Strategies to preserve bone health!

Sapsorrow

I'm in the middle of writing a paper on bone health, and I came across a review written by my lecturer, here are some particularly shocking epidemiological statistics I pasted from it;

Currently, in the US alone, ten million individuals already have osteoporosis, and a further 18 million more have low bone mass, placing them at increased risk from this disorder (National Institutes of Health 2000).

Moreover, one in eight European Union (EU) citizens over the age of 50 years will fracture their spine in 2005 (European Commission 1998).

The estimated remaining lifetime risk of fractures in Caucasian women at age 50 years, based on incidence rates in North America, is 17.5, 15.6 and 16% for hip, spine and forearm, respectively; the remaining lifetime risk for any fragility fracture approaches 40% in women and 13% in men (Melton et al. 1992).

This is of particular concern as it is projected that the number of elderly (80 years and older, in whom the incidence of osteoporotic fracture is greatest) in the EU population will grow from 8.9 million women and 4.5 million men in 1995, to 26.4 million women and 17.4 million men in the
year 2050 (European Commission 1998).

For example,the number of hip fractures occurring each year in the EU alone is estimated to rise from current figures of 414 000 to 972 000 by the year 2050, representing an increase of 135% (European Commission 1998).

Hip fracture patients have an overall mortality of 15–30% (Browner et al. 1996), the majority of excess deaths occurring within the first 6 months after the fracture.

Osteoporosis costs national treasuries over €3500 million annually in hospital health care alone (European Commission 1998).

So my question you you guys is what is our best stratgey to combat this problem?

Should supplementation be reccomended as the norm? If so with what nutrients and how much?

Should we target some groups that others or do young men matter as much as post menopausal women for example?

What about functional foods?

What do we do and eat that is particularly damaging to our bones? How much can exercise do?

What about genetic variability, how big a role does that play?

What are peoples thoughts on the role of non-digestible oligosaccharides and phytoestrogens and bone health?

What about vitamin K is that involved?

This area of nutrition really worries me and as one of my best friends who is also a member of my family (a 35 year old male) has osteoperosis it's something close to home, and I'd really like to hear what everyone thinks.

EileenG

http://forum.bodybuilding.com/showthread.php?t=548521&highlight=bone+basics%2C+men

I wrote this a long time ago, but it still holds.

Since then, I've discovered that the best time to develop really dense bones is pre-puberty. High impact sports and weight training for the early teens seem to pay dividends in bone strength.

I'm convinced that diet has a huge amount to do with it. not just the amount of calcium, but also the amount of sugary junk food which tends to erode bones. There are soda-addicted teenagers now showing the early signs of oeteopenia.

rubadub

EileenG wrote: »

There are soda-addicted teenagers now showing the early signs of oeteopenia.

And I think diet colas are the worst as they have phosphoric acid, most other sodas have different acids in them, though I am not sure how harmful they are.

http://en.wikipedia.org/wiki/Phosphoric_acid#Biological_effects_on_bone_calcium_and_kidney_health

Biological effects on bone calcium and kidney health
Phosphoric acid, used in many soft drinks (primarily cola), has been linked to lower bone density in epidemiological studies. For example, a study[2] using dual-energy X-ray absorptiometry rather than a questionnaire about breakage, provides reasonable evidence to support the theory that drinking cola results in lower bone density. This study was published in the American Journal of Clinical Nutrition. A total of 1672 women and 1148 men were studied between 1996 and 2001. Dietary information was collected using a food frequency questionnaire that had specific questions about the number of servings of cola and other carbonated beverages and that also made a differentiation between regular, caffeine-free, and diet drinks. The paper cites significant statistical evidence to show that women who consume cola daily have lower bone density. Total phosphorus intake was not significantly higher in daily cola consumers than in nonconsumers; however, the calcium-to-phosphorus ratios were lower. The study also suggests that further research is needed to confirm the findings.

