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Osteoporosis: How Diet, Exercise And Lifestyle Can Help Fight Osteoporosis

March 29, 2023
6 minute read

DID YOU KNOW?

Osteoporosis is the most common bone disease in humans and is a serious disease for post menopausal women. Features of Osteoporosis include: low bone mass, deterioration of the microarchitecture of the bone tissue, bone fragility, diminished bone strength and increased fracture risk.

• Bone health is the balance between bone resorption (breakdown) and bone formation.  Bone loss and increased fracture risk is caused by an imbalance between removal of bone and replacement

• By the time most people are thinking about osteoporosis and bone health the damage has already been done to their bone architecture and the conversation with their Dr becomes about taking medication to stop the deterioration as improving bone health or making bones stronger after a diagnosis of Osteoporosis is uncommon – it’s really about managing the condition and preventing it from getting worse.

LETS TALK NUMBERS (THEY SHOULD SHOCK YOU)

  • 4.74 million Australians have poor bone health:  22% have osteoporosis and 78% have osteopenia (the step before osteoporosis). By 2022, it is estimated there will be 6.2 million Australians over the age of 50 with osteoporosis or osteopenia. That is a 31% increase from 2012
  • According to the National Prescribing Scheme, it is estimated that by 2022, a fracture will occur every 2.9 minutes, resulting in 501 fractures per day, 3521 fractures per week, and 183,105 fractures per year.
  • According to the National Prescribing Service, In the first 5 years post-fracture, the study found that approximately 26% of women and 37% of men died. If a repeat fracture occurred within the same timeframe, the mortality risk increased dramatically to 75% for men and 50% for women.

THE DETAILS

Well just a few more stats to really hammer the point home because I want everyone to be as outraged as I am and pass that passion onto their clients:

  • approximately 1.5 million OP hip fractures occur each year in the US of which 250,000 are hip fractures
  • After an OP hip fracture, a woman's risk of dying doubles and mens' risk triples
  • Of those that sustain an OP hip fracture, 10-20% die in the subsequent 6 months, 50% of those who survive will be unable to walk without assistance, and 25% will require long term home care

So, if you survive, your independence and quality of life will be substantially impacted.  These stats and this language should be Sobering.

It's important to know what impacts bone health so we can start talking to our clients and patients about it and offer preventative advice(good news comes later).  The sooner we become aware of Bone Health, the sooner we can enact our preventative Medicine.

Peak bone mass in women is at 28 years, then bone mass is slowly lost at a rate of .4% per year in the femoral neck.  After menopause the loss accelerates to 2% per year during the first 5-10 years of Menopause.

Common things that negatively impact bone health:

  • Age of menarch, menstrual regularity.
  • Nutrient deficiencies:  vitamin D & K2, Magnesium, Calcium
  • Balanced diet:  acid vs alkaline diet
  • Smoking (cadmium/nicotine) cause bone loss
  • Excessive alcohol consumption
  • Certain Medications including Corticosteroids:  they reduce the body's ability to absorb calcium and increase how fast bone is broken down. The more of these drugs you take and the longer you take them, the greater your risk of developing osteoporosis.
  • History of fracture in a 1st degree relative increases risk fracture (genetic risk)
  • Parathyroid gland problems

IS THERE ANY GOOD NEWS?

The time to really think about bone health is (at the latest) in your 30’s – especially for women. Perimenopause is a time when oestrogen production is declining and this can start in the early 40’s contributing to a decline in bone health. The first 5 years after menopause bone loss is accelerated due to oestrogen decline.

