Osteoporosis is a massive problem. One review indicates that the annual incidence of osteoporotic fractures in women is greater than the combined rates of breast cancer, stroke and heart attack. It’s also a male issue. In Australia, the lifetime risk of sustaining an osteoporotic fracture is one in four for men.
And it’s not just osteoporosis, the end stage of a progressive bone-decaying disorder, that can lead to fractures. Studies show that a substantial number of those who suffer from osteopenia, the phase just before osteoporosis, when bones are becoming increasingly fragile, will go on to sustain fractures. I saw a male patient recently — a vegetarian in his mid-50s who did regular exercise, which included weight training, and considered himself to be at the peak of his powers — who had significant osteopenia.
Clearly, we are not intervening early enough to avert a medical disaster that is entirely preventable. The trouble is it’s a silent disorder. By the time our bones start to seriously crumble and break, we might be facing monstrous incapacity and untold suffering. Among those who have a hip fracture, 30 per cent of men and 20 per cent of women will die within one year. Why are our bones in such bad shape and what pre-emptive action can we take to ensure that we don’t add to the burgeoning osteoporosis statistics?
Calcium: beyond milk
Much of the dilemma hinges around poor nutrition and the fact that we aren’t getting enough of the rudimentary nutrients needed by our bones. This is surprising, seeing as we’re all consuming so much food. Somehow, with all that eating we’re not getting enough calcium. By “we”, I mean pregnant mothers, children, adolescents, women of reproductive age and a whole lot of men, not to mention seniors; so just about most of us.
If dairy is the most bio-available form of calcium, shouldn’t we all simply be drinking more milk? We would need to drink three cups of milk daily to get our daily quotient of 1000mg of calcium. For men, this would be a problem, as dairy consumption is associated with prostate cancer.
Then there’s the green vegetable option, but here we have to be careful not to consume vegetables that are high in oxalates, as these get in the way of calcium absorption. Spinach, for example, is rich in oxalates, which means Popeye was deluding us as children, and this is probably where the whole calcium deficiency thing began. Kale, broccoli and bok choy are free of oxalates. If you can develop a taste for kale, and really it’s quite delicious, half a cup will provide 94mg of calcium.
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Certain types of fish are also good calcium sources, with a half tin of sardines with their bones providing approximately 300mg of calcium. Tahini, which is sesame seed spread, and hummus, a chickpea spread, as well as soybeans are all reasonable sources of calcium.
As it turns out, we might not need as much as 1000mg of calcium a day, as some of the experts have suggested. A recent review by Professor Ego Seeman from the University of Melbourne, who’s recognised as a world authority on calcium metabolism, indicates that bone loss occurs only in those who are getting less than 400mg of calcium daily. We might therefore have been overestimating the amount of calcium we actually need.
For those who are concerned about obtaining even the revised amounts of calcium from food, according to Professor Seeman’s data, there are always calcium supplements. Unfortunately, as Professor Seeman points out in the same review, the benefits of calcium supplementation have been modest. Some research has even connected calcium supplementation in women with a rise in heart attacks, while other studies have failed to demonstrate such a relationship. Research hasn’t even investigated what effects calcium supplementation will have on men.
If we don’t need as much calcium as the experts have suggested, then why aren’t our bodies being served by this essential nutrient? The whole dilemma surrounding calcium might have something to do with vitamin D.
The vitamin D factor
Vitamin D is more than just a vitamin. It’s a master hormone that not only regulates the amount of calcium we absorb from our food but also marshals our immune system, setting up a firewall that protects us against a whole range of cancers. Vitamin D is manufactured predominantly from sunlight all around our bodies and we only need five minutes of midday sun in summer three times a week, and 20 minutes in winter, to obtain the necessary amount of this critical hormone.
There is some research suggesting that bacteria, in order to establish a successful insurgency inside our bodies, have found a way to neutralise vitamin D’s immune-boosting capacity, at the same time rendering it ineffective at facilitating the absorption of calcium. It’s not that we need to be fortifying our foods and supplementing with vitamin D. It’s just that what we already have isn’t working. In order to reinvigorate vitamin D, we would have to find and eliminate our primary nemesis — the bacteria.
As if a dysfunctional vitamin D and calcium system weren’t enough, evidence also indicates we aren’t getting sufficient amounts of the other essential nutrients, like protein, especially as we get older, as well as zinc and magnesium to look after our bones. The best way to assess the status of these nutrients is with a 24-hour urine collection rather than a blood test.
Health authorities suggest we have an X-ray to assess our bone density way into our 50s. This is far too late. Our bones start going downhill from our mid-30s, along with the decline in our hormones. Substances such as homocysteine and excess free-radical stress, together with a host of other potentially malevolent forces outlined in my book You Have the Power, can infiltrate and ultimately decimate the architecture of our bones. Finding a health practitioner who can assess these and commencing a program dedicated to optimising bone health will go a long way to foiling an impending health catastrophe.