On the other hand, a study funded by Pepsi suggests that insufficient intake of phosphorus leads to lower bone density. The study does not examine the effect of phosphoric acid, which binds with magnesium and calcium in the digestive tract to form salts that are not absorbed, but rather studies general phosphorus intake.[3]

However, a well-controlled clinical study by Heaney and Rafferty using calcium-balance methods found no impact of carbonated soft drinks containing phosphoric acid on calcium excretion.[4] The study compared the impact of water, milk, and various soft drinks (two with caffeine and two without; two with phosphoric acid and two with citric acid) on the calcium balance of 20- to 40-year-old women who customarily consumed ~3 or more cups (680 ml) of a carbonated soft drink per day. They found that, relative to water, only milk and the two caffeine-containing soft drinks increased urinary calcium, and that the calcium loss associated with the caffeinated soft drink consumption was about equal to that previously found for caffeine alone. Phosphoric acid without caffeine had no impact on urine calcium, nor did it augment the urinary calcium loss related to caffeine. Because studies have shown that the effect of caffeine is compensated for by reduced calcium losses later in the day,[5] Heaney and Rafferty concluded that the net effect of carbonated beverages—including those with caffeine and phosphoric acid—is negligible, and that the skeletal effects of carbonated soft drink consumption are likely due primarily to milk displacement.

Other chemicals such as caffeine (also a significant component of popular common cola drinks) were also suspected as possible contributors to low bone density, due to the known effect of caffeine on calciuria. One other study, involving 30 women over the course of a week, suggests that phosphoric acid in colas has no such effect, and postulates that caffeine has only a temporary effect, which is later reversed. The authors of this study conclude that the skeletal effects of carbonated beverage consumption are likely due primarily to milk displacement.[4] (Another possible confounding factor may be an association between high soft drink consumption and sedentary lifestyle.)

Cola consumption has also been associated with chronic kidney disease and kidney stones through medical research.[6] The preliminary results suggest that cola consumption may increase the risk of chronic kidney disease.

El_Dangeroso

Very good recommendations in this thread.

I think when it comes to maintaining bone, it's good to refer to what's good for maintaining teeth, teeth being made and maintained by the same materials.

First and foremost is the things to add into the diet.

Calcium has been mentioned, but it's virtually useless when consumed without magnesium to balance it, that's why all traditional societies consume bone broth, which contains ideal ratios of calcium and magnesium along with glucosamine, which contributes to bone, muscle and joint health. I couldn't help but notice a massive stock pot on pretty much every street in thailand, they seem to go to a big effort to get some bone broth in their diet. We used to do that here but then food scientists discovered a way to synthesise the taste of stock using yeast extract and the tradition died.

Magnesium and calcium is distributed to teeth through saliva, which is why if your salivary gland is removed, your teeth crumble.

Next important is vitamin D3. 4,000IU is usually necessary at this latitude. It's best to get a blood test to determine how much needs to be supplemented. It is compulsory to ensure a high dietary intake of magnesium and K2 if supplementing with D3.

Often forgotten is vitamin K2. The effective version is K2 MK4 for bone. Dietary sources include grass-fed butter and liver, foods that are now deemed too high in saturated fat to recommend, which is a shame. I also highly recommend high vitamin butter oil as a source of K2. It has the nice side-effect of making your skin glow and plaque stops growing on your teeth.

If you eat liver then you get a perfect balance of vitamin A and K2.

Things to avoid are things that generally inhibit mineral absorption namely tannins and phytic acid. Your body can generally handle a little of these in the context of a nutritious diet but definitely not the amount that we consume today in a largely poor and nutrient deprived diet.

Sources of tannins include tea, coffee and wine. Tannins aren't that strong in their inhibitive properties, phytic acid is much stronger in that respect.

Sources of phytic acid include grain fiber and beans. If you do eat grains or beans you need to soak, sprout or ferment the grains beforehand to minimise phytic acid by activating the phytase in the plant. If grains or beans are toasted this will destroy the phytase and soaking or sprouting won't work.

