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Osteoporosis, Part 3: Nutrition, Supplements, and Lifestyle Changes

Posted by April 28th, 2014 in Wellness

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In our last two posts, we’ve looked extensively at osteoporosis, examining the risk factors, diagnostic tests, and treatments of the disease. For this last post, we’ll turn to what you can do right now to improve your bone density and bone quality, and reduce your risks for osteoporosis. We’ll focus on four areas: nutrition, exercise, stress reduction, and supplements. Keep reading to learn more!
Your bones are living tissue, and in this case, the old saying “you are what you eat” holds true. There are several ways you can make sure that you are eating a diet that is nutrient-rich and promotes the creation of new bone, helping to stave off bone loss.
Calcium-Rich Foods
When you think of foods for bone health, most people automatically think of dairy – yogurt, cheese, and especially milk. You might be surprised to learn that milk can actually work against you. Milk acidifies the body, and your body will take calcium from your bones to neutralize the acid. That calcium then leaves the body, and your “bone-building” glass of milk can actually leave you with a calcium deficit. Additionally, many people experience symptoms of lactose intolerance and inflammation from dairy, so it’s good to get non-dairy foods that are good sources of calcium on your plate.
You might be surprised how many non-dairy foods there are that are rich in calcium. Sardines, whitebait, and salmon are rich in calcium, as are green leafy vegetables (think collard greens, okra, curly kale, and broccoli), chickpeas, green beans, and figs. Want something you can put on your cereal? Almond milk is a terrific source of calcium, as are raw almonds. If you’re nuts for nuts, brazil nuts, hazelnuts, and walnuts are another great source. Sesame seeds are also loaded with calcium — a tahini dip or salad dressing can be a great way to give an added boost of calcium to fresh veggies. Plant proteins contain more than 10 times the calcium and magnesium as animal proteins, which can raise tissue acidity. That said, animal proteins contain some essential amino acids that plants lack. When you’re choosing meats, aim for grass-raised, organic cuts.
Super Foods… and Super Villains
“Superfoods” can help protect your body against oxidative damage, preventing bone loss. These include raw cacao, hemp seed, gogi berry, aloe vera, bee pollen/royal jelly (your best bet — raw, local honey), kelp, spirulina, blue-green algae, phytoplankton, coconut, and acai berry. These can be pricey — and let’s face it, aren’t exactly entrée material — but there are plenty of ways to work them into your diet. Add raw honey to an acai bowl at breakfast, create a curry with coconut milk, and if you’re indulging in a dessert, add raw cacao nibs as a garnish.
Another strategy to help your body build new bone tissue is to avoid foods that acidify your blood. Again, an influx of acid leads your body to use its stores of calcium to neutralize the acid, leaving less material for bone growth. Dairy, processed foods, refined sugars, fried foods, sodas and other carbonated drinks, and many canned foods should be eliminated if not restricted.
Toxins and Other Troubles
Toxins, especially heavy metals like mercury and lead, are major contributors to your fracture risk. Preservatives and dyes in packaged and processed foods are also major culprits in displacing the calcium and magnesium your body needs to build strong bones. In addition to what you eat and drink, try to reduce your exposure to environmental toxins including gases, paints, glues, plastics, phthalates, and electromagnetic radiation. Stay hydrated — and help your body naturally flush toxins — by drinking pure water throughout the day.
We’ll talk more about supplements in a moment, but while we’re on the subject of food and drink, make sure you treat any intestinal issues and stay on top of your digestive health. If you are experiencing gas, bloating, heartburn, constipation, abdominal cramps or uneasiness, loose bowels, or post-meal fatigue, check in with your MD. If your digestive system isn’t working properly, your body is most likely not absorbing nutrients as well as it could be. To get the most from your diet and supplements, make sure your digestive system is healthy.
Staying active is a great way to reduce bone loss and build stronger bones. Walking or running are both terrific activities for staying in shape and promoting bone health. Incorporating strength-bearing exercises is also important for bone health. Basic moves like lunges, squats, and pushups — even just short, five-minute sets — can be beneficial. Convinced you don’t have time to exercise? Work physical activity into your daily routine. Taking the stairs instead of the elevator, or parking further from work (to give yourself a little walk) takes almost no time at all, and keeps you on your feet. Walking lunges or standing squats are easy to do while you’re watching TV or talking on the phone. You’d be surprised how much bending and lifting is already part of basic tasks you do around the house, too — whether you’re cooking, cleaning, or keeping up with your kids, if you’re keeping on your feet, you’re supporting your bone health.
Stress Reduction
We know, we know — reducing your stress can be, well, stressful! You’ve got more tasks on your to-do list than there are hours in the day, and getting in some rest isn’t on the agenda. But scheduling in some “me time” can be critical in reducing bone loss. When you are under mental stress for a prolonged period of time, your body’s sympathetic nervous system goes into overdrive. It uses hormones (including progesterone, testosterone, DHEA, and estradiol) and nutrients (B vitamins, vitamin C, magnesium, and more) much more quickly than normal. Stress isn’t just a strain on your mind and your emotions — it is also exacting a toll on your body. To combat stress, try to incorporate some or all of the following in your routine:

  • Perform deep breathing exercises for five minutes daily. Conscious deep breathing is not only relaxing, it also increases oxygenation and pH, and reduces inflammation.
  • Exercise cannot only help you build bone tissue more quickly, it can also get you breathing and reduce your stress. If you want to double up on these benefits, choose an exercise that is in itself mindful and relaxing, such as yoga or tai chi.
  • Take a bath with Epsom salts and lavender three times a week. Just 10 to 20 minute baths can relax your body and your mind.
  • As often as you can, try to get a full eight hours of deep, uninterrupted sleep. Sleep allows your body to recharge and lets your busy mind relax, fighting stress and inflammation.

