Got Osteoporosis?

I got this awesome email from Dr. Joel Fuhrman so I thought I’d share it here.

The National Osteoporosis Foundation estimates that 50% of women and 25% of men over the age of 50 will have an osteoporosis-related fracture during their lifetime.1 The best protection against osteoporosis is a combination of weight-bearing exercise and excellent nutrition.

Bone strength is directly related to muscle strength.
The most effective way to strengthen bone and protect against osteoporosis-related fractures is by increasing muscle strength.2 Weight-bearing exercises are ideal for improving balance and building bone strength.3 While swimming and biking are good for cardiovascular conditioning, they will not help protect against osteoporosis like running or lifting weights will.4 Back strengthening exercises are especially beneficial, providing lasting protection against spinal fractures in women who are at risk for osteoporosis.5

In Osteoporosis Protection for Life, I have put together a comprehensive approach combining dietary advice, supplements and special bone-strengthening exercises, offering a significant improvement over drug treatment for osteopenia and osteoporosis. This DVD gives people the information they need to put an effective osteoporosis prevention plan into action. Just a few minutes a day or fifteen minutes twice or week is all it takes to complete the exercises that will keep your bones strong for life.

For women, in addition to usual weight-bearing exercise, I also recommend wearing a weighted vest for a few hours each day to strengthen bones, not only during exercise, but as you work, shop, bend, stand, and move all day. Wearing a weighted vest has other benefits as well, such as burning more calories all day, increasing core strength, and stabilizing muscles, thus improving balance and decreasing the risk of falls.6

Certain foods promote breakdown of bone and osteoporosis. Other foods supply the body with the nutrients necessary to build and maintain healthy, strong bones.

The worst foods for bone health:
Animal protein and other high protein foods leave acidic residues in the blood, and the body responds by dissolving bone to release basic calcium salts to neutralize the acid, which results in loss of calcium in the urine. Many studies have found that high animal protein intake to be associated with low bone mass.7,8 In contrast, plant protein intake is associated with decreased hip fractures in the elderly.9 Natural plant foods do not leave an acidic residue in the blood or promote urinary calcium excretion.10
Salt promotes the excretion of calcium in the urine.11
Caffeine also contributes to urinary calcium loss. High caffeine intake is associated with increased bone loss and osteoporotic fractures.12,13
Soda, including diet and decaffeinated soda, is associated with bone loss.14,15 Soda consumption increases parathyroid hormone (PTH) in the blood, which increases blood calcium concentrations by stimulating bone breakdown. This increased blood calcium is then excreted in the urine.16

The best foods for bone health:
Whole plant foods are the best foods for bones. Studies show that individuals with the highest consumption of fruit and vegetables have the strongest bones. 17,18
Beans, seeds, and greens. A diet full of natural plant foods provides the calcium required to build strong bones. Green vegetables in particular are rich calcium sources. For example, one four-ounce serving of steamed kale has just as much calcium as one cup of milk. Broccoli, bok choy, sesame seeds, and garbanzo beans are also excellent calcium sources. Furthermore, the body absorbs about 50% of the calcium in green vegetables, compared to only 32% of the calcium in milk.19
Green vegetables are also high in vitamin K, which is a crucial component for maintaining healthy bones.20
Nuts and seeds are rich in magnesium, an essential mineral for the formation of bone tissue.21 They also help maintain adequate calorie and protein intake, to maintain muscle and bone mass without having to rely on high acid-forming animal products.

