Keep your bones strong
Calcium gets all the press, but there are many other vitamins and minerals crucial for bone health, says Dr Marilyn Glenville.
The good news is once you get the dose right, calcium supplementation really can reduce the risk of fractures and has a positive effect on bone density. The greatest benefit is in reducing bone loss five years or more after the menopause. Different doses and types of calcium have been used across various studies: calcium carbonate (otherwise known as chalk, difficult to absorb), calcium citrate (even with poor digestion, you should still absorb 45 percent) and calcium hydroxyapatite (only 20 percent absorption).
To find out whether your supplement is easy to absorb, leave it in a glass of warm vinegar (this simulates your gut) for 30 minutes. If it does not completely dissolve, then it is probably leaving your body in much the same form that it entered it! I use calcium citrate supplements in my clinic. The best way to take calcium in supplement form is in divided doses during the day, as this increases absorption.
2. Vitamin D
This plays a crucial role in preventing and treating osteoporosis since it is responsible for calcium absorption from food and supplements and moving calcium and phosphorus into bones. Unfortunately, sunscreen can interfere with vitamin D production. I am concerned about extreme recommendations to stay out of the sun or to use strong sunscreens.
Here in Australia, where sun exposure has been campaigned against for years, vitamin D deficiencies are now recorded in one out of every four people. Vitamin D on its own can prevent fractures by up to 25 percent, especially in the elderly. When it is taken with calcium the results are even better. One study of 3,000 women showed that those taking 1,200mg of calcium plus 800IU of vitamin D daily had 43 percent fewer hip fractures. Choose the D3-cholecalciferol supplemental form not the less efficient D2-ergocalciferol.
This is as important as calcium, yet is often not even included in ‘bone’ supplements. A lack can slow bone growth, decrease osteoblastic (bone-building) activity, increase osteoclastic (bone-dissolving) activity, and cause fragile bones. Magnesium supplements in women have been shown to prevent fractures, with 71 percent of women significantly increasing bone density and 16 percent halting bone loss completely. A hair mineral analysis is good way to test for a magnesium deficiency. I recommend magnesium citrate, as citrates are easy to absorb.
4. Vitamin C
Vitamin C is vital for manufacturing collagen, the ‘cement’ that makes up 90 percent of the bone matrix. Because your body cannot make or store vitamin C you have to get it from your diet. I suggest the ascorbate supplemental form as it’s gentler on the stomach.
5. Vitamin K
Named K for ‘koagulation’ – because it converts proteins to blood-clotting factors – vitamin K also manufactures osteocalcin, a unique protein that hardens calcium. Antibiotics, coeliac disease, Crohn’s disease, and ulcerative colitis are all associated with vitamin K deficiencies. In one study, women who did not consume enough vitamin K had 30 percent more hip fractures. Taking K in supplement form is a new area of research: one study does show that people taking it had a 43 percent lower rate of bone loss; however, until more research is available, my recommendation would be to eat more leafy greens, which are a good vitamin K source.
This plays a crucial part in the conversion of vitamin D into its active form which, in turn, is necessary for calcium absorption. Research shows that giving post-menopausal women boron supplements resulted in a 44 percent reduction in the amount of calcium excreted in their urine. The easiest way to take it is in a combined form with calcium and magnesium.
Zinc helps vitamin D to boost calcium absorption from food and, like vitamin C, it is essential for the proper formation of collagen and osteoblasts, the cells that renew bone. Low zinc intake is associated with low bone density in pre- and post-menopausal women. As with magnesium and calcium. choose the most absorbable forms – zinc citrate or zinc ascorbate.
8. Helpful herbs
* Black cohosh (Cimicifuga racemosa): One study has found this slowed down the rate of bone loss similar to the rate seen with the selective estrogen receptor modulator (SERM) drug raloxifene.
* Nettle (Urtica spp.): Nettle tea increases absorption of minerals, including calcium.
* Horsetail (Equisetum arvense): A natural source of silicon, necessary for healthy bones, skin, hair, collagen formation, and ligaments, this also inhibits bone resorption and stimulates bone formation.
* Alfalfa (Medicago sativa): This contains calcium and also acts like a phytoestrogen, stimulating bone growth.
Test yourself: How acidic are you?
As you get older your level of stomach acid drops, reducing your digestive efficiency. In other words, you may be eating well but if you are not absorbing vital nutrients from your food, this is not good news for your bones or general health.
* If you suffer with heartburn, take 1 tablespoon of lemon juice. If this helps the heartburn, then your stomach acid is low
* Dissolve a level teaspoon of bicarbonate of soda in water and drink it on an empty stomach. If you have enough stomach acid, the bicarb will be converted into gas and produce belching. If not, you may have low stomach acid.
If you suspect that you have low stomach acid take a betaine hydrochloride (plus pepsin) supplement with meals to see if it helps.
Dr Marilyn Glenville is a leading nutritional health expert for women and the author of Osteoporosis: How to treat, prevent and reverse it (Kyle Cathie, $24.99), from all bookstores, from which this excerpt is reproduced with permission. Visit her at www.marilynglenville.com