Osteoporosis

Also indexed as:Bone Loss, Brittle Bone Disease

Stand tall against osteoporosis. No matter what your age, it’s never too late to stop bone loss now for better posture and fewer fractures down the road. According to research or other evidence, the following self-care steps may be helpful.

• Pump it up
  Make weight-bearing exercise a regular habit to increase bone density and prevent osteoporosis
• Cut the caffeine
  Avoid excessive calcium loss in the urine by switching to healthier beverages
• Aim for lifelong calcium and vitamin D nutrition
  An extra 800 mg of calcium and 400 to 800 IU of vitamin D a day can help protect the bones, from childhood through adulthood
• Get your soy
  Make tofu, soy milk, soy protein, and other sources of beneficial isoflavones a regular part of your diet
• Watch the salt
  Avoid excessive salt intake and high-salt processed and restaurant foods that may contribute to calcium and bone loss.

About This Condition

Osteoporosis is a condition in which the normal amount of bone mass has decreased.

People with osteoporosis have brittle bones, which increases the risk of bone fracture, particularly in the hip, spine, and wrist. Osteoporosis is most common in postmenopausal Asian and Caucasian women. Premenopausal women are partially protected against bone loss by the hormone called estrogen. Black women often have slightly greater bone mass than do other women, which helps protect against bone fractures. In men, testosterone partially protects against bone loss even after middle age. Beyond issues of race, age, and gender, incidence varies widely from society to society, suggesting that osteoporosis is largely preventable.

Symptoms

Osteoporosis is a silent disease that may not be noticed until a broken bone occurs. Signs may include diminished height, rounded shoulders, dowager’s hump, and evidence of bone loss from diagnostic tests. Symptoms may include neck or back pain.

Healthy Lifestyle Tips

Smoking leads to increased bone loss. For this and many other health reasons, smoking should be avoided.

Exercise is known to help protect against bone loss. The more weight-bearing exercise done by men and postmenopausal women, the greater their bone mass and the lower their risk of osteoporosis. Walking is a perfect weight-bearing exercise. For premenopausal women, exercise is also important, but taken to extreme, it may lead to cessation of the menstrual cycle, which contributes to osteoporosis.

Excess body mass helps protect against osteoporosis. As a result, researchers have been able to show that people who successfully lose weight have greater bone loss compared with those who do not lose weight. Therefore, people who lose weight need to be particularly vigilant about preventing osteoporotic fractures.

