Bones are not inert structures, like the beams or pillars of your house. They are dynamic living tissue that requires a wide range of nutrients for optimal health—and not just minerals like calcium. Throughout your life, bones constantly add and remove material. This process is called remodeling. Each week you recycle up to seven percent of your bone mass. Normally, the rate of buildup and breakdown is the same. However, if the amount of bone loss exceeds the amount replaced, the bones become brittle and full of holes. This condition is called osteopenia in its early stages and in its latter stages osteoporosis, or “porous bones.”

While minerals like calcium get all of the attention in preventing osteoporosis, it is important to realize that osteoporosis involves both the mineral (inorganic) and nonmineral (organic matrix) components of bone. The organic matrix is composed primarily of collagen protein.

What Causes Osteoporosis?
Normal bone metabolism is dependent on an intricate interplay of many nutritional, lifestyle and hormonal factors. Many dietary factors have been suggested as a cause of osteoporosis including: low-calcium–high-phosphorus intake, high-protein diet, high-acid-ash diet, high salt intake and trace-mineral deficiencies, to name a few. Osteoporosis is most common in postmenopausal Asian and white women. Other risk factors for osteoporosis include family history of osteoporosis; physical inactivity; smoking; short stature, low body mass and/or small bones; and never having been pregnant.

What Dietary Factors Are Important in Osteoporosis?
A diet that is too high in protein, salt or acid ash causes calcium removal from bones and increases calcium loss in the urine. Eating an alkaline-based diet that focuses on vegetables, fruit, nuts and legumes is best, while avoiding overconsumption of meat and dairy.

Soft drinks containing phosphates (phosphoric acid) are definitely linked to osteoporosis because they lead to lower calcium levels and higher phosphate levels in the blood. When phosphate levels are high and calcium levels are low, calcium is pulled out of the bones. The phosphate content of soft drinks, such as Coca-Cola® and Pepsi®, is very high, and they contain virtually no calcium. If you are concerned about developing or are at risk of developing osteoporosis, you will want to eliminate soft drinks from your diet.

Refined sugar intake also increases the loss of calcium from the bone. Regular consumption of refined sugar increases loss of calcium from the blood through the urine. Calcium is then pulled from the bones to maintain blood calcium levels as foods containing refined sugar generally do not contain calcium.

Calcium is not the only nutrient that is important for bone formation. Many trace minerals such as copper, manganese, zinc and boron are also important. A deficiency in trace minerals can also predispose someone to osteoporosis.

Green leafy vegetables from the cabbage family, including broccoli, Brussels sprouts, kale, collards and mustard greens, as well as green tea offer significant protection against osteoporosis. These foods are a rich source of a broad range of vitamins and minerals that are important for maintaining healthy bones, including calcium, vitamin K and boron. For example, one function of vitamin K is to convert inactive osteocalcin to its active form. Osteocalcin is an important protein in bone. Its role is to anchor calcium molecules and hold them in place within the bone. Hence, a lack of vitamin K in the diet is a major risk factor for osteoporosis even if calcium intake is high.

What Are the Best Supplements for Osteoporosis?
While calcium supplementation is important in preventing and treating osteoporosis, much more is needed to build and maintain healthy bone. In fact, calcium alone provides very little benefit. In addition to calcium (800–1,000 mg daily), critical nutrients linked to osteoporosis include silica, vitamins D and K, magnesium, B6, folic acid and B12.1,2 BioSil® Healthy Bones PlusTM from Natural Factors® provides an ideal spectrum of these nutrients to support bone health including:

• BioSil® is a highly bioavailable from of silica (choline stabilized orthosilicic acid) that has shown impressive clinical results in improving bone health including bone mineral density (BMD). It works via an interesting mechanism of action to increase the collagen content of bone. About 30% of bone is composed of collagen. It provides the structural matrix upon which mineralization of bone occurs. Collagen is to bone what 2X4s are to the frame of a house. Decreased collagen content of the bone is a key underlying factor in osteoporosis and low bone density. As collagen levels decline with age, so do the number of mineral binding sites.

