Protect bone health with complementary and alternative medicine approaches
According to statistics, osteoporosis and low bone mass (a precursor of osteoporosis) are present in 44 million women and men in the U.S. age 50 and older. One in two women and one in five men will experience a fracture related to osteoporosis as they age. Of even greater concern, by 2020 the total number of people with these conditions is projected to reach 61 million.
“There are a number of complementary and alternative medicine (CAM) approaches that can help you protect the health of your bones and reduce your risk of osteoporosis,” explains Dr. Michael Scott, PinnacleCare’s Director of Complementary and Alternative Medicine. “Bone is living tissue and requires a variety of important minerals and vitamins to support and maintain healthy density and connective tissue structure. Those who wish to take a proactive approach to bone health may want to consider specific dietary and nutritional supplement options. For example, vitamin D and magnesium are needed to utilize calcium and for properly building strong bones; vitamin K is important for production of osteocalcin; manganese is needed for bone mineralization and connective tissue synthesis; and research demonstrates that zinc, strontium, vitamin B6, vitamin C, silicon, copper and boron are all required to help form the connective structures in bone.”
Indeed, a clinical trial studying postmenopausal women combined hormone replacement therapy with magnesium (600 mg per day), calcium (500 mg per day), vitamin C, B vitamins, vitamin D3, zinc, copper, manganese, boron, and other nutrients for an eight- to nine-month period. In addition, participants were told to avoid processed foods, limit protein intake, emphasize vegetable over animal protein, and limit consumption of salt, sugar, alcohol, coffee, tea, chocolate, and tobacco. Bone density increased a remarkable 11 percent, compared to only 0.7 percent in women receiving hormone replacement alone.
Lifestyle changes you can make for healthier bones
When you know how bone is formed and broken down, it’s easier to understand osteoporosis. Bone is made of collagen and calcium phosphate. The protein collagen makes a flexible framework which is strengthened and hardened by the calcium. Over time, old bone is removed through resorption and new bone is added through formation. Until you’re around 30, there are more cells that build bone (osteoblasts) than there are cells that break bone down (osteoclasts). After the age of 30, that balance shifts and bone becomes more porous, thin and weak, increasing the risk of fracture.
Several lifestyle choices can affect the strength and health of your bones.
- Exercise: A number of studies have shown that weight-bearing exercise is an effective way for both men and women to guard against bone loss. Examples of weight-bearing exercise include walking, golf, yoga, tai chi, dancing, hiking, and tennis. If you’ve already been diagnosed with osteoporosis, talk with your physician to learn which types of weight-bearing exercise are appropriate. One caveat—for premenopausal women, exercising too much can interrupt the menstrual cycle which can actually increase osteoporosis risk, so avoid exercising to the extreme.
- Dairy foods: While the calcium in dairy products can have a positive effect on the health of bones, researchers have found that what type of dairy product you eat or drink makes a significant difference. Non-fat milk and yogurt have high levels of calcium and lower levels of protein and sodium, the latter of which may increase the loss of calcium in the urine and lower overall calcium levels. Researchers note that there are more effective ways to increase your calcium intake, but non-fat milk and yogurt can be helpful for younger women seeking to boost their calcium intake.
- Caffeine intake: Caffeine, especially large amounts of it, can have a negative effect on bone health. It increases the loss of calcium through urine and studies have linked caffeine consumption to a decrease in bone mass for women who don’t have an adequate intake of calcium, so limiting your caffeine is wise.
- Dietary protein: Studies of the effect of dietary protein on osteoporosis risk have yielded mixed results. Researchers suspect that the equivocal results may have to do with the fact that dietary protein has several different effects on bone health. While it increases the amount of calcium lost in urine, it is necessary for bone formation and low protein intake has been tied to low bone mineral density. Until more definitive information is available, it may be advisable to avoid too much or too little protein intake.
- Salt: Some studies have found that increases in salt in the diet increase the loss of calcium in the urine which may, in turn, result in bone loss. To date, however, there has been no clear cut link between salt intake and osteoporosis risk. Some physicians recommend lowering salt intake and avoiding processed foods which are high in salt as a potentially protective strategy.
- Soft drinks: High consumption of cola-based sodas by women has been associated in some studies with an increase in bone loss. Another study of children who drank at least six glasses of soda containing phosphoric acid (primarily found in colas) per week had a more than five greater risk of low calcium blood levels.
Nutritional supplements that may decrease osteoporosis risk
The most well-known supplement associated with the reduction of osteoporosis risk is calcium. The addition of a calcium supplement has been found to offer a protective effect for premenopausal women, women who have been in menopause for three months or more, and girls. Some studies have not found similar evidence for calcium supplementation in men or women immediately after they reach menopause. Many physicians recommend 500 mg of supplemental calcium in addition to the average 500 to 700 mg most people get each day from foods. To find out if calcium supplementation is appropriate for you, talk with your physician.
Vitamin D plays a role in protecting bone strength and density because it increases calcium absorption. It’s especially important for people who have a mild vitamin D deficiency, a condition that is fairly common in fit, elderly people, because the deficiency can speed up age-related bone loss. Vitamin D in combination with calcium can also help prevent musculoskeletal issues that can increase the risk of falls and the bone fractures they can cause.
Another key factor for bone health is vitamin K, which plays a role in bone formation. A number of human trials have found that supplementation with vitamin K2 can decrease loss of bone density and significantly reduce the occurrence of fracture in women who have been diagnosed with osteoporosis. In terms of an integrative approach, vitamin K2 when taken with bisphosphonate medications such as Fosamax was shown to decrease the rate of fractures in women with osteoporosis compared to taking the medication alone.
Several long-term studies have shown that the synthetic flavonoid ipriflavone, derived from the soy isoflavone compound daidzein, boosts the incorporation of calcium into bone and lessens bone breakdown, particularly for the lumbar vertebrae. One study, however, found that the supplement was not effective for post-menopausal women with osteoporosis, so researchers posit that it may be beneficial primarily for younger women or those with less severe osteoporosis.
There have been reports of a serious side effect of ipriflavone in some women that you should be aware of. In one trial, 29 of the 132 women in the ipriflavone group completing the three-year study developed a clinically significant drop in lymphocytes. These cells, which make up approximately 25 percent of the white blood cells in the healthy adult, are critical components of the immune system and its ability to respond to viral infections. In some of these women, a return to normal levels took almost two years after they had stopped the ipriflavone.
This finding has also been reported in one other smaller clinical trial, which suggests that women choosing to take ipriflavone should have their white blood cells monitored by their doctor before and every 3 to 4 months after beginning treatment with ipriflavone. In double-blind studies, the frequency of perceived side effects in ipriflavone-treated people (14.5 percent) was actually less than that observed in people receiving the placebo (16.1 percent) and side effects were mainly mild stomach upset.
Work with your PinnacleCare advisor to keep your bones healthy
Talk with your health advisor to learn more about how to include CAM approaches to improving your bone health and to find a physician who has the experience and expertise in CAM to guide your care.
“Extra calcium won’t lower bone fracture risk, ladies.” This article on MSNBC.com outlines the results of a recent Swedish study on the effects of higher than normal levels of calcium intake on fracture and osteoporosis risk. http://www.msnbc.msn.com/id/43160225/ns/health-womens_health/