What You Need for Healthy Bones

Veronika Charvátová wrote . . . . . . . . .

Your bones are like living cities, always rebuilding and repairing themselves and exchanging materials with their environment – discover what they need to stay strong!

Your skeleton gives your body its shape, houses and protects your organs, gives your muscles something to cling to and stores minerals such as calcium and phosphorus. In the centre of your bones (some of them) is red bone marrow which is responsible for producing blood cells so your skeleton is much more than just a collection of bones – it is a living network of cells, protein fibres, minerals and blood vessels.

As bones grow, become worn or suffer minor damage from physical activity, they are constantly repaired. Damaged bits are cleared away and new bone is built in the gaps. This allows bones to adapt to the changing demands placed on them. For example, if you start a new sport that puts unusual pressure on your bones, their architecture will slightly rebuild to make them better suited to the new challenges.

Calcium

There’s no denying that we need calcium for healthy bones – it is the most abundant mineral in your body and some 99 per cent of it is in your skeleton. The rest floats around in the blood and is used by your muscles, nerves and for many biochemical reactions. We need around 700 milligrams of calcium a day and the best plant sources are almonds, sesame seeds and tahini, chia seeds, beans, calcium-set tofu (that’s most of the tofu on the market), dried figs, oranges, kale, broccoli, Brussels sprouts, plant milk fortified with calcium and some fortified breakfast cereals.

The recommended daily dose is achievable entirely through diet. If you take a multivitamin supplement that contains calcium, that can contribute a little but you should not take a high-dose calcium supplement as intakes of over 2,000 milligrams a day may be dangerous.

Anything that can affect calcium levels in the body – food, lifestyle or medication – has an impact on your bones. If you lose more calcium than you’re receiving, over time it can result in bone loss leading to osteopenia (the forerunner to osteoporosis) and it can happen at any age. So, it’s easy to ensure you get sufficient calcium but how do you make sure you’re not flushing it out of your system at the same time? How can that possibly happen?

If your diet includes animal protein from meat and dairy, during digestion it produces acid and your body has to neutralise it as maintaining an acid-alkaline balance is essential to it. If there isn’t sufficient calcium readily available in your blood and muscles, bone calcium may be extracted and used. And this is where plant-based diets win big-time! They don’t cause this acid imbalance in the first place because of all the alkaline salts contained in fruit and vegetables and other wholesome plant foods rendering neutralising unnecessary. What’s more, they provide many nutrients that bones need. This marks a sharp distinction between foods from animals and foods from plant sources – animal protein may damage bones while plant protein protects them.

Having said that, a plant-based diet isn’t always great for your bones as sugary and processed foods, fizzy drinks, caffeine and high salt intakes can cause calcium loss. If your staples are biscuits, chips, pot-noodles, sweets and coke, your bones may be in trouble. If you’re also a smoker, it gets worse as smoking reduces calcium absorption from food. Luckily, all this is easily remedied with diet and lifestyle changes.

One more important point – you cannot utilise calcium without vitamin D…

Vitamin D

This vitamin is essential for calcium absorption but also helps to keep it in the body and regulates calcium blood levels. In spring and summer, we mostly get vitamin D through exposing our unprotected skin to sunlight, which triggers vitamin D production in the body. Fair-skinned people need about 15-20 minutes of face and arms exposure, two to three times a week but the darker your skin, the longer the exposure you need. About 30-40 minutes should be sufficient for most dark-skinned people.

Of course, there is a problem – in autumn and winter, we not only cover up more than in the summer but the sun doesn’t shine as strongly and therefore we don’t make enough vitamin D as a result. That’s why it’s recommended that everyone, regardless of diet, takes a vitamin D supplement from October to April. People who always wear a sunscreen, cover up or work indoors should take a supplement throughout the year.

Vitamin D is so important that even if you have plenty of calcium in your diet, you won’t be able to use it properly without this essential vitamin. The consequences are extremely serious, possibly resulting in rickets or osteomalacia – softening of the bones. A supplement providing 10 micrograms (400 IU) is sufficient for most people and you should never go above 100 micrograms as high doses can be toxic.

Vitamin D is essential for healthy bones and teeth but that’s not where the story ends. We also need it for a strong immune system and having healthy vitamin D levels has been shown to lower your risk of depression, cognitive decline, cancer, heart disease and diabetes – so make sure you get enough!

