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Beating Osteoporosis

Osteoporosis: Is Calcium the Key?

Is Calcium the Key to Preventing Osteoporosis?

World Osteoporosis Day takes place every year on October 20. The campaign, organised by the International Osteoporosis Foundation (IOF), aims to raise global awareness of the prevention, diagnosis and treatment of osteoporosis and metabolic bone disease.

Our bones are constantly being broken down and rebuilt in a process known as ‘bone turnover’. In our early years, bone is built faster than it is broken down, and we reach our ‘peak bone mass’ at some point during our 20s. After this time, preserving healthy bones becomes a vital health concern. If bone is broken down more quickly than it is remade, then osteoporosis may occur.

This condition is of particular concern to postmenopausal women who produce less of the bone-protecting hormone oestrogen. Women lose more bone during their menopausal years than at any other time in their life [1]. However, men are under-diagnosed when it comes to osteoporosis and are more likely to go untreated.

The Key Three: Calcium, Magnesium and Vitamin D

Calcium is widely understood to play a key role in bone health and in preventing osteoporosis. After all, 99% of the body’s calcium is stored in bone. However, a calcium-rich diet in the absence of other bone-building nutrients is not effective in building healthy bones. Good quality studies have even linked high calcium intake with increased risk of bone fracture. This is most likely because calcium must work alongside other nutrients to build and maintain healthy bones.

Calcium must be absorbed and retained effectively to benefit bones. This requires two more nutritional helpers: magnesium and vitamin D. These three nutrients work synergistically – none is effective without the others.

60% of the magnesium in our body is stored in our bones. Magnesium works hand in hand with calcium by stimulating the hormone calcitonin which helps to draw calcium into bone and keep it there. Magnesium is also required in order to convert vitamin D to its active form.

Unfortunately many of us fail to meet the recommended daily intake of magnesium. Deficiency in this mineral is a particular concern for girls. In a recent national survey, more than 50% of girls between the ages of 11 and 18 had inadequate magnesium intake, putting them at risk of osteoporosis in later years.

Vitamin D is also essential for calcium absorption, helping to transport calcium out of the intestine and into the bloodstream. An estimated 60-70% of the UK population are low in Vitamin D. Elderly people and darker skinned populations are at particular risk of osteoporosis due to this. It is difficult to obtain sufficient Vitamin D from diet alone. Supplements or sun exposure (around 15 minutes each day) are the best ways to obtain the daily requirement of this vitamin to support healthy bones and prevent osteoporosis from occurring.

Nutrients for Bone Retention

Building healthy bone is only one part of the picture. Once healthy bone has been built, it is important to ensure that it is retained. Preventing bone from being broken down is essential in warding off osteoporosis. Special compounds in plant foods play a key role in preventing bone from being broken down. These compounds have ‘bone resorption inhibiting properties’. They support bone health by ‘turning off’ osteoclasts, the cells that break down bone tissue.

Dried plums, a source of phenols, have been shown in human studies to improve bone density by preventing bone breakdown. Other phytonutrients such as quercetin and hesperidin, present in fruits and vegetables such as onions, broccoli and citrus fruits, show similar benefits. Including these fruits and vegetables regularly alongside sources of calcium, magnesium and Vitamin D is the key to nourishing strong and healthy bones, therefore preventing osteoporosis in later life [2].

Bone Boosting Recipes

Dried Plum ‘Bone Booster’ Snack Bars

Prep Time: 10 minutes Cook Time: 30 minutes Serves: 8

Special phenolic compounds in dried plums increase levels of a hormone linked to bone formation. These compounds also help to prevent bone from being broken down. Dried plums, or prunes, are also high in antioxidants and provide an excellent source of potassium, boron and copper – essential nutrients for bone health. Soy flour provides a source of ‘bone boosting’ phytoestrogens, while almonds, pumpkin seeds and sunflower seeds are useful sources of calcium and magnesium. [3]

