Osteoporosis: The Healthy Bones Guide

Like many other things in life, healthy bones are something we take for granted until we start having problems. However, even though we don't see it, after 30 years of age, our bones start losing more calcium than they replace. Calcium loss in conjunction with a sedentary lifestyle can cause our bones to become less dense and more fragile. Consequently, as we age, we become more prone to broken bones. Called osteoporosis, this condition affects millions of people worldwide and is the underlying cause of 1.5 million fractures annually. It is estimated that one in three women and one in five men will experience osteoporotic fractures. The combined lifetime risk for a forearm, vertebral, or hip fracture is approximately 40%, and according to recent research, a hip fracture in the elderly can double the risk of death women and triple the risk of death for men. Even after the bone heals, the risk of death lasts for ten years with a hip fracture and five years with other fractures. Consequently, it is very important that we maintain bone health throughout life.

The human body has 206 bones. The bones are composed of several layers. The outermost layer is called the compact tissue. The next layer is called cancellous tissue. Sponge-like material, the blood cells and nerves reside in the tunnels. Resembling a thick, jelly-like material, the bone marrow is in the innermost part of the bone. The end of the bones are covered with subchondral tissue. A specialized catilage, this material acts as a connective tissue in adults and is a tissue in which the bones develop in children.

Bones are alive and dynamic. In the womb, rather than forming bones, a fetus makes catilage. As the fetus develops and throughout the growing years, the cartilage calcifies. In calcification, layers of calcium and phosphate salts accumulate on the cartilage. At the end of long bones, there is a growth plate made out of cartilage. In a process called ossification, as children grow, the cartilage cells divide and increase in number. New cartilage cells push the older cartilage cells towards the center of the bone, Eventually the older cartliage cells die and are replaced by bone. When the bone reaches its full size, this process stops. Throughout childhood and early adulthood, bones continue to grow until approximately 25 years of age.

Even after bone growth stops, old bone is removed and new bone is added throughout life. Bones have five types of cells: osteogenic cells, osteoclasts, osteoblasts, osteocytes, and bone-lining cells. Osteogenic cells respond to bone traumas and initiates bone remodeling. While osteoclasts dissolve bone, osteoblasts form new bone. Found on the surface of new bone, osteoblasts control calcium and mineral deposition in response to a hormone that makes special protiens which activate the osteoblasts. On the other hand, osteocytes are cells inside the bone. Sensing new cracks or pressure on the bone, they direct osteoclasts to where they are needed. Bone-lining cells regulate the movement of calcium and phosphate in and out of bones. In adults, bone is replaced at a rate of 10% per year.

To determine your risk for osteoporosis, a bone density test can be ordered. Fast and painless, a bone density test uses x-rays tests to determine how many grams of calcium and other bone minerals are in a segment of bone. The higher your bone mineral content, the denser your bones are.

After your test is completed, you will be given two scores: a T-score and a Z-score. The T-score compares your bone density with what is expected in young, healthy adults of your sex while a Z-score is the number of standard deviations above or below what is expected for someone your age, sex, weight, and ethnicity. T-scores are given a measurement from above -1.0 to below -2.5. If your test is above -1.0 your bone density is considered normal while anything below -1.0 can indicate you are at risk for osteoporosis or you have osteoporosis. While T-scores indicate whether you are at risk for osteoporosis, Z-scores indicate whether something other than age, sex, weight, and ethnicity may be responsible for osteoporosis. A Z-score less -1.5 may indicate if there are other factors to blame.

To prevent bone loss or even reverse bone loss, it is important that we know the causes. The causes can include:

• Genetics
• Ethnicity - Caucasian, Asian, and Hispanic women have the greatest risk while African-Americans have the lowest risk.
• Age
• Low body weight
• Later menstruation - If you started menstruating at 15 years of age or older, you have an increased risk.
• Sedentary lifestyle
• Alcohol - While drinking in moderation may even reduce the risk for osteoporosis, the same cannot be said for excessive drinking. Not only can excessive drinking deplete your calcium reserves, it can prevent your body from absorbing calcium in food too.
• Stress - Stress produces cortisol.
• Dieting - Unknown to many, each time you lose ten pounds, you not only lose fat, but you lose water, muscle, and bone as well. One recent report found that for every ten pounds you lose, you lose one percent of your bone too.
• Too much sodium
• Phosporous imbalance
• Too much protien
• Excessive exercise
• Caffiene - Since caffiene is a dieretic, when we lose water, we lose calcium too. Consequently, there is less calcium for our bones too absorb. Furthermore, it may also interfere with the absorption of Vitamin D. Vitamin D plays a role in the body's absorption and use of calcium. In a study at Creighton University in Omaha, Nebraska, researchers found less than 300 miligrams or as little as 18 ounces of coffee could accelerate bone loss in the spine of post elderly women.
• Smoking and pollution - Cadmiun is found in both cigarette smoke and pollution. We can breath it and ingest it.
• Certain medications
• Over-the-counter drugs

Between the ages of 25 through 50 years of age, humans need at least 1,000 mg. of calcium per day. If you're younger or older, you need even more. Unfortunately, many of us do not get enough calcium. Consequently, it is very important to know good sources of calcium.

• Dairy sources
• Leafy, green vegetables
• Broccoli
• Almonds, walnuts, sesame seeds, sunflower seeds
• Oysters, shrimp, salmon, mackerel, sardines
• Garbanzo beans, soybeans, tofu
• Dried figs and apricots, prunes

Although eating a healthy diet can help reverse osteoporosis, with today's fast-paced, busy lifestyle, eating a healthy diet can be hard at time. Consequently, nutritional supplements can fill in the gaps.

• Calcium - Since the bones are made primarily out of calcium, calcium is an important supplement. However, taking calcium alone will not be as helpful. The optimal dosage of calcium should be between 1,000 mg. and 1,3000 mg. When you look for calcium supplements, you should look at the amount of elemental calcium not the total calcium in the supplement.
• Magnesium - Magnesium can increase bone density, but most Americans are deficient in magnesium. The recommended dosage of calcium is 300 to 500 mg. per day. It is important to remember that calcium and magnesium should be taken in a 2:1 ratio.
• Vitamin D - The best source of Vitamin D is the sun. However, if you do not get enough sun, you can take a supplement for it. There are two types of Vitamin D: D2 and D3. While researchers used to think Vitamin D 3 was more important, they now believe both types are equally important. Adults under 50 years of age should get 400 to 800 IUs per day while adults over 50 years of age should get 1,000 IUs per day.
• Vitamin K - The recommended dosage is 150 mcg. per day.

Fortunately, although not all risk factors for osteoporosis can be avoided, many of them can. To prevent and reverse osteoporosis, if you're a smoker or a drinker, try to stop. A nutritionally adequate diet and exercise can help significantly too.