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Osteoporosis is a public health problem affecting 75 million persons in the United States, Europe and Japan, including one third of postmenopausal women and most of the elderly in the United States, Europe and Japan. Osteoporosis results in more than 1.3 million fractures annually in the United States.
What is osteoporosis?
Osteoporosis is a condition characterized by deterioration of bone tissue leading to decreased bone mass and bone fragility.
Nutrition is one of many factors that influence bone mass and fragility fractures. Supplements are helpful, including vitamin D and calcium. There is some growing evidence that phytoestrogens and nondigestible oligosaccharides could play a role in reducing the severity of osteoporosis.
The Mediterranean diet has food items that contain a complex array of naturally occurring bioactive molecules with antioxidant, anti-inflammatory and alkalinizing properties. Therefore, the Mediterranean diet is beneficial in terms of osteoporosis prevention or treatment.
Here are some suggestions on how to reduce your chances of getting osteoporosis.
Reduce or stop smoking
Weight bearing exercises
Calcium at mealtime with dinner. You can have a diet with dairy foods or take extra calcium supplements.
Vitamin D is useful in preventing or treating osteoporosis. Foods rich in vitamin D include milk, cheese, sardines, cooked greens. Exposure to sun a few minutes a day. Evidence supports the use of calcium, or calcium in combination with vitamin D supplementation, in the preventive treatment of osteoporosis in people aged 50 years or older. The ideal dosage of vitamin D and calcium varies with each individual, but, on average, we suggest a minimum doses of 1000 mg of calcium, and 600 IU of vitamin D.
Reduce or avoid soft drinks due to their phosphorus content.
Soy isoflavones such as genistein
Dried plums may exert positive effects on bone in postmenopausal women.
Estrogen replacement--use lowest amount of natural estrogens
Selective estrogen-receptor modulators
B vitamins and osteoporosis
The effect of B-vitamins on biochemical bone turnover markers and bone mineral density in osteoporotic patients: a 1-year double blind placebo controlled trial.
Clin Chem Lab Med. 2007; ANZAC Research Institute, University of Sydney, Sydney NSW, Australia and Department of Clinical Chemistry and Laboratory Medicine, University Hospital of Saarland, Homburg, Germany.
This study analyzed the effect of a homocysteine lowering treatment in individuals with osteoporosis. Patients with osteoporosis were treated with either a combination of 2.5 mg folate, 0.5 mg vitamin B12 and 25 mg vitamin B6 or placebo. B-vitamin supplementation had no consistent effects on bone turnover or bone mineral density.
Vitamin D and osteoporosis
Vitamin D3 is crucial for optimal bone health. Vitamin D increases intestinal absorption of calcium and phosphorus. Vitamin D deficiency [as defined by a serum 25(OH)D level of less than 20 ng/mL] is pandemic. This deficiency is very prevalent in patients with osteoporosis. Vitamin D deficiency causes osteopenia, osteoporosis and osteomalacia, increasing the risk of fracture. Unlike osteoporosis, which is a painless disease, osteomalacia causes aching bone pain that is often misdiagnosed as fibromyalgia or chronic pain syndrome or is simply dismissed as depression. Vitamin D deficiency causes muscle weakness, increasing the risk of falls and fractures, and should be aggressively treated with pharmacological doses of vitamin D. Vitamin D sufficiency can be sustained by sensible sun exposure or ingesting at least 800 IU of vitamin D3 daily. Patients being treated for osteoporosis should be adequately supplemented with calcium and vitamin D to maximize the benefit of treatment.
In addition to calcium, other minerals that may be helpful for patients with osteoporosis include magnesium, boron, phosphorus, and strontium. Little long term research is available with these minerals to know what role they play in the long term management of osteoporosis prevention or treatment.
To prevent osteoporosis, try to be physically active, preferably throughout life. Walk, dance, do pushups, do yoga or stretching for flexibility, reduce smoking, and, if possible join a gym where you lift weights using all muscle groups. If you can't join a gym, buy a few cheap barbells and lift weights at home, do gardening, or lift rocks in your backyard... anything to make your muscles work. When muscles contract, they pull tendons that are attached to the bones, and this tells the bones to deposit calcium and thus bones become stronger and less apt to fracture. Bone is a living tissue that responds to exercise by becoming stronger. Just as a muscle gets stronger and bigger with use, a bone becomes stronger and denser when it is called upon to bear weight. Taking lots of calcium without being physically active is not going to be as effective. Take preemptive action and reduce your chances of having to rely on osteoporosis drugs.
