Wellness Database: Osteoporosis
Osteoporos is a common condition in which bone density and tissue are reduced over time. It is often result of poor nutrition and can be prevented or reversed through supplementation and lifestyle changes. Lack of exercise, Vitamin D, and Omega-3 Fatty Acids can all contribute to the condition. Supplementing with glucosamine, fish oil, vitamin k, and eating plenty of fruits and vegetables may help to prevent or reduce the occurence of osteoporosis.
Supplements May Help To Prevent Osteoporosis and Reduce Fracture Risk
Summary: In a 6-month, double-blind, pilot study involving 70 subjects randomized to receive daily supplementation with calcium only or the geniVida (TM) bone blend (consisting of genistein 30 mg/d, vitamin D3 800 IU/d, vitamin K1 150 microg/d, and polyunsaturated fatty acids), supplementation with the GBB was found to be associated with maintained BMD of the femoral neck, as compared to the placebo group which experienced a decline in BMD. In addition, increases in N-telopeptide and bone-specific alkaline phosphatase were found in the GBB group, as compared to the placebo group. The authors conclude, "The GBB may help to prevent osteoporosis and reduce fracture risk, at least at the hip, in postmenopausal women. Larger and longer-term clinical trials are warranted."
Reference: "Effect of a combination of genistein, polyunsaturated fatty acids and vitamins D3 and K1 on bone mineral density in postmenopausal women: a randomized, placebo-controlled, double-blind pilot study," Lappe J, Kunz I, et al, Eur J Nutr, 2012 Feb 3; [Epub ahead of print].
Supplementation May Be Beneficial For Bone Health in Postmenopausal Women
Summary: In a randomized study involving 115 postmenopausal women, daily supplementation with fortified milk and yogurt along with either a) 800 mg calcium and 10 microg vitamin D3, b) 800 mg calcium, 10 microg vitamin D2 and 100 microg vitamin K1, or c) 800 mg calcium, 10 microg vitamin D3, and 100 microg K2, along with biweekly nutrition and lifestyle counseling sessions, was found to be associated with significant increases in bone mineral density (BMD), as compare to a control group who followed their usual diet. While a decrease in L2-L4 BMD was found in the control group, significant increases were found in the groups supplemented with calcium, vitamin D3, and vitamin K1 or K2. These results suggest that supplementation with a calcium, vitamin D3, and vitamin K1 or K2 may be beneficial for bone health in postmenopausal women.
Vitamin D May Reduce Risk of Bone Fractures
Summary: In a nested, case-control study involving a cohort of 600 female Navy recruits subsequently diagnosed with stress fracture of the tibia or fibula and 600 matched controls, a monotonic inverse dose-response gradient was found between 25(OH)D level and risk of stress fracture. Comparing the highest to the lowest quintiles of serum 25(OH)D concentration, there was approximately half the risk of stress fracture (OR=0.51), with a range of serum 25(OH)D from 1.5-19.7 in the lowest quintile (mean: 13.9) ng/ml, to 39.9-112 (mean: 49.7) ng/ml in the highest quintile. The authors state, "There was double the risk of stress fractures of the tibia and fibula in women with serum 25(OH)D concentration < 20 ng/ml, compared to those with >= 40 ng/ml. A target for prevention of stress fractures would be a serum 25(OH)D concentration of > 40 ng/ml, achievable with 4000 IU/day vitamin D(3) supplementation."
Reference: "High serum 25-hydroxyvitamin D is associated with low incidence of stress fractures," Burgi AA, Gorham ED, et al, J Bone Miner Res, 2011 June 22; [Epub ahead of print]. (Address: Naval Health Research Center, San Diego, California, USA).
Vitamin D Important for Osteoporosis Patients
Summary: In a study involving patients with hip with spine fracture due to osteoporosis living in various parts of Japan, low levels of serum 25(OH)D were found in patients with hip fracture (16.3 ng/mL) and spine fracture (18.1 ng/mL) patients, and high serum ucOC was found in 37% of hip fracture patients and 44% of spine fracture patients. Additional research is warranted to investigate the effects of vitamin D supplementation in this population.