Ingredients

  • Olive oil cooking spray
  • ¼ cup Dried Plum (Prune) purée
  • ¼ cup honey
  • ¼ cup orange juice
  • 1 egg white
  • 2 tsp grated orange zest
  • ¼ cup soy flour
  • ½ tsp cinnamon
  • ½ teaspoon baking powder
  • ½ cup rolled oats
  • ½ cup whole almonds
  • ½ cup unsweetened shredded coconut
  • ¼ cup raw pumpkin seeds
  • ¼ cup raw sunflower seeds

Directions

Heat oven to 160°C. Spray an 8×8” baking pan with cooking spray and line with parchment paper, leaving the paper overhanging on 2 sides. In a large mixing bowl, whisk together dried plum purée, honey, orange juice, egg white and orange zest. In small bowl, whisk together flour, cinnamon and baking powder. Fold flour mixture, oats, almonds, coconut, pumpkin seeds and sunflower seeds into dried plum mixture.

Press mixture evenly into prepared pan. Bake about 30 minutes or until firm to the touch. Cool on rack; remove from pan, using paper to lift it out. Cut in four, then cut across in half to make 8 bars.

Nutrition Facts

Calories: 212
Cholesterol: 0mg
Total Fat: 12g
Saturated Fat: 4g
Sodium: 41mg
Carbohydrate: 22g
Protein: 6g
Fibre: 3g
Potassium: 159mg

‘Better Bones’ Banana Oat Bars

Makes one 9×9-inch pan. 6 Servings.

Oats and flaxseed provide lignans which support bone and hormonal health after menopause. Bananas provide potassium which helps to prevent loss of calcium from the body. Anti-inflammatory omega 3, in the ground flaxseed and walnuts, is linked with improved bone density. Special phenolic compounds in dried plums increase levels of a hormone linked to bone formation. These compounds also help to prevent bone from being broken down. Dried plums, or prunes, are also high in antioxidants and provide essential nutrients for bone health such as potassium, boron and copper.

Ingredients

  • 2 large, very ripe bananas
  • 1 teaspoon vanilla (optional)
  • 2 cups rolled oats
  • 1/4 cup pitted, chopped prunes
  • 1/4 cup chopped walnuts
  • 2 tbsp ground flaxseed
  • Grated nutmeg or cinnamon (optional)

Directions

Heat the oven to 180°C and lightly grease a 9×9-inch square baking dish with olive oil.

Peel the bananas and mash their flesh in a medium mixing bowl until no large chunks remain. Stir in the vanilla, if using. Add the oats and stir them in. Stir in the prunes and nuts.

Pat the thick mixture evenly into the baking pan. Sprinkle the top lightly with cinnamon. Bake for 30 minutes or until the edges just begin to crisp up.

Per serving:

Calories: 200
Fat: 4.9g
Fibre: 5.6g
Sugar: 10.7g
Protein: 5.5g

Written by Nadia Mason

References
1. Feskanich D, Willett WC, Colditz GA. Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr. 2003;77:504-511.
2. Hooshmand et al (2011) Comparative effects of dried plum and dried apple on bone in postmenopausal women. Brr J Nutr 106(6):923-30.
3. Gunn et al (2015) Nutrients Increased Intake of Selected Vegetables, Herbs and Fruit may Reduce Bone Turnover in Post-Menopausal Women 7(4): 2499–2517.

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New research links FOS and Bone Health

A recent study published in the Journal of Nutrition suggests a link between fructooligosaccharides (FOS) and bone health. It indicates that combining a calcium supplement with FOS is more effective than taking a calcium supplement alone (1).

The two-year study followed 300 post-menopausal women and measured markers of bone health. The women were randomly divided into three groups. One group of women were given a daily calcium supplement, while a second group were given a combination of calcium and FOS . The third group were given a placebo supplement. At the end of the study, measures of bone turnover and bone density were taken.

At the end of the study, there were no significant differences in bone density between any of the three groups. However, the results showed that the combination of FOS and calcium had the greatest effect on bone turnover.

Bone is constantly being broken down and rebuilt. The rate at which this happens is known as ‘bone turnover’ and is a known indicator of bone quality. The change in bone turnover markers in the women taking both FOS and calcium indicates ‘a more favourable bone health profile’ according to the researchers in this study.

