Today we take the road less traveled. We’re leaving the normal realm of yoga and “good daily habits” articles and plunging deeper into a health topic that America is becoming more concerned about: What is Osteoporosis?
What is Osteopenia? What is Osteoporosis?
Osteopenia and osteoporosis are related medical conditions that present varying levels of bone loss, measured by bone mineral density. Bone density is a marker used to pinpoint how strong a bone is and the possibility that it might break. The following is a more thorough description of the two conditions, differences between the two, and potential treatment options for both.
Osteopenia is a condition where your bone density is slightly lower than normal, but not to the point where it’s defined as osteoporosis. Osteopenia in and of itself is not considered to be a disease. An individual who has osteopenia is at a greater risk for osteoporosis and can benefit from bone-strengthening treatment options. Typically, our bones are as dense and strong as they’re ever going to be by the time we reach 30 years of age. From then on, as we age, our bones start to get thinner and thinner.
Women are more likely to develop osteopenia (and thus osteoporosis) than men, for two major reasons.
- First, women’s bones are naturally thinner than bones of males.
- Second, hormonal changes during menopause can accelerate bone loss over time.
Depending upon bone density measures and various other factors, including poor health and/or mobility, women with osteopenia may actually have the same risks for a broken bone as those with osteoporosis.
Osteoporosis is a disease where your bone density has thinned significantly and the creation of new bones isn’t able to keep pace with the removal of old bone. As our bones get weaker, we’re at an elevated risk of unexpected fractures. There are very few symptoms early on in the disease (outside of developing osteopenia). But as bone loss becomes more severe, it’s common to feel back pain due to collapsed or fractured vertebra, a loss of height, or stooped posture over time. Fortunately, there are steps you can take now to keep your bones strong and healthy.
The Primary Difference between Osteoporosis and Osteopenia
It’s important to keep in mind that having osteopenia isn’t the same as having osteoporosis; think of osteopenia as a warning sign that you could eventually develop osteoporosis. While the decrease in bone mass experienced with osteopenia isn’t typically considered severe, it’s regarded as a risk factor when it comes to the development of osteoporosis. The good thing is, being diagnosed with osteopenia can actually help prevent osteoporosis if lifestyle changes and treatment are dealt with early on.
How to Protect Against Osteoporosis
Now let’s take a look at what we can do to protect against osteopenia and osteoporosis.
The main dietary recommendation for osteopenia and osteoporosis is focused around getting enough calcium. This plays squarely into the lap of the dairy industry, which has long touted dairy, and milk in particular, as being “our best source of calcium for strong bones.” Do you remember all those cute milk celebrity commercials where mom and daughter are smiling at each other with their milk mustaches? I don’t disagree that dairy can provide calcium for your diet, but strongly believe there are more efficient dietary options to get your daily fill.
The recommended daily amount of calcium is over 1,000 milligrams for men and women. A glass of milk in the morning will give you a good 300 milligrams (mg) of calcium. Throw in a cup of yogurt at lunch and you’ll be over 700 mg for the day. Still, let’s try to tackle this another way. How about having a spinach (240 mg) salad with tofu (400-500 mg) and sunflower seeds (50 mg) for lunch and bean (75 mg) and veggie corn tacos with broccoli (180 mg) for dinner? That should get you pretty close to your daily calcium allotment and you didn’t touch a lick of dairy.
While I don’t have any vendetta against dairy, I think we’d all agree that vegetables, legumes and seeds are a healthier alternative if we have the option. Other calcium-rich foods include dark leafy green vegetables, oily fish like salmon and tuna, almonds and other seeds. Calcium-fortified breads and cereals also contain a fair share of calcium, although I try to obtain my calcium from the most natural and unaltered source possible.
Another nutrient in your diet that may be even more important than calcium is Vitamin D. Think of vitamin D as the nutrient that helps your body absorb all this calcium that you just added to your diet. Without vitamin D, your body acts like a water-resistant jacket when confronted with calcium; it just pushes it out of the way and out of your body. Add in some vitamin D, and your body absorbs calcium like a sham-wow. That’s a mid 2000’s infomercial reference for those of you who missed that one.
Vitamin D actually helps your body better absorb calcium, yielding stronger bones. Vitamin D can be found in fatty fish, eggs, dairy and vitamin-fortified food choices. However, the best place to get some vitamin D is by stepping outside and soaking up some rays. The ultraviolet light from the sun helps trigger a chemical reaction in your skin to produce Vitamin D in your body. And the great thing about the sun is this: you can’t ever get too much vitamin D from the sun (though this doesn’t mean lying out at the beach all day with no sunscreen). This is contrary to many supplement products on the market, where you can actually ingest too much (artificial) vitamin D, causing significant damage to your body.