You also need to ensure that you have a gut that can absorb all the nutrients. This is where it is probably prudent to avoid gluten considering it damages the gut of 83% of people.

Oops, sorry for the essay! I think that bone is generally the most obvious sign of a poor diet. Perfectly healthy people have straight, strong teeth that are immune to decay.

Sapsorrow

Temple_Grandin wrote: »

Often forgotten is vitamin K2. The effective version is K2 MK4 for bone. Dietary sources include grass-fed butter and liver, foods that are now deemed too high in saturated fat to recommend, which is a shame. I also highly recommend high vitamin butter oil as a source of K2. It has the nice side-effect of making your skin glow and plaque stops growing on your teeth.

If you eat liver then you get a perfect balance of vitamin A and K2.

Thanks for the comments guys, great post too eileen!

So do you think the low fat reccomendations are having an indirect effect on our bone health? As far as I can tell the research on vitamin K and bone health is a bit inconclusive compared to the likes of vitamin D or magnesium. Are the effects evident yet? I think most of the stats are based on population growth trends regarldess of dietary changes that have/are occuring!

Do you think the phytate negates any potential beneft of soy phytoestrogens?

Also regarding exercise is it better to do cardio type stuff or weights?

I really can't see how europe can cope with the ageing population crisis, my professor suggested that one solution is to actively encourage mass migration from the third world to help support our economies as they are going to be the only ones left with sustainable birth rates. I can only imagine how fecked my generation are going to be compared to my parents one etc..

El_Dangeroso

khrystyna100 wrote: »

Thanks for the comments guys, great post too eileen!

So do you think the low fat reccomendations are having an indirect effect on our bone health? As far as I can tell the research on vitamin K and bone health is a bit inconclusive compared to the likes of vitamin D or magnesium. Are the effects evident yet? I think most of the stats are based on population growth trends regarldess of dietary changes that have/are occuring!

Do you think the phytate negates any potential beneft of soy phytoestrogens?

Also regarding exercise is it better to do cardio type stuff or weights?

I really can't see how europe can cope with the ageing population crisis, my professor suggested that one solution is to actively encourage mass migration from the third world to help support our economies as they are going to be the only ones left with sustainable birth rates. I can only imagine how fecked my generation are going to be compared to my parents one etc..

There's a load of RCT's on K2 and bone health if you do a search on pubmed. It's just as important as D or calcium, there's even a trial showing it to prevent cancer.

I do think the recommendation to avoid fat is having an impact, low fat means sub-optimal intake and absorption of fat-soluble minerals. That's why people who get their gall bladders removed are at a much higher risk of osteoporosis.

Re: Isoflavones/phytoestrogens, a recent trial showed them as having no effect on bone density. In fact there are no controlled trials in humans showing any benefit to phytoestrogens. I think isoflavones are best avoided because they mimic estrogen.

That is messed up about mass-migration..

Sapsorrow

Temple_Grandin wrote: »

There's a load of RCT's on K2 and bone health if you do a search on pubmed. It's just as important as D or calcium, there's even a trial showing it to prevent cancer.

I do think the recommendation to avoid fat is having an impact, low fat means sub-optimal intake and absorption of fat-soluble minerals. That's why people who get their gall bladders removed are at a much higher risk of osteoporosis.

Re: Isoflavones/phytoestrogens, a recent trial showed them as having no effect on bone density. In fact there are no controlled trials in humans showing any benefit to phytoestrogens. I think isoflavones are best avoided because they mimic estrogen.

That is messed up about mass-migration..

Yes an of course low fat is gonna balls up your vitamin D intake/absorption. I forgot completely about that, is 5,000iu daily safe for long term supplementation? I was reading that 10,000iu can actually start solubilising calcium into the blood.

The inconsistencies i the phytoestrogen trials as far as I can tell may have something to do with genotype differences in the ER receptors. Thats why HRT doesn't always work too. Also it seems that way with vitamin D and some other functional elements in bone health, that the benefits largely depend on your genetic make up and so they're a lot of variability messing up the results of intervention trials. Have you heard of any studies on bone health controlling for genotypic differences among subjects?

