Beating osteoporosis and having healthy bones is not simply about consuming more calcium; it is about vitamin D, magnesium, phosphorus, exercise, diet, Vitamin K2, and reducing alcohol, stress and even gut problems.
If there’s one thing that’s not simple, it’s bone health. But we’ll try.
1.Osteoporosis – the facts
- 1 in 5 men; 1 in 3 women globally over the age of 50 will suffer osteoporotic fracture – that’s 8.9 million fractures a year.
- Half of those people experiencing a fracture will have another.
- Two thirds of vertebral fractures are never diagnosed and thus left untreated.
Osteopenia is where your bones are weaker than they should be, but are not yet in a state of osteoporosis, where they could break.
2. You need Calcium
Everybody knows that calcium is crucial to bone health.
2.1 The levels of calcium in your body depend upon:
- Your calcium consumption
- The amount needed by, or released from, your bones
- The amount passing into your urine via your kidneys
2.2 The levels of calcium in your bloodstream are tightly controlled by three hormones:
- Calcitron – from your Thyroid
- PTH – Parathyroid hormone
- Vitamin D – in its active form calcitriol
2.3 The best calcium sources are:
- Tofu (from Soy): 100 mg contains 650 mg calcium
- Almonds: 1 cup; 200 gm contains 520 mg calcium
- Kale: 100 gm contains 400 mg calcium
- Beans: Soy – 100 gm contains 280 mg; Chickpeas 100 gm contains 120mg
- Dairy – milk, cheese – (1 cup of milk, 300 mg calcium)
- Greens – cabbage and spinach (1 cup, 200 mg); broccoli (1 cup, 60mg)
2.4 How does the bone incorporate Calcium?
It is estimated that 99% of the body’s calcium is in the bones. You think they are rigid structures but they are not. Your bones are ever-changing. Cells called osteoclasts are constantly breaking down old bone, so that cells called osteoblasts can reform the compounds into a fresh, new and stronger bone.
3. How much calcium do you need for bone health?
According to American Bone Health, there is evidence that too little calcium, and too much calcium are both harmful. For example, too much can cause serious heart problems.
A woman or a man over 50 should have a total calcium intake (diet and supplements) per day of 1500 mg to prevent osteoporosis.
4. What else do you need?
4.1 Vitamin D
For many people in the Western World, the issue isn’t low calcium, it is low vitamin D. In research on Covid in 2020, more than half the population of that sunny country Spain, had dangerously low plasma levels below 50 nmol/L.
Without enough vitamin D, bones can become thin, brittle and misshapen, causing a condition called ‘rickets’ in children and ‘osteomalacia’ in adults. American Bone Health and other Websites suggest that to prevent osteopenia, you need 2500 IUs of Vitamin D a day. 2500 IUs is 62.5 micrograms.
That would be at least 90 minutes of sun exposure to your body according to Professor Holick of Boston Medical School’s Bone Health Care Clinic, who believes you need between 100 and 150 nmol/L in your bloodstream to be properly healthy. The Endocrine Society says the same.
Chris Woollams at CANCERactive notes that 82% of women on diagnosis with breast cancer have levels below 50 nmol/L, and these women after drug treatment with bisphosphonates and Aromatase Inhibitors are at high risk of osteopenia and osteoporosis. No wonder. Woollams and Holick both recommend 5,000 IUs or 125 microgram as a supplement.
Magnesium is essential for healthy bones and people with higher consumption of magnesium have higher bone densities. Unfortunately, approximately 40% of adults in the Western world have low plasma levels of Magnesium.
This is caused by:
- Poor diet – a colourful Mediterranean or Rainbow Diet is full of magnesium-rich foods (whole grains, legumes, pulses, vegetables, fruit, olive oil, nuts and seeds etc.)
- Alcohol – Almost all alcohol is known to deplete magneesium levels; the exception being red wine.
- Consuming too much dairy – when dairy lines the gut it makes magnesium absorption harder.
- Drugs – many drugs, for example chemotherapy drugs, reduce magnesium levels in the body.
The answer is to eat a colourful Mediterranean diet, drink red wine and avoid too much dairy consumption.
Phosphorus is important in incorporating calcium into bones. A good helping of lentils should provide enough for a few days; or nuts and seeds.
Boron is an important mineral for bones. Unfortunately, levels decline in our bodies as we age. Boron supplementation has been shown to improve bone health (1) and you might benefit from a trace mineral liquid supplement if you are concerned.
4.5 Vitamin C
Vitamin C supplement use appears to have a beneficial effect on levels of Bone Mineral Density, especially among postmenopausal women using concurrent estrogen therapy and calcium supplements (2).
4.6 Vitamin K2
There is a great deal of research now on how vitamin K2 improves bone health (amongst significant other benefits!) (3).
4.7 A healthy microbiome
Yes, all illness starts in the gut and osteoporosis is no exception. People who suffer colitis or Crohn’s don’t absorb minerals like calcium or magnesium as well as healthy people.
Also, because vitamin D acts like a hormone in the body and a day in the sun might cause a large production which can have a knock on effect to other hormones, the liver de-activates it in the body. It was thought that the adrenals activated the vitamin D as required by the bones. Now it is known thast a group of gut bacteria produce a Short Chain Fatty acid (SCFA) called butyrate and that can activate Vitamin D. However, drugs, antibiotics, poor diet, sugar, alcohol, stress, smoking, parasites and more, could all damage levels of the bacteria that make butyrate.
Research is clear that lifting a few light weights in the gym help strengthen your bones. Load bearing exercise is the official term.
American Bone Health – https://americanbonehealth.org
The basics of bone health – https://www.ncbi.nlm.nih.gov/books/NBK45504/
Boston Med School, Bone Health – https://www.bmc.org/endocrinology