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Recipe for Good Bones

It is important to understand that your bones are a living, active material and not dead or static. Your bones are continually building, renewing, repairing, and breaking down.

Both men and women reach their peak bone mass at 30 years old and then lose about .4 % mass each yearThe first 1-5 years after women reach menopause is when the rate of loss is at its greatest. A common misconception is that men don't lose bone at the same rate as women, they actually do, but they create more bone density during the growth period so the loss isn't at the same percentage of bone density they started with. So it's optimal that children and young adults build their bones to reach maximum bone density before they reach 30 years of age (Journal Nutrition 126, 1996). Risk factors that influence bone loss are your age, hormones, inactivity, nutrition, lifestyle, illness, medications, genetics and ethnic background (Osteoporosis International, 1993).

When bone loss is greater than bone repair, or when there is not enough calcium from our diet and our body "robs" calcium from our bones, it leads to a condition called osteopenia, which is widespread bone loss affecting 34 million Americans. This can lead to a more significant problem of having porous bones, or osteoporosis. Osteoporosis is responsible for 1.5 millions fractures in the US each year, with 10 million people with osteoporosis, and a total direct cost per year at 17.5 billion a year in the US alone. (American Journal of Clinical Nutrition).  At least a third of women and a tenth of men over 50 will have osteoporosis related fracture in their lifetime. 50% of women who break a hip will never walk again and 1/3 of all hip fractures will occur in men. If we check our diets and learn from cultures that have less bone fractures, then we can change these frightening statistics. 

First Start with Some Calcium…

 According to the surgeon general, 75% of Americans are not getting the recommended daily supply of calcium,putting them at risk for osteoporosis. Ideally, calcium should come from food sources, where it is most absorbable.  Too much calcium from supplements and not from food sources can lead to kidney stones, bone spurs, and mineral imbalances (The Calcium Information Center, 1997 from "Non-Dairy: Something to Moo About, Inc).  A recent study of postmenopausal women by the American Journal of Clinical Nutrition showed that women who get their sources of calcium mainly through diet have healthier bones than those who relied on supplements alone for heir calcium needs. The study shows that only 35% of calcium through supplements alone is absorbed by the body. Calcium supplements are a billion dollar industry, the number one supplement sold today in the US, according to the Nutrition Business Journal.  Calcium needs an acidic gastric environment to absorb best, so calcium from an antacid is very contradictory, and taking a calcium channel blockers can present a problem with optimal absorption. Institute of Medicine (IOM) of the National Academy of Sciences recommends different amounts of calcium throughout our lives: Infants to 3 years require 250-500mg a day, children 4-8 should get 800mg, and kids up to 19 years should get 1300mg per day. Adults, until menopausal age for women should get 1000mg and women 50 years and older should get 1200mg per day. Pregnant teenagers need more calcium and breastfeeding women need an extra 550mg a day. Menopause increases calcium loss in the bones due to the drop in estrogen, which keeps the calcium in the bones. The most amount of loss occurring in the first 5 years of onset (J Bone Min Res 1987).

A test for chemical markers in the blood and urine can show how much calcium you are absorbing, and a bone densitometry is a simple, painless test that measures bone density.  The DEXA scan is the most accurate test and is used in clinical trails for to measure calcium absorption, but takes awhile to see change.

Don’t Forget the Collagen 

One of the most important pieces of information about bone density is usually left out many supplements and literature. At a recent Metagenics® seminar about calcium supplements, it was pointed out that much research supports the need for MCHC (Micro-Crystalline Hydroxy-apatite Crystals) a whole bone extract, as an excellent source of calcium and other nutrients essential to bone formation (Bone, 1989). Since bone is organic and living, you need the reinforce the strength and rigidity by reinforcing the collagen matrix (MCHC) which makes up 30 % of bone, as well as the inorganic minerals (calcium, magnesium, phosphorous), which makes up 45% of bone (Manitoba Medical review, 1965; Clinical trails Journal, 1973; American Journal of Clinical Nutrition, 1982).  MCHC includes macro-minerals like calcium, magnesium and phosphorous; trace minerals like boron, zinc, copper and selenium; type 1 collagen, which is the predominant type found in healthy bone matrix; bone amino acids, protein, and growth factors.  When you look for supplements, look for MCHC, and research the company that produces it. There are organizations that use organic ingredients that have the most absorbable minerals in the form of MCHC and these are typically not sold at regular grocery stores at discount prices.  Medications like Fosamax and Boniva reduce the break down of bone, but do little to remove the old bone that breaks down. If you take these, or want more information, talk to your doctor about the side effects (which can be a build up of your old bone and gastrointestinal symptoms), and any drugs you are taking that might interact with calcium. You may have to supplement with calcium and vitamin D even if you decide to take prescribed medications. As we all already know, calcium is very important for healthy bones and teeth. Did you also know that calcium helps the body perform other very important roles? These include the transmission of nerve impulses, muscle contraction and relaxation, blood clotting, normal heartbeat, stimulation of hormone secretion and the activation of enzyme reactions.

Add Some Minerals...

