Vegan Choices for Healthy Bones

What is Osteoporosis?

Osteoporosis is characterized by an increase in porosity of the bones and a corresponding decreased bone mass, resulting in an increased risk of fractures of the bones. Osteopenia is a term used to denote bone loss that is not as severe as osteoporosis. Risk factors for osteoporosis include sedentary lifestyle, cigarette smoking, excessive alcohol intake, family history of the disease, and various medical conditions such as: rheumatoid arthritis, celiac disease, hyper thyroidism, diabetes, chronic lung disease, Cushing’s syndrome, and hyper para-thyroidism.

According to the International Osteoporosis Foundation:

• Worldwide, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every three seconds ([1]).
• Osteoporosis is estimated to affect 200 million women worldwide - approximately one-tenth of women aged 60, one-fifth of women aged 70, two-fifths of women aged 80, and two-thirds of women aged 90 and above ([2]).
• Osteoporosis affects an estimated 75 million people just in Europe, USA, and Japan ([3]).
• Worldwide, one-in-three women over age 50 will experience osteoporotic fractures, as will one-in-five men aged over 50 ([4]^,[5],[6]).
• Nearly 75% percent of hip, spine, and forearm fractures occur among patients 65 years old or over ([6]).
• By 2050, the worldwide incidence of hip fracture in men is projected to increase by 310 percent and 240 percent in women, compared to rates in 1990 ([7]).
• Osteoporosis takes a huge personal and economic toll. In Europe, the disability due to osteoporosis is greater than that caused by cancers (with the exception of lung cancer) and is comparable or greater than that lost to a variety of chronic noncommunicable diseases, such as rheumatoid arthritis, asthma and high blood pressure related heart disease ([8]).

Dietary factors that affect osteoporosis:

Refined sugar. Hamsters fed a high-sucrose diet (56% of calories) developed osteoporosis ([9]). In young rats, the replacement of starch by sucrose in the diet interfered with bone development ([10]). In an observational study, consumption of large amounts of candy was associated with low bone mineral density (BMD) in both men and women ([11]).

There are many possible ways in which consuming refined sugars could lead to bone loss. Since refined sugars are essentially devoid of micronutrients, eating refined sugar decreases the intake of various vitamins and minerals that are important for bone health. Sugar is acidic to the body and the body will use calcium from bone and teeth to reduce acidity in the body, thus weakening the bones.

Cola beverages. In observational studies, higher intake of cola drinks was associated with lower bone mineral density in women and a higher incidence of fractures in adolescent girls ([12]^,[13]). The apparent adverse effect of colas on bone health could be due in part to their content of phosphoric acid, which may cause calcium to be released from bone in order to buffer the acidity. The caffeine in cola drinks may also be a factor.

Caffeine. Ingestion of a single dose of caffeine transiently increased urinary calcium excretion in both men and women in a dose-dependent manner ([14]^,[15],[16]). Many ([17]^,[18],[19]) observational studies found that a higher intake of caffeine was associated with lower bone mineral density, more rapid bone loss, or increased risk of hip fracture.

Sodium. In a short-term study, high intake of sodium chloride increased urinary calcium excretion in healthy postmenopausal women in a dose-dependent manner ([20]). High salt intake has also been associated with increased urinary excretion of hydroxyproline, which is indicative of increased bone resorption ([21]). In a study with rats, the addition of 1.8 percent sodium chloride to the drinking water significantly decreased bone mineral density ([22]). An observational study found that higher sodium intake was associated with more rapid bone loss especially in postmenopausal women ([23]).

Carbonated beverages. Excessive phosphorous reacts with the calcium to form an insoluble compound and inhibiting absorption of calcium from the digestive system, phosphorus causes bone loss. It also causes calcium losses from bone by metabolizing to phosphoric acid, which has to be neutralized with calcium. Excessive phosphorous is contained in soft drinks, cheese and chocolate drinks.

Milk. Milk is widely promoted as a food that is good for our bones. However, a 12-year prospective study of 77,761 female health professionals found that the incidence of hip fractures was higher by 45 percent in women who consumed two or more glasses of milk per day than in those who consumed one glass or less per week ([24]).

Nutrients to support strong bones:

Calcium. Calcium is a major component of bone tissue. Adequate calcium intake is important both early in life for achieving optimal peak bone mass and later in life for slowing bone loss. Green juice, leafy greens, sesame seeds, seaweeds (kelp) and broccoli sprouts are great sources of calcium.

Magnesium. It is impossible to build bone without magnesium. Magnesium is necessary for numerous bone-related reactions including the conversion of vitamin D to its bioactive form, which is necessary for calcium absorption. Several studies have shown that about 80 percent of the American population get only two-thirds of the recommended daily allowance (RDA) of the required magnesium. Additionally, the (RDA) for magnesium is known to be too low. Kelp, almonds and legumes are great sources of magnesium.

Vitamin D. Vitamin D enhances the intestinal absorption of calcium and phosphorus, promotes bone mineralization, and is involved in regulating serum calcium and phosphorus levels. Vitamin D deficiency in adults causes osteomalacia, which is characterized by softening of bones, bone pain, and muscle weakness. A lot of older people do not get enough vitamin D because they tend to stay out of the sun. Fenugreek sprouts, shiitake mushrooms, sunflower sprouts and the sun are great sources of vitamin D.

Manganese. Manganese is required for bone mineralization and for synthesis of the organic matrix on which calcification takes place. A study reported in Science News found that osteoporotic women had serum manganese levels of only 25 percent of that of the control group. Spinach, pumpkin seeds and hazelnuts are great sources of manganese.

