I firmly believe that the more natural we can be, the more healthy we can be. God gave us our physical nature and he created the plants as food and remedy for us. Pharmacy has been around for hundreds of years but is now virtually all man-made. Although there are many medications that are helpful with an important place in our healthcare today, much of it is causing harmful unwanted side effects. There are natural alternatives that can be used instead of or in conjunction with many of the pharmaceuticals available.
I have also found my spiritual practices, my thinking and lifestyle provide much of my good health.
NATURAL TREATMENTS
From her book, The Myth Of Osteoporosis, Gillian Sanson writes that there is no evidence that osteoporosis drug therapies prevent hip fracture in elderly adults. It makes much more sense to consider lifestyle and environmental factors. It is important to maintain body weight, walk regularly, get as much exercise as tolerated, stay active, maintain flexibility and balance, treat vision issues, remove fall hazards, eat a balanced nutritious diet, get regular sunlight, or Vitamin D if necessary, and avoid certain medications like benzodiazepines, steroids, sleeping pills, or medications that weaken bone, affect body function or affect mentation.(6) This section will discuss exercise and the vitamins, minerals and nutrients in bone supporting foods. Part 4 will discuss the foods themselves and the herbs that contain many of the vitamins, minerals and nutrients in amounts that will encourage good, long-lasting bone health.
MY LIFE-GIVING PRACTICES
As a nurse for over 30 years, I cannot tell you how frustrated I have been that doctors don’t talk much about nutrition and they don't mention how important our spiritual practices or thinking are to our health. In my experience, they refer their patients to nutritionists or dietitians and use medication as their major tool. I saw countless patients eating foods that were obviously harmful to their system and taking pill after pill to feel better with the doctor's blessing, throughout my career. Poor food and drugs were used as self-treatment for a poor mental state related to a poor spiritual or physical state and no one seemed to care. Many I took care of had obvious spiritual and mental issues suffering anxiety, depression, fear, hopelessness or grief and were only doing what they knew, to feel better. I lived that way myself for many years. I finally got out of the severely compromised medical mind-set into the life-giving natural mind-set built on the foundation of faith.
After healing from many chronic and debilitating illnesses with Jesus' help, I strive to keep doing what strengthens my relationship with Him, first and foremost. I pray constantly, thanking, worshipping, singing and just having conversations with my Father throughout the day. Regular reading of His Word is of high importance and memorization of scripture so it is in my heart and mind is priority. I ask Him for strength, wisdom, health, favor, courage and protection and to bless my work and family. Frequent confession, quick or repeated forgiveness, unrelenting faith, constant prayer, renewed thoughts, healthy food, rejuvenating rest, regular exercise and other faith-based, natural approaches, keep me moving ahead with purpose, ready for anything. The support of good friends, a loving family and my church fellowship are also indispensable. When I am not feeling good, I get honest about my choices. Am I slacking in my relationship with Jesus, my time in the Word? What about my exercise routine? My sleep pattern? What have I been eating? Too much eating out, junk foods or sugar or not enough water? Food in all forms, forms us-spiritual food, emotional food, mental food and physical food. These all work together to make us whole and in balance with our true and natural selves. Like a puzzle, we need all the pieces to fit together to make us complete.
Not all health professionals ignore these important matters, so I am thankful when I find them. I have met some great health professionals who are informed and share what they know. I was pleased to have found several excellent books and writings by thoughtful people. You will find them in the resources section. Now, let's look at movement first and move on to the nutrients in food that can add on to our health.
EXERCISE
Many state that regular exercise is the most important step a person can take to improve the strength of their bones. Please be sure and do a warm-up and cool-down routine as part of the work-out.(7) Strengthening and weight bearing exercises have shown to improve balance and increase BMD (bone mineral density), thus reducing fall risk.(46) Weight-bearing and muscle-strengthening exercises stimulate bone formation and slow age-related bone loss.(47) Bone is living tissue that becomes stronger with exercise. If a young person exercises regularly, they will usually achieve a greater peak bone mass than those who do not. Coordination, balance and muscle strength are also improved with exercise. It has been found that weight-bearing, which is working against gravity and resistance exercises, like weight-lifting or using large stretch bands, are best.