So, it does not matter how much calcium or other minerals you take, they will not be bound within the bone. In a very detailed double-blind study in postmenopausal women with low bone density, BioSil increased the collagen content of the bone by 22% and increase bone density by 2% within the first year of use. This data indicates that this highly bioavailable from of silica is an absolute must for women wanting to improve bone health. Increasing the collagen content of the bone also leads to greater bone tensile strength and flexibility, thereby greatly increasing the resistance to fractures. The recommended dosage is 6–10 mg per day.3

• Vitamin D supplementation is associated with increased bone density and studies that combined vitamin D with calcium produced better results than either nutrient alone especially when easily ionized forms of calcium (e.g., citrate) were used.4-6 Vitamin D supplementation is especially helpful for elderly people who don’t get sufficient exposure to sunlight (which stimulates the body’s manufacture of vitamin D)—those who live in nursing homes, farther away from the equator, or those who do not regularly get outside. Most experts are recommending daily dosages between 2,000–5,000 IU (see www.vitaminDcouncil.org for more information).

• Magnesium supplementation is thought by some experts to be as important as calcium supplementation in the prevention and treatment of osteoporosis.7 Women with osteoporosis have lower bone magnesium content and other indicators of magnesium deficiency than people without osteoporosis. The recommended dosage is 250–500 mg daily.

• Vitamin B6, folic acid and vitamin B12 are important in the conversion of the amino acid methionine to cysteine. If a person is deficient in these vitamins, there will be an increase in homocysteine levels. Homocysteine has been implicated in a variety of conditions, including atherosclerosis and osteoporosis. Combinations of these vitamins will produce better results than any one of them.8

• Vitamin K1 and K2 are very important for bone health. In particular, a number of trials have demonstrated vitamin K2 supplementation can significantly reduce age-related bone loss, especially when used in conjunction with calcium and vitamin D.9

Final Comment
Although nutritional factors are important, one of the other critical things a person can do to strengthen their bones is to get physical activity. Physical exercise, consisting of one hour of moderate activity (e.g., walking, weight lifting, dancing, etc.) three times a week, has been shown to prevent bone loss and actually increase bone mass in postmenopausal women. In contrast to exercise, lack of physical activity doubles the rate of calcium lost from the system.10

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

References
1. Kitchin B, Morgan SL. Not just calcium and vitamin D: other nutritional considerations in osteoporosis. Curr Rheumatol Rep. 2007;9(1):85-92.
2. Palacios C. The role of nutrients in bone health, from A to Z. Crit Rev Food Sci Nutr. 2006;46(8):621-8.
3.  Spector TD, Calomme MR, Anderson SH, et al. Choline-stabilized orthosilicic acid supplementation as an adjunct to calcium/vitamin D3 stimulates markers of bone formation in osteopenic females: a randomized, placebo-controlled trial. BMC Musculoskelet Disord. 2008 Jun 11;9:85.
4. Rizzoli R, Boonen S , Brandi ML, et al. The role of calcium and vitamin D in the management of osteoporosis. Bone 2008;42(2):246-9.
5. Boonen S , Vanderschueren D, Haentjens P, Lips P. Calcium and vitamin D in the prevention and treatment of osteoporosis - a clinical update. J Intern Med 2006;259(6):539-52.
6. Quesada Gómez JM, Blanch Rubió J, Díaz Curiel M, Díez Pérez A. Calcium citrate and vitamin D in the treatment of osteoporosis. Clin Drug Investig. 2011;31(5):285-98.
7. Rude RK, Gruber HE. Magnesium deficiency and osteoporosis: animal and human observations. J Nutr Biochem. 2004 Dec;15(12):710-6.
8. McLean RR, Hannan MT. B vitamins, homocysteine, and bone disease: epidemiology and pathophysiology. Curr Osteoporos Rep. 2007;5(3):112-9.
9. Knapen MH, Schurgers LJ, Vermeer C. Vitamin K2 supplementation improves hip bone geometry and bone strength indices in postmenopausal women. Osteoporos Int 2007;18(7):963-72.
10. Borer KT. Physical activity in the prevention and amelioration of osteoporosis in women: interaction of mechanical, hormonal and dietary factors. Sports Med 2005;35(9):779-830.

Michael T. Murray, N.D. is widely regarded as one of the world’s leading authorities in the field of natural medicine. He is a graduate, former faculty member and serves on the Board of Regents of Bastyr University in Seattle, WA and is the author of over 30 books including co-author of the best-selling, How to Prevent and Treat Diabetes with Natural Medicine, Hunger Free Forever and his latest book, What the Drug Companies Won’t Tell You and Your Doctor Doesn’t Know.

Published in WholeFoods Magazine, August 2011