Our bones define us, make us beautiful, provide leverage for movement and allow us to stand upright. We build bone until our third decade. After that, a steady loss begins, like sand slipping through an hourglass. Nevertheless, while osteoporosis has become a major public health problem, it is not inevitable. A number of strategies will keep your bones strong—and some of them run counter to the party line on osteoporosis prevention.
Granted, some of the osteoporosis risk factors are outside of your control—namely being older, female, menopausal or white. Happily, you have some control over a fleet of bone-robbers: inactivity; stress overload; malnutrition; cigarette smoking; being excessively thin; hiding from the sun; and excessive consumption of caffeine, alcohol, sodas, salt and acidifying foods. (More on acidifying diets in a minute.) The point is that you can put the brakes on bone loss. Here’s how.
Try This: Bone-Building Tea
Lifestyle Tips for Healthy Bones
Move Your Bones
Physical activity tones bone and muscle, and strong muscles minimize the risk of bone-shattering falls. To stimulate new bone formation, the exercise has to stress the bone. Weight-bearing exercises—walking, jogging, jumping rope, climbing stairs—maintain hips and spine. Strength-training exercises (working against the resistance of weights, elastic bands or tubes, or your own body weight) also strengthens your bones.
It’s never too late to start. Research shows that endurance and resistance training boosts bone mass in elders. Exercises like tai chi and yoga that improve balance are valuable to help prevent falls. One study showed tai chi reduced bone loss in postmenopausal women.
“Mix it up,” suggests Amy Joy Lanou, Ph.D., associate professor of health and wellness at the University of North Carolina and coauthor of Building Bone Vitality (McGraw-Hill, 2009). “Walk every day. Practice yoga or garden a couple days a week.”
Eat for Bone Health
Ask the average American how to build strong bones and he would probably say, “Drink milk.” Th at reply’s dependability is thanks to the millions of dollars poured into the “Got Milk?” campaign, which features photos of celebrities with milk “mustaches”—as though they lap up the stuff like cats.
In her book, Lanou and coauthor Michael Castleman highlight data suggesting that dairy consumption does not reduce fracture rates. In fact, fracture rates are higher in countries where dairy consumption is high, such as Norway and the United States. In many parts of the world—including those with relatively low fracture rates, such as Asia and Africa—humans don’t drink milk once they’ve been weaned.
Acidic Diets Affect Bones
Curiously, before agriculture gave us a ready supply of dairy cows and cereal grains, humans had more massive bones. So says Michael Bizeau, Ph.D., assistant professor and coordinator of the nutrition program at Metropolitan State College of Denver. Our ancestors ate non-grain vegetables, fruits and, when the hunters got lucky, meat. Bizeau thinks we still haven’t adapted to a grain-heavy diet, which can generate acid and inflammation and which contains phytates that bind minerals like calcium in the gut.
What does acid and inflammation have to do with bones? A lot, as it turns out. Inflammation has been linked to osteoporosis, as well as a number of other diseases. Anti-inflammatory diets—those rich in vegetables, fruits and omega-3 fatty acids—appear to reduce the risk of osteoporosis. This kind of diet is also alkalinizing (which reduces acidity).
Diets that generate acid cause calcium loss. Here’s why: Acid-base balance is critical for many bodily processes. When dietary acid enters the blood, calcium compounds come out of bone to neutralize it. Eventually, that calcium is flushed out in the urine. Although the loss is small, the theory is that, over time, acidic diets slowly, steadily deplete the bone’s calcium stores.
Foods That Are Acidic
Which foods generate acid? Dairy products, eggs, meat, some beans, some nuts and cereal grains. Lanou says hard cheeses, like cheddar or Swiss, are the worst offenders.
On the other hand, alkalinizing foods are fruits (especially dried fruits) and the vast majority of vegetables. While higher-protein foods generally produce acid, plant foods—even those rich in protein—contain alkaline nutrients. Protein is critical for bone health. Plants have that, plus a host of other bone-essential nutrients—calcium, potassium, magnesium, vitamin K, boron and others. And, as noted above, they’re more likely to be anti-inflammatory. Studies have indeed shown an association between high fruit and vegetable consumption and greater bone mineral density.
When you consider the average American diet—heavy on dairy, meat, eggs, calcium-stealing sodas and salt; sparse in fruits and vegetables (and exercise)—the epidemic of osteoporosis isn’t that surprising. Lanou says that simply eating more fruits and vegetables—six to nine servings a day—helps buffer acidic foods. Can’t resist the burger? Eat a salad and an apple with it. Or toss back a handful of super-alkalinizing raisins. You might also reduce your intake of animal foods, substituting alkalinizing non-genetically modified soy foods, which some studies show to boost bone density. If you are seriously concerned about acidity in relation to your diet, it should be noted that Lanou does recommend eliminating cheese, noting it’s three to four times more acid-forming than milk and twice as likely to create acid as meat and eggs.
Herbs and Foods for Healthy Bones
Are supplements necessary?
