Osteoporosis is one of the most common and disabling diseases affecting women with many women losing between 2%-5% bone mass in the 5 years following menopause. However, it’s not the bone loss itself that puts women at risk of fracture. It’s the decrease in the quality of bone that is the issue. I have seen many women who naturally have low bone density who never break bones. That’s why I like to focus on ways every woman can build healthy bones instead of treating all women as if they are at risk for bone disease and subjecting them to drug side effects and endless testing.
That said, there are risk factors that could set you up for poor bone quality. Some of these are related to lifestyle choices and include a diet high in refined carbohydrates, lack of exercise, muscle weakness, general lack of fitness, smoking, drinking alcohol in excess, vitamin and mineral deficiencies (vitamin D, calcium, magnesium, boron, trace minerals). Other risk factors include depression (due to the associated high levels of cortisol,) ovulatory disturbances resulting in progesterone deficiency, use of corticosteroids, Rheumatoid Arthritis, a history of amenorrhea, never having borne a child, and having a mother with a diagnosis of severe osteoporosis. Of course there can be many other risk factors, so be sure to discuss with your health care provider.
7 Easy Ways to Keep Your Bones Healthy for Life
Fractures and breaks related to osteoporosis typically occur in the hip, spine or wrist. But they can occur in other parts of the body. Hip fracture rates for white women in the United States rise abruptly between the ages of 40-44. In fact, as much as 50% of bone loss in women occurs before the onset of menopause. While osteoporosis is usually not life-threatening, about 20 percent of elderly people who break a hip die within one year. That’s why it’s important to follow a healthy lifestyle as soon as possible!
Here are 7 easy ways to ensure your bones stay strong and healthy:
- Eat a low acid diet. In their book Building Bone Vitality: A Revolutionary Diet Plan to Prevent Bone Loss and Reverse Osteoporosis—Without Dairy Foods, Calcium, Estrogen, or Drugs, Amy Joy Lanou, Ph.D. and Michael Castleman show that maintaining a slightly alkaline PH level in the blood can prevent osteoporosis. This can be achieved by eating a low acid diet. For example, eat 3 servings of fruits and vegetables (alkaline) for every serving of high-quality animal protein such as red meat, chicken or fish (acidic). 2 servings of fruits and vegetables will neutralize the slightly acidic effect of grains. Add seeds, nuts, beans and legumes for additional sources of protein. Be sure to reduce refined foods. Also many people today are adding collagen to their diet. This is widely available in supplement form and powders that can be added to smoothies, drinks and other foods. Bone broth can also be a good source.
- Take supplements. Your bones are dynamic organs that thrive in a mineral-rich environment. But most people today are deficient in one or more minerals that are vital for their health. This is primarily due to conventional farming practices that rely on pesticides, herbicides, and chemical fertilizers that deplete the soil of nutrients. Take a high-quality vitamin and mineral supplement to restore these trace minerals. Make sure it includes adequate levels of boron (12 mgs per day), calcium (500-1,500 mgs per day), magnesium (400-800 mgs per day), vitamin D (2,000 IUs per day), vitamin C (2,000 mgs per day), beta carotene (25,000 IUs per day), and trace minerals.
- Get enough exercise. Two 40-minute sessions of weight training per weeks have been shown to increase bone density as much as estrogen according to research by Miriam Nelson, Ph.D. Author of Strong Women, Strong Bones. In addition, higher impact activities such as vertical jumping and stair climbing can also build bone. A comprehensive exercise program that includes weight-bearing aerobic exercise, strength training, and balance and stretching exercises is ideal. Walking, biking, and climbing are exercises that are proven to keep bones well mineralized.
- Practice proper alignment. Proper skeletal alignment is crucial for maintaining healthy bones and hips throughout life. Pilates and yoga are good types of exercises for developing awareness of your alignment. Ester Gokhale’s Primal Posture training is also a good option.
- Balance your hormones. Progesterone plays an important role in bone metabolism. I recommend ¼-1/2 teaspoon of 2 percent natural progesterone cream daily on the skin. Pueraria mirifica can also help balance hormones and support your bone health. High cortisol levels can increase your risk for osteoporosis. If you are depressed or chronically stressed, you need to get help.
- Limit caffeine. Caffeine increases the rate at which calcium is excreted in urine. Limit your caffeine intake to the equivalent of no more than 2 cups of coffee. Be sure to cut out soft drinks as well. In addition to containing caffeine, they also are high in phosphorus, which directly interferes with calcium absorption.
- Quit smoking and limit alcohol. Smokers and women who consume more than 2 alcoholic drinks per day are at the highest risk for osteoporosis.
Should You Get Bone Density Screening?
Bone density screening to determine your current bone density is done through a dual-energy X-ray absorptiometry (DEXA). These machines measure density of bones in specific areas of your body including hips, forearms, spine, or sometimes your entire body. It takes about 10 minutes and is painless. The issue I have with these tests is that they can be misleading, especially if you have small bones. Women with smaller bones often register in the lower bone density range compared with the general population. This suggests that you are at high risk for osteoporosis even if your bone quality is good and you have been in that range your entire life.
A more useful test for many women is a urine test to determine your rate of bone loss. The NTx test and Pyrilinks test measure collagen breakdown products. Testing for bone breakdown product s is a useful way to monitor any bone building program because it will show you improvement long before a DEXA scan will.
Sometimes women lose bone too quickly. This can sometimes be caused by parathyroid abnormalities. If you are at high risk for osteoporosis and have had a low DEXA test reading, you may want to pursue parathyroid testing with your health care provider.
Why You Should Avoid Bisphosphonates
Bisphosphonates are drugs commonly used to treat low bone density. They work by prevent bone breakdown. While this sounds like a good idea, these drugs—which include alendronate (Fosamax), ibandronate (Boniva) and risedronate (Actonel)—can be downright dangerous. That’s why they are on my list of drugs I won’t take!
Bisphosphonates work by inhibiting bone resorption by cells called osteoclasts, which are necessary for the continual remodeling of bone that occurs throughout life. Studies of women taking alendronate show nontraumatic spinal fractures and atypical femur fractures that don’t heal. Here’s why: Suppressing bone turnover creates excessive mineralization of bone, which makes it more brittle. Plus when bone gets too thick, blood vessels can’t nourish it.
These drugs also seem to inhibit normal repair of microdamage to bone. Finally, bisphosphonates bind so tightly to bone they can stay in the circulation for decades—even after a woman has stopped taking them! That means, even after you stop taking them you can still suffer the consequences of these drugs.
What do you do to build strong, healthy bones? Please share your comments below.