Protecting your bones
It's not
just about what you eat
The bone-thinning condition called osteoporosis can
lead to small and not-so-small fractures. Although many people think of calcium
in the diet as good protection for their bones, this is not at all the whole story.
In fact, in a 12-year Harvard study of 78,000 women, those who got the most calcium
from dairy products actually broke more bones than women who rarely drank milk.1
Similarly, a 1994 study of elderly men and women in Sydney, Australia, showed
that higher dairy product consumption was associated with increased fracture risk.
Those with the highest dairy product consumption had approximately double the
risk of hip fracture compared to those with the lowest consumption.2 To protect
your bones you do need calcium in your diet, but you also need to keep calcium
in your bones.
How to get calcium into your bones
1. Get calcium
from greens, beans, or fortified foods. The most healthful calcium sources are
green leafy vegetables and legumes, or 'greens and beans' for short. Broccoli,
Brussels sprouts, collards, kale, mustard greens, Swiss chard, and other greens
are loaded with highly absorbable calcium, and a host of other healthful nutrients.
The exception is spinach, which contains a large amount of calcium but tends to
hold onto it very tenaciously, so that you will absorb less of it.
Beans
are humble foods, and you might not know that they are loaded with calcium. There
is more than 100 milligrams of calcium in a plate of baked beans. If you prefer
chickpeas, tofu, or other bean or bean products, you will find plenty of calcium
there, as well. These foods also contain magnesium, which your body uses along
with calcium to build bones.
If you are looking for a very concentrated calcium
source, calcium-fortified orange or apple juices contain 300 milligrams or more
of calcium per cup in a highly absorbable form. Many people prefer calcium supplements,
which are now widely available.
Dairy products do contain calcium, but it
is accompanied by animal proteins, lactose sugar, animal growth factors, occasional
drugs and contaminants, and a substantial amount of fat and cholesterol in all
but the defatted versions.
2. Exercise, so calcium has somewhere to go. Exercise
is important for many reasons, including keeping bones strong. Active people tend
to keep calcium in their bones, while sedentary people lose calcium.
3. Get
vitamin D from the sun, or supplements if you need them. Vitamin D controls your
body's use of calcium. About 15 minutes of sunlight on your skin each day normally
produces all the vitamin D you need. If you get little or no sun exposure, you
can get vitamin D from any multiple vitamin. The Recommended Dietary Allowance
is 200 IU (5 micrograms) per day. Vitamin D is often added to milk, but the amount
added is not always well controlled.
How to keep it there
It's not enough
to get calcium into your bones. What is really critical is keeping it there. Here's
how:
1. Reduce calcium losses by avoiding excess salt. Calcium in bones tends
to dissolve into the bloodstream, then pass through the kidneys into the urine.
Sodium (salt) in the foods you eat can greatly increase calcium loss through the
kidneys.3 If you reduce your sodium intake to one to two grams per day, you will
hold onto calcium better. To do that, avoid salty snack foods and canned goods
with added sodium, and keep salt use low on the stove and at the table.
2.
Get your protein from plants, not animal products. Animal protein-in fish, poultry,
red meat, eggs, and dairy products-tends to leach calcium from the bones and encourages
its passage into the urine. Plant protein-in beans, grains, and vegetables-does
not appear to have this effect.4
3. Don't smoke. Smokers lose calcium, too.
A study of identical twins showed that, if one twin had been a long-term smoker
and the other had not, the smoker had more than a 40 percent higher risk of a
fracture.5
American recommendations for calcium intake are high, partly because
the meat, salt, tobacco, and physical inactivity of American life leads to overly
rapid and unnatural loss of calcium through the kidneys. By controlling these
basic factors, you can have an enormous influence on whether calcium stays in
your bones or drains out of your body.
Hormone supplements have serious risks
Some doctors recommend estrogen supplements for women after menopause as a way
to slow osteoporosis, although the effect is not very great over the long run,
and they are rarely able to stop or reverse bone loss.
Many women find these
hormones distasteful because the most commonly prescribed brand, Premarin, is
made from pregnant mares' urine, as its name suggests. What has many physicians
worried is the fact that estrogens increase the risk of breast cancer. The Harvard
Nurses' Health Study found that women taking estrogens have 30 to 80 percent more
breast cancer, compared to other women.6 Moreover, Premarin may aggravate heart
problems. In a study of 2,763 postmenopausal women with coronary disease followed
for an average of four years, there were as many heart attacks and related deaths
in women treated with the combined regimen of estrogens and a progesterone derivative,
as with placebo, but the coronary problems occurred sooner in women taking hormones.
Hormone-treated women were also more likely to develop dangerous blood clots and
gallbladder disease.7 Controlling calcium losses is a much safer strategy.
