves both the mineral (inorganic) and non-mineral (organic matrix, composed primarily of protein) components of bone. This is the first clue that there is more to osteoporosis than a lack of dietary calcium. In fact, lack of dietary calcium in the adult results in a separate condition known as osteomalacia, or softening of the bone.
In contrast, osteoporosis is a lack of calcium and other minerals, as well as a decrease in the non-mineral framework (organic matrix) of the bone. Little attention has been given to the important role that this organic matrix plays in maintaining bone structure.
Although the entire skeleton may be involved in postmenopausal osteoporosis, bone loss is usually greatest in the spine, hips, and ribs. Since these bones bear a great deal of weight, they are then susceptible to pain deformity, or fracture.
At least 1.5 million fractures occur each year as a direct result of osteoporosis, including 250,000 hip fractures, the most catastrophic of fracture. Nearly one-third of all women and one-sixth of all men will fracture their hips in their lifetime.(2)
Maintaining Bone Health
Recently, there has been an incredible push for increasing dietary calcium intake to prevent osteoporosis. While this appears to be sound medical advice for many, osteoporosis represents much more than a lack of dietary calcium. It is a complex condition involving hormonal, lifestyle, and nutritional factors.
A comprehensive plan that addresses these factors offers the greatest protection against developing osteoporosis. The primary goals in the treatment and prevention of osteoporosis are to:
Preserve adequate mineral mass
Prevent loss of the protein matrix and other structural components of bone
Assure optimal repair mechanisms to remodel damaged areas of bone
Achieving these goals requires adoption of lifestyle, dietary, and nutritional supplementation practices to build healthy bones.
Milk Misconceptions
Contrary to what dairy industry advertisements tell us, milk consumption may not lead to strong bones. While numerous clinical studies have demonstrated that calcium supplementation can retard bone loss, the date is inconclusive regarding a high dietary calcium intake from milk and prevention of osteoporosis and bone fractures.
One of the first clues that milk consumption may not be beneficial for bone health is data showing that countries with the highest dairy intake have the highest rate of hip fractures per capita.
In analyzing data from the Nurses’ Health Study, a study involving 77, 761 women, researchers found no evidence that higher intake of milk reduced fracture incidence.(3) In fact, women who drank two or more glasses of milk per day had a relative risk of 45% for hip fracture, compared to women consuming one glass or less per week. In other words, the more milk that was consumed, the more likely a woman would experience a hip fracture. This data simply does not support the idea that every body needs milk.
Prevention and reversal
While calcium does play a role in preventing and reversing osteoporosis, it is not the only factor. Bone is dependent on a constant supply of many nutrients. A deficiency of any of a number of nutrients such as boron, magnesium and vitamin K will adversely affect bone health.
To truly support bone health in patients at high risk for osteoporosis, a comprehensive multi-nutrient supplement that contains these and other nutrients required to maintain and build healthy bones is recommended. In patients with existing osteoporosis, it is recommended to add ipriflavone to the program.
Ipriflavone has shown excellent results in helping to prevent further bone loss. And, along with calcium and other important nutrients, can actually help rebuild bone.
Calcium supplementation
Bone density prior to menopause is a significant factor in determining whether or not a woman develops osteoporosis. With this in mind, building strong bones should be a lifelong goal beginning in childhood. In reality, most women are probably not overly concerned about osteoporosis until a couple of years before menopause (the periomenopause).
Fortunately, taking calcium just prior to the onset of menopause has been shown to produce considerable benefit in increasing bone density. For example, in a two-year study, 214 women near the age of menopause received either 1,000 or 2,000 mg of calcium or a placebo.(4) While the control group actually lost 3.2% of their bone density of their spine, the calcium-treated groups increased the density by 1.6%. These results highlight the importance of calcium supplementation in the battle against osteoporosis.
While calcium supplementation cannot increase bone density in postmenopausal women with osteoporosis when taken alone, it has been shown to be effective in reducing bone loss for women who have already passed through menopause.(5-7)
Neither oyster shell, bone meal, nor calcium hydroxyapatite is the best form of calcium. Studies have indicated that these calcium supplements may contain substantial amounts of lead or have a lower absorption profile compared to other forms of calcium.(8)
Calcium bound to citrate and other Krebs cycle intermediates such as fumarate, malate, succinate, and aspartate appears to be the best overall form of calcium. Refined calcium carbonate is still an excellent form for the majority of women.
The additional benefits with using minerals bound to Krebs cycle intermediates is that over 95% of the Krebs cycle intermediated ingested are used to produce cellular energy with the remainder being excreted in the urine, where they may act to prevent kidney stone formation. The Krebs cycle intermediates fulfill every requirement for an optimum calcium chelating agent.
References
1. Dempster DW and Lindsay R: “Pathogenesis of osteoporosis.” Lancet 341:797-805, 1993.
2. Lindsay R: “The burden of osteoporosis: Cost. Am J Med 98 (Suppl.2A): 9S-11S, 1995.
3. Feskanich D, et al.: “Milk, dietary calcium, and bone fractures in women: A 12-year prospective study.” Am J Public Health 87:992-7, 1997.
4. Elders PJM, et al.” “Long-term effect of calcium supplementation on bone loss in perimenopausal women.” J Bone Min Res 9:963-70, 1994.
5. Aloia JF, et al.: “Calcium supplementation with and without hormone replacement therapy to prevent postmenopausal bone loss.” Annals Intern Med 120:97-103, 1994.
6. Reid IR, et al.: “Long-term effects of calcium supplementation on bone loss and fractured in postmenopausal women: A randomized controlled trial.” Am J Med 98:331-5, 1995.
7. Devine A, et al.: “Ipriflavone prevents radial bone loss in postmenopausal women with low bone density in elderly postmenopausal women.” Osteoporos Int 7:23-8, 1997.
8. Bourgin BP, et al.: “Lead content in 70 brands of dietary calcium supplements.” Am J Public Health 83:1155-60, 1993.
(Michael T Murray, N.D. is a respected author and leading researcher in the field of natural medicine. He is also a practicing naturopathic physician in Bellevue, Washington, and teaches botanical medicine at Bastyr University in Seattle. He has written more than 20 books, including his best-selling “Encyclopedia of Natural Medicines,” and “Natural Alternatives to Over-the-Counter and Prescription Drugs.”)