Weight-bearing exercises can be low or high-impact and include walking, elliptical machines, low-impact aerobics, tread-mills, stair-steppers, jogging, tennis, dancing, jumping rope, skiing, weight machines and golf.(47,64,65) Lifting your body weight and functional exercises like standing on tip-toes or using balance discs can be beneficial and may need to be explained by a professional.(65)
Check with your doctor if you have any health conditions like heart, diabetes, obesity, history of fractures, if you are in poor shape or 0ver 50. The Surgeon General says the optimal goal is at least 30 minutes of exercise on most days of the week, preferably daily. Start slow and do not over do it. If you are sore for more than 48 hours afterwards, ease up and go more slowly. Do not proceed with any chest discomfort or tightness. If you currently have osteoporosis with a history of low trauma fractures, check with your doctor about what activity is safe and avoid exercises that bend or twist your back. Do not do any forward-bending exercises or do any high-impact exercises if you are at risk.(64,65) Try to stretch and learn how to ease into a good personal program. There are exercise specialists who can work with you to advise about this and make sure they are trained in working with bone health.(64) Exercise also provides flexibility for bones, increases circulation and helps clear waste products.(1)
A study done by Dr. Fred Kasch, Professor Emeritus at San Diego State University and founder of the Adult Fitness Clinic, is a pioneer in the fitness field. He followed middle-aged men for more than 35 years and found that physical declines associated with aging could be slowed down with regular physical activity. Important changes to the body appeared to begin at 90 minutes and continued up to 300 minutes a week. He said, “There are many ways to Rome.” He taught that various exercise regimens will achieve the same goal. We now know that starting young is important and young bones respond well to weight-bearing exercise to produce the greatest bone mass possible for that individual. Running and jumping activities were the best. Wolff’s law is the “use it or lose it" principle of bone physiology. Microstructure of the bone is compromised by disease and enhanced with exercise. Bone formation is increased with greater mechanical load. Children should play at least an hour a day. In the Nurse’s Health Study, women who did no other exercise but walk for at least 4 hours a week, had a 41% lower chance of hip fracture. Walking does not affect the spine as positively so try to vary the routine adding in strength and weight bearing exercise as tolerated. Also remember to add in balance and core exercises and if you are already compromised with activity, start slow and consider getting a coach.(5) I like to use a balance disc that is inexpensive and works the muscles of the back and legs and an exercise ball that helps improve balance and flexibility.
SLEEP & REST
It is very important to get enough sleep. Studies now show that there is a possible relationship between sleep and osteoporosis. Less than 6 hours of sleep was found to be significantly related with osteoporosis in older individuals.(47,123) Try to sleep in a dark bedroom. It is best to cover all lights including windows, smoke detector and clocks. Keep your room cool and quiet. We run a quiet fan to shut out all extra noise. I also try to get to bed and get up around the same time every day. A constant bed routine has really helped me to produce the right amount of cortisone. If I do get tired during the day, I lie down for a few minutes as needed, to recoup. Just a few minutes can bring me from an adrenaline state back into cortisone for energy, which does not push my body negatively. We keep the Sabbath on Saturday as we have not found any scripture in context that says we can disobey the 4th Commandment. A wise man I heard said that if we didn't have a weekly Sabbath, we would be a slave to our work. Before I kept it, that was true for me. I felt the need to work 7 days a week. Now I get to have a rest and honor God in the process.
NATURAL NUTRIENTS
Regarding natural treatments, Dr. Lani Simpson impressed me in her book, Dr. Lani’s No-Nonsense Bone Health Guide. She knows about how our gut health helps us to properly break down food and absorb nutrients from the food. We will discuss gut health later, but first let's look closer at the nutrients in the foods that support bone health.
There are fat-soluble and water-soluble vitamins. Fat-soluble vitamins, A, D, E and K, need fat to be absorbed, are stored in our fat and are found in fats, but most of these can also be found in vegetables with D being mainly from sunshine. The water-soluble ones are B and C and they are excreted quickly and need to be replenished often. Choline, an essential nutrient is also water-soluble. When cooked, water-soluble vitamins and nutrients may leach into cooking water so consume the water or try to steam if possible. We make casseroles often, making everything in the same pan and this allows us to use the water too. Fat-soluble vitamins are stored in the liver and fat, so are not excreted easily. These will leach into fat when cooked so be aware of this when making your food. A well balanced diet will contain all of these vitamins and many sources say there are no problems with under or overdosing if you eat a large variety of healthy foods. All vitamins are important to overall bone and body health, but the following are thought to be the more important ones specifically, with calcium and Vitamin D the most important.
