Osteoporosis is a progressive loss of bone mass and density resulting in fragile, weaker bones. Around half of all women and one in five men over the age of 50 experience fractures due to loss of bone density, with hip fractures alone responsible for 70,000 hospital admissions each year. This in itself is a very good reason to take measures to protect our bone health as we age.
We mostly tend to think of bones as solid and rock-like but in fact they are living tissue, constantly breaking-down and renewing as they respond to our environment. Osteoporosis occurs when bone is broken down and reabsorbed more rapidly than it is renewed. Bones are mainly made of calcium and collagen but also contain vital magnesium and protein.
Growth hormones and the sex hormones testosterone, oestrogen and progesterone all stimulate bone growth, which explains why the occurrence of osteopenia and osteoporosis is higher in women after the menopause, when their sex hormone production decreases. So, what can we do to prevent this condition and keep our bones strong and healthy throughout our life and into old age?
Causes of Osteoporosis
Low Protein & Insulin
Researchers have found that low protein diets in the elderly might increase a type of molecule that binds to and eliminates sex hormones from the body (sex hormone-binging globulin, or SHBG), which in turn decreases the availability of oestrogen and testosterone and contributes to loss of bone density. Low protein intake potentially leads to lower insulin levels, which increases SHBG. By a similar note, healthy bone production increases insulin sensitivity, so people with insulin resistance or diabetes may have poorer bone quality.
Chronic inflammation and the oxidative stress that accompanies it increase the breakdown process of bones and decrease its renewal. Inflammation can occur not only with classic illnesses such as arthritis and auto-immune conditions but also where food intolerances or allergies occur, when emotionally or physically stressed, through lack of exercise and by having a poor insulin response through a sugar-rich diet. Gut inflammation (such as with food intolerances/allergies) can decrease absorption of bone-strengthening nutrients too.
Stress & Steroid Overuse
Chronic stress is one of the western world’s great enemies and it can also have a major impact on bone density. Cortisol, the principle stress hormone, increases the breakdown and inhibits the renewal of bones and steroids force the adrenal glands to produce more cortisol. When stress becomes chronic, the effects of cortisol become dampened down, which creates inflammation.
How We Can Prevent Osteoporosis?
Weight bearing exercise which forces you to work against gravity is a crucial part of insuring our bones against deterioration as we age. Examples of weight-bearing exercises include weight training, walking, hiking, jogging, climbing stairs, tennis, and dancing, but also things like tai chi and yoga – anything where we are supporting our own weight. Keeping active in this way has been shown to enhance bone re-formation, as bones react to increases in loads and forces put on them by building up to grow stronger.
Balance Blood Sugar
Ensuring we consume enough protein and keeping blood sugar levels well balanced makes sense on so many levels. Ensure some protein is eaten at every meal and snack and reduce (or eliminate!) refined flours, sugars and other carbohydrates.
Anti-Oxidant Rich Diet
Antioxidants are vital to combat the damaging effects of oxidative stress encountered in inflammation and these are found in brightly coloured fruits, vegetables and spices. Aiming to eat a rainbow every day will go a long way to ensuring that any inflammation that might be occurring is doing less damage to bone health. Listening to your body and gauging whether you feel any discomfort after eating certain foods is also vital to ascertain whether you are reacting to anything, which may be causing inflammation. Eliminating any suspected culprit foods then reintroducing them after 4 weeks is the gold standard to see whether your body is reacting negatively towards them.
We can’t always change the stress we encounter day to day, but we can change the way we deal with it. Gentle exercise, deep breathing, meditation, gardening, listening or playing to music, mindfulness and simply laughing are all excellent ways to ensure we are not overcome by stress and should help keep cortisol release balanced. Tai chi and yoga have also been proven to be great stress-busting activities!
Last but not least, ensuring we have adequate levels of bone-enriching micronutrients is key. Contrary to popular belief, calcium is not the most important nutrient when it comes to bone health. If calcium is taken in the wrong form or in too high a dose it can cause high blood calcium levels (hypercalcemia), which can actually weaken the bones. Dietary (and supplemental) calcium should be kept to a lower dose and combined with magnesium and vitamin D to ensure it gets directed to the right place.
Vitamin D stimulates bone re-building and inhibits breakdown by promoting the absorption of calcium and regulating how much calcium enters and leaves bone tissue and magnesium regulates calcium transport to the bones.
Vitamin K2 is an essential co-factor for production of the main bone protein and so should also form part of the bone-protective protocol.
Finally, silicon reverses the loss of calcium in the urine and boron interacts with other bone-protecting minerals and vitamins as well as having anti-inflammatory effects.
In A Nutshell
Simply restoring sex hormone levels and supplementing with calcium and vitamin D is usually not enough to prevent osteoporosis. An active lifestyle and a diet rich in and including additional supplementation of antioxidants, vitamins and minerals that reduce oxidative stress and inflammation and support healthy bone formation, as well as controlling obesity and insulin resistance are key.
If in doubt about bone health, seeing a Nutritional Therapist who understands how micronutrients work in the body and can take into consideration your unique health history is an important part of the process.