Pamper your bones

To be healthy, your bones need a wide range of nutrients – more than simply calcium and vitamin D! They also need vitamins A, C, K and the B group as well as minerals, such as magnesium, potassium, selenium, boron, iron, copper and zinc. A wholesome plant-based diet provides all these if it’s centred around fruits and vegetables, pulses, wholegrains, nuts and seeds with the obligatory supplement top-ups of vitamins D and B12. A word of caution – alcohol consumption is bad for bones so go easy on it!

Bones respond to how they are used so physical activity is also a key player. Any weight-bearing exercise, such as walking, running, dancing, yoga, ball games, gym classes or even gardening, stimulates your bones and makes them stronger while sedentary lifestyle can weaken them. Unfortunately, swimming or cycling don’t count because you’re not carrying your full body weight so if these are your thing, complement them with another activity.

If you treat your bones right, they will stay strong well into old age – feed them the good stuff, move them about, don’t smoke and you’ll reap the rewards!

Source: Viva!

Could Common Asthma Meds Weaken Bones?

Amy Norton wrote . . . . . . . . .

People who use common asthma controller medications are vulnerable to developing brittle bones and suffering fractures, a new study shows.

The findings point the finger at anti-inflammatory corticosteroids — whether taken by pill or inhaler.

Corticosteroids are widely used to prevent asthma attacks, particularly in the form of inhalers. When asthma is more difficult to control, oral versions of the medications may be prescribed for a time.

It has long been known that oral corticosteroids — especially at high doses — can lower bone density. And some evidence has suggested inhaled versions can do the same.

No one, however, is saying people with asthma should abandon their controller medications.

“Inhaled corticosteroids play a crucial role in the control of airway inflammation in asthma,” said lead researcher Christos Chalitsios. “Patients with asthma should not stop using their inhalers.”

But doctors should prescribe corticosteroids at the lowest dose needed to control the disease, said Chalitsios, a research assistant and PhD candidate at the University of Nottingham School of Medicine, in the United Kingdom.

The findings are based on medical records for nearly 3,700 older adults with asthma and either osteoporosis or a history of bone fracture. Each was compared with at least four other patients the same age who had asthma, but no bone disease.

Overall, the study found, the risk of bone trouble climbed along with the number of steroid prescriptions patients had in the past year.

Those with four or more prescriptions for an oral corticosteroid were about four times more likely to have osteoporosis, versus those with no prescriptions. The risk of a bone fracture was doubled when patients had nine or more prescriptions.

Meanwhile, inhaled steroids were also linked to fragile bones, though to a lesser degree, the investigators found.

Patients using inhalers were 35% to 60% more likely to have osteoporosis, versus non-users. And the risk of bone breaks started to rise once patients had more than six prescriptions for the year — by as much as 31% among those with 11 or more prescriptions.

The findings, which did not prove that steroids actually cause osteoporosis or fractures, were published online Oct. 20 in the journal Thorax.

Asthma specialists not involved in the study said it gives support to something that’s been suspected: Inhaled corticosteroids, too, may eventually weaken the bones.

But that does not mean patients should stop them.

“We have very good data showing inhaled corticosteroids improve control of asthma,” said Dr. Megan Conroy, a pulmonologist at Ohio State University’s Wexner Medical Center, in Columbus.

“And that reduces the likelihood of patients needing oral corticosteroids,” she pointed out.

Instead, Conroy said, doctors should talk to patients about ways to protect their bone health. In general, experts recommend getting adequate calcium and vitamin D, as well as regular weight-bearing exercise, including walking, climbing stairs and training with weights.

It’s not clear exactly “how much” vitamin D and calcium patients need to help counter medication effects, according to Dr. Louis DePalo. At a minimum, he said, they should be sure they are not deficient in vitamin D, which can be gauged with a blood test.

DePalo is system clinical director of the Mount Sinai-National Jewish Respiratory Institute, in New York City.

With his own patients who are long-time corticosteroid users, DePalo also suggests starting bone-density screening at an earlier age than is generally recommended (age 65 for women).

“And then I have to make the argument to the insurance company, who wants to know why this 40-year-old is being screened,” DePalo said. “Studies like this can help me make that argument.”

