With new studies showing that long-term use of osteoporosis medications like Fosamax offer no continuing benefit after five years, people are wondering what to do to improve their bone density.
And a lot of people should wonder. Thirty-five million American women and 17 million men have low bone density: thinning, weakening and breakable bones. One out of two women will have an osteoporotic fracture in their lifetime.
The good news is that there are excellent nutritional approaches that dramatically and safely increase bone density (and health), and help prevent osteoporosis.
The bad news? Most physicians aren't familiar with those approaches!
Fortunately, knowledge is power. And this article provides the knowledge you need. Let's start by examining five common beliefs about bone health. I'll tell you which ones are TRUE, and which are myths that have been BUSTED—and discuss the very best strategies for building bone.
1. Antacids are good for strong bones, because they contain lots of calcium.
BUSTED! An analysis of data from the massive Women's Health Initiative linked calcium supplements to a 31% increased risk of heart attacks. And a new study from Swedish researchers shows that only intakes below 750 mg of calcium a day put a person at increased risk for fractures—while intakes above 1,100 mg might increase risk! In other words, supplementing your diet with high doses of calcium may do you more harm than good!
BEST STRATEGY: Regularly eat calcium-rich foods like leafy greens, fatty fish with bones (such as sardines and salmon) and dairy products. Keep supplementation of calcium (including antacids) to a minimum—no more than 500 to 600 mg daily. (For more info on calcium's downside, see the Research Briefs section of my February 15, 2012 newsletter.) If taking a calcium supplement, be sure it also contains magnesium and vitamin D.
2. Avoid sunshine, because even though it raises levels of bone-building vitamin D, it needs to be avoided because of melanoma, a deadly skin cancer.
BUSTED! It is unlikely that most of the increase in melanoma rates is being caused by an increased exposure to sun. Most melanomas are not in sun-exposed areas. They are under our clothes. If there is an increase in rates of melanoma, it's more likely to occur because of a fatty, salty, sugary diet; an environment saturated with toxic chemicals; and a population that is sleep-deprived—all resulting in weakened immune systems. The real cancer problem is lack of vitamin D, which study after study links to the development of cancer. In fact, it's estimated that the vitamin-D depriving advice to avoid sunshine doesn't prevent cancer. In fact it causes an estimated 145,000 unnecessary cancer deaths every year!
BEST STRATEGY: Avoid sunburn, not sunshine. Go for at least a 30-minute outdoor walk several times a week, particularly during the summer months. And don't wear sunblock unless you're out long enough to sunburn. Both sunlight exposure and walking help build bones.
3. The longer you use osteoporosis medications, the stronger your bones.
BUSTED! New research shows that taking Fosamax for more than five years may actually weaken the crystalline structure of bones, resulting in bones that are less elastic and therefore more fracture-prone.
BEST STRATEGY: If you must take Fosamax, take it with vitamin D—a strategy that makes it five times more likely the drug will effectively build bones.
4. You can literally "walk away" from bone fracture risk.
TRUE! Dozens of studies show that regular walking builds bone. One of the most recent showed that walking or jogging three times a week increased several biomarkers of bone density. Even better is that those who exercised and took 1,000 mg a day of omega-3 fatty acids (fish oil) had even healthier levels of those biomarkers than people who just exercised.
BEST STRATEGY: A brisk, 30-minute walk, at least three times a week, along with a fish oil supplement.
5. Natural, nutritional approaches for helping prevent osteoporosis are an unproven scam.
BUSTED! And busted over and over again. For example, the mineral strontium has been shown in many studies to protect bone. In one of the most recent, researchers from Belgium analyzed bone strength in osteoporotic women who had been treated for a decade with strontium and found a 35% reduced risk of spinal fractures and a 38% reduced risk of non-spinal fractures. In another recent study published in the January 2012 edition of Osteoporosis International, strontium outperformed Fosamax in building bones. Another review of dozens of studies with thousands of patients found strontium to be very effective and safe in long-term treatment of osteoporosis. So much for the scam!
BEST STRATEGY: Take 340 to 680 mg of strontium daily. This is best combined with other bone-building nutrients such as vitamins D and K, magnesium, and Boron (strontium absorption is modestly improved by taking it at a different time of day than calcium and vitamin D).
For a collection of articles (and a video) with more ideas on the best ways to beat osteoporosis, see Health A-Z: Osteoporosis.
1. "Fracture risk associated with continuation versus discontinuation of bisphosphonates after 5 years of therapy in patients with primary osteoporosis: a systematic review and meta-analysis." Lisa-Ann Fraser, Kelly N Vogt, Jonathan D Adachi, and Lehana Thabane. Ther Clin Risk Manag. 2011; 7: 157166. Published online 2011 May 9. doi: 10.2147/TCRM.S19385
2. "Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women's Health Initiative limited access dataset and meta-analysis." Bolland MJ, et al. BMJ 2011; DOI: doi:10.1136/bmj.d2040.
3. "Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study." Warensjo E, et al. BMJ. 2011;342:d1473.
4. "What is the Dose-Response Relationship between Vitamin D and Cancer Risk?" Garland CF, et al. Nutrition Reviews, August 2007(II): S91S95.
5. "Bone micromechanical properties are compromised during long-term alendronate therapy independently of mineralization." Bala Y, et al. Journal of Bone and Mineral Research, 2011 Dec 20. doi: 10.1002/jbmr.1501 [pub ahead of print]
6. "The 25(OH)D level needed to maintain a favorable bisphosphonate response is (greater than or equal to) 33 ng/ml." Carmel AS, et al. Osteoporosis International. 2012 Jan 12. [Epub ahead of print]
7. "Long-term aerobic exercise and omega-3 supplementation modulate osteoporosis through inflammatory mechanisms in post-menopausal women: a randomized, repeated measures study." Tartibian B et al, Nutrition & Metabolism. 2011 Oct 15;8:71.
8. "Maintenance of antifracture efficacy over 10 years with strontium ranelate in postmenopausal osteoporosis." Reginister JY, et al. Osteoporosis International. 2011 Nov 29 [Epub ahead print]
9. "Effects of strontium ranelate and aledronate on bone microstructure in women with osteoporosis. Results of a 2-year study." Rizzoli R, et al. Osteoporosis International. 2012 Jan;23(1):305-15. Epub 2011 Sep 10.
10. "Strontium Ranelate: Long-term Efficacy Against Vertebral, Nonvertebral and Hip Fractures in Patients With Postmenopausal Osteoporosis." Jean-Yves Reginster; Mickael Hiligsmann; Olivier Bruyere.Posted: 07/29/2010; Ther Adv Musculoskel Dis. 2010;2(3):133-143