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Bone Health - Osteoporosis
Osteoporosis literally means porous bone. Because of their strong and static nature bones are often thought of as lifeless and affixed, unchanging for most of our adult lives. But bone is a matrix of active, living tissues constantly changing in response to the pressures placed upon them. Our bones are made of crystals of calcium salts (mineral, nonorganic) in a protein matrix (non-mineral, organic). Specific cells, called osteoblasts, produce the matrix and attract calcium compounds to form new bone, while a different set of cells, called osteoclasts, resorbs the bone tissue to allow new shapes and structures to form in response to gravity and the pull of muscles. This process of remodeling helps repair micro-damage that occurs as a result of daily activity and prevents the accumulation of old fragile bone.(1) The process of bone “resorption” (the breakdown of bone tissue) is on-going as the body requires stored minerals, tissue repair or re-modeling. Ideally, formation of new bone tissue keeps pace with resorption but as we age, the process of renewal can be slower, and bones lose density.
Osteoporosis, defined as a reduction of bone mass or bone density, is a multi-faceted disease driven by many interrelated factors, and must be addressed as such for optimal prevention and treatment.(2) There is much more to Osteoporosis than simple lack of dietary calcium. Scientific advancements have revealed that osteoporosis stems not only from the hormonal fluctuations common in menopausal women, but oxidative stress, elevated blood sugar, inflammation, metabolic syndrome and lack of attention to the protein bone matrix, making both men and women vulnerable to the disease.(3)
Factors to Consider
Support the Stomach
The absorption of calcium is dependent on its becoming ionized in the intestines, a job that can only be done effectively when there is ample stomach acid present. For many women in their 40s, 50s and beyond, stomach acid is greatly depleted, making this conversion impossible. When stomach acid is low, the form of calcium supplements chosen becomes extremely important. Choose calcium citrate or calcium gluconate, forms of the mineral that have already been ionized, which will greatly improve mineral absorption, versus calcium supplements in the carbonate form, which will pass through the body mostly unabsorbed.
Bring on Balance
Vital Hormones such as estrogen and testosterone promote bone formation and regulate bone resorption, and when those hormone levels drop, osteoporosis can occur. At puberty, bone production increases dramatically, producing the growth spurt of the early teen years. This effect seems to be driven mostly by estrogens, the “female” hormones, in both boys and girls.(4) Near the end of puberty, androgens, the “male” hormones, increase in both women and men. The androgen surge fuses the bone growth plates, with the result being that the bones can no longer elongate. Young adults generally maintain a steady-state balance in which new bone formation is nearly equal to bone resorption.
Sex hormones also remain at roughly steady levels throughout young adulthood and early middle age.(5) After about the age of 35, however, the total amount of bone in the body begins to diminish. In women, the process begins fairly sharply with the onset of menopause, when estrogen levels drop dramatically. In postmenopausal women, bone is lost both from the inner and outer surfaces of bones, as bone resorption by osteoclasts exceeds the already reduced new bone formation by osteoblasts. In men, however, new bone formation on the outer surface of bone keeps pace with resorption on the inner surface for much longer.(6) This obvious connection probably accounts for the fact that osteoporosis was thought for so long to be a problem unique to women, and may account for the fact that men begin to suffer fractures from osteoporosis about a decade later than women.(7)
Skip the Sugar
Elevated blood sugar, and the condition of Metabolic Syndrome, have both been linked to loss of bone density and osteoporosis. Bone functions as an endocrine organ secreting compounds that act like hormones.(8) Healthy production of bone matrix protein increases insulin sensitivity in other tissues.(9) Conversely, people with metabolic syndrome who are insulin resistant have poorer bone quality and an increased risk of osteoporotic fracture.(10)
Keep it Positive
High intake of coffee, alcohol and smoking all create a negative calcium balance, meaning more calcium is being lost than taken in; habits associated with an increased risk of developing osteoporosis.