BONE HEALTHY MINERALS
DIETARY CALCIUM
As stated in Part 2, calcium is an important mineral for bone health. An article published by Harvard Medical School updated August 2018, states that even though the requirement of 1000 mg of calcium daily has been the norm for years, many health authorities do not agree. In the late 1970s, a couple of brief studies were completed indicating that consuming 1200 mg a day for women over 50 years old would preserve postmenopausal calcium balance. This was before we found out that too much may be harmful and that our bodies don't use it like it was earlier believed. In the years since, we have found out that supplemental calcium intake does not reduce fracture risk and may cause problems with it being deposited in tissues. Dr. Walter Willett, chair of the Department of Nutrition at Harvard T.H. Chan School of Public Health, says that you are likely to do just as well on half as much calcium. "Essentially, I think that adults do not need 1,200 mg of calcium a day. The World Health Organization's recommendation of 500 mg is probably about right. The United Kingdom sets the goal at 700 mg, which is fine, too. It allows for a little leeway," he states.(81) Both the Harvard Medical School article and the Johns Hopkins article about calcium state that a calcium-rich diet is actually very healthy for the bones and for the heart.(20,81)
Calcium-rich foods include yogurt (plain, organic and whole), cheese, cottage cheese, sardines, salmon, turnips, kale, bok choy, broccoli (30), collard greens, figs, oranges, shrimp, beans (31), almonds, mustard greens, turnip greens, spinach, green beans, (45) and fermented soy. I do not add in any calcium-fortified foods. That process is not natural and the calcium is not either. We do not eat anything processed on any regular basis. Fortified foods are an unnatural source of vitamins, like supplements and I suspect in the future that they will say that these are unhealthy as well. There are some who say that we don’t get enough calcium from our diets. I find that I get enough calcium from my diet but that is to be assessed on an individual basis. Chinese people have a low incidence of osteoporosis, and eat sesame seeds and sesame oil frequently.(7) They also eat their soy products fermented. They do not eat unfermented soy and I will explain about that later. Please note that tofu is an American product designed for the fast paced, convenient life-style. Not healthy...unless fermented and organic.
BORON
Has no RDA but is suggested at 3 mg daily.(49) It is believed that boron reduces the excretion of calcium, magnesium, and phosphorous, all of which are vital to strong bones. It is said to lower the incidence of arthritis and prevents osteoporosis by decreasing calcium loss and bone demineralization. Be aware that large doses can be toxic if thinking about supplementation. Again, natural sources are fine. Sources include dried fruits, like raisins & prunes, almonds, apples, bananas, broccoli, celery, pears, grapes, legumes, nuts, peanuts, apricots, avocados, tomatoes,(40,45) root vegetables like potatoes, carrots, parsnips grown in boron rich soil.(49)
COPPER
The RDA is 1.5-3 mg. Copper is involved in collagen production and helps provide the structure that holds bone together. It appears that typical intake of copper is less than the recommended daily allowance and can lead to reduced bone formation, but further studies are needed. Excess intake can cause adverse effects, so be aware with supplementation.(49) Sources include beans, nuts, mushrooms, liver, oysters, cereals (processed, so not the best source), chocolate,(40) animal liver, shellfish, nuts, fruit, oysters, kidneys and legumes.(49)
IRON
The RDA is 10 -18 mg. Do not exceed with supplementation and do not give supplements to children.(49) Iron is involved in collagen synthesis. Laboratory tests show low levels of iron may lead to lower bone strength. Vitamin C helps us absorb iron. Sources include dark green, leafy vegetables, such as spinach, and red meat,(40) shellfish, brewers yeast, offal, cocoa powder, dried fruit, cereals (fortified and processed).(49)
MAGNESIUM
The RDA is 300-400 mg with dietary intake usually sufficient. It contributes to the structural development of bone tissue and around 60% is found in our bones. It influences the activity of osteoblasts and osteoclasts and has positive associations with bone mineral density. It is essential for hundreds of biochemical process in our body.(49,86) Excessive alcohol use can deplete this important mineral. According to a study reported by NIH, higher dietary magnesium intake has a protective effect on risk of fractures related to osteoporosis.(98) Sources include chocolate, green vegetables, nuts, seeds, squash, whole grains, hard water,(40) spinach, beet greens, okra, tomato products, artichokes, plantains, potatoes, sweet potatoes, collard greens, raisins,(38) brown rice, soybeans, nuts, brewers yeast, whole wheat flour, legumes,(49) including black-eyed peas, pinto/kidney beans, lentils, nuts identified specifically-almonds, cashews and peanuts.(45)