*One note regarding both calcium and vitamin D. There are a plethora of nutritional supplements on the market that are advertised to help you reach your recommended daily value of each nutrient. My perspective is, whenever possible, get your daily nutrient fill from food. There are several studies that question the effectiveness of supplementation, and we just don’t understand the long-term impacts of supplementation on our bodies.
Unfortunately, for those of us who drink a lot of coffee, research suggests that caffeine may play a role in contributing to the loss of calcium in your body. However, the research on this is still less than proven, and most in the medical community recommend moderating the amount of caffeine in your diet (2 cups or less) vs. completely eliminating it.
Regular consumption of more than two alcoholic drinks a day increases your risk of osteoporosis as well. Too much alcohol interferes with the body’s calcium balance and affects the production of vitamins and hormones that play an essential role in building and maintaining healthy bones. Research has also shown a direct connection between cigarette smoking and a decrease in bone density.
You may not be surprised that caffeine, alcohol and tobacco contribute to lower bone density, but this next item may come as a surprise: animal protein. Although the research is relatively new, there appears to be a correlation between high intake of animal protein and loss of bone density. It’s thought that the high levels of animal protein actually assist in leaching calcium from your bones.
Sodium is another ingredient that may contribute to the lessening of your bone density. High levels of dietary sodium have been shown in several studies to have a negative impact on bone strength and density.
Exercise makes muscles and bones stronger and will help protect against bone loss. In addition, strength and balance exercises will assist in building stronger muscles that will help you to avoid falls. While some fear that over-utilizing bones and muscles will contribute to further deterioration, appropriately-performed exercise (walking, swimming, and resistance activities) are a big component of most action plans to reverse or manage osteopenia and osteoporosis.
Weight bearing exercises are one of the best choices when it comes to preventing osteoporosis. Similar to muscle, bone becomes stronger through exercise, especially weight bearing exercises that force the body to fight against gravity. Good weight bearing exercises include stair climbing, walking, dancing and weight training.
The most frequently prescribed pharmaceuticals for osteoporosis are bisphosphonates. Bisphosphonates are a type of antiresorptive that helps to slow down the body’s natural process of breaking down bone density. There is one concern with bisphosphonates. Newer research finds minimal benefit of bisphosphonate use after three to five years and some rare but severe side effects such as decaying of the jaw and cracks/fractures in the femur bone. I’ve included a link below to a consumer reports article that lays out the pros/cons of bisphosphonates in more detail.
Hormone therapy (estrogen) is another type of treatment, though there is some research linking estrogen use to increases in heart disease and certain types of cancer. While there are other drugs coming onto the market, the majority of them all focus on the same thing: slowing down the process of our bones breaking down.
Based on your circumstances, especially if you’ve already broken a bone, your physician might prescribe prescription medication to lower the potential risk of developing osteoporosis and additional fractures. However, there is concern in the medical community about over medicating people, especially those that only have osteopenia and not full-fledged osteoporosis, as long-term effects of medication to the body have yet to be studied.
There are several herbal treatments that have been used to treat osteoporosis, including whey protein, black cohosh and red clover. Vitamin supplements include Vitamin D, calcium, magnesium, Vitamin K, DHEA, Boron and fish oil. While natural treatments tend to not have the same robust research studies measuring their effectiveness, they are becoming a growing part of the osteoporosis treatment equation. Dr. Andrew Weil, a world-renowned integrative medicine doctor, has a comprehensive list of natural and herbal treatments for osteoporosis.
Is it Time to Panic?
Absolutely not. Osteopenia and osteoporosis should not be taken lightly, but bone thinning is a natural process of our bodies. Most of us, as we gracefully age, will be confronted with some degree of bone weakening. Appropriately identifying the condition and working with our physicians (and/or online resources) to monitor, improve, or maintain bone density, should be sufficient to keep the condition in check. That being said, let this post be a friendly reminder: Certain practices that will lead to better health in numerous other ways (exercise, diet with a “plant slant,” no tobacco, low sodium), will also have a positive benefit on your bone density and help keep osteoporosis in check!
Interested in additional reading and research on osteoporosis but not sure where to go? Below are links to some best selling books on the topic.
Until next time,