Natural Therapies to Optimize Bone Health

Bone and our skeletal structures are not static; bone is a physiologically active tissue which is constantly remodeling. Our lifestyle and nutrition can have a strong impact on our skeletal health. Exercise, macronutrients and micronutrients are needed in order to support healthy bone metabolism.

As we age, some loss of bone naturally occurs. While some bone loss is natural, it can be accelerated by lack of weight bearing exercise, nutritional deficiencies, stress, medications, hormonal imbalances, low vitamin D levels and steroid use. Women are most at risk for bone loss, due to declining estrogen levels as we age.

There are a variety of medications which are recommended to prevent ongoing bone loss, however as with every medication they can have side effects. Natural approaches to bone loss include: weight bearing exercise, nutritional support, and supplement support. While a variety of pharmaceutical interventions have been well studied, the role of a more holistic approach to support of bone health has been poorly studied.

Nutritional Support for Healthy Bone Metabolism

Basic Foods to Include

Raw cultured dairy: Kefir, yogurt and raw cheese. These foods are high in calcium, magnesium, vitamin K, and Vitamin D.

Wild caught fish: help to decrease chronic inflammation. They contain Omega-3 fats that help to reduce inflammation. Fatty Acids: These compounds have the ability to help total bone mass. Studies performed at the cellular level have demonstrated that fatty acids may inhibit the formation of cells responsible for bone resorption.

Sea vegetables: such as nori, are high in minerals and calcium.

Green leafy vegetables: contain vitamin K and calcium.

Foods to Avoid

Alcohol: increases inflammation.

Soda: high in phosphorus that can leach calcium from the bones.

Sugar: increases inflammation.

Sodium and high salt foods: may result in bone loss.

Excessive caffeine consumption:

Exercise

Weight bearing exercise is recommended..

Vibration platforms may ben beneficial.

20 minutes of modest impact activity, resistance training, or vibration therapy three times a week can improve bone mineral density.

High-impact weight-bearing exercises

•    Dancing

•    Doing high-impact aerobics

•    Hiking

•    Jogging/running

•    Jumping Rope

•    Stair climbing

•    Tennis

Low-impact weight-bearing exercises can also help keep bones strong and are a safe alternative if you cannot do high-impact exercises.

•    Elliptical training machines

•    Low-impact aerobics

•    Stair-step machines

•    Fast walking on a treadmill or outside

Muscle-Strengthening Exercises

Resistance exercises and include:

•    Lifting weights

•    Elastic exercise bands

•    Weight machines

•    Lifting your own body weight

•    Functional movements, such as standing and rising up on your toes

Yoga and Pilates can also improve strength, balance and flexibility.

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Micronutrients

Minerals and vitamins play a prominent role in bone health and many individuals may be deficient. Measurement of levels of these nutrients and targeted supplementation should be considered. Micronutrients important in bone health extend far beyond just calcium and vitamin D.

Calcium

99% of the body’s calcium resides in the skeleton.

Calcium intake is one of the important modifiable environmental factors for the normal development and maintenance of bone.

Calcium citrate: recommendations vary between 500mg and 1000 mg per day. Adequate intake is necessary, however excessive consumption may be harmful.

The recommended dietary allowance of calcium is 1,200 mg/day but the majority of women older than forty consume less than 600 mg/day in the United States, thus the remainder must be made up in supplement form.

Very high levels of calcium supplementation have been associated with increased risks of kidney stones and myocardial infarction.

The principal dietary source of calcium is milk and milk products although lesser sources include salmon, almonds, and leafy green vegetables such as spinach, kale, and turnip greens.

Magnesium

About 60% of all magnesium in the body is found in bone, where it is a structural constituent, along with calcium and phosphate.

The RDA for magnesium is 320-420 mg.

Dietary sources of magnesium: almonds, cashews and peanuts, raisin bran cereal, potato skins, brown rice, kidney beans, black-eyed peas and lentils. Eight ounces of milk has approximately 25 mg of magnesium.

Consider: supplementation with 500mg of magnesium.

Vitamin D

Recommendations on dosing vary, helps with calcium absorption.

Levels should be checked in order to determine appropriate supplementation.

Dietary sources of vitamin D include oily fish such as salmon and swordfish, with lesser amounts in tuna and other fish. It is difficult to consume sufficient amounts of vitamin D from dietary sources

Vitamin K

Vitamin K is important in overall bone metabolism and health.

Food sources include: collard greens, fresh spinach, Brussels sprouts, iceberg lettuce, and prunes.

The optimum daily intake of vitamin K has been established as 90 µgm (micrograms) per day for women and 120 µgm per day for men. In a study of hip fracture risk, women who consumed more than 109 µgm of vitamin K per day had an decreased risk of hip fracture compared to women with lower levels of vitamin K intake.

supplementation with100 µgm/day would to achieve slightly more than the recommended daily allowance and may have beneficial effects on bone structure.

