About OSTEOPOROSIS

Osteoporosis is the progressive thinning of bone or porous bone. Learn more about your bones and their strength, the causes and prevention of osteoporosis, and treatment options.

Prevalence: Approximately one and one-half million fractures per year occur because of Osteoporosis. It is estimated that one third of all women in the U.S. develop Osteoporosis severe enough to be the cause of fractures. These fractures can be disfiguring and painful and can be caused by minimal trauma, even as little as lifting a small box or even just the weight of the person’s own body. There are twice as many fractures today as there were thirty years ago.

Types of Fractures: Three types of fractures generally occur - wrist fractures, vertebral crush fractures and hip fractures. The hip fractures are the most devastating in terms of mortality in that many (up to 20%) die within one year of the fracture and as many as 50% become unable to live at home and are placed in nursing homes.

Bone Is Living Tissue: Many people look at bone as being hard, static tissue. In fact, bone is always breaking down and building up. This process is known as remodeling. The old bone is replaced with new bone in order to make areas of stress stronger so these areas can withstand the pressures placed upon it. For example, in a tennis player one may find that the bone in the upper playing arm is stronger and thicker than in the other arm . . .

Function of Bone: Our bones give our bodies form to the structure of the body. They allow us to stand, walk and sit. They also protect our vital organs - the ribs protect the heart and lungs and the skull protects the brain. Our blood cells are formed in bone. The bone also serves as a “mineral bank," a ready and available source of minerals.

Composition of Bone: Bone is made of a number of substances besides calcium and there are a number of natural substances involved in the process of the formation of bone. These are as follows: collagen and other proteins, calcium phosphate, calcium carbonate, magnesium, fluoride, sulfate and other trace minerals. A number of nutrients (such as vitamin K, vitamin D, manganese, and others) are important in the formation of bone:

