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Our bones are alive... and much more complex and in need of nutrition than originally thought. While it occurs to us to think about bone loss as we age, the majority of our youth today are deficient in calcium and bone building nutrients.
Healthy bones form the foundation for a vital, energetic life. Our skeletons confer mobility, flexibility, mechanical support, and serve as a calcium reservoir, which the body draws upon to help maintain consistent levels of calcium in the blood. Building and maintaining healthy bones throughout life requires an intricate interplay among several physiological and lifestyle factors.
Although bones often are viewed as inert, they really are dynamic, living tissue. Bones are built primarily of a collagen-protein framework, which makes them flexible, and mineralized calcium phosphate, which makes them strong and rigid. This combination allows bones to withstand considerable mechanical stress.
Throughout life, bones undergo cycles of tear-down and repair. Osteoclast cells remove old bone (resorption), and osteoblast cells lay down new bone (formation). This modeling-remodeling process is regulated by factors such as nutritional status, sex hormone status, parathyroid hormone levels, and vitamin D status. Perhaps the most critical life stages for ensuring bone health are childhood through young adulthood. During these times, bone formation outpaces bone loss, resulting in net bone accumulation. About 50% of peak bone mass accrues during adolescence. About 90% of a person's total bone mineral content is deposited by age 18, and 99% is deposited by age 22. Bone density slowly builds until around age 30, when peak bone mass is attained.
Osteoporosis
Osteoporosis is the most common bone disorder encountered in clinical practice, according to an October 1997 report by Mayo Clinic researchers. According to them, "It is also one of the most important diseases facing our aging population."
There was a time when physicians viewed osteoporosis as an inevitable part of the aging process, completely out of our control. Nothing could be further from the truth. Osteoporosis is not a "normal" part of aging. In fact, it can be prevented and treated effectively.
Other Bone Diseases
Vitamin D deficiency causes rickets, a painful, deforming bone disease characterized by undermineralization of the skeleton. In the past, rickets was fairly common in the U.S. but was virtually eradicated after routine vitamin D fortification of most milk products in the1930s. According to several recent reports, however, rickets is again on the rise and vitamin D supplementation may be prudent especially for dark-skinned infants who are exclusively breast-fed and not exposed to sufficient sunlight.
Incidence; Risk Factors
The result is a widespread emergence of osteoporosis in adults under forty years of age. In addition to this startling discovery, research has placed degenerative joint conditions, such as osteoarthritis, at nearly 50 million Americans.
Nearly 50% of healthy American women are at an increased risk of bone breakdown. Besides being female, other risk factors include having a small frame, fair complexion, family history of bone conditions, sedentary lifestyle, consumption of alcohol, hormone imbalances, and a diet low in fats.
Modifiable factors that increase risk for bone loss:- Cigarette smoking and alcohol abuse
- Medications such as some types of anticonvulsants or glucocorticoids (corticosteroids, prednisone, dexamethasone)
- Low levels of estrogen in women or low levels of testosterone in men.
Non-modifiable factors that increase risk forbone loss:- Gender. Women are at greater risk than men.
- Age. Bone loss increases with age.
- Body size. Small, thin women are more susceptible than larger women.
- Ethnicity and heredity. Caucasian and Asian women are at greatest risk.
- African-American and Hispanic women have a lower but still significant risk.
- Genetics. If a parent suffers from osteoporosis or an osteoporotic bone fracture, the children tend to have reduced bone mass and increased risk.
Signs & Symptoms
Common symptoms of poor bone health include brittle bones, gum disease, poor bone healing, weak muscles, premature greying (before forty), joint and tendon soreness, and lots of plaque on the teeth.
Diagnosis & Tests
The question of when you should have your bone health screened depends on your diet and lifestyle. Some women should assess bone health as early as their late twenties or early thirties. Before you begin supplementation or other intervention, you should learn your rate of bone breakdown.
Treatment & Prevention
Therapy is determined by a baseline rate of bone breakdown. Subsequent screening can measure relative changes resulting from therapy.
There are a multitude of ways to support the health of joints and bones, deterring the onset of serious deterioration of both bone and cartilage. If you start with the basics (a healthy diet and regular exercise) and add proper supplementation, then you are off to a great start.
Begin by eating a healthy diet of whole grains, plenty of vegetables, fish, and mineral-rich nuts and seeds. Avoid bone-leaching foods such as red meats, refined and acid-forming foods, fried or fast foods, sodas, dairy, sugared foods, caffeine, excess salt, and foods that contain solanine, such as eggplant, tomatoes, and those of the nightshade family.
Include regular exercise in your lifestyle. In addition to providing oxygenation to body tissue, it improves metabolization and absorption of vitamins and minerals. Regular exercise builds and strengthens muscle and bones.
Do not smoke. It increases bone brittleness and inhibits bone growth.
Modifiable factors that promote bone health:- Regular physical activity
- Sound eating habits
- Adequate calcium consumption
- Adequate vitamin D status
Complications
Left untreated, rapid bone breakdown leads to a gradual weakening of bone tissue. Eventually, vertebrae in the spine can crack and compress from even simple activities like bending to tie a shoelace. This results in permanent spinal deformities ("Dowager's Hump") and painful fractures of the wrist, hip, and spine. Monitoring your bone health early is the key to successful treatment.
