Strong Body, Strong Bones
By Dr. Holly German
May is National osteoporosis month in the US. “Osteoporosis” means porous bones. In 2017, 55% of Americans over the age of 50 were diagnosed with osteoporosis. An even greater number have osteopenia, a less severe form of bone loss. Like so many other common illnesses in the US, osteoporosis rates are increasing. Fortunately, naturopathic and preventative medicine can help to curb this epidemic.
Osteoporosis is a Whole Body Issue
The first thing to consider when aiming to improve bone health is the overall health of the person. Modern medicine takes a mechanistic view of the body, partitioning off the different body systems and treating them as separate entities. But through a holistic medical lens we see that our skeletal system, like all other body systems, is actually just one part of the greater whole. Therefore, when we want to improve bone health we must take a whole body approach.
We now understand that a body in a state of chronic inflammation is more likely to develop osteoporosis. Things like a poor diet, sedentary lifestyle, hormone imbalances, chronic stress, lack of sleep, etc. can cause inflammation and contribute to bone loss.
Especially if you are over 50 (male or female), you should talk with your doctor about your risk factors for osteoporosis. The most common risk factors are: age, female, family history, ethnicity (Caucasian and Asian women are at highest risk), taking certain medications (steroids, blood pressure medications, GERD medications, and anti-cancer medications to name a few), and having certain diseases (like irritable bowel disease, diabetes, and rheumatological conditions).
When appropriate, your doctor may refer you for a DEXA scan which will yield a T-score that can be used to assess fracture risk. As a naturopathic doctor focusing on preventative medicine, I often refer out for DEXA scans as part of routine screening starting either during the first year post-menopause (natural or surgically-induced) for women or at age 50 for men. The World Health Organization (WHO) has created the following diagnostic criteria for osteoporosis. Anyone who meets these criteria should consider treatment to increase bone density.
- History of fracture of the hip or spine
- Bone mineral density in the osteoporosis range (T-score of -2.5 or lower)
- Bone mineral density in the low bone mass (osteopenia) range with a high risk of fracture based on FRAX score (an osteoporosis/fracture risk scoring system) for major osteoporotic fracture 10 year probability 20% or higher OR hip fracture 10-year probability 3% or higher.
Prevention is key with most chronic health conditions and osteoporosis is no exception. But no matter where you are on the spectrum of bone health, these measures can help prevent further bone loss and increase bone building.
- Adopt a healthy lifestyle early on! We start losing bone mass at age 30 yet most people think of
- osteoporosis as a problem confined to the geriatric population. While it’s true that most cases of osteoporosis are not diagnosed until later in life, the patterns that contribute to bone loss start much earlier in life.
- Maintain a healthy weight and body composition. Being both underweight and overweight can increase the risk of developing osteoporosis. Increased muscle mass supports a healthy skeletal system. Adipose or fat tissue does not support bone-building and certain types of adipose tissue can generate hormones (like cortisol) that contribute to bone loss.
- Be physically active. Weight-bearing exercise is particularly important for bone building. When muscles contract, their tendons stimulate the nearby bones to increase their osteoblastic (bone-building) activity. Lifting weights, using resistance bands, and walking with ankle and wrist weights are some great options that can be adapted to people of all ages and ability levels.
- Reduce prolonged sedentary hours. Even if you do make it to the gym a few times a week, long periods of being sedentary are deleterious to your well-being. If you have a desk job or sit a lot, make it a point to be up moving at least 10 minutes of every hour.
- Optimize your hormone health. Part of the reason osteoporosis risk is higher after age 50 is because of the shift in hormones that takes place after menopause in women and andropause in men. Changing levels of estrogen and testosterone influence our bone-building cells. Other hormones like cortisol, DHEA, insulin, and thyroid hormones also greatly influence our bone health. I make it a habit of routinely testing these hormones to ensure they are at optimal levels for patients of all ages. Addressing hormone imbalances is a critical part of maintaining healthy bones.
- Consume an anti-inflammatory diet. Limiting the obvious processed and packaged foods is the most important part of an anti-inflammatory diet. Also, consider getting your blood tested for food intolerances to uncover any hidden inflammatory foods that may be present in your diet.
- Eat a nutrient-dense diet. Our bones are made of more than just calcium. Bone-building cells (called osteoblasts) require a synergy of a variety of nutrients: calcium, magnesium, vitamin D, phosphorus, boron, strontium, vitamin K, vanadium, potassium, vitamin C, and more trace minerals. Eating a wide variety of plant foods is the best way to ensure you are getting all of these important nutrients. Some bone-building super foods are: leafy greens (kale, bok choy, collard greens, etc.), sweet potatoes, wild salmon, citrus fruits, almonds (especially soaked or sprouted), figs, organic soy in small amounts (especially natto, miso, tempeh, tofu), white beans, and mushrooms.
- Consider a complete mineral supplement – As mentioned above, bone-building nutrients have a synergistic relationship. Taking calcium alone doesn’t actually build bone. In fact, recent research indicates that plain calcium supplements can cause calcium to “land” in other areas of the body (like the tendons or blood vessels) rather than the bone. Talk to your naturopathic of functional doctor about high-quality bone-building products to supplement a healthy diet.