Patients’ exposure to corticosteroids can also be minimized by “stepping down” their dose, Conroy said. That’s an option for people whose asthma is well-controlled by their inhaler medication.

If, on the other hand, the asthma is so severe that oral corticosteroids are being repeatedly used, it might be time for a switch, according to Conroy. Newer “biologic” drugs, given by injection, could be an option, she said.

Chalitsios said some patients may also benefit from medications that protect bone density, called bisphosphonates. His team found that many patients were not on those medications in the year leading up to their osteoporosis diagnosis or bone fracture: Even among patients frequently prescribed oral corticosteroids, only half were also prescribed a bisphosphonate.

Source: HealthDay

How to Keep Your Bones Strong and Prevent Fractures

If you’re a young adult, start thinking about your bone health, an expert advises.

Most people reach peak bone mass — the strongest bones they’ll ever have — between 25 and 30 years of age, according to Dr. Philip Bosha, a physician with Penn State Sports Medicine in State College, Pa.

“To some extent, genetics determines the peak, but lifestyle influences, such as diet and exercise, are also factors,” Bosha said in a Penn State news release.

According to the American Academy of Orthopaedic Surgeons, bone mass starts to slowly decrease after age 40. Taking 1,000 milligrams of calcium and 1,000 International Units (IU) of vitamin D a day can help maintain your bones. You should also do weight-bearing exercises such as running and brisk walking, as well as resistance training to maintain bone and muscle strength.

After age 50, the daily recommended calcium intake for men remains 1,000 milligrams per day, but rises to 1,200 milligrams for women, including those who are entering or have gone through menopause.

Declining estrogen levels due to menopause can lead to rapid bone loss. All women 65 and older — and those between 60 and 64 who have an increased risk of fractures — should get a bone density study, according to Bosha.

“If the bone density study shows osteoporosis, it may be reasonable to start taking a medication called a bisphosphonate, which you can get in a variety of forms,” he said. “Some are pills taken on a weekly or monthly basis and other varieties can be taken intravenously.”

Other medications to improve bone density include calcitonin, which can be used as a nasal spray; parathyroid hormone, which is taken by injection; and medications called selective estrogen receptor modulators.

Bosha said men and women who are 70 and older should take 1,200 milligrams of calcium per day and 800 IU of vitamin D. At this age, men become far more likely to have lower bone density, increasing their risk of fractures. Some men should consider a bone density study, Bosha said.

“For people of this age, avoiding falls is crucial,” he said. “Maintaining balance and muscle strength through exercise and maintaining strong bones through adequate calcium and vitamin D intake can help decrease the risk of severe fractures from falls.”

Source: HealthDay


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Osteoporosis — What are your risks?

You might not think of bones as being alive, but they are. Every day, your body breaks down old bone and replaces it with new bone. As you get older, however, the ratio becomes unequal: more bone is lost than gained. If too much is lost, then you can develop the bone disease osteoporosis.

Osteoporosis can cause bones to become weak, brittle and prone to break. Due to loss of bone tissue, bones that were once dense and strong can be unable to withstand the stress of even normal activity, such as bending over or coughing. Osteoporosis-related fractures most commonly occur in the spine, wrist and hip. In addition to bone fractures, osteoporosis can cause bone pain, loss of height and a stooped posture. All of these symptoms can lead to feelings of anxiety and depression.

No one can say for sure which individuals will develop osteoporosis. But research has revealed what makes some people more likely than others to develop it. That’s why it’s important to be aware of the risk factors — and what you can do about them.

Bone health basics

Generally speaking, the risk of developing osteoporosis and being more prone to bone fractures depends on your bone health — the size and strength of your bones and the condition of your bone tissue. Bone health is a result of how well your skeleton developed during childhood and early adulthood, as well as your peak bone mass — the maximum amount of bone tissue you have. Most people achieve peak bone mass in their late 20s to early 30s. Bone health is also affected by how rapidly bone mass is lost as you get older.

Risk factors that can’t be changed

Some risk factors for osteoporosis, such as your age and family history, aren’t things you can control. But just because you’re at risk doesn’t mean you will get the disease. You can monitor your bone health for early signs of abnormal bone loss and take steps to prevent osteoporosis or to slow its development.