Vitamin D May Improve Bone Health
Summary: In a study involving 122 apparently healthy, postmenopausal Saudi women, of whom the majority were found to have serum vitamin D levels below 50 nmol/L, women with osteopenia were found to have significantly lower serum vitamin D levels as compared to women with normal BMD levels. Furthermore, while mean total caloric, total fat, and saturated fat intakes were above the recommended levels, 60% of the subjects were found to have lower calcium intake than the estimated average requirement and nearly the entire study population was found to have vitamin D intake lower than the estimated average requirements. BMD of the femoral neck was found to be significantly associated with serum vitamin D. The authors conclude, "Our findings reveal the important role of dietary vitamin D and calcium in osteopenic patients and the likely requirement for supplementation of these nutrients in the Saudi population."
Vitamin K May Prevent Bone Loss and Fractures
Summary: In a cross-sectional study involving 365 elderly subjects, 200 of whom were also included in a 2-year longitudinal follow-up study, dietary intake of vitamin K was found to be significantly associated with higher bone mineral density (BMD) and better quantitative ultrasound assessment (QUS), while no significant associations were found between vitamin K intake and bone biochemical markers. In addition, "Those subjects who increased their vitamin K intake showed a lower loss of BMD, a lower decrease in SOS and a nonsignificant increase in BUA." These results suggest that maintaining a higher intake of vitamin K may offer protection against bone loss and osteoporotic fractures in the elderly.
Reference: "Dietary vitamin K intake is associated with bone quantitative ultrasound measurements but not with bone peripheral biochemical markers in elderly men and women," Bullo M, Estruch R, et al, Bone, 2011 April 4; [Epub ahead of print]. (Address: Human Nutrition Unit, Facultat de Medicina i Ciències de la Salut, IISPV, Universitat Rovira i Virgili, Reus, Spain).
Dr. Andrew Myers: Bone Dysfunction Syndrome
What Is Bone Dysfunction Syndrome?
Bone Dysfunction Syndrome is a nutritional deficiency resulting in osteoarthritis and osteoporosis. This can lead to reduced mobility, reduced quality of life, increased risk of fractures, and chronic pain. Osteoarthritis does not cause osteoporosis, nor does the reverse seem to occur.
The shared link between the two is that they both occur primarily due to a chronic Vitamin D deficiency. Individuals who don’t receive adequate levels of Vitamin D are at a heightened risk of developing Bone Dysfunction Syndrome. People who do get sufficient Vitamin D reduce their risk of the occurrence of this syndrome.
The two most significant deficiencies are Vitamin D and Omega-3 fatty acids. Additional deficiencies include Glucosamine, Minerals such as Calcium and Magnesium. Supportive nutrients include Green Tea and Pomegranate.
Preventing Bone Dysfunction Syndrome
- Exercise - Regular exercise is cri tical to preventing Bone Dysfunction Syndrome. Exercise can strengthen muscles around afflicted joints, stimulate the bones to build new mass, and reduce chronic pain caused by inflammation.
- Diet - Limit intake of carbohydrates and simple sugars as these can lead to joint inflammation. Eat foods rich in calcium, magnesium, and Vitamin D.
- Key Nutrients:
1) Vitamin D – May reduce pain, improve muscle strength, and reduce the occurrence of osteoarthritis and osteoporosis.
2) Glucosamine – May strengthen cartilage, particularly in the knees.
3) Omega-3 Fatty Acids – Increases calcium absorption in the gut, increases calcium levels in bone, strengthens bones, and reduces joint swelling and stiffness.
- Go Outside: Vitamin D is free! Simply spend an extra 20 minutes outside in the sun every day. Even on cloudy days you can receive Vitamin D from the sun.
