OSTEOPOROSIS
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TOO MANY PEOPLE think of osteoporosis as a relatively minor problem that makes you somewhat more liable to break your arm or leg. There is bad and good news about osteoporosis. The bad news is that nearly half a million older people--particularly women--take a fall each year that lands them in a hospital or nursing home with a broken hip that broke at least in part because of the effects of osteoporosis. Only three in four ever go home again. The others eventually are confined to nursing homes for the rest of their lives. This is a heavy price to pay for a preventable problem.
The good news is that until very recently it was believed that supplements were of no use in preventing bone loss in postmenopausal women. But the latest research shows that supplements can indeed stop bone erosion completely: If you are over the age of fifty-five, you can keep your bones strong by consuming the amount of calcium found in three glasses of milk every day and by taking certain other measures.
Osteoporosis, or loss of bone density, is a crippling affliction of the elderly. It causes older people to lose strength in their bones, to lose inches in height, and to suffer fractures and breaks that can lead to hospitalization and, ultimately, complete lack of mobility. Sometimes the bones become so fragile that a powerful cough breaks a rib, or a slip that should have been a misstep fractures a hip.
Who is vulnerable to osteoporosis? Women are at higher risk than men because they have less bone mass to begin with, and, because of hormonal changes, they lose it faster. But some women are more at risk than others. Women at highest risk include:
Asian women
white women, especially blond or redheaded women of Northern
European ancestry
postmenopausal women
underweight women
women with small bone structure
heavy alcohol users
heavy caffeine users
smokers
women on a high-protein diet
women with a family history of osteoporosis
women who have experienced menopause before age forty
women who are diabetic women with thyroid disease
women with asthma or other lung diseases
women who take glucocorticoids (for example, cortisone or prednisone prescribed for rheumatoid arthritis)
If you fit several of these descriptions, you should be all the more vigilant about taking steps to prevent osteoporosis. The key to avoiding it is prevention: Every woman should monitor her calcium intake throughout her life. Beginning in her teens, she should consume at least 1,200 mg. of calcium daily. When she reaches menopause (or if she's nursing), she should increase her intake to 1,500 mg. The reason calcium intake is affected by menopause is that the process of depositing calcium in the bones is very much dependent on the female hormone estrogen, which is diminished after menopause.
I think that one reason osteoporosis has become such a problem today is that the major source of calcium--dairy products--are also high in calories and saturated fat. Many people, particularly women, are avoiding these foods for the sake of weight control and cholesterol. In addition, controversy about the value of calcium supplements has kept women from using them.
When the diet is deficient in calcium, the body "steals" the essential mineral from the bones for other metabolic processes, making them brittle and thin. When a woman is consuming under 500 mg. of calcium a day (half of what her body needs), which describes one quarter of American women, she simply doesn't have enough of the mineral present in her body to carry on normal functions. Every day, her bones are losing a degree of strength and resiliency.
I recommend to all my women patients a daily supplement of calcium in the doses mentioned. It's very important that you take the right kind of calcium. There are a variety of calciums available as supplements including calcium lactate, calcium phosphate, calcium gluconate, and calcium carbonate. All of these calciums have disadvantages, the primary one being that the amount of calcium that the body can absorb from them is small. The best, widely available calcium is calcium citrate. It's very well absorbed, even by people with poor digestion, and it is not particularly expensive. Research has shown it's best absorbed when taken at bedtime. I also suggest that women increase their calcium consumption through their diet. This can mean more nonfat yogurt, skim milk, lowfat cheeses, greens, and sardines with bones. Bok choy and broccoli are among the best vegetable sources of calcium.
