Bone health is an important wellness issue for everyone. Building and maintaining healthy bones throughout your life will reduce your risk of later developing degenerative conditions such as osteopenia and osteoporosis.
Osteoporosis is a degenerative condition in which bones become porous, fragile and prone to fractures. Osteopenia is the early stage of bone loss and is considered to be a precursor to osteoporosis. The main areas of the body at risk include hips, wrists, and spine. These conditions are especially prevalent among post-menopausal women.
In healthy individuals, a dynamic process called “bone remodeling” occurs in which bones are continually broken down by “osteoclasts” and replaced by “osteoblasts”. It is this balance of bone deposition and bone resorption that is vital to bone health. Pathology occurs in individuals whose bone resorption exceeds the rate of replacement during their adult life.
Pharmaceutical options to treat osteopenia and osteoporosis are focused only on one aspect of bone remodelling—reducing the breakdown of bone. They do NOT enhance bone density. Furthermore, these drugs have potentially serious side effects. Drugs such as Fosamax and Actonel can cause bone and joint pain, flu-like symptoms, fatigue, kidney damage, osteonecrosis of the jaw, constipation and diarrhea.
There are many natural ways to prevent a diagnosis of osteopenia and osteoporosis. But there are also many ways to prevent further loss of bone density if you are diagnosed with one of these conditions.
It is important to know that bone health is dependent on several vitamins and minerals. Calcium is perhaps the most well-known, but ongoing research is revealing that calcium, taken with certain trace minerals, is far more effective for bone density. As with everything in nature, there are synergistic relationships between nutrients, and hence the importance to consume nutrients together, rather than in isolation.
Also important is the ability to properly absorb these vitamins and minerals, and to prevent excess excretion in the urine—something which is often overlooked.
With respect to calcium, for instance, certain carbonated and caffeinated beverages like pop and coffee, can interfere with calcium absorption. These substances have been proven to increase acidity in the blood. If the body is experiencing too much acidity in the blood, it will take calcium, as well as other minerals, from the bones to “buffer” this acidity and balance out the blood’s pH. The bones act as a reservoir for many vitamins and minerals in times of need. So some foods, and substances in foods like preservatives found in packaged products, end up contributing to the excretion of calcium in urine.
This in turn contributes to degenerative health conditions such as osteopenia and osteoporosis.
In addition to caffeine and carbonated products, some other factors that impair absorption and lead to loss of bone density include: consumption of alcohol, long-term use of certain drugs such as aspirin and corticosteroids, smoking or usage of nicotine products, diets high in salt, sugar, and animal proteins, lack of exercise and sedentary lifestyle, and excessive stress. Each of these affects the absorption of all vitamins and minerals.
Creating a Comprehensive Bone Health Regime
Nutrition is the most important determinant of bone health. A varied, healthful diet that has adequate levels of protein and essential fatty acids, and is high in vegetables, fruits, and legumes is integral for bone health and is also preventative against all disease in general by contributing to higher antioxidant levels and creating an alkaline environment in the body. Dark, leafy green vegetables are good sources of bone minerals, as are most fibrous foods, nuts, seeds, beans and legumes, etc. Herbs are also mineral powerhouses such as nettle, oatstraw, red clover, etc. Dairy products are controversial as many people do not have the enzyme capacity to digest and absorb the calcium and minerals found in dairy products.
In addition to diet, routine exercise, particularly gentle weight-bearing exercise, is an important aspect of bone health. Aim to exercise for at least 30 minutes, 3-5 times per week. Gentle weight-bearing activities include walking, biking, dancing, yoga, pilates, and the Chinese martial art, Tai Chi. Physical activity benefits bones through putting strain on them, which activates the osteoblast cells in the bones. Developing muscle is also important because with increased muscle strength, stability and agility and balance are increased, strengthening the structures that support and surround bone, greatly reducing the likelihood of falls.
Approaches to bone health must factor each individual as a whole. Bone supplementation, as ALL other supplementation, must take the individual into account. Each person has different requirements depending on several factors such as diet and nutrition, lifestyle, exercise habits, body frame, pharmaceutical and/or other medications or supplements (i.e. iron supplements), level of inflammation in the body, kidney and liver health, digestive functioning, etc.
The Essential Vitamins & Minerals to include in any Comprehensive Bone Health Regime
Calcium – We have all heard about calcium, but what is the best form of calcium to take? Most calcium supplements contain calcium carbonate and calcium citrate. However, only 20-25% of calcium carbonate or calcium citrate from supplements is absorbed.