1. NOF. “Bone Health Basics.” National Osteoporosis Foundation. 2010. (accessed February 2011).
2. Rubin C, Turner AS, Muller R, et al. Quantity and quality of trabecular bone in the femur are enhanced by a strongly anabolic, noninvasive mechanical intervention. J Bone Min Res 2002;17:349-357.
3. Marques EA, Mota J, Machado L, Sousa F, Coelho M, Moreira P, Carvalho J. Multicomponent training program with weight-bearing exercises elicits favorable bone density, muscle strength, and balance adaptations in older women. Calcif Tissue Int. 2011 Feb;88(2):117-29.
4. Resnick, Mayer. “Running not swimming or biking is best kind of loading exercise for childrens bone growth.” 2004. (accessed February 2011).
5. Sinaki M, Itoi E, Wahner HW, et al. Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women. Bone. 2002;30(6):836-841.
6. Greendale GA, Salem GJ, Young JT, et al. A randomized trial of weighted vest use in ambulatory older adults: strength, performance, and quality of life outcomes. J Am Geriatr Soc 2000 48(3):305-11.
Greendale, GA, Hirsh SH, Hahn TJ. The effect of a weighted vest on perceived health status and bone density in older persons. Qual Life Res 1993 2(2):141-52.
Shaw JM, Snow CM. Weighted vest exercise improves indices of fall risk in older women. J Gerontol A Biol Sci Med Sci 1998 53(1):M53-8.
Snow CM, Shaw JM, Winters KM, Witzke KA. Long-term exercise using weighted vests prevents hip bone loss in postmenopausal women. J Gerontol A Bio Sci Med 2000;55(9):M489-91.
7. Sellmeyer DE, Stone KL, Sebastian A, Cummings SR. A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. Study of Osteoporotic Fractures Research Group. Am J Clin Nutr. 2001;73(1):118-122.
8. Devine A, Dick IM, Islam AF, et al. Protein consumption is an important predictor of lower limb bone mass in elderly women. Am J Clin Nutr. 2005;81(6):1423-1428.
9. Frassetto LA, Todd KM, Morris RC Jr, Sebastian A. Worldwide incidence of hip fracture in elderly women: relation to consumption of animal and vegetable foods. J Gerontol A Biol Sci Med Sci. 2000 Oct;55(10):M585-92.
10. Welch AA, Mulligan A, Bingham SA, Khaw KT. Urine pH is an indicator of dietary acid-base load, fruit and vegetables and meat intakes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population study. Br J Nutr. 2008 Jun;99(6):1335-43.
11. Teucher B, Fairweather-Tait S. Dietary sodium as a risk factor for osteoporosis: where is the evidence? Proc Nutr Soc. 2003;62(4):859-866.
12. Rapuri PB, Gallagher JC, Kinyamu HK, Ryschon KL. Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes. Am J Clin Nutr. 2001;74(5):694-700.
13. Hallström H, Wolk A, Glynn A, Michaëlsson K. Coffee, tea and caffeine consumption in relation to osteoporotic fracture risk in a cohort of Swedish women. Osteoporos Int. 2006;17(7):1055-1064.
14. McGartland C, Robson PJ, Murray L, et al. Carbonated soft drink consumption and bone mineral density in adolescence: the Northern Ireland Young Hearts project. J Bone Miner Res. 2003 Sep;18(9):1563-9.
15. Mahmood M, Saleh A, Al-Alawi F, Ahmed F. Health effects of soda drinking in adolescent girls in the United Arab Emirates. J Crit Care. 2008 Sep;23(3):434-40
16. Larson NS, Amin R, Olsen C, Poth MA. “Effect of Diet Cola on urine calcium excretion” ENDO 2010; Abstract P2-198.
17. Tucker KL, Hannan MT, Chen H, et al. Potassium, magnesium, and fruit and vegetable intakes are associated with greater mineral density in elderly men and women. Am J Clin Nutr 1999;69(4):727-736.
18. New SA, Robins SP, Campbell MK, et al. Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? Am J Clin Nutr 2000;71(1):142-151.
19. Weaver CM, Plawecki KL. Dietary calcium: adequacy of a vegetarian diet. Am J Clin Nutr 1994;59(suppl):1238S-1241S.
20. Feskanich D, Weber P, Willett WC, et al. Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr 1999;69(1):74-79.
21. Rude RK, Singer FR, Gruber HE. Skeletal and hormonal effects of magnesium deficiency. J Am Coll Nutr. 2009 Apr;28(2):131-41.

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