  • Vitamin K – This vitamin is important in the formation of an important protein (osteocalcin) that provides the matrix upon calcium crystals can form. It's present in dark green leafy vegetables and is also produced in the gastrointestinal tract by “good” bacteria.
  • Manganese – This trace mineral stimulates the production of protein-like substances (mucopolysaccharides) which also provide a structure for calcium to deposit. Reduction of manganese in the food supply due to farming techniques and food processing can cause a lack of it in the body. Also, additives such as EDTA and heavy metal exposures (cadmium) can deplete manganese from the body.
  • Magnesium – Magnesium is a mineral that is involved in at least fifty different biochemical reactions in the body. Approximately 50% of the body’s magnesium is present in bone. Without magnesium, bone crystals have an abnormal shape, thereby reducing the quality of the bone, and poorer quality bone is more susceptible to fracture. Reduced magnesium in the body is caused by diet, stress (adrenaline secretion), alcohol consumption and diuretic drugs. Magnesium is found in whole grains, nuts, seeds and green vegetables.
  • Folic acid - is a B vitamin involved in many different biochemical processes. This vitamin affects bone by its involvement in the breakdown of a substance called “homocysteine," a harmful chemical that causes bone loss as well as atherosclerosis (clogging or hardening of the arteries). Folic acid is also involved in the formation of blood, reduces the formation of neurological malformations in infants, can help protect against cervical cancer and is valuable in the healing of diseased gums. Reduced folic acid in the body is caused by diets low in green leafy vegetables, overcooked or processes vegetables, alcohol consumption, birth control pills and certain medications such as Dilantin (used for seizures). It is present in green leafy vegetables.
  • Boron -- This trace mineral has been shown to decrease the secretion of calcium and magnesium from the body so you hold on to these minerals better. It increases levels of estrogen and testosterone in the body. Boron also enhances the conversion of Vitamin D to its active form and is present in fruits, vegetables and nuts.
  • Vitamin B6 – This B vitamin affects osteoporosis formation by its role in decreasing homocysteine levels, enhancing the structural proteins in bone and in enhancing the production of Progesterone. Reductions in the body are caused by decrease in diet, Vitamin B6 antagonists in the forms of chemicals in the environment such as certain herbicides (weed killers used on lawns and crops), chemicals used in metal manufacturing, anti-tarnish and metal plating processes and certain food coloring. The refining of foods, cooking, canning freezing and exposure to cigarette smoke also depletes Vitamin B6. Vitamin B6 is found in whole grains, watermelon, bananas, fish, chicken, beef, tomatoes and nuts.
  • Zinc – This mineral participates in the formation of bone by its enhancing effects on Vitamin D, which is involved in the absorption of calcium. Zinc is also needed for the formation of the cells that break down and build up bone as well as its role in the production of proteins used in bone. This mineral has a part in more than 20 chemical reactions in the body. It is necessary for wound healing, for taste, smell, sight, normal immune system function, the activity of insulin and for the syntheses of protein and DNA. Decreases in the body are caused by the refining of grains. Zinc is found in whole grains, meat, poultry, and legumes. (Zinc is balanced by copper in the body and therefore should be present in the diet as well as one can deplete the other.)
  • Vitamin D – Vitamin D is necessary in order for calcium to be absorbed into the body and then deposited in bone. It is usually formed in the body by exposure to sunlight and can also be obtained from fortified dairy products, fish, eggs and liver.
  • Vitamin C – Vitamin C plays an integral part in the formation of proteins that provide the matrix of the bone. It has also shown positive effects in terms of prevention of heart disease and cancer as well as decreasing the negative effects of diabetes. Further, vitamin C enhances immune function and acts as a natural anti-biotic as well as a natural anti-viral agent.
  • Silicon – Large amounts of silicon are present in the sites of calcification of growing bones. It is found in brown rice but is not present in white rice (refined).
  • Calcium – This is the mineral with the highest concentration in bone. Besides being important for bones and teeth, calcium has been shown help reduce blood pressure, cholesterol and triglycerides and may even help in the prevention of colon cancer. Too much calcium intake may decrease the absorption of magnesium and zinc thereby leading to deficiencies of both of these essential minerals. Magnesium balances calcium in several ways including preventing the formation of calcium based kidney stones and reducing the formation of calcium deposits in the arteries. It is found in milk products and green leafy vegetables.

Hormones That Affect Bone Formation

  • Estrogen has several actions, which affect the conservation of bone. It reduces the loss of calcium from the bones as well as improving the absorption of calcium. It also can inhibit the parathyroid hormone, which is involved in the breakdown of bone.
  • Progesterone sends messages to the bones to build bone. It also works with estrogen to conserve calcium and limit the removal of calcium from the bones.
  • Testosterone also promotes the bones to build and maintain bone.
  • Corticosteriods impair intestinal absorption of calcium, which leads to increased loss of calcium from bone. These hormones direct bone cells to release calcium and further, directly inhibit the formation of new bone.
  • Thyroid hormone in excess or deficiency can cause bone loss.

General Causes of Osteoporosis

  • A deficiency of any of the components, vitamins and minerals needed for bone formation.
  • Faulty or substandard formation of bone secondary to the lack of minerals, vitamins and or hormones needed for the remodeling of bone.
  • A defect in the body’s repair systems.

Women's Issues

  • In striving to be thin many women and especially adolescent girls eat reduced caloric diets that are often deficient in nutrients necessary for the formation and maintenance of bone.
  • In the past girls were discouraged from activities that would produce increased muscle mass.
  • Women undergo more surgery in the form of hysterectomies, the removal of ovaries and tubal ligations. These surgeries can decrease the amounts of sex hormones in the body that are critical in the formation of bone.