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation	Why
Get your soy	Make tofu, soy milk, soy protein, and other sources of beneficial isoflavones a regular part of your diet.
Soy foods, such as tofu, soy milk, roasted soy beans, and soy protein powders, may be beneficial in preventing osteoporosis. Isoflavones from soy have protected against bone loss in animal studies. In a double-blind trial, postmenopausal women who supplemented with 40 grams of soy protein powder (containing 90 mg of isoflavones) per day were protected against bone mineral loss in the spine, although lower amounts were not protective. In a double-blind study, administration of the soy isoflavone genistein (54 mg per day) to postmenopausal women for one year reduced bone breakdown, increased bone formation, and increased bone mineral density of the hip and spine. The effect on bone density was similar to that of conventional hormone-replacement therapy. The same amount of genistein also prevented bone loss in a two-year double-blind study. Choose dairy foods wisely Different dairy products appear to have different effects on bone density and fracture rates. Opt for nonfat milk and yogurt over cottage cheese or American cheese. The effect of dairy products on the risk of osteoporosis-related fractures is subject to controversy. According to a review of 46 studies, different dairy products appear to have different effects on bone density and fracture rates. Milk, especially nonfat milk, probably does more good than harm because of its relatively lower protein and salt content, as well as its higher level of calcium. Cottage cheese and American cheese, on the other hand, probably do more harm than good. Cottage cheese is high in protein and salt but low in calcium, factors which could contribute to bone loss. American cheese is extremely high in salt and high in protein. These foods are not recommended as calcium sources for the prevention of osteoporotic fractures. Although there may be better ways of getting calcium, younger women who wish to prevent osteoporosis might consider nonfat milk and nonfat yogurt to be reasonable dietary calcium sources. Cut the caffeine Avoid excessive calcium loss in the urine from by switching to healthier beverages, like herbal teas, juices, and water. Caffeine increases urinary loss of calcium. Caffeine intake has been linked to increased risk of hip fractures and to a lower bone mass in women who consumed inadequate calcium. Many doctors recommend decreasing caffeinated coffee, black tea, and caffeine-containing soft drinks as a way to improve bone mass. Curiously, while caffeine-containing tea consumption has been linked to osteoporosis in some studies, others have reported that tea drinkers have a lower risk of osteoporosis than do people who do not drink tea. Possibly, the calcium-losing effect of caffeine in tea is overridden by other constituents of tea, such as flavonoids. Fine-tune your protein Too much or too little protein in your diet may increase osteoporosis risk. Studies attempting to uncover the effects of high animal protein intake on the risk of osteoporosis have produced confusing and contradictory results. The same is true of studies attempting to find out whether vegetarians are protected against osteoporosis. Moreover, while some studies report that protein supplementation lowers death rates and shortens hospital stays or reduces bone loss among people with osteoporosis,30 others have found that such supplementation is of little value. These conflicting findings may occur in part because dietary protein produces opposing effects on bone. On one hand, dietary protein increases the loss of calcium in urine, which should increase the risk of osteoporosis. On the other hand, normal bone formation requires adequate dietary protein, and low dietary protein intake has been associated with low bone mineral density. Current research shows that finding the line between too much protein and too little protein remains elusive, though extremes in protein intake—either high or low—might possibly increase the risk of osteoporosis. Watch the salt Avoid excessive salt and high-salt processed and restaurant foods that may contribute to loss of calcium and bone. Short-term increases in dietary salt result in increased urinary calcium loss, which suggests that over time, salt intake may cause bone loss. Increasing dietary salt has increased markers of bone loss in postmenopausal (though not premenopausal) women. Although a definitive link between salt intake and osteoporosis has not yet been proven, many doctors recommend that people wishing to protect themselves against bone loss use less salt and eat fewer processed and restaurant foods, which tend to be highly salted. Steer clear of soda People who drink sodas, particularly colas, may be more likely to experience bone loss and bone fractures. People who consume soft drinks have been reported to have an increased incidence of bone fractures, although short-term consumption of carbonated beverages has not affected markers of bone health. The problem, if one exists, may be linked to phosphoric acid, a substance found in many soft drinks, particularly colas. In one study, children consuming at least six glasses (1.5 liters) per week of soft drinks containing phosphoric acid had more than five times the risk of developing low blood levels of calcium compared with other children. In a study in adults, higher consumption of cola beverages was associated with more bone loss in women, but not in men. Consumption of non-cola carbonated drinks, on the other hand, was not associated with bone loss. Although a few studies have not linked soft drinks to bone loss, the preponderance of evidence now suggests that a problem may exist. Supplement Amount Why Calcium 800 to 1,500 mg daily depending on age and dietary calcium intake Calcium supplements help prevent osteoporosis, especially for girls and premenopausal women. It is often recommended to help people already diagnosed with osteoporosis. Strontium 600 to 700 mg daily under medical supervision Studies indicate that supplementing with strontium may help reduce bone pain, increase bone mineral density, and reduce the risk of some fractures. Vitamin D 400 to 800 IU daily depending on age, sun exposure, and dietary sources Vitamin D increases calcium absorption and helps make bones stronger. Vitamin D supplementation has reduced bone loss in women who don’t get enough of the vitamin from food and slowed bone loss in people with osteoporosis. It also works with calcium to prevent some musculoskeletal causes of falls and subsequent fractures. Copper 2 to 3 mg daily Copper is needed for normal bone synthesis, and one trial reported that copper reduced bone loss. DHEA Take under medical supervision: 50 mg per day DHEA may be helpful in preventing osteoporosis. In one trial, bone mineral density increased among healthy elderly women and men who were given DHEA. Fish Oil and Evening Primrose Oil 6 grams daily Fish oil combined with evening primrose oil (EPO) may improve calcium absorption and promote bone formation. Folic Acid (High Homocysteine) 5 mg with 1,500 mcg of vitamin B12 daily Homocystinuria, a condition associated with high homocysteine levels, frequently causes osteoporosis. By lowering homocysteine levels, folic acid may help prevent osteoporosis. Ipriflavone 600 mg daily along with 1,000 mg calcium daily Ipriflavone promotes the incorporation of calcium into bone and inhibits bone breakdown, thus preventing and reversing osteoporosis. Magnesium Adults: 250 mg up to 750 mg daily; for girls: 150 mg daily Supplementing with magnesium has been shown to stop bone loss or increased bone mass in people with osteoporosis. Progesterone Consult a qualified healthcare practitioner Preliminary evidence suggests that progesterone might reduce osteoporosis risk by promoting bone density. Red Clover Take an extract supplying 26 mg of biochanin A, 16 mg of formononetin, 1 mg of genistein, and 0.5 mg of daidzein per day In one study, supplementing with isoflavones from red clover reduced the amount of bone loss from the spine by 45%, compared with a placebo. Vitamin B12 (High Homocysteine) 1,500 mcg with 5 mg of folic acid daily Homocystinuria, a condition associated with high homocysteine levels, frequently causes osteoporosis. By lowering homocysteine levels, vitamin B12 may help prevent osteoporosis. Vitamin K 1,000 mcg daily Vitamin K is needed for bone formation, and supplementing with it may be a way to maintain bone mass. Black Cohosh Refer to label instructions Black cohosh has been shown to improve bone mineral density in animals fed a low-calcium diet. Boron Refer to label instructions Supplementing with boron has been reported to reduce urinary loss of calcium and magnesium. However, those already supplementing with magnesium appear to achieve no additional calcium-sparing benefit when boron is added. Therefore, people with osteoporosis should supplement with magnesium or boron, not both. Calcium and Vitamin D (Amenorrhea) Refer to label instructions Despite the lack of evidence that calcium and vitamin D supplements alone are helpful to amenorrheic women, they are still generally recommended to prevent the added burden of calcium and vitamin D deficiency from further contributing to bone loss. Fish Oil Refer to label instructions Supplementing with fish oil may improve calcium absorption and promote bone formation. Horsetail Refer to label instructions Horsetail is a rich source of silicon, and preliminary research suggests that this trace mineral may help maintain bone mass. Manganese Refer to label instructions A combination of minerals including manganese was reported to halt bone loss in one study. Some doctors recommend manganese to people concerned with bone mass maintenance. Silicon Refer to label instructions Silicon is required in trace amounts for normal bone formation, and supplementation with silicon has increased bone mineral density in a small group of people with osteoporosis. Vitamin B6 (High Homocysteine) Refer to label instructions Homocystinuria, a condition associated with high homocysteine levels, frequently causes osteoporosis. By lowering homocysteine levels, vitamin B6 may help prevent osteoporosis. Vitamin B-Complex Refer to label instructions In one trial postmenopausal women who combined hormone replacement therapy with B vitamins and other nutrients and dietary changes increased their bone density by a remarkable 11%. Whey Protein Refer to label instructions Some whey proteins may reduce bone loss. Milk basic protein (MBP) is a mixture of some of the proteins found in whey protein and has been shown to promote bone density Zinc Refer to label instructions Supplementing with zinc appears to be helpful in both preventing and treating osteoporosis.