As we age, a number of key metabolic and physiological processes slow down or can become damaged. The endocrine system (hormones), cardiovascular system and gastrointestinal system are without a doubt leading causes of problems associated with the aging process. However, the musculoskeletal system is often overlooked as a significant contributor to chronic and debilitating disease in later life. The bones and muscles have a number of extremely important functions in the body. They provide structure, literally helping us remain upright, keep us staying physically active and help with other physiological functions, including regulation of pH (acid/base balance). Our bones also serve as a reservoir for the greatest amount of calcium found in our bodies. With a loss of calcium from bones, our bones lose strength, we become shorter over time and have increased risk for bone fractures, sometimes severe.
Alarming Statistics On Osteoporosis
In 2014, the National Osteoporosis Foundation released alarming statistics, estimating that a total of 54 million U.S. adults age 50 and older are affected by osteoporosis and low bone mass. Assuming that the prevalence rates remain unchanged, studies project that by 2020 the number will grow to 64 million and in 2030 up to 71 million. Osteoporosis causes an estimated two million broken bones each year and often results in immobility, pain, placement in a nursing home and other health problems. We really need to do whatever we can NOW to help protect our bones and prevent the onset and experience the deleterious effects of osteopenia (low bone mass) and osteoporosis.
Calcium Levels Must Remain In Balance
Undoubtedly, one of the most important aspects of bone strength is the amount of calcium and other minerals found in bones. This contributes to the “hardness” of our bones and the ability to withstand incredible amounts of weight and stress that we place upon our bones on a daily basis. If our bones lose their rigidity, they would literally snap from the weight of just taking a small step. Our bodies attempt to regulate the amount of calcium in the bloodstream very closely. Because calcium is vital to so many functions in the body, including contractility of the heart and other muscles, the body will do whatever it can to keep the levels of calcium at equilibrium. When calcium in the blood reaches critically low levels, the body uses hormones that act on the kidneys and bone to help raise calcium levels. One hormone that is released is parathyroid hormone which has two main actions: 1) telling the kidneys to reabsorb calcium which normally would be lost in the urine and 2) activating bone “bulldozers” called osteoclasts which break down bone tissue to release calcium into the blood. After blood calcium levels return to normal, parathyroid hormone release stops, however the loss of calcium from the bone must be replenished.
Vitamin D Is Crucial For Bone Health
Another very important hormone involved in bone metabolism is vitamin D. You have heard me rant and rave about the importance of vitamin D in previous blog articles for many other health conditions, but I can not stress enough the importance of vitamin D in bone health as well. Vitamin D plays an inverse role when compared to PTH. Vitamin D will enable your body to absorb calcium from your intestines (from the food that you eat) and also activates the “bone builder” cells called osteoclasts that lay down new bone matrix from calcium absorbed in the body. This is why it is not only important to supplement or get adequate calcium from your diet but also vitamin D too. While good sources of vitamin D include fortified dairy products, egg yolks and tofu, the majority of our vitamin D is made in the skin when exposed to sunlight. It takes about 20 to 30 minutes (depending on your skin complexion) in direct sunlight during peak sun exposure time (usually from about 11-3pm) to obtain all the vitamin D you need for the entire day. However, if you are concerned about skin cancer there are many supplements on the market today that help to boost vitamin D levels. I typically recommend vitamin D3, a form of vitamin D most studied and most effective for its positive effects on improving bone health.
Many Conditions Associated With Dairy Consumption
As many are well aware, I typically recommend that patients shy away from incorporating dairy into their normal diet. While the FDA and media have launched recent campaigns touting dairy as the best way to get adequate calcium into your diet, I am a strong believer that dairy is extremely inflammatory and causes a whole host of chronic health problems. For example, I long suffered from very bad eczema. I tried many creams, lotions, ointments and steroids all to no avail. The eczema covered one side of my forehead, eyelids and elbows. I felt like a freak! After starting to eliminate dairy and getting confirmation that I was indeed sensitive to dairy through an IgG Food Intolerance Test, my skin made a miraculous transformation in a very short period of time. I haven’t touched dairy in over 8 years, and do not desire to go back to feeling crummy and I love the way my skin looks now! Many of my patients have similar experiences not only with skin disorders like eczema and acne, but also digestive complaints, asthma, chronic allergies and arthritis and other autoimmune problems. I have a number of patients who have had gynecological complaints, like ovarian cysts, be reversed by eliminating dairy too.