SOURCES OF CALCIUM
FOOD MILLIGRAMS OF CALCIUM
Whole milk, 8 oz. ...................................291
1% milk, protein fortified, 8 oz. ................349
Nonfat dry milk, 1/4 cup dry ....................377
Yogurt, plain, low-fat, 8 oz. .....................414
Yogurt, plain, nonfat, 8 oz. ......................452
Cheese, cheddar, 1 oz. ..........................204
Cheese, cottage, creamed, 4 oz. .............68
Cheese, goat, hard, 1 oz. .......................254
Cheese, goat, semi-soft, 1 oz. ................84
Cheese, feta, 1 oz. ................................140
Cheese, mozzarella, part skim, 1 oz. ......183
Cheese, muenster, 1 oz. ........................203
Collard greens, frozen, cooked, 1 cup ......357
Kale, frozen, cooked, 1 cup ....................179
Broccoli, cooked, chopped, 1 cup ............178
Chard, cooked, chopped, 1 cup ...............102
Mustard greens, cooked, chopped, 1 cup ..50
Spinach, frozen, cooked, 1 cup ................278
Calcium-enriched orange juice, 8 oz. .........225
Salmon, canned, with bones, 3 oz. ...........203
Sardines, with bones, 31/4 oz. .................351
Oysters, 1 cup .......................................111
Source: U.S. Department of Agriculture
The mineral magnesium, which is involved in calcium metabolism, also plays a crucial role in helping to avoid the development of osteoporosis. One study demonstrated this by supplementing postmenopausal women with half the recommended amount of calcium and twice the recommended amount of magnesium. These women gained bone density at a rate sixteen time greater than women who simply had nutritional counseling with no supplements.
Deficiencies of vitamin D can promote bone loss. Please note that if you're taking a good multiple vitamin, it may well contain 400 I.U. of vitamin D, and in that case there's no need to take more.
In addition, the mineral boron seems to reduce the loss of calcium from the body. In one study boron supplementation significantly reduced the excretion of calcium in postmenopausal women.
Reduced calcium consumption isn't the only factor that affects bone loss. Certain dietary factors actually cause the body to lose calcium. A diet high in protein increases calcium excretion and therefore bone loss. Many people today are restricting their protein intake by eating less meat, and I recommend this. Of course meat isn't the only source: Fish and chicken are also high in protein. The point is to reduce your overall intake. Six ounces per day--the equivalent of a small chicken breast or a small fish fillet--is enough.
Caffeine can also cause calcium loss from the body. If you drink more than one cup of coffee or tea per day, you're ingesting a chemical that's actually acting to leach calcium from your bones. Limit coffee consumption to no more than one caffeinated drink per day. And be sure that any carbonated drinks you consume don't have caffeine as an ingredient.
Alcohol can also leach calcium from your body, so limit your consumption. I believe that to maintain optimum health, it's best to avoid alcohol entirely, but certainly don't have more than two to three drinks per week.
Did you need to know another bad thing about cigarettes? Well, they lower estrogen levels in women, thereby increasing the risk of osteoporosis. Moreover, smokers have been found to have double the risk of hip fractures of nonsmokers.
Excess salt and sugar in the diet have both been linked to depletion of calcium stores.
Exercise is absolutely crucial to prevent bone loss. Whereas lack of exercise can promote the loss of bone density, you can rebuild density by becoming active. Many women think that by taking some calcium supplements they're fighting osteoporosis. Taking the supplements is better than nothing, but exercise will compound the benefits. You don't have to take up windsurfing; a simple program of a half-hour walk every day or even every other day will help tremendously.
NATURAL PRESCRIPTION FOR OSTEOPOROSIS
- Increase foods containing calcium, including nonfat or ]ow4at dairy products. You can add dry, powdered milk to certain recipes -- puddings, meat loafs, muffins, and baked goods--to boost calcium content.
- Reduce your protein intake (limit to 6 ounces dally) and your salt intake (avoid the salt shaker and use spaffngly in cookJng).
- Eliminate caffeine, sugar, and alcohol from your diet.
- Stop smoking
- Adopt a program of regular exercise.
IN ADDITION TO YOUR DALLY SUPPLEMENTS, TAKE:
- Calcium: 1,200 mg. of calcium citrate at bedtime.
- Magnesium: 400 mg. daily.
- Boron: 2 mg. daily.
- A good multiple vitamin that will provide 400 I.U. of vitamin D.
IN ADDITION: There is a new drug that's being used to treat osteoporosis, though it hasn't been approved by the FDA for that purpose (it has been approved to treat another bone disorder). The drug is called Etidronate, and it's taken in conjunction with calcium. If 3,our problem with osteoporosis is severe, discuss this drug with your doctor.
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