Wednesday, January 18, 2012

Rethinking osteoporosis - Causes of osteoporosis

It is often suggested that the major causes of osteoporosis are low calcium intake and lower estrogen levels at menopause. Tracking a cross-cultural perspective, however, we find that this is not always true. For example, people in many countries have lower calcium intakes than in the US, yet osteoporosis is less prevalent in these cultures. As an example, the Japanese calcium intake has only recently risen to 540 mg per day, much less than the US RDA for post-menopausal women of 1,200 mg per day. And yet the US hip fracture rate is twice that of Japan! In fact, research has shown that countries with the highest calcium intake have the highest hip fracture rates. Furthermore, I have identified at least 19 nutrients in addition to calcium that are essential to bone health.

The same holds true for estrogen. Women all over the world experience a lowering of estrogen at menopause, but not all women experience osteoporosis. Attributing the causes of osteoporosis to the natural decrease in estrogen at menopause is too simplistic. The fact is that Mayan Indian women, Bantu women of Africa, and Japanese women all have lower estrogen levels than women of various ethnic groups in the United States, but they all experience many fewer fractures than American women. Also, the few years before menopause are a time of very rapid bone loss for most women, yet a woman’s estrogen level at this time is generally higher than during her reproductive years.

There are ways to detect low bone density and ongoing bone loss. It is not easy, however, to predict who will actually suffer an osteoporotic fracture. Bone density tests attempt to measure bone mass in various areas of the body, and markers of bone resorption can tell if your body is likely breaking down excessive bone at any given time. These tests can detect low bone density and high bone breakdown before a fracture occurs, and thus help identify your chances of a future fracture. They cannot, however, predict who will fracture. For example, over half of all women who experience an osteoporotic fracture do not have an “osteoporotic” bone density. They have either moderately low bone density, known as osteopenia, or even normal bone density. Given this, everyone, even those with good bone density, would do well to maintain a strong bone-building program.

A more realistic picture of the causes of osteoporosis portrays a variety of bone-depleting factors, each building one upon the other. Each bone-depleting factor adds to the others until the total load is more than our bone can support, so to speak. The camel image shown here depicts many of the factors that contribute to poor health and osteoporotic fractures. The array of bone-depleting factors is more wide-ranging and more important than generally recognized.

Total load model of bone-depleting factors ©2009.
Please click here for a printable version.

The camel drawing shows that there are many complex factors contributing to osteoporosis — and even this overloaded camel doesn’t contain all of them! It’s virtually impossible, in fact, for any single person to have all of these factors going on at once, although certainly many of them are interconnected. But it shows us that the causes of osteoporosis can vary greatly from person to person. So it makes sense that the best ways to prevent and treat osteoporosis will also vary from person to person. Every case must be carefully analyzed to develop the best individualized osteoporosis program. Yet for everyone, dietary improvements — specifically, changing to an Alkaline for Life® diet — nutrition supplement therapy, exercise, and lifestyle modifications are powerful bone-strengthening tools.