If I Can’t Drink Milk Where Do I Get Calcium?
This is one of the most common questions I hear in my practice. So is it ok to eliminate dairy from your diet? The answer, in my opinion, is yes! Think about it: we are the ONLY species on earth that I know of that eats another animal’s milk. What’s up with that? You don’t see a goat going around suckling from a cow! Unless humans are somehow involved thinking it’s cute and/or are trying to intervene to help them grow. So what are good sources of calcium if you can’t have dairy but are looking to keep your bones strong and healthy? Many greens are a great source of calcium (for ½ cup serving)– collard greens contain 210grams of calcium, kale 205mg, bok choy 190mg, turnip greens 104mg, spinach 99mg (maybe Popeye was onto something! J). Other foods that are great sources of calcium are sardines 325mg, tofu 350mg, tapioca 300mg, chia seeds 300mg (1.5ounces), figs 135mg (5 figs), white beans 120mg, almonds 93mg (1/4 cup) and sesame seeds 51mg. Remember that the recommend calcium intake for most adults is 1000mg per day and vitamin D 600IU per day. This is easily obtained from combining a variety of calcium rich foods.
Dairy May Actually Cause Osteoporosis
Another reason that you should avoid milk and dairy products is that new evidence is showing that calcium from milk does not actually protect against developing osteoporosis and in fact it may CONTRIBUTE to fractures and other health conditions. Say it ain’t so!? A recent Swedish study showed that higher milk consumption is actually associated with higher death rates and an increased risk for bone fractures in women who consumed just 1-2 glasses of milk per day. The more milk consumed, the higher the mortality and fracture rates. While milk may improve bone density, it may actually lead to erosion of osteoblast cells, the bone builder cells. Long term, this will prevent our bodies from continuing to lay down new bone tissue, cause weakening of bone and eventually fractures. Milk and dairy consumption have also been linked to heart disease, many different types of cancer and autoimmune disease.
Vitamin K2: A New Very Important Player in Bone Health
Since it was discovered in 1929, vitamin K has long been known for its effect on the blood clotting process. Vitamin K1 found primarily in leafy green vegetables has been the focus of much of the research involving vitamin K over the last 80 years. More recently, vitamin K2, found in organ meats, egg yolks and dairy, has been shown to be a very important player in bone health. It is a more important inducer of bone mineralization by osteoblasts (bone builders) than is vitamin K1. The Japanese eat a dish called “natto” or fermented soybean, frequently eaten several times per week that is very high in vitamin K2. People living in the regions where this dish are eaten have very high vitamin K2 blood levels with much lower rates of osteoporosis and bone fractures. A recent two year Japanese study showed that vitamin K2 at 45mg/day (a very high dose) reduced the incidence of vertebral (spinal) fractures by 52% in 120 patients with osteoporosis as compared to subjects who did not receive any K2. Vitamin K2 also appears to be helpful in heart disease as well. It appears that vitamin K2 seems to control calcium deposition in the walls of the major arteries throughout the body, including the heart. When vitamin K2 levels are deficient this leads to aberrant calcium deposition in the arteries, forming plaques and leading to increased risk for having cardiovascular events. On the flip side, the calcium that is deposited in the walls of the arteries is pulled from the bones, leading to osteoporosis too. There are strong links now being studied between those with osteoporosis and heart disease based on this vitamin K2 connection.
Rates of osteoporosis are increasing drastically in the U.S.. Osteoporosis is a preventable condition. Factors like smoking, menopause, caffeine and soda consumption all can contribute to the development of osteoporosis and bone fractures. In my opinion, all people over the age of 50 should be encouraged to have a DEXA scan done. This is a test that determines a person’s bone density and gives a calculated score to determine if you have normal bone density, osteopenia (lowered bone density) or osteoporosis. Because of the higher incidence of osteoporosis in women, especially those who have gone through menopause, women should be encouraged to start getting DEXA scans as a preventative measure earlier and more frequently than men. While we touched on calcium, vitamin D3 and vitamin K2 as huge benefactors to bone health, there are still other nutrients that should be considered when trying to improve one’s bone density. Other minerals that should be considered as part of a comprehensive bone-building regimen are strontium, boron, manganese, magnesium and potassium. These are usually found in bone specific dietary supplements.