Osteoporosis: Vitamins and Minerals

Why do we need vitamin D?

We need Vitamin D in order to absorb calcium properly. But as we grow older, we become less able to utilise the vitamin, and a deficiency may lead to muscular weakness and contribute to instability, falls and subsequent fractures. Some drugs interfere with Vitamin D absorption. If you regularly take any drug, ask your doctor about this.
Many dietary sources of Vitamin D are oily fish like herring, sardine, mackerel; also egg yolk, milk butter, cod liver oil.

Some foods like breakfast cereals, margarines and skimmed milk powder are fortified with Vitamin D – if so, this will be stated on the pack.

We also get Vitamin D from sunlight, which is why getting out into the fresh air in winter as well as summer is important, especially as we grow older and may give in to the temptation of staying indoors. Some calcium supplements include Vitamin D as the natural complement. It is generally better to take a combined supplement rather than trying Vitamin D alone, in order to get the right balance.

It’s not fully proven, but there is some evidence that if you’ve had children you may be less susceptible to osteoporosis. The advantage may come from increased intake of calcium rich foods, which many pregnanat women include in their diet. Also, high levels of oestrogen during pregnancy boost Vitamin D productivity which in turn promotes calcium absorption. And on top of all that, the hormone progesterone, which is present in higher levels in pregnancy, adds to the bone conserving effect.

Magnesium – another part of the jig saw
The mineral magnesium is thought to help stabilise hormones that control calcium balance and can help increase the efficacy of Vitamin D. Western diets contain very variable amounts of magnesium, and there’s a school of thought that supports increasing dietary intake of the mineral as a way to keep bones strong, especially if you are increasing calcium.

Orthodox medicine does not hold with the idea that we may be magnesium deficient, but it’s as well to know which foods contain it. One of the best sources is cocoa, which means that it is also in chocolate, both milk and plain.
Other sources are wheat bran, nuts, tea and coffee, oats and rice. And it comes via the tap in drinking water – more in hard than in soft water – so make a habit of drinking several glasses a day.

And finally, phosphorus
This mineral also plays a part in calcium absorption and in the formation of tissue between bones. We get it in meat, poultry, fish, cereals, soft drinks, and it’s highly unlikely that we get too little.

Should I take a multivitamin pill?
If you are concerned about receiving sufficient nutrients in your daily diet, the answer might be to go for a multivitamin pill that offers a balance of various vitamins and also minerals. You won’t get as much calcium in a multi-pill as you do in calcium-only types though. Look on the labels to compare contents. In any case, a vitamin pill is not an excuse to give up being concerned about what you eat. A balanced duet is important for general fitness and health, whatever supplements you take.

The good mid-life diet
• Reduce sugar, not only in tea and coffee, but by choosing natural, unsweetened fruit juice instead of canned soft drinks. And don’t forget the sugar content of cakes, biscuits, puddings and jams.
• Reduce salt, both in cooking and when seasoning food at the table. Some salted foods need to be eaten sparingly; crisps, salted nuts, smoked fish, smoked bacon, smoked meats like salami.
• Eat vegetables and salads daily. Best is combination of green, leafy vegetables, yellow and red vegetables, peas and beans for fibre content and uncooked salads. At least 3 helpings a day.
• Have fresh fruit daily. At least 2 servings.
• Go for fibre. You’ll get it in cereals, and it’s a way to make calcium-rich milk go down too, so try to eat at least one helping a day. Other fibre foods which can protect against heart disease and bowel disorders are bananas, avocado pears, celery, fresh fruit, lentils and other dried beans and pulses, and oatmeal. Remember, unprocessed bran can hinder calcium uptake, so avoid the stuff.
• Limit meat consumption. Red meat is best kept to 2 or 3 helpings a week; substitute chicken, fish, nuts as sources of protein.
• Limit fats and dairy products. To protect against heart disease, fat intake should be about a third of total calories consumed. Use olive, sunflower, safflower oils rather than animal fats for cooking, whether it’s roasting, frying, or in salad dressings. Choose skimmed milk, low-fat yoghurts.
• Drink plenty of liquids. It can be water, up to 6 large glasses daily, or fruit juice, or herbal tea which is, of course, caffeine-free;
• Alcohol consumption should be limited. Maxuimum safe limit for women is 14 units a week. 1 unit being half a pint of beer or a small glass of wine or standard measure of spirits. Alcohol can cause flushes, and in excess hampers calcium absorption and damages bone cells, so drinking even less is better.

What if I smoke?
As well as all the other horrors connected with smoking, it triggers and early menopause and is strongly associated with risk of fractures. Even some passive smokers, women who live with heavy smokers, have been found to have an earlier-than-average menopause with risk of greater reduction of bone density.
Keep your coffe intake down and don’t take it black. An American study shows that drinking more than 2 cups a day appreciably reduces bone density, though women who also drank a least one glass of milk as well lost less bone density than other coffee drinkers.

The fringe and beyond
Claims for various ‘alternative’ ways to combat osteoporosis make headlines from time to time, some of which are based on research, others merely on passionate conviction. A trace element called boron has been named as a vital ingredient in maintaining calcium levels and so reducing bone loss in post-menopausal women. The results seem impressive – calcium loss reduced by 50%, blood levels of oestrogen doubled in one report – but as is so often the case with alternative remedies, the number of women studied was very small, just a dozen, and more research is needed before claims can be justified. But boron exists in fruit such as apples and pears, in leafy vegetables and nuts, and is available at health food stores in tablet form, though most nutritionists would’nt recommend buying it.

Yet another trace element, silica, is said to ‘empower’ calcium and therefore prevent osteoporosis, as well as strengthen nails and hair. The orthodox view is that we get enough in our diet, since silica is present in the earth, but the alternative view is that high-tech farming has destroyed it and modern food-processing removes what little is left. Brown rice, wholemeal flour, fresh fruit eaten with the peel intact and organically-grown products can provide silica.

Another branch of the alternative fringe, Chinese medicine, advocates herbal concoctions that act on the kidneys. Recent reports on possible kidney damage from Chinese treatments suggest that this one should be approached with great caution.