FOS seems to enhance calcium absorption in the large intestine, and the researchers suggest that this is the reason for its effect on bone health. These findings certainly support the need for more research in this area, particularly for vulnerable groups such as postmenopausal women.

More about FOS

FOS or prebiotics are found in chicory root, jerusalem artichoke, asparagus, leeks, onion, beans, peas and lentils.
FOS or prebiotics are found in chicory root, jerusalem artichoke, asparagus, leeks, onion, beans, peas and lentils.

FOS is a prebiotic nutrient found in plant foods. Prebiotics are not digested, and simply pass through the body. In doing so, they act as ‘food’ for healthy bacteria in the bowel, boosting numbers of health-promoting acidophilus and bifidobacteria, and crowding out disease-causing bacteria. As well as improving calcium absorption, FOS also supports both digestive and immune health.

High concentrations of FOS or prebiotics are found in chicory root, jerusalem artichoke, asparagus, leeks, onion, beans, peas and lentils. FOS can also be taken in supplement form, and its sweet taste means that it works well mixed into oatmeal, yoghurt or smoothies, or simply used as a low-calorie sweetener to enhance flavour.

In the UK, most of us average an intake of around 12g of fibre each day – only half of the recommended amount. More research is still needed in the area of FOS and bone health. In the meantime, increasing fibre intake, and prebiotic foods in particular, seems a sensible measure to ensure the recommended intake for optimal health.

References

Slevin, M, Allsopp P, Magee M, Bonham V, Naughton J, Strain M, Duffy J, Wallace E, McSorley E. 2014. “Supplementation with Calcium and Short-Chain Fructo-Oligosaccharides Affects Markers of Bone Turnover But Not Bone Mineral Density in Postmenopausal Women”. Journal of Nutrition Jan 2014

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Potassium boosts bone health

A randomised, double-blind placebo-controlled trial has suggested that potassium citrate may have significant benefits for bone health (1).

The research involved 201 healthy elderly men and women who received supplements each day for 24 months. All of the adults received a calcium and vitamin D supplement each day. In addition, the adults were given either a daily potassium citrate supplement or a placebo pill.

After 24 months, bone mineral density was measured by x-ray. A special tool was also used to calculate the risk of fracture for each participant.

Potassium Citrate is strongly linked with bone health
Potassium Citrate is strongly linked with bone health

The researchers suggested that the benefits of the potassium citrate are a result of its alkalinity which helps to prevent calcium loss from bones. The food that we eat determines the pH balance in our bodies. If our diet is acid-forming, then the alkaline mineral calcium is leeched from our bones to restore pH balance. This calcium loss decreases bone mineral density, making bones very vulnerable. Potassium citrate gives the body the resource it needs to keep pH levels balanced without placing stress of the bones. It ensures that the bones are provided with sufficient back-up alkaline which can be stored by the bone ready to be used when alkaline compounds in the blood run short.

The modern diet is believed to have an increasingly acidic load owing to poor food choices. Potassium-rich fruits and vegetables are often overlooked in favour of acid-forming processed red meats, cheddar cheese, sodium, white flour and sugar. Over time, eating an imbalanced diet of excess animal protein, refined grains, sugar, alcohol and salt can cause your body to slip into a state of mild acidosis.

By making small adjustments to your diet, your body can use its mineral stores for building bone, rather than for fighting acidosis. You can shift to a more alkaline diet by making a few simple dietary changes:

  • Eat more than 5 servings of fruit and vegetables each day
  • Reduce intake of processed animal products
  • Replace grains such as wheat and white rice with more alkaline quinoa, millet and buckwheat
  • Drink water with a little freshly squeezed lemon or lime
  • Use potatoes, squash and other root vegetables as your energy-giving carbohydrate sources
  • Eat plenty of spices such as ginger, cinnamon and mustard
  • Try alkaline-forming supplements such as a good quality multivitamin and mineral formula, or a greens powder each day

Reference

1.Jehle S, Hulter HN, Krapf R (2012) Effect of Potassium Citrate on Bone Density, Microarchitecture, and Fracture Risk in Healthy Older Adults without Osteoporosis: A Randomised Controlled Trial. Journal of Clinical Endocrinology and Metabolism. Nov 15 (Epub ahead of print)

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