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Recommendations and treatments for Poor Bone Health: | | | | | Diet |  Increased Fruit/Vegetable Consumption | Eat plenty of fresh green, leafy vegetables and colored foods, such as kale, tomatoes and peppers. These foods are great sources of bone-building nutrients like calcium and vitamin K. Eat other foods high in calcium and magnesium such as seeds and nuts, broccoli, brown rice, avocado, and beans. |
Caffeine/Coffee Avoidance| | Caffeine leaches calcium from the bones. |
Animal/Saturated Fats Avoidance| | Reduce intake of animal fats and concentrate on the "good" fats found in fresh, cold-water fish, olive, canola, evening primrose, and flax oils. |
Soft Drink Avoidance| | Carbonated drinks leach calcium from the bones. |
Alcohol Avoidance| | Alcohol leaches calcium from the bones. |
 Processed Foods Avoidance| | Eat organic whenever possible and eat whole grains instead of refined flour. |
 Reduced Protein Diet| | Eat a moderate amount of protein. Too much (or too little) protein can lead to poor bone health. |
Soy Isoflavones (genistein, daidzein)| | Preliminary and sometimes conflicting research suggests that soy foods have a positive effect on bone health. Two small 6-month studies showed that soy protein and isolated isoflavones (a component of soy), respectively, had beneficial effects on spinal bone density [Potter et al. 1998; Alekel et al. 2000]. |
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Habits |
Aerobic Exercise| | Exercise frequently and consistently, with a special focus on weight-bearing exercises such as walking since these strengthen bones. |
Tobacco Avoidance| | Smoking has been shown to increase the risk of developing osteoporosis. |
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Mineral |
Calcium| | Calcium is essential for healthy bones. |
Salt Intake Reduction| | Because urinary sodium excretion and urinary calcium excretion occur together in the kidneys, increasing the level of dietary sodium triggers urinary calcium losses [Massey and Whiting, 1996]. According to data from salt-loading trials, when calcium consumption is moderate or high, 500mg of sodium ingested as sodium chloride will draw out about 10mg of calcium. [Institute of Medicine 1997, p. 75; Massey and Whiting, 1996] In other words, sodium leaches calcium from the bones. |
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KEY | | May do some good | | | Likely to help | | | Highly recommended |
GLOSSARY
Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. The body also needs calcium to carry nerve signals, keep the heart functioning, contract muscles, clot blood and maintain healthy skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.
Cartilage
Specialized fibrous connective tissue that forms the skeleton of an embryo and much of the skeleton in an infant. As the child grows, the cartilage becomes bone. In adults, cartilage is present in and around joints and makes up the primary skeletal structure in some parts of the body, such as the ears and the tip of the nose.
Corticosteroid (Corticosteroids)
Steroid hormone produced by the adrenal cortex.
Flax (Flax Oil, Flax Seed)
Flax Seed or Flax Oil. Flax oil is nutty-flavored oil that is pressed out of flax seeds and is one of the richest sources of Essential Fatty Acids (EFAs), a vital element for good health. The oil making process removes many of the seed's phytoestrogens which offer several health-related benefits including reducing the risk of cancer and alleviating menopausal symptoms. Many choose to use the whole seed because of its fiber and lignan content. Flaxseed oil is light- and temperature-sensitive and must be stored in the refrigerator.
Hormones (Hormone)
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Kidneys (Kidney, Renal)
Bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage. The kidneys are sophisticated reprocessing machines, each day handling about 50 gallons of blood to sift out about half a gallon of waste products and extra water. The waste and extra water become urine, which flows to the bladder through tubes called ureters. The actual filtering occurs in tiny units inside the kidneys called nephrons. Every kidney has about a million nephrons. In a nephron, a glomerulus -- which is a tiny blood vessel, or capillary -- intertwines with a tiny urine-collecting tube called a tubule. A complicated chemical exchange takes place, as waste materials and water leave your blood and enter your urinary system. The kidneys recycle chemicals such as sodium, phosphorus, and potassium and thus regulate their levels. Renal: Pertaining to the kidneys.
Mineral (Minerals)
Plays a vital role in regulating many body functions. They act as catalysts in nerve response, muscle contraction and the metabolism of nutrients in foods. They regulate electrolyte balance and hormonal production, and they strengthen skeletal structures.
Osteoarthritis (Osteoarthritic)
A condition involving degeneration of cartilage and supporting joint tissue, which results in pain, swelling and reduced mobility, as the cartilage wears away and allows bone to rub against bone.
Osteoblast (Osteoblastic, Osteoblasts)
A bone-forming cell.
Osteoporosis
A disease in which bone tissue becomes porous and brittle. The disease primarily affects postmenopausal women.
Parathyroid Hormone
A hormone released by the parathyroid glands that acts to keep a constant level of calcium in body tissues.
Protein (Proteins)
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Rickets
Vitamin-D deficiency characterized by abnormal calcification of bone tissues.
Sodium
An essential mineral that our bodies regulate and conserve. Excess sodium retention increases the fluid volume (edema) and low sodium leads to less fluid and relative dehydration. The adult body averages a total content of over 100 grams of sodium, of which a surprising one-third is in bone. A small amount of sodium does get into cell interiors, but this represents only about ten percent of the body content. The remaining 57 percent or so of the body sodium content is in the fluid immediately surrounding the cells, where it is the major cation (positive ion). The role of sodium in the extracellular fluid is maintaining osmotic equilibrium (the proper difference in ions dissolved in the fluids inside and outside the cell) and extracellular fluid volume. Sodium is also involved in nerve impulse transmission, muscle tone and nutrient transport. All of these functions are interrelated with potassium.
Testosterone
The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.
Vitamin D
A fat-soluble vitamin essential to one's health. Regulates the amount of calcium and phosphorus in the blood by improving their absorption and utilization. Necessary for normal growth and formation of bones and teeth. For Vitamin D only, 1mcg translates to 40 IU.
Vitamin K
Helps the blood clot when the body is injured.
Last updated: May 04, 2008
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