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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:

What You Can Do Now to Prevent Osteoporosis. Reviewed by Kendall Ford Moseley, M.D., Johns Hopkins Medicine, Jun 17, 2022. Did you know that that 50 percent of women in the U.S. age 50 or older will break a bone due to osteoporosis? Overall, about 54 million Americans have osteoporosis - a gradual thinning out of the bones - or low bone density, which may lead to fracture.

Osteoporosis Prevention: What You Need to Know by WebMD Editorial Contributors, Medically Reviewed by Melinda Ratini, DO, MS, Jul 30, 2021. Exercise Your Bones, Calcium and Vitamin D Build Bones, What Else Prevents Osteoporosis? Don't drink too much alcohol. Quit smoking. Avoid the "female athlete triad." Drink less soda. Will Medicine Prevent Osteoporosis and Fractures? Do I Need a Bone Density Test? Are Kids at Risk for Osteoporosis?

Osteoporosis Prevention from National Health Service (NHS) UK. Regular exercise, Healthy eating and vitamin D supplements, Stop smoking and drink less alcohol, Get some sun.

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."

How to reverse bone loss from Northwell Health, Orthopaedic Institute, Jan 18, 2019. A decrease in bone density is a natural part of aging, but healthy living can slow down and even reverse bone loss. Loss of bone density may accelerate as time passes, but you can take steps in your 30s, 40s, 50s and beyond to help fortify skeletal strength and prevent the worst effects of bone loss.

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."

Intake of dairy milk associated with greater breast cancer risk. Reviewed by James Ives, M.Psych. (Editor), Feb 25 2020. Intake of dairy milk is associated with a greater risk of breast cancer in women, according to a new study conducted by researchers at Loma Linda University Health.

Milk and Dairy Products Singled Out as #1 Cause of Osteoporosis from V Between the Lines, Aug 28, 2015. "Dairy milk is the biggest contributor to the brittle bone disease."

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.

Is Milk Your Friend or Foe? By Dennis Thompson, HealthDay News, WebMD Archives, Oct 29, 2014. Instead of reduction in fractures, study suggests higher risk of heart disease, cancer. Drinking lots of milk could be bad for your health, a new study reports. Previous research has shown that the calcium in milk can help strengthen bones and prevent osteoporosis. These benefits to bone health have led U.S. health officials to recommend milk as part of a healthy diet. But this new study found that drinking large amounts of milk did not protect men or women from bone fractures, and was linked to an overall higher risk of death during the study period.

Can Drinking Too Much Milk Make Your Bones More Brittle? From Health Essentials, Cleveland Clinic, Jan 14, 2021. High milk consumption linked to higher mortality, hip fractures. A Swedish study suggests that while milk may be good, more is not better. This study found that too much milk - three or more glasses a day - was not only associated with mortality but also an increased risk of fracture and hip fracture. Plus, it found that women who reported drinking three or more glasses of milk each day nearly doubled their risk of death in relation to women who drank less than one glass each day. Men were not as affected as women, but those who drank three or more glasses of milk each day still showed a significant increase in mortality. A separate study reported that higher milk and dairy product consumption does not necessarily lower the risk of osteoporosis and hip fracture ...

Milk and Osteoporosis - Is Dairy Really Good for Your Bones? By Kris Gunnars, BSc, Healthline, Apr 20, 2018. Consuming dairy doesn't make sense from an evolutionary perspective. Human beings are the only animal that consumes dairy after weaning and consumes the milk of another species. Some observational studies show that dairy intake is linked to a detrimental effect on bone health. However, even more observational studies show beneficial effects. Multiple randomized controlled trials show that dairy products lead to improved bone health in all age groups.

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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