Dealing with osteoporosis as we age

Maintaining bone health

Osteoporosis literally means “porous bones” and results from decreased bone density.

Bones affected with demineralization are prone to fractures with minimal stress. The exact cause of primary osteoporosis is not known but is believed to be due to a complex interplay of different factors, including genetics, nutritional deficiencies, hormone imbalances and lifestyle factors.

Secondary osteoporosis is due to some underlying medical condition.

The signs and symptoms of osteoporosis include insidious onset, no early warning signs, bone and muscle pain, characteristic humpback, bone fractures, vertebral compression or crush fractures and fractures of the wrist.

There are 216 bones in the human body. Bones are meant to support, protect and maintain the shape of the body. They are a major reservoir for the mineral calcium and up to 99% of calcium in the human body is stored in bones. The two types of bone are “dense” and “spongy.”

Bones are in a constant state of remodelling and are broken down and built back up. Peak bone strength occurs between the ages of 30 to 35. The hormones estrogen, progesterone, testosterone and growth hormone prevent bone breakdown.

Factors related to the development of osteoporosis include advancing age, fair skin, being female, early menopause, a lack of children, smoking, alcohol abuse, a slender build, physical inactivity, family history, poor digestion, malabsorption, poor nutrition and low calcium intake.

The diagnosis of osteoporosis is primarily based on bone density testing. Physical examination and measuring height are good indicators of vertebral bone loss. A loss of more than five centimetres from previous peak height, without a coexisting medical condition, usually indicates significant bone loss. A loss of height of between 2.5 to five centimetres indicates some degree of bone loss.

Lab testing, including calcium levels, bone enzymes and hormones may offer some insight into bone dynamics. Additional testing, including urinary bone markers and mineral assessment can be insightful.

Secondary causes of osteoporosis include osteomalacia, hyperparathyroidism, hyperthyroidism, multiple myeloma, high blood calcium levels, Cushing’s disease, chronic corticosteroid use, alcoholism, metastatic cancer, anorexia nervosa, high blood prolactin and biliary cirrhosis.

Osteoporosis is a chronic progressive deterioration of bone density. Peak bone mass occurs for both males and females between the ages of 30 and 35 years. After age 40 years bone decreases by about 1% per year. Basic x-rays can reveal bone loss when bone mineralization decreases by 30 to 40%. After 50% bone loss there is significantly increased risk of bone fractures.

Hormone therapy for osteoporosis, primarily as estrogen, can decrease bone loss by up to 50%. Progesterone also increases bone density. However, the increased risk of promoting breast and uterine cancer has decreased the use of hormone therapy for treating osteoporosis. Calcitonin is a hormone that increase calcium uptake into bones.

Lifestyle factors are vital for preventing and treating osteoporosis. Starting a daily exercise routine is important including at least 20 minutes of aerobic exercise and light to moderate weight bearing exercises. Brisk walking, hiking, dancing, climbing stairs and racquet sports are beneficial aerobic exercises. Strength training with light to moderate weight resistance can help to prevent bone loss. Quitting smoking, drinking only in moderation and getting at least seven to eight hours of sleep per night are all helpful.

Dietary factors can help prevent the development of osteoporosis. Decreasing consumption of animal protein can decrease phosphate levels which can prevent calcium leaching from bones. Acidic foods such as excess sugar and refined carbohydrates can also promote bone loss. Decreasing alcohol consumption may be beneficial. Limiting coffee and caffeine consumption to less than three cups per day can prevent bone loss. Consuming foods high in calcium such as dairy products and dark green leafy vegetables can promote positive calcium balance. A diet rich in whole grains and cereals, vegetables and fruits are also rich in tract minerals that are good for bone health.

The adult female human body contains about 1,200 grams of calcium and the adult human male body contains about 1,400 grams. The recommended dietary allowance of calcium for an adult female is between 1,000 and 1500 milligrams per day and between 1000 and 1300 milligrams per day for adult males. One glass of milk contains about 300 milligrams of calcium, one cup of whole almonds contains 350 milligrams of calcium and one cup of cooked spinach contains 260 milligrams of calcium.

Vitamin and minerals are also important for bone health, including different vitamin Bs, folic acid, vitamin C, vitamin D, vitamin K, boron, copper, magnesium, manganese, silicon, strontium and zinc. Vitamin D is important for increasing calcium absorption from the digestive system, preventing calcium loss from the kidneys and increasing calcium uptake into bones.

Vitamin K acts as an important cofactor in calcium deposition in the bone matrix. Vitamin K increases a small protein called osteocalcin in cells called osteoblasts in bones that help to stimulate bone growth and modelling.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.

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About the Author

Doug Lobay is a practicing naturopathic physician in Kelowna, British Columbia.

He graduated with a bachelor of science degree from the University of British Columbia in 1987 and then attended Bastyr College of Natural Health Sciences in Seattle, Washington, where graduated with a doctorate in naturopathic medicine degree in 1991. While attending Bastyr College, he began to research the scientific basis of naturopathic medicine. 

He was surprised to find many of the current major medical journals abounded with scientific information on the use of diet, vitamins, nutritional supplements and herbal medicines.

Doug is a member of the College of Naturopathic Physicians of British Columbia and has practiced as naturopathic family physician for more than 30 years.  He maintains a busy practice in Kelowna where he sees a wide age range of patients with various ailments.

He focuses on dietary modification, allergy testing, nutritional assessments, supplement recommendation for optimal health, various physical therapy modalities, various intravenous therapies including chelation therapy.

An avid writer, he has written seven books on various aspects of naturopathic medicine that are available on Amazon and was also a long-time medical contributor to the Townsend Letter journal for doctors and patients, where many of his articles are available to view on-line. He has also given numerous lectures, talks and has taught various courses on natural medicine.

Doug enjoys research, writing and teaching others about the virtues of natural health and good nutrition. When not working, he enjoys cycling, hiking, hockey, skiing, swimming, tennis and playing guitar.

If you have any further questions or comments, you can contact Dr. Lobay at 250-860-7622 or [email protected].

The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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