Dietary Habits

  • Increased intakes of animal protein cause calcium to be leached from bone in order to buffer the acids caused by the metabolism of these foods.
  • Increased intakes of phosphorus in the form of meats, plus processed foods such as soft drinks, baked goods and other foods to which phosphates have been added. Phosphorus and calcium balance each other so when there is an uneven increased intake of phosphorus it depletes calcium.
  • Increased intake of sugar causes an increase in the secretion of calcium, magnesium, chromium, copper, and zinc. The secretion of calcium is magnified when sugar is combined with caffeine.
  • Caffeine causes losses of calcium and magnesium. Two mugs of coffee can decrease calcium by 15mg per day.
  • Maintenance of acid and alkaline in the body. Foods that cause increased acids in the system promote the release of calcium, sodium, magnesium and potassium. These minerals are used to buffer or neutralize the acid.

Lack of Exercise

  • Those confined to bed rest can lose up to 1% of lumbar spine bone density in one week! Astronauts exposed to weightlessness also experience rapid bone loss. Sedentary life styles in general lead to bone loss.
  • Muscle mass correlates with bone mass. Increased muscle mass is related to an increase in bone mass.
  • Exercise increases the flow of nutrients and other substances, which stimulate bone formation.
  • Exercise causes pressure and tension on the bone by the actions of the muscles through electrical transmission, which signal the bones to repair and regenerate.

Other Causes

  • Smoking depletes the body of nutrients (especially vitamin C), decreases levels of estrogen, and increases the body’s exposure to toxic metals such as cadmium and lead. Nicotine interferes with calcium absorption and also can directly damage bone.
  • Alcohol consumption inhibits absorption and increases secretion of calcium, vitamin C, zinc and copper. It also interferes with B vitamins and damages the liver, which is important in the metabolism of vitamin D.
  • Aluminum-containing antacids - the aluminum disrupts the body’s phosphorus balance, causing an increased loss of calcium.
  • Medications such as corticosteriods, diuretics, anti-biotics, Dilantin, and others have an effect on bone.
  • Toxic metals such as lead (decreases calcium absorption by the inhibition of Vitamin D, interferes with progesterone metabolism) cadmium (damages the kidneys and affects calcium metabolism), aluminum (interferes with the formation of bone and decreases collagen and therefore bone formation as well as decreasing the absorption of calcium.)
  • Decreased stomach acid results in decreased absorption of calcium and other minerals.

WHAT CAN BE DONE TO REBUILD BONE

  • Increasing nutrient intake through a diet, which includes whole grains, 4-5 cups of vegetables per day, legumes, fruits, nuts, seeds, flesh foods, dairy and water.
  • Adopting an alkaline diet.
  • Nutritional supplements.
  • Exercise, especially weight-bearing exercises (walking, running etc.) including weight lifting. Short periods of diverse weight-bearing activities are more effective than long periods of running, bicycling or swimming. Exercise at least three times per week for an hour (build up to this if you have not been exercising at all). Incorporate strength training too.
  • Improving digestion, including stimulation of stomach acid and the restoration of “good” bacteria into the intestine.
  • Avoiding substances known to promote osteoporosis such as alcohol, caffeine, sugar etc. as listed above.
  • Judicious use of replacement hormones.

RECOMMENDED READING

  • Better Bones, Better Body by Dr. Susan E. Brown
  • Preventing and Reversing Osteoporosis by Dr. Alan R. Gaby
  • What Your Doctor May Not Tell You About Menopause by Dr. John Lee

OSTEOPOROSIS IS:

  • thin and substandard bone
  • a degenerative disease
  • common only in westernized countries
  • a female socialization issue in westernized countries
  • becoming more common among the young
  • an intelligent bodily response to the stress of long-term imbalance
  • a manifestation of systemic breakdown

OSTEOPOROSIS IS NOT:

  • just thin bone
  • normal aging
  • common all over the world
  • a female disorder
  • a disorder only affecting the elderly
  • faulty bone metabolism, something that normally happens as we age
  • an isolated disorder

Adapted from Better Bones, Better Body, by Dr. Susan Brown