PHOSPHORUS
The RDA is 800-1200 mg. Present in body as phosphates, aids process of mineralization and helps with structure.(49) We should eat twice as much calcium as phosphorus as high levels of phosphorus can cause bones to lose calcium. Most people probably take in enough phosphorus in their diet, although vegetarians who do not eat dairy products run the risk of developing phosphorus deficiency, which can result in a serious bone disease. It can be toxic at high doses but a healthy person eating a balanced diet would have no issues with this. Kidney disease could cause a buildup. Phosphorus is essential for bone growth. Around 85% of our body’s phosphorous is located in our bones as calcium phosphate.(87,40) Sources include cereals (processed), dairy, eggs, fish, meat, legumes, nuts, and grains(40) and dark-colored sodas (try to avoid all sodas if possible).(87) You can see why high soda consumption could affect bone health.
POTASSIUM
The RDA is 3500(49)-4700 mg.(40) Toxic at high doses, as it can affect the heart and muscles, so be aware of supplementation or medication and dangerous at low doses as well.(49) It plays a vital role in maintaining bone health and certain potassium salts neutralize the acids produced during the body’s metabolic processes. These acids deplete bone. Sources include avocados, bamboo shoots, beans, cereals (processed), orange juice, scallops,(40) fresh fruit and vegetables, especially bananas.(49)
ZINC
RDA is 15 mg. Zinc is a crucial element that is required for more than 200 activities in the body and in trace amounts is vital to collagen synthesis providing a structural platform for bone formation. As with magnesium, excessive alcohol intake can reduce our supply of zinc. Can be harmful in high doses so be aware of supplementation. Food sources include offal, meat, mushrooms, oysters, eggs, whole grain products, brewer’s yeast,(49) fish, legumes, milk, poultry, whole grain breads specifically,(40)
SILICON
No set RDA, but it is believed our need is up to 20-30 mg a day. Most people get plenty in their diet and it assists in the utilization of calcium inside the bones.(49) It is a mineral that can enhance osteoblast (building) cells and inhibits bone breakdown.(90) Is also involved in initiation of the mineralization process. Sources are prunes, apricots, brown rice and green beans,(45) whole grains, vegetables, hard drinking water, seafood,(49) oats, string beans, spinach, lettuce, potatoes with skins, beets, carrots, any root vegetables, bananas, raisins, strawberries, oranges, beer and red wine.(90)
STRONTIUM
Strontium is trace element, is not essential and is found in seawater and soil. It is similar to calcium but a heavier atom and will replace calcium in our body. A prescription form called strontium ranelate (Protelos) is approved in Europe for osteoporosis treatment but has not been approved in the U.S. There are other forms being marketed here called strontium citrate or chloride which are a different kind of compound and are not regulated so have not been tested or studied for safety. Also there are varying amounts of chemicals in each supplement. Because of these factors, no one is able to tell if they cause serious harm at this point. The author of the American Bone Health article states it is not good for bone health.(89) Some calcium supplements have strontium added. The European Medicines Agency has come out with the warning that strontium ranelate is to be used only by those with severe osteoporosis and that they must be frequently monitored. Use is restricted to only those who cannot use other medications. They are told to stop with any cardiovascular problems. Studies showed fracture-reducing effects but also showed increased risk of cardiac events and blood clots in those with history of those issues and other possible adverse effects include liver inflammation, seizures, and a drop in red blood cells.(88)
SEA SALT
