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Posted: September 30, 2008

Fighting Back with Diet and Activity

Avoiding the Crippling Grip of Osteoporosis

Osteoporosis is having a bone-brittling and devastating effect on the U.S. population – both women and men – and is a daily way of life or serious threat to more than half of all Americans over age 50.

With 10 million older adults estimated to have the disease and 34 million others identified by the National Osteoporosis Foundation (NOF) as having low bone mass, placing them at high risk for developing osteoporosis, the condition has become a major national health threat.

Almost insidiously, this condition -- known casually as "brittle bone disease" and the "silent disease" -- displays no obvious symptoms until it is advanced. It painlessly attacks bone tissue, breaking down bone mass, making bones porous, brittle, and fragile. If not prevented or left untreated, osteoporosis progressively deteriorates bone until it breaks, especially in the hip, spine, and wrist, though any bone is at risk.

For caregivers, the grim and often tragic reality is that their loved ones' quality of life is lessened by osteoporosis-related fractures. As devastating as today's picture is, the situation is expected to worsen. In fact, NOF says 50% of all women and 25% of all men over age 50 today will suffer an osteoporosis-related fracture in their remaining lifetime and the total number of fractures is expected to increase with multiple breaks.

Fighting Disease Naturally

With that dismal outlook as a backdrop, we are fortunate that there are ways to prevent osteoporosis in our elderly -- and to guard against it ourselves. Good eating habits are directly connected to building healthy bones and are easily achieved with just a little attention and simple lifestyle changes.

For example, eating a rainbow of fruits and vegetables as a part of your diet will support bone health, as will an active physical lifestyle. Aim for a minimum of five servings of a variety of fruits and vegetables each day and make an effort to include foods with calcium and vitamins D and K, which have extra strength to fight osteoporosis.

Getting enough calcium, the major fortifying component of bones, is one of the best ways to lessen the risk of osteoporosis. Calcium strengthens bones, which in turn makes us stronger and less likely to experience bone fractures. On the other hand, inadequate calcium intake speeds bone loss and the development of osteoporosis. Adults over age 50 should strive to get 1,200 milligrams of calcium each day and people over age 65 should get 1,500 mg.

Dairy Products Ideal Source

Dairy products such as non-fat and low-fat milk, cheese and yogurt are the best sources of calcium. Some foods may provide calcium, but they aren't absorbed as well by the body. Dark, leafy vegetables, canned fish with bones, some nuts such as almonds, and soy products that are calcium-fortified are also good sources.

A calcium supplement is recommended for those who are lactose intolerant or for anyone who doesn't eat three or more daily servings of calcium-rich foods. Calcium carbonate or calcium citrate are good choices, but more than 500-600 mg per dose won't be absorbed by the body.

Also, be careful not to jeopardize calcium absorption by taking too much caffeine, alcohol, protein and sodium. These have all been associated with increasing the risk for osteoporosis because they hasten calcium excretion from the body.

After Osteoporosis Strikes

What about after osteoporosis strikes? Vitamin D has recently become a hot topic in osteoporosis treatment following research findings that vitamin D deficiency is prevalent in osteoporosis patients. In response, new data shows that an aggressive vitamin D treatment plan should be considered in the care of these patients. Vitamin D helps the absorption of calcium and prevents urinary calcium loss. In fact, without sufficient amounts of vitamin D, the body can't absorb enough calcium to meet the body's needs even when suggested calcium levels are met.

Vitamin D is synthesized in the skin when exposed to UVB rays from the sun, and it can also come from diet. People who live north of 37 degrees latitude get very few UVB rays between November and February, so they can't produce much vitamin D at that time of year. Also, using a sunscreen with SPF 8 will reduce vitamin D production by 95%.

The skin's ability to produce vitamin D decreases significantly with age, as well. Food and supplementation are more reliable ways to get the D your body needs. Older adults and those who avoid the sun should get 800 IU (International Units) each day.

One cup of vitamin D fortified milk each day is one of our best sources of this important vitamin. It supplies a quarter of the estimated daily need of vitamin D for adults. Dairy products made with milk are not generally fortified. Fatty fish and fish oils such as cod liver oil and vitamin D fortified cereals, breads, and crackers are other food options.

Vitamin K Can Help

Another natural vitamin -- K -- is little known, but it is quickly gaining a healthy bone reputation for its association with reduced fracture incidence and higher bone mineral density. Following vitamin K supplementation, a recent review of 13 studies found less bone loss and an 80% reduction in hip fractures. It also has been shown to influence osteocalcin, a protein needed to bind calcium to the bone matrix.

When studies tested the bone health benefits of calcium, calcium plus vitamin D, and then calcium plus D and K, the latter had the best effect on osteoporosis. It has also been shown that people with osteoporosis have low levels of vitamin K, suggesting the source could help prevent the disease.

These findings are so strong that the American Medical Association suggests individuals at risk of fracture consume a diet rich in vitamin K. Current recommended intakes are 90 mg a day for women and 120 mg for men, but these reflect what the average American eats and not what the body needs. There is growing support for an increase in these recommendations.

Vitamin K is found in leafy green vegetables like lettuce, broccoli, Brussels sprouts, and vegetable oils, but the darkest greens like spinach, kale, and collards really pack the best punch. There are supplements for vitamin K as well in the form of multi-vitamins, some bone supplements, and single supplements up to 500 mg.

Eating a proper diet, maintaining good nutrition, and supplementing with natural vitamins will not only bring an overall well-being that affects all aspects of life, but it also will protect your quality of life and that of your loved one against the debilitating effects of osteoporosis.


Lori Zanteson is a California-based freelance writer. She specializes in topics related to families and can be reached at


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