Oxidation of fatty acids and other molecules produces reactive oxygen species that directly and indirectly impair new bone formation and promote excessive bone reabsorption.(11) In a similar fashion, chronic inflammation hastens the absorption of existing bone while impeding normal production of new bone.(12) Fat cells produce a steady efflux of inflammatory cytokines while diminishing cells’ insulin sensitivity; both factors further impede normal bone production.(13)
Conventional Medical Diagnosis And Treatment
Pharmaceuticals, such as Actonel® or Fosamax®, have shown limited success, and are associated with some potentially serious side effects including atrial fibrillation and osteonecrosis of the jaw.(14) These drugs work chiefly by inhibiting the cells responsible for breaking down bone tissue, but neglect multiple other factors responsible for osteoporosis.(15) Although these drugs do increase bone density, poorly appreciated is that they disrupt the natural cycle of regeneration and resorption that is important for the strength of the bone.(16)
Nutritional Guidelines : Dietary Recommendations Can the Cola
Beverages high in phosphate, like carbonated soft drinks, can create a negative calcium balance, encouraging the body to draw calcium out of the bones, leading to demineralization, with heavy consumption, over time.
Go for the Greens
Leafy green vegetables such as kale, collard greens and lettuce are rich in bone building nutrients, specifically vitamin K1 and Boron. Vitamin K1 is a nutrient essential for the proper function of the protein matrix, the structure that holds calcium molecules in place. Low vitamin K levels can contribute to bone demineralization, even in the presence of dietary calcium. The trace mineral Boron has been found to greatly reduce calcium excretion from the body, by triggering the most active form of estrogen and vitamin D in the body, both required for optimal calcium absorption.
Calcium & Vitamin D. Adequate calcium intake is required to allow healthy bone remodeling and prevent osteoporosis. Vitamin D promotes intestinal absorption of calcium, and also regulates how much calcium enters and leaves bone tissue in response to the body’s other calcium requirements.
Boron. The trace mineral Boron has been found to greatly reduce calcium excretion from the body, by triggering the most active form of estrogen and vitamin D in the body, both required for optimal calcium absorption. In one study, post-menopausal women who supplemented with 3mg of Boron per day reduced the amount of urinary calcium excreted by almost half.
Trace Minerals. While bone is primarily composed of matrix protein and calcium compounds, small amounts of other trace minerals are essential for normal bone function. These include magnesium, which regulates calcium transport; silicon, which reverses loss of calcium in the urine; and boron, which interacts with other minerals and vitamins and also has anti-inflammatory effects.(17)
Zwell Lifestyle Recommendations
Sweat – Perhaps the earliest contributing lifestyle factor for osteoporosis is lack of weight-bearing exercise. As many as 20% of young and middle aged women already have an abnormal spinal curvature related to bone loss in their vertebrae, a situation that only gets worse as one ages(18) A sedentary lifestyle reduces the constant forces that bone needs to experience in order to continue its normal process of remodeling.(19) Studies show that both women and men who engage in regular exercise have much lower risk of osteoporosis and fracture.(20)
Sleep & De-stress – The body goes into a natural state of repair and rebuild during restful sleep. Only a few nights of impaired sleep can dramatically impact your ability to healthfully manage stress, metabolize food and maintain a balanced body weight. Even a few nights of sleep deprivation can impair your glucose tolerance and insulin response, a state harmful to healthy bones.
CRON – Eating a diet rich in leafy greens that is low in calories and high in nutrients is good for your bones. The Calorie Restricted, Optimal Nutrients way of eating comes from the science of anti-aging medicine. Whether it can conclusively add years to your life remains to be seen, but mounting evidence tells us that this common-sense way of eating will certainly add life to your years and keep strength in your bones.
Connect – Decreased mobility from falls and fractures can often lead to feelings of isolation and depression. But a diagnosis of osteoporosis does not need to hold you back. When it comes to bone health, an ounce of prevention truly is the best medicine so be active in every way; proactive, interactive and physically active. The end result will be a more productive and enjoyable life.
1. Martin 2009, Mitchner 2009, Body 2011
2. Clarke 2010
3. Clarke 2010, Confavreux 2009, Lieben 2009; Zhou 2011
4. Gennari 2003, Clarke 2008
5. Clarke 2008
6. Seeman 1999
7. Hagino 2003
8. Kanazawa 2010
9. Kanazawa 2010, de Paula 2010
10. Hernandez, McClung 2010
11. Graham 2009, Maziere 2010
12. Chang 2009
13. Mundy 2007, Kawai 2009).
14. Jager 2003, Howard 2010
15. Roelofs 2010, Varenna 2010
16. Abrahamsen 2010
17. Aydin 2010 Mizoguchi 2005, Kim 2009, Li 2010, Spector 2008, Scorei 2011
18. Dwyer 2006, Cutler 1993
19. Akhter 2010
20. Ebeling 2004, Englund 2011