Both Bizeau and Lanou say no, with the possible exception of vitamin D. Vitamin D is needed for calcium absorption from the intestines. It also helps keep muscles strong, reducing the risk of falls. This is one vitamin the body makes. In the presence of ultraviolet light, skin manufactures vitamin D from cholesterol. That’s good news, given that few foods contain vitamin D. Chief sources are those acidifying animal foods—oily fish, eggs (from vitamin-D-fed hens) and fortified milk, as well as fortified soy milk, orange juice and sun-exposed mushrooms.
Why, then, are so many people vitamin-D deficient? We’ve gotten better at protecting our skin from those cancer-causing, wrinkle-producing ultraviolet rays. During the winter, the sun’s intensity at higher latitudes isn’t sufficient for stimulating that production. Plus, the body’s ability to make vitamin D declines with age.
In 2010, the Institute of Medicine (IOM) revised its recommendations for vitamin D as follows: 600 international units (IU) for people 1 to 70, and 800 IU for those older than 70. Several studies—most of which also include calcium—show that daily doses of 800 IU produce better results on bone than 400 IU per day.
Some experts think the IOM’s daily doses aren’t high enough for many Americans. If you’re at risk for osteoporosis, consider asking your doctor to order a blood test to better determine your dose. Because this fat-soluble vitamin needn’t be taken daily, Bizeau recommends a “D Day.” On that day, you can take the whole week’s dose. He also suggests you postpone slathering on the sunscreen until after you’ve been outside for 15 to 30 minutes.
What about calcium? Doctors routinely recommend supplements, which seems reasonable given that calcium forms most of bone’s mineral content and deficiency raises the risk of osteoporosis. Yet, while calcium supplements can increase bone density, the majority of studies fail to show a significant protective effect from fractures. Worse, calcium supplements have been associated with an increased risk of heart attacks and kidney stones.
Rather than pop pills, a better strategy is to consume foods rich in calcium and other bone-essential ingredients. Bizeau says your best bet is to eat plenty of green leafy vegetables—collards, kale, turnip greens, bok choy, chard and the like.
Best Bets for Vitamin D
Herb enthusiasts will be pleased to know that dandelion (Taraxacum officinale) and stinging nettle (Urtica dioica) greens are great choices. One cup of raw, chopped dandelion greens contains about 100 mg of calcium. You can add fresh dandelion leaves to salad. Vinegar makes them less bitter, though that bitterness stimulates digestion.
Fresh dandelion, nettles and calcium-rich parsley can be juiced or blended into smoothies. (Wear gloves when handling fresh nettles. After they have been chopped or blended, they won’t sting.) You can cook with both greens too, using them in the same way you use spinach. Last summer, I made a delicious pesto with basil, fresh nettle leaves, olive oil, pine nuts and garlic.
You can also make excellent dips and spread from legumes. A half can of chickpeas (garbanzo beans) contains 38 mg of calcium, along with protein and other nutrients. They generate acid, though not nearly as much as meat and cheese. If you blend those chickpeas with tahini (made from calcium-rich sesame seeds), lemon, olive oil and garlic, you get hummus.
For centuries, herbalists have used herbs to maintain the health of multiple bodily systems, including the skeleton. Note that the scientific research is preliminary. No long-term trials have been done on people at risk for osteoporosis.
That said, nutritive herbs, so rich in vitamins and minerals, are your best bet. Dandelion and nettle again top the list. Medical herbalist Amanda McQuade Crawford, author of Herbal Remedies for Women (Three Rivers Press, 1997) and star of “What a Relief!” on Veria TV Network, also uses oatstraw (Avena sativa), red clover (Trifolium pratense), alfalfa (Medicago sativa), horsetail (Equisetum arvense) and yellow dock root (Rumex crispus).
Crawford’s favorite way of preparing these herbs is to make them into infusions. (Boil water, turn off the heat, add 1 tablespoon dried herb per 8-ounce cup water, steep 15 minutes covered, strain.) I recommend making a quart of tea. After it cools, you can decant it into a nonreactive water bottle. Drink three to five cups a day.
You can also finely chop the dried herbs, put in a jar, cover with organic apple cider vinegar until the level rises two to three inches above the herb. Shake daily for 10 to 14 days. Strain. Add to salad dressing or take a tablespoon a day mixed into a cup of warm water.
Regular consumption of green and black tea (Camellia sinensis) may reduce osteoporosis risk. Research suggests that tea might decrease the risk of fracture because it enhances bone mineral density, increases activity of bone cells that add bone and inhibits bone cells that break down bone.
Black cohosh (Actaea racemosa) is better known for its ability to reduce menopausal symptoms. Lab studies and one study in postmenopausal women suggest that extracts of black cohosh root and rhizome also may promote bone development.
Chaste tree berry (Vitex agnus-castus) has been researched primarily as an herb that corrects menstrual cycle irregularity and relieves premenstrual syndrome. Regular menstrual cycles offer some assurance of sufficient estrogen to maintain bones. Also, a study of chaste tree in rats found a bone-protective effect.
Linda B. White, M.D., is a visiting assistant professor in the Integrative Therapies Program at Metropolitan State College of Denver.