DIET/NUTRITION

There is a lot you can do preventatively to reduce your risk of osteoporosis:

  • Assess digestive health – many of my patients have low hydrochloric acid production in their stomachs which may impact the ability to absorb key nutrients like calcium and iron and break down the proteins that you are eating.
  • Other unresolved gut and digestive problems will also be impactful - many people just "put up" with issues but there is a bigger picture to be aware of
  • Poorly managed stress can increase cortisol which is damaging to bone health and affect digestive health.
  • Poor sleep has many flow on affects including blood sugar balance and elevated cortisol
  • Review/understand medications: certain medications may cause or contribute to bone loss.
  • Avoid factors that promote calcium excretion:  sodium, sugar, excessive protein, soft drinks)

Choose an alkalising diet – increased diet induced acidity takes a toll on bone health. A diet high in animal protein may affect your acid/base balance (balance this idea with the fact that most older adults are protein deficient) 

Want to see how your diet stacks up in nutrient density: try using an app like chronometer or try nutritiondata.self.com and track what you are eating for a week or two.

NUTRIENTS

There is a lot you can do preventatively to reduce your risk of osteoporosis: ensure adequate intake of key nutrients:

  • ·Calcium- 800-1400mg day. Source:sardines, almonds, chia seeds, broccoli, buckwheat, dairy products, egg yolk, green leafy veg, turnips.
  • ·Magnesium - 350-400mg day. Source:almonds, cocoa, eggs, leafy greens, figs, legumes, wholegrains.
  • ·Vitamin D -1000IU per day or adequate safe sun exposure. Bone density correlates directly with serum vitamin D levels. Source: Synthesized by action of sunlight on the skin or (food)
    cod liver oil, butter, egg yolk, sprouted seeds.
  • ·K2: 100mcg day. Increases production of osteocalcin that improves bone calcification and inhibits arterial calcium deposits. Source:bacterial synthesis in the gut, broccoli, cabbage, eggs, kale, kelp, liver, oats, beef liver, spinach.
  • ·Other important vitamins & minerals: Zinc, copper, manganese,boron, silica, folate, B12, B6, Vitamin C, K1.

EXERCISE

Stimulate bone tissue building activity with exercise. An analysis published in BMJ (British Medical Journal) found that programs that include balance, strength, and resistance training reduced the odds of falls resulting in fractures by more than 60%. Harvard Health recommend a program that includes weight bearing activity, muscle strengthening, balance and flexibility.  See govt guidelines for minimums which include 150 mins.

My personal favourite types of exercise that meet these criteria are Resistance Training, Yoga, Walking and Dancing to get the benefits of all of these activities.  The fantastic news is that there are so many ways to move our bodies to meet these criteria. 

BUT: The Govt guidelines recommend being active on most (preferably all) days, to weekly total of: 2.5 to 5 hours of moderate activity or 1.25 to 2.5 hours of vigorous activity or an equivalent combination of both and strength training 2-4x per week.  We know this is a minimum and a lot more than most of our people are doing.

SO WHAT NOW?

This is where exercise professionals have such an important job in bridging the gap.  Many of you will be the most important health contact in your clients lives as you see them so often.

You have amazing power to educate and influence your clients and will able to direct them where to go to get additional help.

The more you understand about the common conditions that your people are at risk for, the more you can tailor your programs and information delivery to them.

Want more info?   Get in touch with me via email

bek@bekdimauro.com or DM me @the_posture_queen

If you would like some handouts for your clients to promote bone health nutrition get in touch and I will send them out.

  • anti inflammatory diet
  • foods high in bone health nutrients

Resources

https://www.bones.nih.gov/health-info/bone/osteoporosis/overview

https://www.healthdirect.gov.au/osteoporosis

Scholarly articles (there are lots)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6490505/

https://www.sciencedirect.com/science/article/abs/pii/S1878124120300964

https://onlinelibrary.wiley.com/doi/abs/10.1111/jocn.16101

About the Author

Bek Di Mauro is a Functional Nutritionist and Personal Trainer based in Adelaide, South Australia. Bek uses a variety of skills to pin point the reason you are feeling unwell or not getting the results you want. These skills include personalised nutrition advice, use of specific dietary protocols, lifestyle choices to support your bodies innate healing potential and mindset coaching to help you get the best results in your healing journey.


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