Absorption rates depend on the stomach’s pH. These are not ideal forms if you have digestive problems such as heartburn/GERD, regular gas and bloating, or require medications such as tums or nexium (which decrease the stomach acid required for absorption of minerals). Those who are deficient in stomach acids may absorb more calcium from citrate malate, which is a water-soluble calcium supplement. However, it is important to correct digestive functioning in order to properly absorb calcium from both food and supplements.
The most highly absorbable form of calcium is ossein microcrystalline hydroxyapatite complex (MCHC), an extract from young bovine. MCHC is extremely bioavailable, well tolerated, and found to prevent bone loss, as well as to restore bone mineral density. MCHC should come from a professional brand to ensure a high-quality source that has not been subjected to hormones or antibiotics, etc.
Vitamin D – Vitamin D plays an important role in many vital body functions, and has a well-established role in calcium homeostasis and the maintenance of healthy bones. It is crucial for calcium absorption, and it also promotes bone mineralization. Twenty minutes of sun exposure each day is the optimal way to get vitamin D because when sunlight touches the skin, it produces vitamin D3(cholecalciferol), converting it into a form that can be metabolized by the liver and kidneys. Cholecalciferol is the naturally occurring form of vitamin D that can also be taken as a supplement. Emulsified supplement forms of vitamin D3 are well absorbed by the body (emulsification is a method of processing that dissolves a substance into an emulsifying liquid to increase surface area for more effective absorption and digestion).
Magnesium – Magnesium is an essential macro mineral that is involved in many enzymatic reactions in the body. Magnesium mediates two hormones that are integral to bone remodelling—calcitonin and the parathyroid hormone. It is also needed to convert vitamin D into its active form. Similar to calcium, magnesium also requires an acidic stomach environment for optimal absorption. The most absorbed supplement form is generally considered to be magnesium citrate. Calcium-magnesium balance is important and the suggested intake ratio is approximately 2:1 (Ca:Mg). It is often beneficial to take magnesium before bedtime as it has the added benefit of inducing muscle relaxation.
Vitamin K – Vitamin K is also required for bone maintenance and to balance calcium. Vitamin K was first identified as essential for normal blood clotting. It is now known to be essential for bone and artery health (keeping calcium in the bones and out of the arteries). Caution taking vitamin K with any anticoagulant (blood-thinning) medications as it can reverse the effects of these medications. Low serum Vitamin K has been found to be associated with lower bone mineral density and increased risk of hip fracture.
Strontium — Strontium is a trace mineral that is essential for bone health. Ongoing research is highlighting strontium’s potential to both increase the activity of the bone-forming osteoblasts and decrease the activity of the bone-dissolving osteoclasts—ultimately enhancing bone strength. Strontium is absorbed in the bowels using same mechanism as calcium, so they may compete against one another. Because of this, strontium supplements should not be taken at the same time as calcium supplements. Adequate calcium (intake and absorption, whether from food or supplements) is necessary if choosing to additionally supplement with strontium.
Boron — Boron also plays an integral part in bone health. Boron reduces urinary excretion of both calcium and magnesium, and stimulates vitamin D activation.
Silicon — Silicon is yet another important component of bone and is integral to bone mineral density. Accumulating research suggests that silicon is also involved in collagen synthesis and beneficial to connective tissue health (muscles and ligaments).
Manganese, zinc, copper – These are trace minerals that are important co-factors for enzymes in our bodies. Each of these trace minerals is essential for maintaining bone density. Zinc in particular is important in the formation of osteoblasts and aiding in the activity of vitamin D, not to mention its crucial role in supporting the immune system.
It is important to note that a multivitamin or calcium supplement will not provide these vitamins and minerals in the dosages that are required for optimal bone health. It is best to take supplements in divided doses throughout the day to achieve adequate intake. It is also important to note that taking anything in excess will not increase bone density, but will only put strain on the organs, mainly the kidneys, to rid the body of the excess that it can not absorb.
For guidance and individualized advice on how to ensure optimal bone health, consult with a Naturopathic Doctor. Naturopathic Doctors are aided by current scientific research and are trained to combine clinical nutrition, acupuncture, herbal medicine, homeopathy, and other preventative measures to restore, as well as to maintain, health. Naturopathic medicine seeks to uncover the underlying cause of illness, and to restore optimal health and vitality.
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