These are common risk factors for osteoporosis:

Age. The older you are, the more likely you are to develop osteoporosis and the more likely you are to break a bone because of it. After you’ve reached your peak bone mass, it’s normal to begin losing a small percentage of bone mass each year. This happens because new bone formation slows with age, while bone breakdown stays the same or increases. The internal structure of bones also begins to weaken, and the outer shell thins.

Gender. Women usually have lower peak bone mass than men do. Women also tend to live longer. So, in effect, women have less bone to lose but more time to lose it. In addition, during menopause, women experience a drop in estrogen levels, which usually accelerates bone loss. Osteoporosis is most common among postmenopausal women.

Ethnicity. Caucasians and Asians are at greater risk of osteoporosis; Hispanics and Native Americans appear to have an intermediate risk, while African-Americans have the lowest risk. These various levels of risk are based in part on differences in bone mass and bone density.

Genetics. Family history is a strong predictor of low bone mass. If your mother, sister, grandmother or aunt has osteoporosis, then you’re at greater risk. But remember that having a family history of low bone mass doesn’t automatically mean the same thing will happen to you. By taking steps to lower your risk, osteoporosis can be prevented.

Body frame size. Men and women with small body frames tend to have a higher risk because they usually have less bone mass to draw from as they age.

Health-related risk factors

Individual health circumstances, including health conditions and medications, can influence osteoporosis risk.

Childbearing. Pregnancy builds stronger bones by raising estrogen levels and increasing weight. Bone density decreases slowly during pregnancy and more rapidly while nursing a baby, but this bone loss recovers within six months after stopping nursing in most women.

Medications. Certain medications can accelerate bone loss and increase your risk of osteoporosis. If you take any of the following medications, then talk to your health care professional about what you can do to counteract their effects on bone health.

  • Corticosteroid medicines. Long-term use of corticosteroids, including prednisone (Rayos), cortisone, prednisolone (Orapred, Prelone, others) and dexamethasone (Maxidex, Tobradex, others), lowers bone mass. If you take one of these medications for more than a few weeks, then your doctor will likely monitor your bone density and recommend preventive measures.
  • Anticonvulsants. If you take a medication to control seizures (anticonvulsants) over a long period of time, then your liver begins to metabolize vitamin D in a way that causes a deficiency of the vitamin. If you take an anticonvulsant medication, such as phenobarbital (Lumina), carbamazepine (Carbatrol, Tegretol, others) or phenytoin (Dilantin, Phenytek, others), then your health care professional may recommend vitamin D and calcium supplements.
  • Thyroid medicines. When used in excessive quantities, thyroid medications such as levothyroxine (Synthroid, Tirosint, others) can cause high thyroid hormone blood levels that accelerate bone loss.
  • Diuretics. These drugs prevent fluid buildup in your body. But by doing so, certain diuretics can cause the kidneys to excrete too much calcium, leading to weaker bones.
  • Other drugs. Certain blood thinners, such as heparin, can cause bone loss when used over a long period of time. So can aromatase inhibitors, a class of drugs used to treat breast cancer, and drugs that are used to treat endometriosis and prostate cancer (gonadotrophin-releasing hormone agonists).

Medical conditions. Certain medical conditions can increase the risk of osteoporosis by slowing bone formation or speeding up bone breakdown. They include:

  • Endocrine disorders, such as hypogonadism, overactive thyroid (hyperthyroidism), hyperparathyroidism, Cushing’s syndrome and diabetes
  • Gastrointestinal disorders, including Crohn’s disease, celiac disease, lactose intolerance and liver disorders such as primary biliary cirrhosis
  • Rheumatoid arthritis
  • Absent or infrequent menstrual cycles in women of childbearing age

Gastrointestinal surgery. Surgery to reduce the size of the stomach or to remove part of the intestine limits the ability of these organs to absorb nutrients, including calcium.

Risk factors you can change

Although the risks may seem daunting, it’s important to realize there are some risk factors for osteoporosis that you can control. It’s never too late to do something about your bone health.

Low calcium and vitamin D intakes. A lifelong lack of calcium plays an important role in the development of osteoporosis. Low calcium intake contributes to diminished bone density, early bone loss and an increased risk of fractures. Because vitamin D is essential for calcium absorption, chronically low levels can contribute to osteoporosis. Some studies suggest that large portions of the U.S. population may have low levels of vitamin D. But the data is difficult to interpret, because the definition of what constitutes deficiency can vary. Still, it’s a good idea to have your vitamin D level checked if are in one of the categories of higher risk of deficiency.