Naturopath and Nutritionist Barbara O’Neill, reminds us that sea salt has many minerals and she suggests specifically Celtic sea salt. This type has 82 trace minerals used by our bodies, including three differing kinds of magnesium (m. sulfate, m. bromide and m. chloride) which are easily absorbed through our mucosa in the mouth. This type of salt does not adversely affect our bodies but adds on to it and helps improve our health. She recommends letting a crystal of sea salt melt on our tongue with each of our 8 glasses of water a day. She also reminds us to avoid "table" salt (NaCl) as this refined, make in a lab and is comprised of only two minerals with iodine usually added. It is not healthy.(139)
An NIH article reported that routine supplementation with zinc, manganese, copper and other metals is generally unnecessary, and excessive supplementation may be harmful. Supplementation with strontium should also be questioned until long-term risks and benefits are better understood. Nutritional needs for bone health can be met with proper food choices.(45)
BONE HEALTHY VITAMINS & NUTRIENTS
VITAMIN D (a hormone)
About 20 to 25 minutes of sun exposure every day and you’ll get enough vitamin D, Stephen Honig, MD, director of the Osteoporosis Center at the Hospital for Joint Diseases, in New York City, says. Vitamin D has been positively linked to stronger bones and is thought to help the risk of depression, obesity and Alzheimer’s disease. Sunlight turns a form of cholesterol in your skin into Vitamin D3.(36) Midday sun is best as time of day and angle of the sun matters. Also the darker your skin, the more time you will need to make enough. We can also make Vitamin D from tanning beds and not much time at all is needed to meet your needs. Remember Vitamin D is stored in our fat (fat-soluble) and used as the need arises. Sources include fatty fish like salmon, trout, swordfish, sturgeon, sardines, mackerel, tuna, other fish like halibut, rock fish, sole, flounder, snapper, pork, mushrooms exposed to UV light, cod liver oil, liver, eggs (esp the yoke), pickled herring, oysters, shrimp, lard, butter, fortified oat, rice and almond milks, fortified regular milk and fortified cereals.(26, 35, 37,45) The foods that are fortified with Vitamin D are suspect to me as the Vitamin D is going to be man-made and the processing of these foods is unnatural, just like the pharmaceutical grade vitamins which are not seen as healthy as nature-made.
VITAMIN C
The RDA for Vitamin C is very minimal with 60 mg in one source,(49) and another says 90 mg for men and 75 mg for women.(84) Many experts believe we need more than this. It is water-soluble and assists in the formation of collagen, stimulates cells that build bone, enhances calcium absorption, and enhances Vitamin D effect on bone metabolism. Also Vitamin C plays a role in the synthesis and functioning of our adrenal steroid hormones which are essential to bone health especially during later years when these slow down.(84) Foods which carry good sources of Vitamin C are cantaloupe, kiwi, mango, acerola, rose hips, Indian gooseberry, oranges (or juice), lemons, strawberries, red peppers, green peppers, broccoli, Brussels sprouts, papaya, potatoes, black currant, pineapples, grapefruits (or juice), tomatoes (and juice).(38,85,45,49) I like to steep rose hips in vinegar or honey since they are high in Vitamin C and so is raw apple cider vinegar. Honey has also been shown to have Vitamin C, so I make both of these and keep them on hand when I feel I need a little extra. Vitamin C is used up quickly with stress, smoking, infections, heavy alcohol use and injuries.(49)
VITAMIN K
The RDA for Vitamin K is 120 mcg for men and 90 mcg for women. It is fat-soluble and involved in bone health and blood clotting, bone turnover and bone strength.(45) Sources include dark green leafy veggies like kale, spinach, collard greens, Swiss chard, mustard greens, turnip greens, Brussels sprouts, parsley, romaine and green leaf lettuce, broccoli, cabbage, coleslaw, cauliflower, some fats and oils, and in fish, liver, meat, natto, cheese, blueberries and eggs. Also Vitamin K is made by our gut bacteria in our lower intestinal tract.(38,83)
AMINO ACIDS
Some believe that amino acids play a large role in keeping our bones fit. They are the building blocks for protein. Essential amino acids are produced by the body, non-essential ones must be obtained by food and semi-essential ones are not usually essential but can be in some circumstances.(91) Amino acids that support bone health include:
Lysine
