Normal healthy bone has remarkable properties — it is as strong as iron, yet as light as pinewood. Constantly remaking and remodelling itself in response to stress, it replaces almost all its component atoms within a year. It is this characteristic which allows bone to mend even after horrific fractures.

However, when the reabsorption process is faster than the bone production, the bones become soft and brittle, and this condition is referred to as osteoporosis, or in the less serious form, osteopaenia. This can result in fractures, particularly of the hip and wrist; and bone compression and distortion, especially in the spine. Most elderly people show a significant height reduction, and many become stooped as the vertebrae compress.

Why is osteoporosis so important?

Apart from the obvious pain and disability associated with the condition, it should be noted that:

In women over 60 years old, complications following fractures are the most common cause of death.
Up to40% of people suffering a hip fracture will die as a result.
50% of the remainder will never regain the ability to walk unaided.

The NHS spends more than £950 million per annum treating over 60,000 fractures, most of which could have been prevented.

Osteoporotic bone is easily distorted by weight bearing. When this occurs in the vicinity of a major joint, such as the hip, it is inevitable that osteoarthritis will develop prematurely, especially if the process began relatively early in life.

Why does this happen?

There are several factors which make osteoporosis more likely to develop:

Age
Hormones
Activity
Diet

Age
Loss of bone density is a normal ageing process, but many young women now show disturbing signs of osteoporosis, due to diets and disordered eating.

Hormones
Osteoporosis can develop due to low oestrogen levels, usually due to the menopause in older women. However, young athletes and dancers have low oestrogen levels due to restricted diets and excessive exercise. This makes them a particularly high risk group. The incidence of stress fractures in these groups is increasing continuously. Other hormonal imbalances can also predispose to osteoporosis, such as thyroid and parathyroid problems.

Activity
Bone density is improved by moderate amounts of weight-bearing exercise, such as jogging, walking, tennis, dancing etc. However, excessive exercise can have the opposite effect, especially if dietary requirements are not being met — the rate of bone breakdown eventually exceeds the capacity of the bone to repair itself. Enforced bed rest or immobilisation can also lead to osteoporosis.

What about diet?

It is generally acknowledged that a low intake of Calcium can aggravate or cause osteoporosis. Recent research suggests, however, that the dietary influence on bone structure is far more complicated than just the total Calcium intake. Unfortunately, this information is not readily available to the general public, with the result that large sums of money are being spent on Calcium supplements which may have very little long term effect on the strength of the bones.

Excessive Calcium intake, unbalanced by other minerals, has been shown to cause kidney stones and calcification of tendons and blood vessels. This can result in increased risk of heart attacks.

The main dietary requirements for strong bones are:

Calcium
Magnesium
Boron
Silica
Zinc
Vitamin D
Vitamin K
Vitamin C

Calcium
There is more Calcium in the body than any other mineral, and 99% is in the bones and teeth. Unfortunately, Calcium is not an easily absorbed mineral — the usual recommended daily intake is given as 700mg–1500mg in order to allow for the fact that most of the Calcium consumed never actually gets into your body! In the West, most dietary Calcium intake has traditionally come from cheese and milk. However, many people now avoid dairy produce, as this is one of the most common causes of food intolerance. As dairy products are rarely replaced with other effective sources, this has created a situation in which Calcium deficiencies are so common as to be almost the norm. Recent surveys in the USA found that the average daily intake was only 50% of that recommended.

Sources of Calcium: dairy produce, dark green vegetables, nuts, seeds, beans, lentils, Calcium-fortified cereals, milk and soya.

Magnesium has a structural function in bone, and also helps to balance Calcium-controlling hormones. Many authorities believe it to be more important than Calcium in bone health.

Sources of Magnesium: seeds, nuts, seafood, whole grains, green vegetables.

Boron helps to 'glue' the Calcium to the bone framework.

Silica forms very long and strong molecules used in the supporting mechanisms of many tissues, including bone.

Zinc balances the production of bone-affecting hormones.

Vitamin D is essential for the absorption of Calcium and the calcification of bones, especially in children. A deficiency of Vitamin D causes rickets.

Vitamin K helps to bind Calcium to bone.

Vitamin C helps to maintain the collagen protein matrix of bone. This encourages tensile strength and fracture resistance.

Dietary requirements of bone-building minerals are increased for:

Children and teenagers
Dancers and athletes
Pregnant or breastfeeding women
Post-menopausal women

What can be done to prevent osteoporosis?

Keep active — take regular weight-bearing exercise, but not in excess. The most suitable forms in this situation are medium impact exercises such as dancing and fast walking.

Maintain healthy hormone levels. Check with your GP if you are menopausal or have not menstruated for 6 months. There are also several herbal supplements that can help.

Improve your digestion to maximise mineral absorption.

Check your diet — a nutritional consultation can identify any relevant imbalances or deficiencies. Body fluids which are too acidic can leach minerals from the bone, so restoring an alkaline state to the body by dietary modifications can positively influence bone density.

Reduce 'mineral stealing' foods such as coffee, tea, chocolate, wheat bran and soft drinks. This is particularly relevant in young women who often consume several glasses of cola etc. in a day.

Have a bone density scan if you are at risk. A recently available test can measure your rate of bone 'turnover' from a urine sample, and gauge your risk.

Consider supplementation with a carefully formulated, high absorption mineral product. Several herbal products have also been shown to be helpful in some cases.

What should a good mineral supplement contain?

Calcium
It is not generally realised that almost all easily available calcium supplements are based on calcium carbonate — otherwise known as chalk — the cheapest and least absorbable form of calcium. It is the major ingredient in most indigestion remedies. However, because the calcium content is high (albeit badly absorbed) it allows manufacturers to claim to supply 100% of the recommended intake at minimal cost.

Highly absorbable forms of calcium are always more expensive — but the requirement for them is consequently much lower. These include:

Calcium lactate, gluconate and citrate
Calcified seaweed (which also contains significant quantities of trace minerals)

Note:
Taking excessive calcium without accompanying magnesium can lead to painful calcium deposits in the joints and muscles, and possible kidney stones.

Magnesium is just as difficult to absorb as calcium. Many supplements sold for bone protection contain none at all; and those that do almost invariably use cheap Magnesium oxide, the active ingredient in magnesia indigestion/constipation remedies. Magnesium oxide has laxative properties precisely because it is badly absorbed and, therefore, passes through the gut rapidly.

Absorbable forms of Magnesium avoid this problem because the required dose is much lower, and less remains in the gut.

These include: Magnesium citrate and gluconate.

Other Minerals
Boron, Silica and Zinc are essential, yet rarely included in popular Calcium supplements.

Co-factors such as vitamins D & K should also be present.



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