Cause of osteoporosis
The major processes responsible for osteoporosis are poor bone mass acquisition during adolescence and accelerated bone loss in persons during the sixth decade (the perimenopausal period in women). Both processes are regulated by genetic and environmental factors. Reduced bone mass is the result of varying combinations of hormone deficiencies, inadequate nutrition, decreased physical activity, comorbidity and the effects of medications used to treat various unrelated medical conditions.
People aged 50 and older who take SSRI antidepressants, including Zoloft, Prozac and other top-sellers, have a higher risk of osteoporosis and broken bones compared with those who don't use the SSRI drugs. Antidepressants have been linked with low blood pressure and dizziness leading to falls, which can increase risks for broken bones. Research in animals suggests that SSRI drugs have a direct effect on bone cells, decreasing bone strength and size.
Hormones that cause osteoporosis
Depo-Provera (depot medroxyprogesterone), a popular birth control injection, seems to promote bone loss or osteoporosis, and the effects increase over a 2-year period.
Depression and osteoporosis
Low bone mineral density is more prevalent in premenopausal women with depression. The bone mineral density deficits are of clinical significance and comparable in magnitude to those resulting from established risk factors for osteoporosis, such as smoking and reduced calcium intake. Immune or inflammatory imbalance may cause low bone mineral density in premenopausal women with depression. However, it is possible that lack of exercise due to depression may be a contributing factor to osteoporosis in women with depression.
There is no proof that any one group of osteoporosis medications works better than other groups. n December of 2008, the Agency for Healthcare Research and Quality sponsored a team at the Rand Corporation in California to compare six drugs in the class known as bisphosphonates. These drugs include alendronate known generically as (Fosamax); zoledronic acid (Zometa); amidronate (Aredia); etidronate (Didronel), risedronate (Actonel); and ibandronate (Boniva). The report also evaluatred at estrogen, a synthetic hormone called calcitonin, calcium, vitamin D, testosterone, parathyroid hormone and drugs in the selective estrogen receptor modulators (SERM) class such as raloxifene. There was no proof that bisphosphonates prevent fractures better than estrogen, calcitonin or raloxifene.
However, estrogen and raloxifene (Evista) can have serious side effects such as strokes, blood clots in the lungs or bleeding in the uterus. Not enough evidence exists to determine how exercise or taking testosterone compares to medications in preventing osteoporosis-related fractures, the researchers said.
Q. I had a hysterectomy at age 24. I am now 35 and have been diagnosed with osteoporosis. I am having a very hard time trying to find out how much of what I need to take and what would be most helpful for me at my age. The doctors of course want me to take medication. Unless absolutely necessary I do not wish to that. Any guidance that you can give would be most appreciated and helpful.
A. We suggest your doctor read this osteoporosis page and guide you.
Q. Regarding the osteoporosis treatment product OsteoPhase. It is supposed to regulate calcium homeostasis. I have osteoporosis and would not mind the expense if the product is effective. What is your opinion? OsteoPhase contain Ostea Tealienwhanensis (shell), Astralagus polysaccharide (root), Coix Lachryma-Jobi (seed), and Angelica Sinensis (root).
Q. Is there anything that can be done regarding bisphosphonate-induced
osteonecrosis of the jaw?
A. See ozone therapy.
Q. I am fighting
osteoporosis and would
like to take inulin to enhance my calcium & magnesium absorption. I read that
different inulin fructans have different efficacy. So, what form of inulin
should I seek? Is fructooligosaccharide inulin the best?
A. We have seen no long term studies that have evaluated the use of inulin for osteoporosis. Even after years and decades of research, there is still no firm agreement in the medical profession regarding the ideal dosages of calcium, vitamin D, mangesium, or other supplements. Hence the role of inulin in osteoporosis is likely to be unanswered for quite a while.
coral calcium help
A. It may, but we have not seen any human studies with coral calcium to know for sure. If the calcium amount is high enough, it should help with osteoporosis.
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