Those on warfarin (Coumadin) should not take vitamin K,

Zinc

Zinc (Zn) is required for overall health and has been used in complementary therapy against bone loss. Animal studies have demonstrated that Zn may help preserve of bone architecture in the setting of estrogen decline.

Zinc is a cofactor in many enzymes.

Bone contains a large proportion of the total body zinc.

Zinc can inhibit loss of bone mass.

Zinc is found in a wide variety of foods including red meat, lamb, shell fish, seeds, nuts, dairy products, poultry and beans.

The recommended daily minimum intake of zinc is 12 mg and for bone health 15 mg is recommended

Manganese

Manganese is found in bone, in addition to other tissues.

Manganese plays a role as a co-factor in the formation of cartilage and collagen, as well as in bone mineralization.

The Recommended Daily Allowance of manganese is 1.8 mg/day for women and 2.3 mg/day for men; relative to bone health, adequate intake of manganese has not been established.

Dietary sources of manganese include cereals, nuts, pineapples, beans, mollusks, dark chocolate, cinnamon, and tea.

Boron

May be important for mineral metabolism and bone metabolism.

The Recommended Daily Allowance of boron has not been established; however, a study of postmenopausal women reported that 3–4 mg/die of boron for a period of one year improved bone mineral density.

Foods rich in boron include prunes, raisins, dried apricots, and avocados.

Prunes are a rich source of boron with approximately 3-4 mg of boron for every three ounce serving of prunes.

Copper

Recently identified to be important in bone metabolism.

In a 2-year double-blind, placebo controlled study, bone loss in post-menopausal women given combined calcium and copper, manganese and zinc supplements was significantly less than in the placebo group and in groups taking the trace mineral or calcium alone.

The recommended daily intake of copper adequate for bone health in adults is 0.9 mg/day.

Dietary copper is found in meats, seafood, nuts and grains.

Silicon

Epidemiological studies have reported that increase silicon intake correlated with increased bone mineral density for men, premenopausal women, and postmenopausal women on hormone replacement therapy Dietary sources of silicon include whole grains and cereals, carrots and green beans.

Intakes near 25 mg/d might promote bone health.

Epidemiological studies report that dietary silicon intake of more than 40 mg/day correlates with increased bone mineral density.

Iron

Has important roles in collagen synthesis and vitamin D metabolism.

Supplementation should be based on levels.

Selenium

Is a constituent of selenoproteins which function as antioxidative scavengers.

Has been reported that selenium inadequacy can influence bone metabolism.

Recommended daily allowance is 55 μg/day.

The main sources of selenium for nutrition are wheat, red meat and sea food.

Anitoxidants

Animal studies have demonstrated that oxidative stress has been related to bone loss, thus compounds with antioxidant properties may be beneficial. Animal studies have demonstrated that supplementation with fish oil and CoQ10 may help bone metabolism.

Vitamin C, inositol and L-arginine

These micronutrients have beneficial effects on bone health.

Vitamin C is essential for the formation of collagen and for fracture healing  

Inositol is a carbohydrate compound found in cantaloupe, grapefruit, oranges, and prunes. It is also found in the form of phytate in whole grains.

L-arginine is a semi-essential amino acid and is important in a number of metabolic processes.

l-arginine influences vascular relaxation and should not be used as a supplement following myocardial infarction.

Studies where arginine, inositol, and silicon were taken together demonstrated increased bone mineral density and increased bone strength

Supplements Not Recommended

Strontium

Has been advocated by some

We do not currently support over the counter strontium supplementation at this time.

 

To Be Aware: The following medications can accelerate bone loss.

•    Aluminum-containing antacids

•    Antiseizure medicines  such as Dilantin or Phenobarbital

•    Aromatase inhibitors such as Arimidex, Aromasin and Femara

•    Cancer chemotherapeutic drugs

•    Cyclosporine A and FK506 (Tacrolimus)

•    Gonadotropin releasing hormone (GnRH) such as Lupron and Zoladex

•    Heparin

•    Lithium

•    Medroxyprogesterone acetate for contraception (Depo-Provera)

•    Methotrexate

•    Proton pump inhibitors (PPIs) such as Nexium, Prevacid and Prilosec

•    Selective serotonin reuptake inhibitors (SSRIs) such as Lexapro, Prozac and Zoloft

Summary

Bone is not static, it undergoes active metabolism and attention to healthy function of bone is important to the foundation of the structure of the body.

Maintenance of bone health extends far beyond adequate calcium and vitamin D intake.

Attention to nutrition can help with bone metabolism.

Targeted supplementation may be necessary.

Zinc supplements may be required for vegetarians.

Regular weight bearing exercise is necessary for health bone remodeling.