Vitamin K. A study in Clinical Endocrinology found that vitamin K supplementation reduced urinary calcium losses in osteoporosis patients by 18 to 50 percent. Green leafy vegetables, spring onions, asparagus and olive oil are great sources of vitamin K.

Vitamin C, strontium, silicon, folic acid, boron, and other nutrients also play important roles. Calcium metabolism is very complex and requires adequate amounts of many nutrients. To prevent and support the healing of osteoporosis you first have to reduce calcium losses by drastically reducing your intake of sugar, salt, phosphorous, and caffeine. Secondly, you have to consume the right amounts of nutrients that support formation of new bone such as calcium, magnesium, manganese, boron, vitamin D, and other key nutrients.

Exercise to strengthen bones:

Weight-bearing exercise, in addition to slowing or reversing bone loss, may increase strength and balance, thereby reducing the risk of falls. Exercise, especially weight bearing exercise, will actually increase bone mass and reverse bone loss. A three-year study of older women at the University of Wisconsin showed that a control group of sedentary women lost three percent of bone density while the group that exercised gained two percent.

The best way to achieve strong bones is to eat a plant-based diet consisting of a variety of fresh, unprocessed, organic vegetables, whole grains and sprouts. Take high quality, whole-food nutritional supplements which contain the essential bone-forming nutrients. Get regular exercise, including an essential weight-bearing program.

[divider type="circle_small" position="hr-circle-center" size="padding-xsmall" /]

[1] Johnell O and Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726.

[2] Kanis JA (2007) WHO Technical Report, University of Sheffield, UK: 66.

[3] EFFO and NOF (1997) Who are candidates for prevention and treatment for osteoporosis? Osteoporos Int 7:1.

[4] Melton LJ, 3rd, Atkinson EJ, O'Connor MK, et al. (1998) Bone density and fracture risk in men. J Bone Miner Res 13:1915.

[5] Melton LJ, 3rd, Chrischilles EA, Cooper C, et al. (1992) Perspective. How many women have osteoporosis? J Bone Miner Res 7:1005.

[6] Melton LJ, 3rd, Crowson CS, O'Fallon WM (1999) Fracture incidence in Olmsted County, Minnesota:

comparison of urban with rural rates and changes in urban rates over time. Osteoporos Int 9:29.

[7] Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7:407.

[8] Johnell O and Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726.

[9] Saffar JL, Sagroun B, De Tessieres C, Makris G. Osteoporotic effect of a high-carbohydrate diet (Keyes 2000) in golden hamsters. Arch Oral Biol 1981;26:393–397.

[10] Tjaderhane L, Larmas M. A high sucrose diet decreases the mechanical strength of bones in growing rats. J Nutr 1998;128:1807–1810.

[11] Tucker KL, Chen H, Hannan MT, et al. Bone mineral density and dietary patterns in older adults: the Framingham Osteoporosis Study. Am J Clin Nutr 2002;76:245–252.

[12] Tucker KL, Morita K, Qiao N, et al. Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study. Am J Clin Nutr 2006;84:936–942.

[13] Wyshak G, Frisch RE. Carbonated beverages, dietary calcium, the dietary calcium/phosphorus ratio, and bone fractures in girls and boys. J Adolesc Health 1994;15:210–215.

[14] Hollingbery PW, Bergman EA, Massey LK. Effect of dietary caffeine and aspirin on urinary calcium and hydroxyproline excretion in pre- and postmenopausal women. Fed Proc 1985; 44:1149.

[15] Massey LK, Berg T. Effect of dietary caffeine on urinary mineral excretion in healthy males. Fed Proc 1985; 44:1149.

[16] Bergman EA, Massey LK. Effect of dietary caffeine on urinary calcium in estrogen replete and estrogen depleted women. Fed Proc 1986; 45:373.

[17] Barrett-Connor E, Chang JC, Edelstein SL. Coffee-associated osteoporosis offset by milk consumption. JAMA 1994; 271:280–283.

[18] Rapuri PB, Gallagher JC, Kinyamu HK, Ryschon KL. Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes. Am J Clin Nutr 2001; 74:694–700.

[19] Hernandez-Avila M, Colditz GA, Stampfer MJ, et al. Caffeine, moderate alcohol intake, and risk of fractures of the hip and forearm in middle-aged women. Am J Clin Nutr 1991; 54:157–163.

[20] Zarkadas M, Gougeon-Reyburn R, Marliss EB, et al. Sodium chloride supplementation and urinary calcium excretion in postmenopausal women. Am J Clin Nutr 1989; 50:1088–1094.

[21] Antonios TFT, MacGregor GA. Deleterious effects of salt intake other than effects on blood pressure. Clin Exp Pharmacol Physiol 1995; 22:180–184.

[22] Chan AYS, Poon P, Chan ELP, et al. The effect of high sodium intake on bone mineral content in rats fed a normal calcium or a low calcium diet. Osteoporosis Int 1993; 3:341–344

[23] Devine A, Criddle RA, Dick IM, et al. A longitudinal study of the effect of sodium and calcium intakes on regional bone density in postmenopausal women. Am J Clin Nutr 1995; 62:740–745.

[24] Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Milk, dietary calcium, and bone fractures in women: a 12-year prospective study. Am J Public Health 1997; 87:992–997.

[divider type="circle_small" position="hr-circle-center" size="padding-xsmall" /]

Article by Tom Fisher RN, BA, Nurse Supervisor at Hippocrates Wellness