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Osteoporosis. A Lifestyle Entity?

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 18 in the January 8, 2014 issue of
The Mississauga News
under the title: Reducing Dairy May Help Treat Osteoporosis
under the feature: Health & Beauty, Medicine Matters.
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

Osteoporosis is a silent process affecting mostly menopausal women resulting in deterioration of bone mass and structure. It produces a fragile state that increases your chances of bone fracture when you fall, and spontaneous backbone fractures. The literal translation means porous bone. It should not be confused with osteoarthritis, which refers to a degenerative process within the joint. The term osteopenia is disappearing due to the confusion it creates.

Osteoporosis may not meet the rigid criteria for a disease, and is more likely to represent an imbalance in calcium metabolism due to prolonged leeching out of bones to neutralize the numerous acids in our diets. Our bones are in a constant state of growth, absorption and remodeling. The body requires nutrients, minerals and hormones for this to occur.

Chief amongst these is calcium phosphate, vitamin D, collagen and estrogen. More than 99% of body calcium is stored in the bones. Calcium is tightly regulated in our bodies and exact levels are needed for nerve and muscle function. You simply cannot gorge yourself with pills and hope to fix things. Regular bone density tests are not required, and treatment should start as soon as a fragility fracture occurs.

Estrogen promotes bone growth, and menopause accelerates losses. Osteoporosis is almost unheard of in the poorest countries, and is most prevalent in countries with a high dairy and meat intake, with genetics influencing the situation. New Canadian Guidelines focus on treatment and devote a few sentences to prevention. Milk intake is not mentioned. Our changing dietary lifestyles are more to blame.

In Canada, our protein intake has doubled in the last century and we consume record amounts of dairy, high fructose corn syrup and pop. Cola contains phosphorous which leeches calcium from our bones. Caffeine and alcohol inhibit the absorption of calcium, and salt promotes excretion through the kidneys. For years, doctors have promoted milk products as a good source of calcium, but my own practice has changed in recent years, and I now advise patients to reduce dairy and red meat. The reason is that the proteins in milk get broken down to methionine, which tends to acidify the blood due to its sulphur atom.

In my practice, osteoporosis treatment begins with taking walks on sunny days. The best source of Vitamin D is to get the sun to transform cholesterol into Vitamin D. A balanced diet that does not leech calcium from bones is better than worrying about taking in large calcium amounts. The first medications were called biphosphonates, and tend to stop bone eating immune cells from functioning. They tend to stick around the bones for long periods, and can cause cell death and other cells to malfunction. No ideal treatment exists, but I prefer a newer approach that uses a very specific monoclonal antibody called denosumab (Prolia). It is a twice a year injection that eliminates the reflux, and doesn't dwindle in the bone matrix.

Improving coordination through exercise and dance can help prevent fractures when we do fall. Providing adequate support rails, walking aids and assistance to our golden and cherished population is a good way to start.


Related resources:

Eating less meat may help reduce osteoporosis risk, studies show by Susan S. Lang, Cornell University, Cornell Chronicle.

Does Dairy Cause Osteoporosis? By Chris Kresser, Health for the 21st Century.

Protein and Calcium Myths from JewishVeg.com. "Countries with the highest consumption of dairy products, such as the United States, Sweden, and Finland, also have the greatest incidence of female osteoporosis. Eskimos, who consume the highest amounts of calcium of any of the world's people, have the highest number of cases of osteoporosis. Osteoporosis occurs relatively infrequently in China, even though they consume very little milk or other dairy products.

The reason is that people on meat- and dairy- based diets are getting far too much protein, generally 2 to 3 times the amount required, and when the excess protein is excreted, calcium and other minerals are drained from the body."

Preventing and Reversing Osteoporosis from Physicians Committee for Responsible Medicine (PCRM), Washington DC. "Osteoporosis can lead to serious and sometimes disabling fractures, particularly in the vertebrae and hip. The condition is more common among women than men, and more prevalent among Caucasians than other racial groups ...

The loss of bone mineral probably results from a combination of genetics and dietary and lifestyle factors, particularly the intake of animal protein, salt, and possibly caffeine, along with tobacco use, physical inactivity, and lack of sun exposure.

Animal protein tends to leach calcium from the bones, leading to its excretion in the urine ... Meats and eggs contain two to five times more of these sulfur-containing amino acids than are found in plant foods ...

International comparisons show a strong positive relationship between animal protein intake and fracture rates. Such comparisons generally do not take other lifestyle factors, such as exercise, into account. Nonetheless, their findings are supported by clinical studies showing that high protein intakes aggravate calcium losses. A 1994 report in the American Journal of Clinical Nutrition showed that when animal proteins were eliminated from the diet, calcium losses were cut in half. Patients can easily get adequate protein from grains, beans, vegetables, and fruits.

Sodium also encourages calcium to pass through the kidneys ... People who reduce their sodium intake to 1-2 grams per day cut their calcium requirement by an average of 160 milligrams per day ...

Caffeine’s diuretic effect causes the loss of both water and calcium ... Smoking is also a contributor to calcium loss. A study of identical twins showed that long-term smokers had a 44 percent higher risk of fracture compared to their non-smoking twins ... Active people keep calcium in their bones, while sedentary people tend to lose calcium ... Vitamin D is also important, as it controls how efficiently the body absorbs and retains calcium."

Dairy milk is singled out as the biggest dietary cause of osteoporosis. Published on September 12, 2005, News-Medical.Net.

Calcium and Milk: What's Best for Your Bones and Health? From Nutrition Source, Harvard School of Public Health. What Is Calcium, and Where Do We Get It? Growing Healthy Bones. What Is Osteoporosis? How Can Osteoporosis Be Slowed Down? Preventing Bone Loss in Adulthood. Should You Get Calcium from Milk? The Bottom Line: Recommendations for Calcium Intake and Bone Health.

Calcium and Osteoporosis - Is Dairy Really Good For Your Bones? by Kris Gunnars.

New Study Sheds Light On Link Between Dairy Intake and Bone Health: Not All Dairy Products Are Equal from Science News, Science Daily. Co-authors on the study include: Katherine L. Tucker, Ph.D.; Douglas P. Kiel, M.D., M.P.H.; Lien Quach, M.P.H, M.S.; Virginia A. Casey, Ph.D.; Marian T. Hannan, D.Sc., M.P.H.

Eating less meat may help reduce osteoporosis risk, studies show by Susan S. Lang, Cornell University, Cornell Chronicle.

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