| Osteoporosis and Bone Health | |
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by Rishma Walji, B.Sc., N.D. and the Osteoporosis Program at the University Health Network
Are
you concerned about the health of your bones?
Osteoporosis is a condition of decreased bone density. It affects one in six women and one in eight men over the age of fifty and is most common among post-menopausal women. Osteoporosis is often the cause of many health complications, as it progresses silently and unnoticed for years. Only after years of bone loss do signs and symptoms appear, such as pain, spinal deformity, and fractures.
An individual’s peak bone mass occurs between the ages of twenty and thirty. Bones reach their maximum density and strength during this time. After peak bone mass is reached, bone rebuilding gradually wanes. For women, the greatest bone loss occurs in the years immediately after menopause when estrogen levels decline.
Risk
Factors for Osteoporosis4
-
Women (although osteoporosis also occurs in men)
-
Age 50 or older
-
Past menopause
-
Prolonged hormonal imbalances
- Excess use of certain medications, such as steroids
- Not
enough calcium or vitamin D in the diet
- Lack
of exercise
- Thin,
“small-boned” body frame
- Caucasian
- History
of fracture
- Family
history of osteoporosis
- Smoking, caffeine, or alcohol consumption
Prevention of Osteoporosis
Bone continually renews itself by remodeling – building up and breaking down. For this to occur, bone needs certain nutrients:
-
Calcium. Calcium has been shown to be effective in helping to build bone mass. For optimum nutrition, the range of calcium intake is between 1000-1500mg per day depending on your age, dietary intake, and other health conditions. Calcium is found in yogurt, green vegetables such as kale, soy products and tofu, seafood such as salmon and oysters, and sesame seeds.
-
Vitamin D. Vitamin D has also been shown to be effective in building bone mass. It is synthesized in our bodies from sun exposure and is also found in foods such as egg yolks, liver, salt-water fish, and fortified beverages. Vitamin D aids in the absorption of calcium. Daily intake should be approximately 400-800 IU per day depending on the season5.
-
Vitamin K. The research on vitamin K to reduce bone loss has been very promising. Until recently, vitamin K has been best known as a treatment for aiding blood coagulation. However, researchers have also found that vitamin K is important for the maintenance of healthy bones3,6. Vitamin K is found in green, leafy vegetables such as broccoli, brussels sprouts, collard greens, lettuce, and spinach. Vitamin K supplements are available in the United States, but are currently unavailable in Canada unless by prescription for treatment of blood coagulation. Because of vitamin K's role in blood coagulation, individuals on blood thinners should check with their doctor before attempting to increase their vitamin K intake.
Exercise
Weight-bearing exercise is vital for bone health. Running, jogging, walking1, dancing, and weight training are all exercises that put more weight on bones than activities such as swimming. The added weight on the legs encourages bone formation, creating a stronger frame that has less chance of being fractured. Exercise also decreases the risk of falls by improving balance. You should begin with a simple exercise protocol from a qualified health care professional.
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Vitamin K Study Recruiting Postmenopausal Women |
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Before vitamin K can be considered truly effective in decreasing fracture risk, randomized placebo-controlled trials need to be performed. To date, all international studies conducted on Vitamin K have shown vitamin K to have a beneficial effect on bone mineral density.
The University of Toronto is currently conducting the first Canadian research study to test the effects of vitamin K against a placebo. Led by Dr. Angela Cheung, MD, PhD, director of the Osteoporosis Program at the University Health Network and Mount Sinai Hospital, the ECKO study (Evaluation of the Clinical Use of Vitamin K in Postmenopausal Women with Osteopenia) will be the largest study of its kind ever conducted with postmenopausal women with low bone mass.
The study is currently looking for postmenopausal women of any age to participate. Participants must NOT be taking hormone replacement therapy, bisphosphonates (or any medication that affects bone density), anti-coagulants or very high doses of vitamin A and/or E.
For more information about this study, contact: Osteoporosis
Program Toronto
General Hospital University
Health Network 416-340-4843 bonehealth@uhn.on.ca |
References
1.
Bonaiuti, D et al. Exercise for
Preventing and treating osteoporosis in postmenopausal women.
Cochrane Database of Systematic Reviews. (3):CD000333,2002.
2.
Ellert, Gwen and Wade, John. The
Osteoporosis Book: Prevention and Treatment for Men and Women. Vancouver: Trelle Enterprises, 1993.
3.
Knapen, M.H.J, Hamulyak, K, Vermeer, C. The
effect of Vitamin K Supplementation on Circulating Osteocalcin (Bone Gla
Protein) and Urinary Calcium Excretion. Annals
of Internal Medicine. 1989;111:1001-1005
4.
NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and
Therapy. Osteoporosis prevention, diagnosis, and
therapy. [Consensus Development Conference. Consensus Development
Conference, NIH.] JAMA.
285(6):785-95, 2001.
5.
Rodriguez-Martinez, M.A and Garcia-Cohen, E.C.
The Role of Calcium and Vitamin D in Osteoporosis.
Pharmacology & Therapeutics. Jan
2002;93(1):37-49.
6.
Shiraki M. Shiraki Y. Aoki C. Miura M. Vitamin K2 (menatetrenone)
effectively prevents fractures and sustains lumbar bone mineral density in
osteoporosis. Randomized
Controlled Trial] Journal
of Bone & Mineral Research. 15(3):515-21,2000 Mar.