Magnesium is a mineral that pushes soft tissue calcium into your bones.  Too much calcium in the soft tissue can lead to atherosclerosis, according to Dean Ornish. Magnesium also stimulates the hormone calcitonin, which also increases calcium in bones.  Research shows that a magnesium deficient diet, full of refined foods, leads to an increase in bone density loss (Journal of the American College of Nutrition, 2004; Clin End Met, Aug 1998). This actually affects as much as 70% of the U.S. population. Another study shows that magnesium is more important than calcium in menopausal women in reversing bone loss (Science News, 1998). According to Debi Smolinski, ND, you can supplement up to 500-1000mg of magnesium, because it is one of the harder nutrients to absorb through food alone. Some people have trouble with more than 100-200mg a day, and you should avoid magnesium chloride, carbonate or oxide because they can lead to loose stools. 

Magnesium is also important for calming nerve function, regulating your body temperature, helping metabolize carbohydrates, amino acids, proteins and fats.It also helps constipation, helps regulate energy production (including fibromyalgia and chronic fatigue syndrome), harmonizes mental and emotional imbalances (including irritability, depression, bipolar, sleep disorders and PMS), and helps calcium in muscle relaxation. While calcium is used to contract your muscles, magnesium relaxes it. Some practitioners believe that you can also give magnesium, instead of a calcium blocking drug, to stop vasospasms in the heart and migraines, without the same side effects (New England Journal Medicine, 1984). 

Add Some Vitamins...

Vitamin D3 (Nutrition 1995), is very important for maximum calcium absorption into bones.  It can also help the prevention of risk factors associated with cancer, type-1 diabetes, depression, cardiovascular disease, autoimmune diseases and fibromyalgia, secondary hyperparathyroidism and muscular abnormalities. Hyperparathyroidism causes lower calcium levels in the blood, which also contributes to bone loss. The best way to get Vitamin D is through 20 minutes of sun exposure a day. Most people do not get this type of exposure, nor want it due to risks with skin cancer.  You may get vitamin D through the diet by eating foods fortified with Vitamin D, egg yolks and fatty fish. Vitamin D deficiency can be detected in a blood test performed in your doctor's office and will let you know if you need to add a supplement to avoid deficiency (Robert Heaney, MD a bone mineral specialist at Creighton University on Omaha suggests 1000-2000 IU's a day, but talk to your doctor to find out the best amount suited for you). Paul Pitchford, author of Healing with Whole Foods, suggests avoiding reduced fat dairy products because they may not support the absorption of the fat soluble vitamins A & D, which help lay down new bone mass. The calcium will go to the soft tissue, rather than the bone. If you want to eat a reduced fat diet, just eat less dairy, or none at all.

According to the Archives of Pediatric and Adolescent Medicine and James E. Dowd, MD author of The Vitamin D Cure, 65 percent of American children are Vitamin D deficient. He suggests that kids get 15 minutes of sunshine without sunscreen daily. If that is not possible, you can supplement ½ -1 teaspoon of cod liver oil daily for newborns and children up to 5 years old. 1 tsp. of cod liver oil has more than 4 times the vitamin D a cup of milk has. He advises that older kids can take a vitamin D supplement 20 IU dose per pound. This is especially important for kids that experience "growing pains", the throbbing aches they experience in their shins, thighs or calf muscles. 

Things to Avoid...

One of the biggest common calcium "robbers" is salt.  Every unit of salt you take in depletes your calcium by one unit. To correct this add more potassium to your diet if you have a high sodium intake. Other include coffee, soft drinks, antacids (J Bone Miner Res. 1989 Feb), corticosteroid use (Postgrad med, 1990), high alcohol intake, fat, processed foods, smoking (J Bone Miner Res, 1999), sugar and large amounts of protein, especially red meat.  Most of this is due to the fact that these foods are acid forming, meaning your body will try to maintain an alkaline state by taking essential minerals, like calcium and magnesium, from your bones. Unfortunately, dairy is also acid forming and common knowledge is to add more dairy (milk and cheese) to the diet to add more calcium. While they do add calcium your body, eating other foods that aren't as acid forming may be the right balance for you.

  • Don't eat acid forming foods: white foods (sugar, flour, and rice), dairy, meat and fish.

  • Do eat alkali forming foods: fruits and juices, vegetables, wine and beer (yep). 

Being sedentary can affect calcium loss so weight bearing exercise, such as walking, running, dancing, aerobics, plus weight training, are optimal in stimulating bone growth and adding muscle mass. Do these exercises 2-3 times a week for maximum effectiveness. 

Foods rich in calcium: Seaweed vegetables have over 1000mg of calcium per serving, nuts/seeds like almonds, hazelnuts, brazil nuts, pistachios, sunflower seeds, and walnuts have over 100 mgs of calcium per serving, grains like amaranth and quinoa have 140-225 mg of calcium per serving, greens like parsley, turnip greens, watercress, kale, spirulina, collard greens and cabbage have 100-200 mg of calcium per serving, beans like garbanzo, black, and pinto have 140 mg of calcium per serving and dairy products like milk, cottage cheese and yogurt have 60-120 mg of calcium per serving. 

Foods rich in magnesium: Apples, avocados, bananas, beans, brown rice, coconut, fish, goat’s milk, grapes, green peppers, oats, nuts, soy products, spinach, and whole wheat.

The statements above have not been evaluated by the FDA. The nutritional suggestions and research are not intended to treat, cure, or prevent disease and should not be used as a substitute for advice from your medical doctor. Please see your health care provider in all matters concerning your physical health.Reci

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