Poor Bone Health

Poor Bone Health: Overview

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.

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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; Contributing 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 for bone 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 and 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 and 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 and 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.

On This Page

Poor Bone Health:

Signs, symptoms & indicators of Poor Bone Health:

Symptoms - Skeletal

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Recommendations 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

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].

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.

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.

Vitamins

Vitamin D

Getting enough calcium and vitamin D is vital to good bone health.

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