Managing Osteoporosis With Diet, Lifestyle, and Supplements 

Osteoporosis is the most common bone disease in humans. It is a disease of bone fragility from a low bone mineral density that leads to bone deterioration predisposing people to easy fracturing of bones. It generally comes from aging and a simultaneous decrease in sex hormones. But it can also come from excessive exercise, malnutrition, malabsorption diseases, hyperthyroidism, hyperparathyroidism, and long-term immobilization or space travel :).

Being predisposed to low bone strength and effortless fractures leads to decreased quality of life due to chronic pain and disability, with a higher risk for death from complications.

Osteoporosis is most common among Caucasians. Unfortunately, more than half of all postmenopausal white women, and one in five men will suffer a bone fracture due to osteoporosis. Hip fractures are the most debilitating, with a third of women not returning to independent living and 20% of men dying from complications following this type of fracture. 

Over 70% of people over 80 are affected. [1-3]

Risk factors for osteoporosis include a tendency to fall, aging, smoking, alcohol consumption, family history of osteoporosis, early menopause, a sedentary lifestyle, regular use of corticosteroids, and any condition that imposes immobilization. [4-5]

Fortunately, lifestyle and dietary amendments will lead to increased bone density and bone health, especially if detected early. Here is how to prevent the deterioration of bone tissue:

Stop smoking

Smoking reduces bone mass and is associated with an increased risk of vertebrae and hip fractures in women [6-7] and vertebrae fractures in men. [8] These effects may involve an alteration in metabolism and concentrations of circulating estrogen caused by smoking. [9]

I dearly recommend to stop smoking. You may do this by joining an Alan Carr group program to help you do it in a group setting with follow-up. 

Reduce alcohol consumption

Bone formation is decreased in people who consume excessive amounts of alcohol. The mechanisms are multifactorial including calcium deficiency, chronic liver disease which results in a predisposition toward vitamin D deficiency, and a higher risk of falling. [10-12] People predisposed to osteoporosis should not consume more than three drinks/week. 

Weight-bearing exercises and balance improving activities

Bone loss occurs when bone formation rate is lower than bone resorption rate. This happens with aging and lack of physical activity. However, weight-bearing exercises (walking and running) combined with strength training and balance exercises prevent bone degradation, restore some bone mass, and provide optimal preventative measures. [13-14]

Although non-weight-bearing exercises, such as swimming, yoga, and cycling, do not provide specific bone health benefits, [15] still, these activities are great for improving balance and can be done along with weight-bearing exercises for maximal support and fracture prevention.

Active children before puberty will achieve a higher peak bone mass than those who are not active, delaying the onset of osteoporosis during aging. [16]

Dietary factors

Since excessive body weight correlates with bone fractures, you want to maintain a healthy weight. To do this, I recommend joining the Guerrilla Diet Health and Weight Loss program. I also recommend learning more about natural hormonal balance.

Some studies show a relationship between caffeine intake and fracture risk; therefore, you want to limit your caffeine intake to less than 1 to 2 cups of caffeinated drinks a day. [17]

Supplements

Calcium

Calcium is a critical and integrative component of the human body, with over 99% of the body’s calcium being contained within the bones and teeth. 

An adequate dietary supply of calcium is required; otherwise, there will be bone resorption to return the calcium levels in the blood to healthy levels. Calcium requirements increase as people age, yet intestinal absorption decreases with age.

The Institute of Medicine advises consuming 1000 mg of calcium a day from 50-70 years and 1200 mg of calcium over 70 years. [18]

However, women not taking estrogen should take a higher calcium intake daily (~ 1,200 mg/day) already from 50 years. 

Long existing evidence suggests that calcium intake of up to 2,000 mg/day are safe for teenagers and adults. Calcium citrate supplements do not cause digestive complaints. They are best absorbed when taken in doses of 500-600 mg, with food that does not have high oxalate levels, preventing calcium absorption. [19-25] With calcium supplements, oxalate-rich foods that you should not consume together include spinach, tofu, potatoes, beets beans, almonds, and dates. 

Although calcium supplements may prevent osteoporosis and osteoporotic fractures, there is an increased risk of heart diseases and kidney stones with higher urine calcium levels. Therefore, if you are at risk of these diseases, instead of supplementing, I recommend consuming foods rich in calcium, such as a tablespoon of whole sesame seed paste a day, or nuts, kale, and other green leafy vegetables apart from spinach.

Vitamin D

Vitamin D is necessary for calcium absorption. It is also crucial for bone health and maintaining your balance through healthy muscular functioning. The active form of vitamin D, produced by the kidneys, declines with age due, and its levels regulate intestinal absorption of calcium. [26-29]

Also, certain medications increase the breakdown or prevent vitamin D absorption, including some anticonvulsive medications and glucocorticoids. Furthermore, elderly people who are housebound may get minimal sun exposure. One study found that the elderly have a twofold lower capacity to produce vitamin D3 in the skin than do young adults. [30]

Vitamin D supplements should help bring serum vitamin D levels to about 40 ng/mL.

I recommend supplementing with a dose of 1000 IU/day until age 70 and 1500 IU/day after 70 years. You can supplement vitamin D together with calcium. And if you do not consume suffient leafy green vegetables, vitamin K2 supplementation is required to help place the calcium into bone tissue.

To conclude

Osteoporosis is a common yet silent disease usually discovered upon the first fracture.

Osteoporosis can be prevented with effective lifestyle habits before any fractures occur. When suffering from the disease, to avoid a downward spiral, supplementation and healthy lifestyle habits are crucial.

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Thank You, 🙂

Dr. Galit Goldfarb

References