Fish Oil Reduces Fracture Risk
Summary: In a study involving data from 137,486 postmenopausal women, higher consumption of saturated fatty acids was associated with an increased risk of hip fracture (HR=1.31 for 4th quartile), higher monounsaturated fatty acid intake was associated with a lower total fracture risk (HR=0.94), higher polyunsaturated fatty acid intake was associated with a lower fracture risk as well (HR=0.95), higher omega-6 fatty acid intake was associated with a lower fracture risk (HR=0.94), and unexpectedly, higher marine omega-3 fatty acids was associated with a greater total fracture risk (HR=1.07). The authors conclude, "In postmenopausal women with a low intake of marine n-3 FAs, a higher intake of n-6 FAs may modestly decrease total fracture risk."
Reference: "Fatty acid consumption and risk of fracture in the Women's Health Initiative," Orchard TS, Cauley JA, et al, Am J Clin Nutr, 2010 Dec; 92(6): 1452-60. (Address: Department of Human Nutrition, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA).
Nutrition From Vegetables Benefits Bones
Summary: In a study involving 144 postmenopausal Korean women with osteoporosis and age-matched controls, intake of calcium, plant calcium, potassium, vitamin A, carotene, vitamin B(1), niacin, vitamin E, vitamin C, and vegetables were associated with significantly reduced risk of osteoporosis, after adjusting for potential confounders. Furthermore, intake of vegetables alone, as well as calcium, plant calcium, potassium, and antioxidant vitamins (vitamins C, E, and beta-carotene) abundant in vegetables was significantly associated with BMD. The authors conclude, "Vegetables may be an important source of calcium and may also provide vitamins and minerals that exert additional beneficial effects on the bone."
Reference: "Calcium from plant sources is beneficial to lowering the risk of osteoporosis in postmenopausal Korean women," Park HM, Heo J, Park Y, Nutr Res, 2011 Jan; 31(1): 27-32. (Address: Department of Obstetrics and Gynecology, Yong San Medical Center, College of Medicine, Chung Ang University, Seoul, Korea).
Fish Consumption Protects Bones
Summary: In a study involving 623 adults (mean age: 75 years) in the Framingham Osteoporosis Study, high intakes of fish (at least 3 servings/wk) were found to be associated with improved bone health. Specifically, consumption of dark fish and tuna was associated with maintenance of femoral neck BMD in men and consumption of dark fish was associated with femoral neck BMD in women. In addition, subjects with the highest intakes of arachidonic acid (AA) were found to have a higher mean baseline femoral neck BMD than those with the lowest intakes. Among men with the lowest EPA+DHA intakes, those with the highest AA intakes lost more FN-BMD than those with the lowest intakes of AA. Intake of linoleic acid was found to be associated with bone loss in women. These results suggest that, "Fish consumption may protect against bone loss. The protective effects of a high AA intake may be dependent on the amount of EPA+DHA intake."
Reference: "Protective effects of fish intake and interactive effects of long-chain polyunsaturated fatty acid intakes on hip bone mineral density in older adults: the Framingham Osteoporosis Study," Farina EK, Kiel DP, et al, Am J Clin Nutr, 2011 March 2; [Epub ahead of print]. (Address: Friedman School of Nutrition Science and Policy, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA).
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Nutrients and Diet
Alpha Lipoic Acid Amino Acids Antioxidants Arginine Calcium Carnitine Carotene Chromium Picolinate Citrulline Coenzyme Q10 DHEA Fat Fiber Fruit and Vegetables Garlic Ginkgo Biloba Glucosamine Vegetarian Diet Green Tea Iron Lutein Lycopene Magnesium Mediterranean Diet Multivitamins Nitric Oxide Nuts Olives Omega 3 Fatty Acids Policosanols Polyphenols Pomegranate Probiotics Pycnogenol Red Yeast Rice Salt Saffron Selenium Soy Theanine Vitamin A Vitamin B Vitamin C Vitamin D Vitamin E Vitamin K White Tea Zinc