A Natural Approach to Bone Health
Bone health is a primary concern for women as they advance in age. Bone is a dynamic, living tissue subject to breakdown, repair, and rebuilding, like any other tissue in the body. Bone loss occurs when the rate of bone dissolution exceeds that of bone formation. Women actually achieve maximal bone density by their mid-thirties. In fact, skeletal bone mass naturally starts to decrease after about age 40, so it is never too early to address bone health. In addition, research has shown that it is never too late to begin preventative steps against excessive bone loss.
For many women and their health care providers, concern about bone loss is one of the main arguments for supplementing with estrogen. Estrogen replacement, however, brings with it its own concerns, and is only part of the story when it comes to bone health. Estrogen can inhibit the cells whose job it is to break bone down. This means estrogen slows down the rate of bone loss, but it will not build new bone. Testosterone and progesterone, however, appear to stimulate the cells that build bone, thereby possibly stimulating bone growth.
Hormones play a pivotal role in the process of remodeling bone, but several vitamins and minerals are indispensable for optimal bone health as well. The formation of healthy bone has two fundamental aspects: First to increase bone mass, and second to create a healthy infrastructure (known as the bone matrix) around which bone can form. Supplementing with key nutrients, along with a balanced diet and exercise program, are integral to any regime for promoting the health of your bones.
The proper nutrition for bone health goes beyond simply supplementing with calcium. Calcium deficiency may only contribute to 25% of all incidences of heightened bone loss. The form of calcium used is also important. Studies to determine the recommended daily intake of 1200-1500 mg for menopausal women used calcium carbonate. Calcium carbonate is a form of calcium our bodies may find difficult to absorb, particularly in an environment that is low in stomach acid. In addition, this recommendation includes calcium derived from dietary sources. Most women eating a standard American diet get about 700 mg of calcium from food intake. Calcium as an amino acid chelate is currently the most absorbable form of calcium available. As we age, we tend toward hypochlorhydria (low stomach acid). Calcium amino acid chelate does not require an acidic environment for absorption, but it is a good idea to supplement with a bone health formula that includes hydrochloric acid, as it can aid in the absorption of calcium and other nutrients from the diet.
Magnesium is important for the formation of a functional bone matrix. In addition, magnesium converts vitamin D to its active form, D3. This is imperative for calcium absorption. Many women with poor bone health may be deficient in the active form of vitamin D. Menopausal women in general tend also to be deficient in magnesium. Folic acid and vitamin B6 (pyridoxine) together perform a vital role in engendering the health of bone tissue. They help the body metabolize and excrete a substance known as homocysteine. High homocysteine levels are associated with defective bone formation (and, incidentally, with cardiovascular disease). Interestingly enough, menopausal women show an impaired ability to metabolize and excrete homocysteine. Furthermore, they tend as a group to be low in folic acid and vitamin B6.
Manganese, silicon, and vitamin K are all necessary for the construction of the bone matrix around which bone mineralization occurs. Vitamin K is another nutrient that is found to be low in individuals with significant bone loss. Too much vitamin K can potentially interfere with blood clotting, so it is important not to exceed approximately 200 micrograms a day of this nutrient.
Zinc and copper are also important minerals for bone health that tend to be low in menopausal women. Both minerals enhance the effectiveness of vitamin D, which promotes the absorption of calcium. Zinc and copper must be supplemented in the appropriate ratio, as imbalances may affect the proper formation of bone. Supplementation with the micronutrient boron has been shown to reduce calcium loss in post-menopausal women. Vitamin C is well known for its role in immune support, but it is also a crucial nutrient that the body needs to build bone matrix and healthy connective tissue. Vitamin C deficiencies are widespread, even with those ingesting the full RDA.
Increasing evidence points to a link between soy intake and bone health. Most of the studies that suggest dietary soy intake is associated with a decrease in the rate of bone loss are either epidemiological or based on an animal model. The amount of soy actually required for this positive effect on bone health is still undetermined. One important study that was conducted on postmenopausal women concluded the amount of isoflavones (the phytoestrogenic component of soy) needed to slow down the rate of bone loss is between 55 and 90 mg/day for at least 6 months.
Ipriflavone is a synthetic isoflavone derivative. Ipriflavone has been shown to inhibit the rate of bone loss and promote bone formation in postmenopausal women, particularly in the spine and wrist. As noted, there are many key nutrients vital for the health of our bones. A comprehensive program that encompasses proper diet, nutritional supplementation, and exercise may prove to be invaluable in preventing or minimizing bone loss.
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Dr. Holly Zapf