The strategy for preventing osteoporosis does not require a tremendous amount of effort. In fact, a large portion of the prevention formula emulates guidelines for a healthy lifestyle.

The role of diet

Nutrition cannot be seen in isolation, but rather as one of many factors influencing bone. There are however, a number of nutrients that may have a role in the development of osteoporosis.

Calcium intake

Whether provision of bone building nutrients is effective after onset of the disease remains questionable, however, ample evidence supports aggressive attention to adequate calcium intake during the active period of bone growth and development.

Although peak bone mass is determined by a number of factors, calcium intake from birth through adolescence is essential as it is a major contributor. The influence of calcium intake during adulthood is not known, but available evidence indicates that those with a lifetime history of adequate calcium intake are less susceptible to osteoporosis at advanced ages.

It is apparently never too late to start supplementation and calcium therapy in the treatment of osteoporosis has received much attention. The recommended dietary allowance (RDA) is 800mg for adults and 1200mg for pregnant and lactating women, which is equal to the recommendation for adolescents. Hormone replacement therapy (HRT) together with a calcium intake of 1000-1500mg per day is recommended during the postmenopausal period to retard bone loss. A sufficient intake of calcium for the elderly (1500mg) is also very important as calcium absorption is decreased in this age group.

It is known that 99 percent of the calcium in the body is found in bone. The remaining one percent is carried in the blood and has a very important physiological role. In the event of the slightest drop in blood calcium level, calcium is withdrawn from the bone to immediately restore the blood level to normal. Bone is thus an essential reservoir of calcium and after a prolonged period of calcium deficiency it can become osteoporotic and may fracture.

Our main source of dietary calcium is dairy products — low fat milks, cheeses, yoghurts, etc contain the same level of calcium as their full fat counterparts. Note that cottage cheese is an exception as it has a very low calcium content. Other sources of dietary calcium are the dark green and cruciferous vegetables such as cabbage, cauliflower, broccoli and brussel sprouts. Sardines and pilchards are other good sources of calcium.

Dietary sources of calcium should be your first priority. However, postmenopausal women and those who cannot reach their calcium requirements through diet will need to supplement. A number of calcium supplements are available, which contain different calcium compounds. Since all these compounds yield varied amounts of elemental calcium (the actual amount of calcium), it is essential to know how much elemental calcium each tablet contains.

Also, taking calcium with meals improves its absorption. Magnesium is involved in calcium balance and sufficient magnesium intake is required for adequate calcium absorption and deposition in bone. Therefore calcium and magnesium are often supplemented together.

Protein

A high protein diet is associated with an increased risk for osteoporosis. This may be due to the high phosphorus content of protein-rich foods that increase calcium excretion. This issue is controversial.

Vitamin D

This nutrient is vital for absorption of calcium from the gut. It is manufactured by our bodies from sunlight and is also added, along with vitamin A, to many of our milks, margarines and breads. Living in sunny South Africa, vitamin D deficiency is quite rare.

Energy

A low body weight increases one's susceptibility to fractures. Since total energy intake determines body weight, insufficient energy intake is associated with a low body weight, which is a risk factor for osteoporosis.

Inactivity

Immobility of varying degrees is well recognised as a cause of bone loss. Maintenance of healthy bones requires exposure to weight-bearing exercise. Bones not subjected to normal use rapidly lose mass. Thus regular exercise, doing anything that puts weight on the bones — walking, cycling, jogging, weight training — will strengthen the bones. Thirty minutes, three times per week is the recommended minimum.

Other nutrients

Fibre

Insoluble fibre interferes with calcium absorption — the calcium requirement is increased by 75mg for every 13g increase in fibre intake per day. The effect of fibre on calcium balance in the long term is still uncertain, and at present the benefits of fibre outweigh this disadvantage.

Alcohol and smoking

These have a toxic effect on bone and therefore excessive alcohol consumption and cigarette smoking are risk factors for osteoporosis as they increase bone loss.

Caffeine

Although inconsistent, evidence has indicated that caffeine consumption may increase excretion of calcium, increasing the risk for osteoporosis. An adequate calcium intake (more than 800mg per day) may protect against the negative effects of caffeine on calcium metabolism.

Osteoporosis is the most common of all bone diseases and is the most destructive of productivity and quality of life. The most important treatment of osteoporosis is the prevention thereof.


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