Osteoporosis

Osteoporosis, which means "porous bone," is a bone-thinning disease that has affected over 200 million people worldwide. It has been called the "silent disease" because it comes on with few or no warning signs. It is the major cause of fractures, particularly of the spine, hip, ribs and wrist in older persons. Common symptoms include a loss of height, a hunched back, and back pain. While the condition itself is not fatal, it makes bones more susceptible to fractures and can make moving around increasingly difficult. It is important to note that osteoporosis is NOT merely a loss of calcium from the bone. That condition is called osteomalacia. Osteoporotic bone is losing not only inorganic (calcium mineral) density but organic bone matrix made up primarily of collagen and specific proteins.

The group at highest risk for osteoporosis may be characterized by the post-menopausal, slender, small-boned, fair complexioned Caucasian woman. Men are also at risk, but tend to have congenitally denser bone, and sustain weight bearing exercise for longer periods. African American and Hispanic populations are much less prone than Caucasians to loss of bone density because they inherit, for the most part, a sturdier skeletal structure.

A woman's risk of osteoporosis greatly increases after menopause because her production of the sex hormone estrogen dramatically drops off at her peak of maturity. After 50 a woman clearly has other concerns than caring for infants, and has no need to continue to maintain her endometrium for the possibility of pregnancy. It so happens that reduced estrogen results in diminished levels of active Vitamin D (crucial for calcium absorbtion) and in increased calcium excretion. For this reason, many physicians choose to routinely administer small doses of synthetic estrogen to menopausal women. Although this seems logical, it is also well known that estrogen ingestion bears many risks including increased incidence of breast, cervical and ovarian cancer. Weight bearing exercise, such as walking for 30
minutes daily or an hour 3 times weekly, plus adequate nutrition which will be discussed below, is far superior treatment, in this author's opinion, to hormone therapy.

In addition, something that many physicians may have forgotten from biochemistry or physiology classes is that adequate stomach acid (HCl) is mandatory for calcium absorption. After the age of 40, when we no longer need to eat as much, stomach hydrochloric acid drops off naturally. If you do supplement with calcium, you may want to take a small glass of lukewarm or room temperature water with the juice of a quarter lemon 20 minutes before each meal. And please make sure to use a bioavailable form of calcium. Calcium citrate is the state-of-the-art way to deliver calcium supplements. Calcium carbonate (such as in TUMS) is very inefficient. "About 45% of the calcium is absorbed from calcium citrate in patients with reduced stomach acid, compared to 4% absorption from calcium carbonate." (Recker R., "Calcium absorption and achlorhydria." New England Journal of Medicine, 1985, 313, pp 70-73)

Coffee, more than 2 ounces of alcohol daily, and smoking all deplete serum calcium and are associated with an increased risk of developing osteoporosis. (Heaney, R., "Nutritional factors and estrogen in age-related bone loss." Clin. Invest. Med., 1981, 5, pp 147-155) One of the worst offenders in osteoporosis is high-phosphate drinks such as soda pops. Serum phosphates compete with calcium in the blood for cellular absorption. Other dietary implications in osteoporosis are excessive protein (we rarely need more than 2 ounces daily) and trace mineral deficiencies. Complex carbohydrates turn out to be culprits, once again: After ingesting sugar, urine calcium increases. Vegetarian diets are associated with a lower risk of osteoporosis because they eat less dense protein (and no mammalian protein) and probably consume less phosphorus and more bioavailable calcium from leafy green vegetables and colorful fruits, particularly berries. (Thom J., Morris J., Bishop A., Blacklock NJ, "The influence of refined carbohydrate on urinary calcium excretion," British Journal of Urology, 1978, 50, pp 459-464.) The so-called "anthocyanadins" (a
class of dark blue and red, highly nutritious pigments found in berries) have a remarkable ability to stabilize collagen, including that found in bone matrix.

The best approach to preventing, and treating, osteoporosis is a comprehensive plan that involves regular weight-bearing exercise, a good source of calcium and Vitamin D (as well as magnesium, B6, folic acid, B12, Vitamin K and trace minerals boron and strontium), botanical medicines for women with estrogen deficiency or in menopause, and a vegetarian diet.

Great juicing sources of
Calcium: alfalfa, comfrey leaves, dandelion leaves, nettle leaves, parsley, mustard greens, red clover flowers, collard greens, kale, broccoli (best is lightly steamed first), cooked garbanzo and soy beans.

Vitamin D: Sunshine (not necessary to put through the hopper), alfalfa, watercress, nettles.

Flavonoids (to stabilize collagen structures): Blackberries, blueberries, cherries, raspberries, salmonberries.

If you suspect you may have, or be heading towards, osteoporosis, or know someone who is concerned about the disease, please consult a medical professional. The naturopathic physician or nutritionist will be the most skilled at dietary counselling. To find the closest naturopathic physician or nutrionist trained in biochemistry and physiology please call the American Association of Naturopathic Physicians at (206) 326-1612.


References (other than those specifically indicated)

Wm McGarey, "Osteoporosis: The silent disease," Patient Care, 1988, 5, pp 191-194.

M Murray, J Pizzorno, "Encyclopedia of Natural Medicine," Prima Publishing, Rocklin CA 95677.