Osteoporosis

 
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What is osteoporosis?

Osteoporosis literally means, porous bones. The bones lose their architecture becoming thin and fragile and increasing the risk of fracture. The bones most often affected are the wrist, the hip and the spine.

~ A curved spine can be a sign that osteoporosis is present.

Who gets osteoporosis?

Osteoporosis is a significant concern with 1 in 3 women and 1 in 5 men in Canada suffering a broken bone as a result of osteoporosis.  It is the most common bone disease affecting humans.

~ It is painless, silent and can go undetected until a fall and subsequent fracture occurs. 

Risk factors for osteoporosis include : 

  • A family history of osteoporosis

  • Post menopausal women

  • Underweight

  • Advanced age (begins age 50 and very high after age 80)

  • Smoking

  • Excess soft drinks consumption

  • More than two alcoholic beverages daily

  • Low levels of physical activity

  • Chronic diseases such as inflammatory bowel disease, chronic kidney disease, type 1 diabetes,

  • Long term steroid use


How can osteoporosis be prevented? 

A paediatric disease with geriatric consequences
— Osteoporosis Canada

We achieve peak bone mass in and around our late teens to mid twenties. After this, we gradually lose bone mass and the loss increases significantly for women around menopause. We have two avenues to achieving and maintaining a healthy bone mass.

  1. Optimising peak bone mass through childhood and young adulthood.

  2. Slowing loss of bone mass after that time

Achieving Optimal Bone Mass

  1. We can encourage children, especially young women to be active. Weight bearing sports are particularly effective as the muscles create some traction on the bone, forcing it to become stronger.

  2. Spend time outdoors in the summer, to optimise sun exposure and natural vitamin D production.

  3. Optimise dietary intake of calcium, vitamin D, magnesium, vitamin C, and protein. See below for more details on food sources of these nutrients.

  4. Avoid smoking.

  5. Minimize alcohol intake.

  6. Maintain an adequate weight. Being underweight may indicate insufficient intake of nutrients or athletic over training. The loss of body fat can lead to amenorrhoea (no menstrual cycle). For young women, without menstruation the bone building effect of estrogen is compromised and the window for building bone mass is diminished.

  7. Vitamin B12 is important for bone formation. Vegan and possibly vegetarian adolescents should ensure adequate dietary or supplemental vitamin B12 intakes as they are at risk of deficiency.

Slowing Down Loss Of Bone Mass In Adulthood

  1. Exercise – regular exercise helps preserve bone mass

  2. Smoking – smokers lose bone more quickly than non-smokers.

  3. Adequate weight – estrogen is a prime preserver of bone mass. Being underweight can reduce estrogen levels and lead to accelerated loss of bone mass.

Nutrients and Bone

 
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  1. Calcium. After age 50 a woman’s calcium requirement increases from 1000mg to 1200mg. Foods high in calcium include dairy products, fortified plant beverages, dark green leafy vegetables, almonds, tofu, sesame seeds (tahini), canned sardines, salmon and mackerel (with the bones). Supplements may be useful, and calcium citrate is a more easily absorbed form.

  2. Vitamin D assists the absorption of calcium and phosphorus from the gut and helps lay those down in bone. It is known as the sunshine vitamin as our bodies can make it when the skin is exposed to sunlight. In northern latitudes such as Canada, where winters are long and without the rays of the sun, we can become depleted during the winter months.

    Health Canada recommends that people age 1-50 years get 600iu of vitamin D daily and over age 70 years it increases to 800iu. After age 9 years the upper safe limit of 4000iu. Osteoporosis Canada recommends higher intakes and year round supplementation. It is a good idea to discuss vitamin D with your health care provider to clarify your needs. Food sources include fortified dairy products and plant beverages, fish liver oils and oily fish such as salmon, mackerel, sardines, and tuna.

  3. Vitamin K. Sufficient vitamin K can be found in dark green leafy vegetables, especially broccoli, Brussels sprouts, cabbage as well as spinach, collard greens and lettuce. If you are taking a blood thinner you should talk with your health care provider before significantly changing your intake of leafy greens as the vitamin K can interact with the medication.

  4. Boron and vitamin C. Both of these nutrients play a role in bone formation and are abundant in plant-based foods such as vegetables and fruits. Consuming the suggested 8-10 servings of vegetables and fruit should provide adequate intakes for bone health. Add some lentils and beans for extra boron.

  5. Magnesium. Adequate magnesium intake has been shown to be beneficial to maintaining healthy bone, however one recent study found too much magnesium can have the opposite effect. It is not difficult to get adequate magnesium from foods and green leafy vegetables, whole grains and nuts are excellent sources.

  6. Vitamin B12 helps with bone formation. As people age, their ability to absorb vitamin B12 can be compromised. It is advisable to have your B12 levels checked periodically if you are concerned. Good sources of vitamin B12 include eggs, dairy, meat and poultry. Vegans should consider taking a vitamin B12 supplement to meet their needs.

  7. Salt. Too much sodium can compromise bone health. See my article on salt for tips and tricks for reducing salt intake and avoiding processed foods.

  8. Protein is a key contributor to bone health. Including protein with each meal and snack can improve protein intake. Appetite often decreases with increasing age so optimising each meal opportunity becomes more important.

  9. There are some studies suggesting that antioxidants found in vegetables and fruits may independently contribute to bone health. When weighed with the fact that a number of key nutrients for bone health (potassium, magnesium, vitamin K, vitamin C, boron) are also found in vegetables and fruits, improving vegetable and fruit intake could be beneficial.

See the DASH diet for improving vegetable and fruit intake. 


Consuming an optimal amount of vegetables and fruit in a day can be challenging. I often suggest making smoothies in the blender and experimenting with different veg and fruit to create your own blends. Consider adding some plain yogurt or silken tofu for added protein if needed. In the summer these can be made into frozen popsicles, a cool way to support your health.

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If you would like more information about supporting your bone health, I would love to work with you.  You can either book online or call 613 233 2040 to book your appointment.


All content provided on this website is for general information purposes only and is not intended to replace medical or specialist advice.

A qualified Medical Herbalist is always your best resource for information related to herbal medicines.

Registered Dietitians are a reliable and trusted resource for nutrition related information, always up to date and always ready to work with you to realise your goals.