Eating disorders. Severely restricting food intake and being underweight can weaken bone.

Lack of physical activity. Regular physical activity is key to preventing osteoporosis and fractures. Lack of exercise accelerates bone loss; whereas, weight-bearing exercises such as walking and resistance training can increase or at least maintain your bone density at any age.

Smoking. Here’s another good reason to quit — smoking is bad for your bones. Smoking interferes with the production of estrogen and testosterone, which are needed to build bone. Smoking also disrupts calcium absorption.

Alcohol use. Alcohol delivers a double whammy to your bones, putting a damper on bone building and stimulating the bone loss process. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.

Source: Mayo Clinic

Study: Vitamin D Supplements Won’t Build Bone Health in Older Adults

Steven Reinberg wrote . . . . . . . . .

Vitamin D supplements have long been touted as a way to improve bone health and possibly ward off the bone-thinning disease osteoporosis in older adults.

But a new study contends that claims of benefits from supplements of the “sunshine vitamin” fall flat.

A review of previously published studies found that taking either high or low doses of vitamin D supplements didn’t prevent fractures or falls, or improve bone density.

Vitamin D is found in very few foods. One of the biggest sources of the vitamin is exposure to sunlight.

“Vitamin D supplement use is common, particularly in North America,” where up to 40 percent of older people take them, said lead researcher Dr. Alison Avenell. She is clinical chair in health services research at the University of Aberdeen in Scotland.

“Most adults don’t need to take vitamin D supplements, although they are unlikely to do harm if taken in low doses,” she added.

Vitamin D supplements do prevent rare conditions, such as rickets in children and osteomalacia (softening of bones) in adults. People at risk of vitamin D deficiency include those with little or no sun exposure, such as nursing home residents who are indoors all the time, or those who always cover their skin when outside, Avenell said.

There’s also existing evidence that vitamin D helps prevent cancer or heart disease, she added.

“Preserving bone strength involves keeping active, not smoking, not being too thin, and taking medications for osteoporosis,” Avenell said.

Based on the new findings, Avenell thinks guidelines that recommend vitamin D supplements for bone health should be changed.

For the new report, Avenell and her colleagues reviewed 81 studies, most of which dealt with vitamin D alone, not in combination with the mineral calcium.

“Calcium supplements on their own have minimal effect on bone mineral density and fracture, and may increase the risk of cardiovascular disease,” Avenell said.

The only evidence that calcium and vitamin D together prevent fractures comes from a trial of older people with very low vitamin D levels in nursing homes. But calcium and vitamin D may also increase the risk of cardiovascular disease, Avenell said.

In addition, most of the studies covered in the new review included women aged 65 and older who took more than 800 IUs (international units) of vitamin D daily.

The new study found no meaningful effect of vitamin D supplementation when it came to reducing any fracture, hip fractures or falls.

This type of study, called a meta-analysis, tries to find common elements among previously published studies. This kind or research, however, is limited by differences in the methods and conclusions of the different studies analyzed by researchers, so the findings may not be consistent across the board.

A group that represents the supplement industry took issue with the findings.

“There is evidence that vitamin D is very helpful, especially when you have low levels,” said Duffy MacKay, senior vice president for scientific and regulatory affairs at the Council for Responsible Nutrition.

Over 94 percent of the U.S. population has vitamin D levels that are too low, he said. “Most Americans do not get enough vitamin D to meet their needs and supplements can fill that gap, but if your vitamin D levels are sufficient you don’t need to supplement.”

The benefit of proper vitamin D levels are seen over a lifetime and can’t be judged in short-term studies that look at any specific benefit, he added.

Dr. Minisha Sood, an endocrinologist at Lenox Hill Hospital in New York City, said this new study should convince doctors that vitamin D supplements don’t have a role in maintaining healthy bones, but they do have other benefits.

Previous research suggests that vitamin D, when taken in tandem with calcium, may help prevent certain cancers and protect against age-related declines in thinking and memory.

“What is important to keep in mind is that those with low vitamin D were not represented in this meta-analysis, and vitamin D supplementation — repletion, actually — is still necessary for those with low vitamin D levels, regardless of age,” Sood said.

The findings were published online in The Lancet Diabetes and Endocrinology.

Source: HealthDay


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