Until the early 1990s, the conventional wisdom on preventing bone fractures in menopausal women focused on calcium - taking them as supplements, in milk and dairy products or in fortified drinks and even in Tums antacids! Along with regular weight-bearing exercise like walking, swimming or weight-lifting, this was the extent of nondrug advice to prevent osteoporosis. Hormone replacement therapy (HRT) was considered next in the line of defense in protecting against bone less, and if these measured failed, then Fosamax, or other drugs like Boniva and Actonel in the related category of bisphosphonate drugs were recommended.
This line of thinking gradually advanced with more research into the physiology of bone formation, as well as with a deeper understanding of the changing nutritional needs of women around menopause. Not only do estrogen levels gradually diminish starting at perimenopause, but decreasing the amount of nutrients we absorb from foods is common in everyone as we get older, with lowering amounts of stomach acids unable to extract maximum value from foods, even in optimum diets. Then in 1995, Preventing and Reversing Osteoporosis broke new ground, with Dr. Alan Gaby, M.D. spearheading a nutritional strategy. He questioned the protective value of estrogen in building or keeping bones strong, flexible and healthy. He showed that HRT can preserve but not create new bone, and that although new growth does slow down after menopause, fresh bones cells do continue to be produced and replaced throughout life.
Dr. Gaby demonstrated that estrogen, conversely, only serves to maintain a brittle patchwork of old bone. Replacing estrogen serves only to keep old bone cells that would otherwise be disposed of by the body! Though bone does show up as more dense on a DEXA bone scan, it is not qualitatively stronger or more resistant to fracture. He proposed that making dietary modifications - especially eating whole foods, grains, fruits and vegetables - as well as taking a broad base of supplements, not only calcium - helps replenish healthy bone.
More recently, nutritionist Amy Lanou, Ph.D., takes Dr. Gaby's finding a step further. In her recent book, Building Bone Vitality: A Revolutionary Diet Plan to Prevent Bone Loss and Reverse Osteoporosis - Without Dairy Foods, Calcium Estrogen or Drugs, she also questions the wisdom of focusing only on calcium, and especially on focusing primarily on dairy sources. A senior researcher for the Physician's Committee on Responsible Medicine, she noticed that people in countries that consume the least dairy products have the lowest incidence of osteoporosis! And that the reverse is also true: people in countries who eat the most diary products suffer the highest rates of fractures. She also discovered that taking more than 500mg per day of calcium does not reduce risk of fracture.
So how is this possible? Dr. Lanou delves deeply into how food - and what foods - push calcium into bone cells. She suggests that it is more wise to measure the effectiveness of different approaches to bone health by their ability to reduce the risk of fracture, rather than their ability to increase bone density, because density sidesteps the issue of building bones that are strong and healthy. As with calcium, how much you take is less important than how much of the calcium you do take goes into the bone to create new, healthy cells. She demonstrates how supplements and HRT keep calcium in the blood, while preserving old bone cells, also raising questions about optimum and alternative ways to measure bone health, i.e., not in the bone, but the blood, or even the urine.
Like Dr. Gaby, Dr. Lanou concludes that an optimum diet is one that reduces acidity in the blood. Meats, processed foods, and sugars - as well as stress - increase blood acidity. Whole foods and especially fruits and vegetables maintain healthy blood alkalinity. In the body's hierarchy of needs, when the body determines that the blood is too acid, it decides to take calcium from bone to rebalance and alkalinize the blood. So looking at bone health from a nutritional standpoint, osteoporosis is the body's way of highlighting an imbalance in either the nutrients you take in, or the nutrients you absorb from your diet and supplements!
There is much solid evidence accumulated over the last two decades showing that a well-rounded and individualized eating plan provides the array of nutrients vital to maintaining lifelong bone health. More than most women realize, an effective, nondrug approach to preventing and reversing osteoporosis may be within reach.
Kathleen Daniel, MS, L.Ac., is an acupuncturist, herbalist and health and wellness coach who can be found at [http://www.aheadofthecurveatmidlife.com], a progressive resource site that breaks old stereotypes and myths about aging, and invites women to take control of their health, life and vitality from perimenopause and forward. Their healthy bone program "Women Doing It for Themselves: 8 Steps for Building Strong Bones for Lifelong Vitality" is a comprehensive nutritional approach using Metabolic Typing in an optimum nondrug approach to maintaining bone density and preventing bone loss.
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