Reversing Osteoporosis
If you already have osteoporosis, there is an additional
step that you might consider: using natural progesterone to reverse it. By a fluke
of nature, an exact copy of human progesterone exists in wild yams, soybeans,
and certain other plants. The amount in cooked foods is not enough to help, but
manufacturers can easily isolate the progesterone and put it into a transdermal
skin cream. The progesterone passes through the skin into the bloodstream. It
reaches the bone, where it stimulates bone-building cells, called osteoblasts,
to build healthy new bone. In one three-year study of post-menopausal women treated
with natural progesterone, bone density increased by about 15 percent, which is
more than enough to have a major effect on fracture risk.8
Many products
with 'wild yam extract' on their labels do not contain enough progesterone to
be of any benefit. However, the most popular brand, Pro-Gest, does have adequate
and effective natural progesterone. It is available from Transitions for Health
(800-648-8211).
Osteoporosis in men
Osteoporosis is less common in men
than in women, and its causes are somewhat different. In about half the cases,
a specific cause can be identified and addressed:9
Steroid medications, such
as prednisone, are a common cause of bone loss and fractures. If you are receiving
steroids, you will want to work with your doctor to minimize the dose and to explore
other treatments.
Alcohol can weaken your bones, apparently by reducing the
body's ability to make new bone to replace normal losses. The effect is probably
only significant if you have more than two drinks per day of spirits, beer, or
wine.
A lower than normal amount of testosterone can encourage osteoporosis.
About 40 percent of men over 70 years of age have decreased levels of testosterone.
In many of the remaining cases, the causes are excessive calcium losses and
inadequate vitamin D. The first part of the solution is to avoid animal protein,
excess salt and caffeine, and tobacco, and to stay physically active in order
to reduce calcium losses. Second, take vitamin D supplements as prescribed by
your physician. The usual amount is 200 IU (5 micrograms) per day, but it may
be doubled if you get no sun exposure at all. If you have trouble absorbing calcium
due to reduced stomach acid, your doctor can recommend hydrochloric acid supplements.
www.VegSource.com
References
1. Feskanich D, Willett WC, et al. Milk,
dietary calcium, & bone fractures in women: a 12-year prospective study. Am
J Publ Health 1997.
2. Cumming RG, Klineberg RJ. Case-control study of risk
factors for hip fractures in the elderly. Am J Epidemiol 1994.
3. Nordin BEC,
Need AG, et al. The nature & significance of the relationship between urinary
sodium & urinary calcium in women. J Nutr 1993.
4. Remer T, Manz F. Estimation
of the renal net acid excretion by adults consuming diets containing variable
amounts of protein. Am J Clin Nutr 1994.
5. Hopper JL, Seeman E. The bone
density of female twins discordant for tobacco use. N Engl J Med 1994.
6.
Colditz GA, Stampfer MJ, et al. Type of postmenopausal hormone use & risk
of breast cancer. 1992.
7. Hulley S, Grady D, et al. Randomized trial of estrogen
plus progestin for secondary prevention of coronary heart disease in postmenopausal
women. JAMA 1998.
8. Lee JR. Osteoporosis reversal: the role of progesterone.
Int Clin Nutr Rev 1990.
9. Peris P, Guanabens N, Monegal A, et al. Aetiology
& presenting symptoms in male osteoporosis. Br J Rheumatol 1995.
Calcium
and Magnesium in Foods (mg)
Food Source
Barley (1 cup)
Black turtle
beans (1 cup, boiled)
Broccoli (1 cup, boiled)
Brussels sprouts (8 sprouts)
Butternut squash (1 cup, boiled)
Chick peas (1 cup, canned)
Collards (1
cup, boiled)
Figs, dried (10 medium)
Great northern beans (1 cup, boiled)
Green beans (1 cup, boiled)
Kale (1 cup boiled)
Mustard greens (1 cup,
boiled)
Navel orange (1 medium)
Navy beans (1 cup, boiled)
Oatmeal,
instant (2 packets)
Orange juice, calcium-fortified (1 cup)
Pinto beans
(1 cup, boiled)
Raisins (2/3 cup)
Soybeans (1 cup, boiled)
Sweet potato
(1 cup, boiled)
Swiss chard (1 cup, boiled)
Tofu (½ cup)
White
beans (1 cup, boiled) Calcium
57
103
94
56
84
80
358
269
121
58
94
150
56
128
326
350*
82
53
175
70
102
258
161 Magnesium
158
91
38
32
60
78
52
111
88
32
24
20
15
107
70
-
95
35
148
32
152
118
113
Source: J.A.T. Pennington,
Bowes and Church's Food Values of Portions Commonly Used. (Philadelphia: J.B.
Lippincott, 1994.) *Information from manufacturer.