Non digestible polysaccharide supplements look very promising too, I'm going to look into them more when I have time in the summer. Hve you any thoughts on them?

Yup I see what he means though, germany and I think italy too are already in the sh*t birth rate wise and the rest of us don't seem far behind. One things for sure, I'm not gonna sit back and depend on a state pension for when I'm elderly! Whos gonna be left working to pay tax! I'd imagine the retirement age will have to be extended but then if we're all in bits from osteoperosis etc how the hell can we be expected to work! I reckon we're gonna witness some strange times in the future, it's a bit scarey. Good way to hedge yer bets is to have lots of babies who will be obliged to look after you when you're old and infirmile (or convince your sisters to do it so you don't have too :pac:)

Iristxo

I don't know if these guys are to be trusted but here it goes anyway

http://thehealthyskeptic.org/vitamin-k2-the-missing-nutrient

I stumbled upon it recently when I was looking in more detail for the nutritional benefits of kefir.

brianthebard

Temple_Grandin wrote: »

Next important is vitamin D3. 4,000IU is usually necessary at this latitude. It's best to get a blood test to determine how much needs to be supplemented. It is compulsory to ensure a high dietary intake of magnesium and K2 if supplementing with D3.

Why is this?

El_Dangeroso

brianthebard wrote: »

Why is this?

Vitamin D actually increases the bodies need for K2. D toxicity is often a mis-diagnosed K2 deficiency.

Vitamin D causes far more calcium to be absorbed into the blood stream, so if you don't have the magnesium to balance the calcium you could end up with little benign soft-tissue calcifications, or in the case of extreme mag deficiency, hypercalcemia.

It's all very complicated I know! I don't generally like supplementing fat soluble vitamins as your body can't excrete them easily. But we just don't get enough D. It's best to get a blood test though, to be on the safe side.

El_Dangeroso

khrystyna100 wrote: »

Yes an of course low fat is gonna balls up your vitamin D intake/absorption. I forgot completely about that, is 5,000iu daily safe for long term supplementation? I was reading that 10,000iu can actually start solubilising calcium into the blood.

Yeah it can, tbh I would never go as high as 10,000IU without regular blood tests for hypercalcemia and monitoring 25(OH)D levels closely. I seem to only need 2,000IU to get into optimal blood levels, some might need 4, 6 or even 8,000.

That's the thing about vitamin D, absorption varies on a number of factors. If you eat meat you need less D, if you don't eat grains you need less D, if you're obese/celiac/leaky gut you need more. Again why it's important to be tested prior to supplementing.

khrystyna100 wrote: »

The inconsistencies i the phytoestrogen trials as far as I can tell may have something to do with genotype differences in the ER receptors. Thats why HRT doesn't always work too. Also it seems that way with vitamin D and some other functional elements in bone health, that the benefits largely depend on your genetic make up and so they're a lot of variability messing up the results of intervention trials. Have you heard of any studies on bone health controlling for genotypic differences among subjects?

I thought they had pretty much debunked the benefits of synthetic HRT? That genomic research is so cutting edge, can't pretend to know a thing about it. Can you send me that paper if you have it?

khrystyna100 wrote: »

Non digestible polysaccharide supplements look very promising too, I'm going to look into them more when I have time in the summer. Hve you any thoughts on them?

They seem to be the next big 'thing' alright. Saw this trial showing oligofructose caused a weight loss of a kilo over 12 weeks without any deliberate calorie restriction, not mindblowing, but interesting.

Oligofructose only works if you stop feeding the bad bacteria along with a nutritious diet, once again, you have to take a holistic approach to get the full benefit. I don't think it's necessary to go down the supplement route. I've been blitzing onions and adding them to soups and eating more artichokes, along with eating live yoghurt (not at the same time!:p)