How to prevent osteoporosis

VALLEY — About 60 percent of women and 40 percent of men over 50 have low bone mass, and those numbers increase with age. The National Osteoporosis Foundation estimates that 50 percent of women and 25 percent of men over 50 will have an osteoporosis-related fracture during their lifetime.

Bone is constantly being broken down and rebuilt, and in osteoporosis, there is an imbalance leading to a decrease in bone mass and an increase in fracture risk. The best protection against osteoporosis is to tip the balance back toward bone building with a combination of exercise and excellent nutrition

Exercise: When we increase muscle strength, we increase bone strength, which is why strength training is important. Mechanical forces produced by exercise stimulate activity in bone-building cells, leading to denser, stronger bones – not just stronger muscles. Weight-bearing exercises improve balance and build bone strength, and non-weight bearing strength training also helps increase bone density. While swimming and biking are good for cardiovascular conditioning, they don’t help protect against osteoporosis like running or lifting weights. In women who are at a risk for osteoporosis, back strengthening exercises are especially beneficial for protection against spinal fractures.

For women, I also recommend wearing a weighted vest for a few hours each day. A weighted vest can be worn during exercise and also while you work or shop and bend, stand, and move throughout the day. Wearing a weighted vest also burns extra calories, increases core strength and stabilizes muscles, thus improving balance and decreasing the risk of falls.

Calcium from greens, seeds and beans: Ninety-nine percent of the body’s calcium is stored in bone.  The intermingling of bone mineral with collagen fibers provides bone with strength and flexibility. A diet full of natural plant foods provides the calcium required to build strong bones. Green vegetables in particular are rich calcium sources. For example, one four-ounce serving of steamed kale has just as much calcium as one cup of cow’s milk. Broccoli, bok choy, sesame seeds, and garbanzo beans are also excellent calcium sources. Furthermore, the body absorbs about 50 percent of the calcium in many green vegetables, compared to only 32 percent of the calcium in milk. I don’t recommend high-dose (1000 mg/day) calcium supplements, because some studies have linked these supplements to an increased risk of cardiovascular disease, and high dose calcium supplements have not been superior to lower doses in studies on preventing bone fractures.

Magnesium from nuts and seeds: Calcium is important, but it’s not the only bone-building mineral. Sixty percent of the body’s magnesium, which is essential for bone formation and structure, is found in bone. Almost half of Americans do not meet the recommended intake for magnesium.

Vitamin K1 from green vegetables: Vitamin K is a crucial component for maintaining healthy bones, specifically for the process of bone mineralization. Higher intake of vitamin K1 is associated with lower rates of bone loss and fractures. Vitamin K exists as K1 and K2; the richest source of K1 is green vegetables, and K2 is produced by microorganisms. It is important to get both K1 from green vegetables and K2 from a supplement.

Plant protein from beans, seeds, and nuts: Starting in mid-life and especially after the age of 70, it becomes more important to ensure adequate protein intake for healthy bones. For most people following a healthful diet, adequate protein for maintenance of bone mass, muscle mass, and muscle strength with age can be achieved easily with seeds, nuts, and beans. Animal products may be added if muscle mass starts to fall too low on a completely vegan diet, in spite of appropriate exercise.

Phytate from beans, whole grains, nuts and seeds: Phytate was once known as an “anti-nutrient,” a substance that prevents us from absorbing certain minerals, however the phytate in plant foods might actually benefit bone health. Studies have found that women who consume more phytate had either greater bone mineral density or less bone mass loss over time.

Antioxidant-rich fruits and vegetables: The best foods for bone health are whole plant foods. Studies show that individuals with the highest consumption of fruit and vegetables have the strongest bones. Higher levels of oxidative stress are linked to lower bone mineral density, suggesting that the antioxidant content of fruits and vegetables may be partially responsible for their bone health benefits.

Bone-healthy supplements: The major source of vitamin D for most people is sun exposure, and vitamin K2 is not easily obtained from plant foods. It is important to get adequate amounts of these bone-supporting vitamins, and supplements are useful.  Vitamin D regulates calcium and phosphorus absorption, and Vitamin D deficiency is known to increase the risk of fractures. Supplementation trials using vitamin K2 in postmenopausal women have shown a 77 percent reduction in the risk of hip fractures.

The worst foods for bone health are those that cause calcium to be removed from bone and lost in the urine. Excess sodium promotes the excretion of calcium. High caffeine intake is associated with increased bone loss and osteoporotic fractures. Soda, including diet and decaffeinated soda, is associated with calcium excretion and bone loss.

A nutrient-dense, plant-rich (Nutritarian) diet, combined with the conservative use of supplements assures individuals they are achieving maximum protection against later life disease.

Dr. Fuhrman is a #1 New York Times best-selling author and a board certified family physician specializing in lifestyle and nutritional medicine. The Eat To Live Cookbook offers over 200 unique disease-fighting delicious recipes and his newest book is Fast Food Genocide (a must-read for all Americans). Visit his informative website at Submit your questions and comments about this column directly to [email protected]