Osteoporosis is a silent killer, a degenerative disease involving the slow degradation of bone mass and integrity. Nutrition is paramount, for it is from food that we acquire the nutrients necessary for building strong bones, maintaining them throughout the life cycle and preventing debilitating diseases.

The process of bone loss throughout life is inevitable. While hormone replacement therapy (HRT) using estrogen and progesterone has been the common treatment, modern medicine is rethinking its approach. Studies investigating HRT in healthy postmenopausal women demonstrate an increased risk of breast cancer , coronary heart disease, and blood clots. Women must decide whether to take HRT with its significant risks or embark on a safer, effective program using diet, supplements, and exercise. In addition, the use of ipriflavone, the derivative form of a soy isoflavone, may serve as a safe alternative to estrogen in keeping bones healthy.

Preventing and treating osteoporosis isn’t as simple as taking a daily calcium supplement. A complementary approach that includes more soy foods, fish, and mineral-rich vegetables in the diet, while eliminating caffeine, soda, and high salt intake, is essential. Incorporating a regular exercise plan involving aerobic and weight training activities assures that bones will remain as dense as possible.

These are just some of the effective measures you can take to deter excessive bone loss and to preserve the integrity of the skeletal system. Nevertheless, introducing key nutrients as supplements to the diet is essential. Calcium, alone, is not the answer. The nutrients listed in the accompanying chart are the most important to address bone loss.

For too long, patients have had to face osteoporosis with only a mediocre arsenal of medical weapons to help them, often with serious side-effects. While every year millions of people develop osteoporosis, the best prevention is to increase bone density with diet, supplements, and exercise. The pharmacological approach is not the answer. Ultimately, nutrition must be considered an integral part of the whole medical-care plan. Simply put, in the best interests of patient care, the most effective program involves a variety of nutritional agents along with alterations in diet and lifestyle.

Nutrients to Reduce Bone Loss

Ipriflavones are a derivative of isoflavones, a class of flavonoids typically found in foods such as soy. They look and act similar to estrogen. Because isoflavones are only one one- thousandth as potent as estrogen, they exhibit bone-preserving properties without the side-effects associated with HRT. This makes them a suitable alternative for women who wish to forego HRT and take a more natural approach. To date, numerous well-controlled studies, typically using a dosage of 600 mg daily, confirm the safety and efficacy of ipriflavone as an effective agent to increase bone density without the dangers associated with HRT.

Soy isoflavones have been gaining attention in the prevention of menopausal effects, including bone loss and hot flashes. Isoflavones fall under the category of “phytoestrogens” because of their ability to act as weak estrogens in the body. When the body does not produce enough estrogen, as in menopause and post-menopause, weaker phytoestrogens can serve to provide small quantities of estrogen. Studies have shown that isoflavones are biologically active in humans and may prevent postmenopausal bone loss and osteoporosis.

Calcium is the major bone mineral and it is the bones of the body that act as its major storehouse. During times of low calcium levels, the body releases calcium from stores in bone. Over the long term, robbing bone calcium leads to thinning and weakening of the bones. Recommended doses for adults are 1,200 mg daily, preferably from calcium citrate since it is better absorbed than most other forms. Recommend postmenopausal women take 1,500 mg daily without HRT but only 1,000 mg daily if on HRT or taking ipriflavone.

Magnesium influences hormones that regulate calcium levels in the body. Recommend 500 mg daily.

Vitamin D regulates serum calcium and phosphorus metabolism important for bone. Recommend 400 to 800 IU daily.

Vitamin K is found in spinach, lettuce, kale, cabbage, cauliflower, wheat bran, organ meats, cereals, some fruits, meats, dairy products, and eggs. Recommend 150 mcg daily.

Boron is found in avocados, cherries, grapes, almonds, peanuts, hazelnuts, scallops, mussels, and clams. Recommend 3 mg daily.

Zinc is involved in the cellular processes of proper bone calcification. Recommend 30 mg daily.

Copper is involved in the bonding of collagen, which imparts strength and flexibility to bone and to its inhibitory effects on cells that break down bone. Recommend 3 mg daily.

Fact or Fantasy?

Osteoporosis is not well understood and frequently sufferers have difficulty distinguishing between fact and myth.

“I am too young to get osteoporosis.”
Fact: Early signs of osteoporosis can be found in women in their 20s and 30s.

“Only women get osteoporosis.”
Fact: Women are not alone when it comes to osteoporosis. Millions of men have osteoporosis and many will suffer hip fracture.

“I drink lots of milk and/or take calcium supplements so I won’t get osteoporosis.”
Fact: Dairy products are not the best way to get calcium and calcium is not the only nutrient important to maintain healthy bones.

“I’ll know when I have osteoporosis.”
Fact: Osteoporosis is a silent killer often unnoticed until bone density is so poor that it causes problems.

“If I have osteoporosis, the worst thing is I’ll get a fracture.”
Fact: Osteoporosis substantially increases the risk of death in the elderly within six months of a fracture.

Carl Germano, RD, CNS, CDN, is a registered, certified, and licensed nutritionist. Author of several best-selling books, including The Osteoporosis Solution (Kensington, 1999), he is a frequent radio guest and lecturer and was recently appointed to the NY State Board of Dietetics and Nutrition.

Source: alive #255, January 2004

Stay Strong, Stay Young
Bone Health: Beyond Calcium
You probably don't think much about the health of your bones until you see an older woman making her way slowly down the street, stooped nearly in half, gingerly tapping her cane ahead of each step.