A last way to support your bone health is with supplements, making sure that your body has the vitamins it needs to maintain a healthy bone density.
Calcium supplements are certainly the most heavily advertised method for combatting bone loss. And your body does need calcium — adults require roughly 1,000 to 1,200 milligrams daily (those who have been diagnosed with osteoporosis may need more). That won’t come all from supplements; you should be getting calcium from your diet as well.
Supplementing with calcium can be tricky — it needs to be properly balanced with other vitamins to ensure that it is being absorbed, and that it is not causing any issues (too much calcium can lead to constipation and calcification of the arteries, a precursor to heart blockages). We only absorb about 30% of the calcium we take in, so increasing absorption is important. Vitamin D and magnesium can both help to aid the absorption and help you get the most benefit from supplements.
Most calcium supplements (including the antacid Tums, which many use as a supplement) are calcium carbonate, which is 40% calcium by weight. Though that sounds like a lot, calcium carbonate is not ideal for many people. It needs to be taken with food, and it dilutes acids that are needed not only for calcium absorption but also for digestion. A better option is calcium citrate or calcium malate, which though lower in calcium by weight are often absorbed more efficiently by the body. These also contain an acid component to help digest the calcium, so your body does not have to take it away from other processes.
Another form of calcium that works for supplementing is calcium aspartate anhydrous (CAA), which is one of the forms of calcium that the body can use only to build bone (instead of allowing the body to use it for other purposes, which again may allow for calcium to build up in the arteries). In a study that followed 1,306 patients through three months of treatment with different calcium supplements, patients who supplemented with CAA increased their bone mineral density at the lumbar spine by an average of 4.07%, compared to an average increase of 0.64% in the group taking calcium citrate.
Last, eggshell calcium is a highly bioavailable form of calcium which contains the full spectrum of trace nutrients needed for bone health, including strontium, magnesium, zinc, and copper. Research has shown that eggshell calcium’s superior bioavailability comes from naturally occurring transporter proteins inherent in the eggshell matrix. This natural source of calcium is easily utilized by the body, and multiple clinical studies have demonstrated that eggshell calcium not only stops bone loss but also builds bone mineral density. One clinical study showed that eggshell calcium reduced pain and bone resorption, and increased mobility and bone mineral density after only 6 months. Eggshell calcium has even been shown to stimulate chondrocyte differentiation and cartilage growth in vitro.
Vitamin D
Getting adequate amounts of vitamin D is also important. Vitamin D regulates intestinal calcium absorption and stimulates bone resorption, making it a vital nutrient in the maintenance of bone health. In fact, a lack of vitamin D can cause calcium-depleted bones (osteomalacia), further weakening bones and increasing the risk of fractures. Most Americans — including an estimated 90% of adults between 51 and 70 years old — do not get enough vitamin D from their diet. In addition to what we eat, we can also get vitamin D from sunlight and from supplements.
Wait, you can get vitamins from the sun? It might sound a bit unusual, but it’s true — sunlight is the most common source of vitamin D. That said, a little goes a long way. To get an adequate amount of vitamin D from sunlight, you just need to get 5 to 15 minutes of sun exposure between the hours of 10 am and 3 pm (the sun’s peak hours) at least twice a week on your face, arms, hands, or back. This is usually enough for people with most skin types to maintain adequate levels of vitamin D, though those with darker skin may need more exposure. Sunscreen does limit your vitamin D absorption, so you can skip it for that brief exposure period. After that though, you should definitely apply sunscreen to protect your skin from UV rays.
You can also get vitamin D from what you eat, but it’s not especially common in foods. Even those foods which have vitamin D, including egg yolks, cod liver oil, and fatty fish like salmon, mackerel, and sardines, don’t have a tremendous amount of vitamin D. Foods that are fortified with vitamin D provide an efficient source of the vitamin, especially orange juice and cereals.
Since food often isn’t an option for vitamin D, supplementing is often needed to make sure you’re getting enough. The National Osteoporosis Foundation (NOF) recommends an intake of 800 to 1000 international units (IU) of vitamin D3 per day for adults who are over 50. At Rejuvé, we believe that higher levels of vitamin D — to maintain a level of 60-90 — are more optimal. Dr. Tang generally recommends patients take an average of 5000-8000 IU of Vitamin D3, but testing for vitamin D can help find your optimal dose.
Nitric Oxide (N-O)
There are also other supplements that can be taken to support strong bones. We recently featured nitric oxide (N-O) on the blog. Recent research has shown that N-O is important for the creation of new bone tissue in the body. N-O is generated by bone cells called osteocytes when you exercise, helping to build stronger bones. In all, there is a growing body of research that implies that N-O may be a helpful treatment for preventing bone loss. If you are looking for a comprehensive approach to combatting osteoporosis, in addition to vitamin supplements and hormone replacement, N-O may be a good supplement to include.
Not sure what to choose? Want to find out your vitamin levels? Rejuvé offers vitamin testing and medical grade vitamin supplements, and Dr. Tang can help you determine what best fits your needs.

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