Nutrition's Role In Osteoporosis

Osteoporosis is a reduction in the amount of bone mass, leading to fractures after minimal trauma.

The major skeletal disease in which nutrition plays a role is osteoporosis, characterized by a decrease in the amount of bone, often so severe that it leads to fractures. All bones are at risk, but the most common sites of fracture include the vertebral column, the wrist and the hip. Osteoporosis affects both men and women, but occurs more commonly in women. This is partly due to the role menopause plays in bone loss. Bone loss begins to occur at a slow rate (0.2 to 0.5 percent per year) during one's late 20s or early 30s. For the first five to 10 years after menopause, the rate of bone loss is accelerated and may occur at a rate of two to four percent per year. After this, it returns to the previous age-related rate of loss. A woman may lose 30 to 50 percent of her total bone mass during the menopausal years. Risk factors for primary osteoporosis include Caucasian race, tobacco use, chronic alcohol use, a low calcium diet, one's family history and a sedentary lifestyle. Osteoporosis may also occur as a result of other chronic diseases or be associated with long-term use of certain medications; this is known as secondary osteoporosis.

Prevention of osteoporosis is important because treatment of osteoporosis, once fractures have occurred, is relatively ineffective and the functional limitations and deformities that develop are often irreversible.

Ninety nine percent of the body's calcium is found in the bones and the teeth. Because of calcium's importance throughout the body, constant skeletal remodelling most likely evolved to provide a continuous supply of calcium.

Calcium absorption is determined by the amount of dietary calcium, the interaction of calcium with other dietary substances within the small intestine, the level of activity of transport systems that move calcium across the intestinal wall and into the body. Calcium is transported across the intestine principally by calcium-binding proteins.

Phosphorus is the second most abundant mineral in the body, exceeded by calcium. About 85 percent of the body's phosphorus is in the bones. While phosphate deficiency can lead to decreased bone mass, excessive phosphate can also harm the skeleton. Excessive dietary intakes of phosphate produce bone disease, particularly if the diet is low in calcium.

Building strong bones, especially before the age of 30, can be the best defense against developing osteoporosis, and a healthy lifestyle can be critically important for keeping bones strong.

Osteoporosis is largely preventable for most people. Prevention of this disease is very important because, while there are treatments for osteoporosis, there is currently no cure. There are four steps to prevent osteoporosis. No one step alone is enough to prevent osteoporosis but all four may. They are:

A balanced diet rich in calcium and vitamin D
Weight-bearing exercise
A healthy lifestyle with no smoking or excessive alcohol use
And bone density testing and medications when appropriate

Depending on your age, an appropriate calcium intake falls between 1000 and 1300 mg a day. If you have difficulty getting enough calcium from the foods you eat, you may take a calcium supplement to make up the difference.

Vitamin D is needed for the body to absorb calcium. Without enough vitamin D, you will be unable to absorb calcium from the foods you eat, and your body will have to take calcium from your bones. Vitamin D comes from two sources: through the skin following direct exposure to sunlight and from the diet. Experts recommend a daily intake between 400 and 800 IU per day, which also can be obtained from fortified dairy products, egg yolks, saltwater fish and liver.

Exercise is also important to good bone health. If you exercise regularly in childhood and adolescence, you are more likely to reach your peak bone density than those who are inactive. The best exercise for your bones is weight-bearing exercise such as walking, dancing, jogging, stair-climbing, racquet sports and hiking. If you have been sedentary most of your adult life, be sure to check with your healthcare provider before beginning any exercise program.

The nutrients mentioned above reflect the major nutritional supplements that may help the condition. Please do remember however that nutritional supplementation is an adjunct to medical treatment and in no way replaces medical treatment.