Claiming over 1.5 million fractures in the US each year, osteoporosis is a condition of the 50 + population, with devastating consequences in many, leading to loss of independence and death. Despite several classes of medications that show promising results in research and clinical practice, the second most common bone disorder in America continues to rage, as it claims our aging mothers’ and sisters’ independence, being by far more prevalent in women than men. Osteoporosis affects 18% of women and 4% of men in the US.
Although the conversation on osteoporosis has been centered for decades on consumption of calcium (usually from cow’s milk) and estrogen replacement therapies, this approach has been proven again and again as an oversimplified solution to a condition that involves a constellation of factors in its genesis and progression. Medical anthropologist and author of Better Bones, Better Bodies, Dr Susan Brown, concludes that “like coronary heart disease, hypertension, obesity, dental and periodontal disease, gall stones and kidney stones, osteoporosis is a disease of Western civilization created by our lifestyles. All these diseases are unknown or uncommon among indigenous and traditional people….as fellow anthropologists have documented”.
Aside from a possible negative impact of increased calcium consumption on cardiovascular health, the mere ingestion of this mineral does not guarantee that it will be absorbed and ushered into the bone particularly if digestive issues are present. Furthermore, it can be argued that consumption of cow’s milk in women has more detrimental consequences than positive outcomes. Besides calcium, there are at least 7 other elements and many trace minerals that are essential to optimal bone physiology including magnesium, phosphorus, copper, among others and they are acquired via a nutrient dense diet, absorbed, and ushered into our bones in the context of healthy digestion and sound metabolism.
What about exercise? When examining the scientific evidence regarding exercise, the improvements seem modest at best. And this is because not all exercise is created equal when it comes to building bone. Just any exercise won’t do. Simply integrating some “weight-bearing” exercises in your routine and going for walks could have some benefits to your health, but it will not lead to positive outcomes in bone density. Positive changes in bone architecture, density and resilience are evoked by exercises that significantly load the bone and the muscular system. Unfortunately, these are the very exercises that our frail population mostly avoids in the fear of injury. And sadly, even physical therapists shy away from prescribing them to their patients due to lack of training on their safe implementation.
The consequences of a fall and hip fracture in an older individual are simply devastating. 70% of these fractures end in loss of independence (nursing home) or death. We cannot overestimate the impact that osteoporosis currently has in the later decades of our lives. This data invites us to look beyond the current paradigm of prevention and treatment and consider all the lifestyle factors involved in bone health. At Natural Medicine and Rehabilitation, we offer individualized assessment and treatment including lifestyle assessment, bloodwork, clinical nutrition, and physical therapy as part of our approach to osteoporosis prevention and treatment.