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Preventing Osteoporosis

Twenty-eight million North Americans have osteoporosis that puts them at high risk for breaking bones. People who suffer osteoporotic hip fractures have a 20 percent chance of dying within the next year. If you have suffered bone fractures with minimal trauma, the odds are strong that you have osteoporosis. A bone density test will help you and your doctor to decide whether you are at high risk for osteoporosis and may be a candidate for drugs to strengthen bones.

You can help to prevent osteoporosis or slow its progression by exercising, maintaining a healthful weight and eating an anti-inflammatory diet that is high in plants and low in sugar-added foods, red meat and processed meats. You should eat plenty of vegetables, fruits and calcium-rich foods, avoid smoking, restrict alcohol and treat vitamin D deficiency.

Why an Anti-Inflammatory Diet Helps
Your bones remodel and change all the time, with cells called osteoblasts constantly bringing calcium into bones and other cells called osteoclasts taking calcium out. If your immunity is over-active, it can slow down the osteoblasts to decrease the amount of calcium coming into bones and weaken them (Endocrinology, Jan 2004;145(1):447–452).

Your immunity is supposed to kill germs that attack you, and then when the germs are gone, it is supposed to dampen down. If your immunity stays active when the threat is gone, it can use the same defenses against invading germs to attack you. This is called inflammation. Pro-inflammatory foods turn on your immunity to cause these cells and proteins to attack and damage your own normal cells, while anti-inflammatory foods dampen down this response to protect your cells from damage from an overactive immunity.

A recent study following 3648 women for eight years found that those who ate the most pro-inflammatory diets (sugar and red meat) were at increased risk for osteoporosis and bone fractures (Osteoporosis International, October 13, 2017;1-9). Another recent study showed that older men who ate the most dietary fiber in cereals, fruits, vegetables, nuts and beans had the least hip bone loss as they age (Journal of Bone and Mineral Research, October 13, 2017).

Diabetics Suffer More Osteoporosis
The bones of diabetics are significantly weaker than those of non-diabetics (Bone, Dec, 2015;81:152-160). Overweight diabetics have a very high rate of osteoporosis (Diabetes & Metabolism, June 2008;34(3):193-205) and bone fractures (J Bone and Min Res, November 2012;27(11):2231–2237). Since obese people often have big bones, doctors used to think that excess weight would strengthen bones, but it does not. When blood sugar levels rise too high, sugar sticks to the outer membranes of all types of cells in your body, including those that form the matrix of bones. This weakens the bones and increases fracture risk (World J Diabetes, Aug 15, 2013;4 (4): 101–113).

Get Calcium from Food, Not Pills
Most scientists feel that you need an adequate amount of calcium to keep your bones strong (Maturitas, 2018;107:7), but a review of the world's literature showed that neither a high calcium diet nor calcium pills strengthen the bones of people over 50 (British Medical Journal, published online Sep 30, 2015). Another study showed that dietary calcium appears to have no effect on the rate of fractures in postmenopausal women (Nutrition, June 2009;25(6):647-54). Furthermore, no evidence exists that consuming more calcium than the recommended dietary allowance will result in better bone health or any other health benefits. (Ann Intern Med, October 25, 2016). People who take in relatively low amounts of calcium on a plant-based diet are not at higher risk for fractures than those who take in much larger amounts of calcium (Journal of Bone and Mineral Research, May 23, 2016).

Several recent studies suggest that you should get your calcium from foods, not pills. A study of more than 50,000 older adults showed that calcium pills with or without vitamin D had only weak, inconsistent effects on fracture risk (Climacteric, 2015;18 Suppl 2:22-31). Researchers at Johns Hopkins followed 2700 people who take calcium pills for 10 years and found that they had a 22 per cent increased risk of arteriosclerotic calcium plaques forming in the arteries leading to their hearts, compared to those who did not take calcium pills (Journal of the American Heart Association, October 11, 2016). This confirms other studies associating arterial plaque formation with calcium pills (Heart, Jun 2012;98(12):920-5). On the other hand, people who took in large amounts of calcium from food (>1400 milligrams per day) were 27 percent less likely to have plaques. This suggests that calcium in pills is processed differently from calcium in foods to accumulate in body tissues and increase risk for heart attacks (J Clin Hypertens (Greenwich), May 2, 2017) and strokes (Journal of the American Heart Association, Oct. 11, 2016). Calcium pills can also increase risk for forming kidney stones in susceptible people (Am J Clin Nutr, July 2011;94(1):270-277).

More than 50 percent of Americans take vitamins and mineral pills (JAMA, 2016;316(14):1464-1474), prompted by heavy advertising from the $32 billion largely unregulated supplement industry. I recommend eating a wide variety of foods that are good sources of calcium, such as cheese, yogurt, fish, leafy green vegetables and beans.

October 22nd, 2017
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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