An essential amino acid that helps to preserve bone density because it helps with the absorption of calcium. It also decreases calcium loss through urine. It is available in beans, nuts, meat, esp red meat, pork, poultry, cheese (esp parmesan), cod, sardines, eggs, spirulina (a blue-green algae), fenugreek seed,(39) avocados, dried apricots, dried mangos, potatoes, beets, leeks, pears, tomatoes, peppers, soybeans, chickpeas, beans, lentils, pumpkin seeds, nuts, quinoa, amaranth, buckwheat, dairy, beef, chicken, pork. Arginine competes with lysine for absorption so be sure and eat plenty of lysine-rich foods since this one is essential. You will notice there are overlaps in foods that have both.(92)
Arginine
A non-essential amino acid that we are capable of synthesizing ourselves. It is crucial for bone creation because it supports the production of collagen. It supports the bone forming cells, the osteoblasts.(39) It is available in chocolate, nuts,(49) turkey, pork, chicken, lentils, soybeans, chickpeas, dairy, spirulina and pumpkin seeds.(91)
Carnitine
Our diet usually will contain enough of this. It is derived from amino acids and is critical for energy production. It is called a conditionally essential nutrient since some are unable to make enough for genetic or medical reasons. It is concentrated in skeletal tissue and is thought to slow bone loss by slowing turnover rate.(39) Most people make sufficient carnitine from lysine and methionine. It is found in meat, poultry, fish, milk,(93) cheese, avocados, asparagus.(39)
ISOFLAVONES
Isoflavones are a class of phytoestrogens which are plant-derived compounds with estrogenic activity. Soybeans and soy products are the richest sources of isoflavones in our diet.(94) While some studies are inconclusive, P. Balch claims in her book, Prescription For Herbal Healing, that over 600 articles in the medical literature support the observation that phytoestrogens perform the same functions as estrogen in the body. Estrogens have been shown to slow the breakdown of bone.(46) According to an NIH journal article, several studies on soy isoflavones show that their ability to reduce bone turnover has been demonstrated through the inhibition of bone resorption and the stimulation of bone formation.(41) Estrogen actions on bone are complex. A major effect is to inhibit bone resorption. Bone cells have two kinds of steroid receptors for estrogen. When estrogen binds to the receptors, a variety of genes become active. Estrogen also has other effects that do not depend on DNA activation.(59) The three common types of phytoestrogens are called coumestans, isoflavones and lignans. All can behave as estrogen in our bodies. Coumestans include foods like alfalfa, legumes, pinto beans, soybeans, chick peas, and clovers. Isoflavones include soy and legumes. Lignans include brans, beans, fruits, and vegetables.(95) A team of researchers led by the University of Hull in the U.K. set out to learn whether soy and isoflavones could help protect women from osteoporosis. Thozhukat Sathyapalan, MD, who was the leader of the study said "We found that soy protein and isoflavones are a safe and effective option for improving bone health in women during early menopause. The actions of soy appear to mimic that of conventional osteoporosis drugs."(42) Dr. Null in his book, The Complete Encyclopedia of Natural Healing, also reiterates that soy isoflavones retard bone loss and increase bone density in menopausal women.(7) I eat these types of foods often as I am in menopause now and experience hot flashes and other symptoms. There is conflicting information about women with a history of estrogen-induced cancers or other risk factors related to estrogen. Some say that women with a history should avoid phytoestrogenic foods while others say consuming them in moderation is fine with no evidence to the contrary. The Oregon State University web article titled, Soy Isoflavones, states studies are mixed at the moment and more needs to be done to determine full risks. Some studies have shown a reduction in risk of breast cancer with isoflavone use and that a lifelong exposure to isoflavones may be needed to lower breast cancer risk later in life.(94) I am not encouraging or discouraging use for this particular population, just providing information. Remember soy contains high amounts of phytates and should be soaked and fermented prior to eating.(139) Miso, Natto and Tamari are good choices.(132) Red clover blossoms are a wonderful addition to my diet for this and I make infusions regularly.
Let food be thy medicine and medicine be thy food.
Hippocrates
Part 4 OSTEOPOROSIS: Finding More Answers-Eat Nutritious Food, will complete the OSTEOPOROSIS series and will provide more information on herbs and foods that contain nutrients that are believed to assist with bone health.
REFERENCES (available at the end of Part 4)
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