An Holistic Approach to Osteoporosis

In two weeks we spring forward but the sidewalks are still icy and slippery, so although I miss walking, I am extra cautious. Osteoporosis (or bone loss) affects 10 million people aged 50 and older, 80% of whom are women. When bones lose mass, they become soft and brittle, increasing the risk of injuries and broken bones. Here in New England, where snow and ice are present, being aware of the risks of osteoporosis is essential for preventing injuries. Nutrition and Osteoporosis Three vitamins are involved in the formation and maintenance of healthy bones in our bodies: Vitamin C, vitamin D and vitamin K. Vitamin C Vitamin C is a water-soluble vitamin that the body does not synthesize, so we need to obtain it from the foods we eat. Because vitamin C is water-soluble, we don't store it in the body; instead, we eliminate it through urine, so we constantly need to consume it in our food. Vitamin C is required for collagen production and stability. Because collagen is a major protein in bone, its stability is directly tied to adequate vitamin C. Without it, collagen synthesis is reduced, and its catabolism (breakdown) increases, compromising bone integrity. Scurvy was a common condition among sailors while sailing across the oceans. Without any way to keep fruits and vegetables onboard they became severely deficient in vitamin C, which led to damaged connective tissue, soft bones and death. While citrus fruits are known to be a good source of vitamin C, so are bell peppers, brussel sprouts and broccoli. Vitamin D Vitamin D is the sun vitamin — a fat-soluble vitamin we obtain from the sun and from some foods, like fatty fish and beef liver. Vitamin D enters the body as an inactive compound and must be activated primarily in the liver and kidneys. A healthy liver and kidneys are essential for vitamin D activation. Vitamin D maintains adequate levels of calcium and phosphorus in the blood by promoting the absorption of calcium from the intestinal tract, which enables the mineralization of bone. Without it, bones become thin, brittle or misshapen. The normal range of vitamin D is 40 to 60 IU. However, most people in the northeast are deficient in vitamin D due to the long winter that keeps us bundled up and indoors for months. Vitamin K 2 Many people think of vitamin C and D when they think of bone health but neglect the essential role of vitamin K in transporting calcium from the blood to the bones. Vitamin K plays a vital role in bone health: Glue activation: Vitamin K activates the glue that binds calcium and bone minerals to form strong bones. Cellular Regulation: The bones are constantly being remodeled by two teams: builders and a demolition crew. Vitamin K helps building cells mature into permanent bone cells. At the same time, vitamin K limits the production of cells that break bone down. Stopping Bone Loss: It blocks NF-kβ, a pro-inflammatory immune messenger that causes the body to break down bones. Vitamin K deficiency is associated with reduced bone density at the hip and an increased risk of fragility fractures. Organ meats and fermented foods are key sources of vitamin K, as well as dark leafy greens such as kale and spinach. Hormones and Osteoporosis Hormones play a crucial role in protecting our bones throughout life. Estrogen regulates calcium metabolism, promotes bone formation and inhibits bone breakdown in women. In men, testosterone directly stimulates bone building. However, men need estrogen too, to maintain bone health. A study, "Evaluation of Clinical Meaningfulness of Red Clover Extract to Relieve Hot Flushes and Menopausal Symptoms in Peri- and Post-Menopausal Women," suggests people in midlife with lower estrogen may benefit from a daily cup of red clover tea. Red clover is a phytoestrogen, meaning it binds to estrogen receptors and elicits a response like estrogen but milder. Chronically elevated cortisol reduces calcium absorption in the gut and calcium loss through the kidneys, as well as the activation of vitamin D and bone formation. High cortisol also reduces estrogen and testosterone and their protective effects. Long-term cortisol elevation leads to inflammation and bone breakdown, therefore reducing stress, prioritizing sleep and reducing inflammation are essential for bone health. Osteoporosis and Gut Bacteria Research indicates that the gut microbiome plays a significant role in bone homeostasis and the development of osteoporosis. Gut bacteria influence osteoporosis through several pathways: Nutrient Absorption: They synthesize vitamin K2, which is critical for bone health. Intestinal pH: The composition of the microbiome influences gut pH, which is vital for calcium absorption. Short-Chain Fatty Acids: Microbial fermentation of fiber produces short-chain fatty acids that regulate bone cell metabolism and can increase bone mass and prevent bone loss by inhibiting bone resorption. The best way to support a thriving community of gut bacteria is to eat a high fiber diet and regularly include fermented foods. Osteoporosis and Movement Recent studies suggest that there is no single movement that is most beneficial; instead, engaging in a variety of movements can increase bone density and longevity. Historically, humans engaged in different types of movement in different seasons. While summer was for gardening, hiking and swimming, winter was for snowshoeing and indoor activities. Studies suggest that movement contributes to bone regeneration, specifically weight bearing aerobic exercises. Osteoporosis can reduce quality of life and life expectancy. It is therefore crucial for people to be proactive preventing the condition. Eat a nutrient dense diet, spend time in the sun daily, reduce stress and inflammation and find time for a variety of movements.