Bottom Line Health
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| Soy has been promoted for bone strength on the mistaken premise that Asian women have less incidence of osteoporosis than American women. Not true. While their rate of hip fractures is lower than in the US, the Japanese have twice the rate of vertebral fractures. The difference in hip fractures is probably due to a difference in anatomy, which makes the hip less likely to break on impact.
Other evidence suggests that isoflavones do promote bone strength. |
J. Douglas Bremner
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 The body is in effect responding to the message that more bone strength is needed, much as it does when it increases muscle mass and tone with exercise. And the good news is that it builds up bone strength more effectively than bisphosphonates. Rather than randomly laying down calcium in parts of the bone that may not greatly enhance the strength of the bone, as bisphosphonates do, this type of exercise results in a laying down of calcium in the parts of the bone that matter. And what's more, the effects don't wear off after five years. |
Bill Sardi
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 Flax lignans and bone strength
Another compelling potential health benefit from flaxseed is its ability to help maintain bone strength. Women with osteoporosis excrete less enterolactone, the primary estrogen molecule in flaxseed, meaning their dietary consumption of lignans is low. [Clin Endocrinol 56: 321-28, 2002] Flaxseed and flaxseed oil, along with fish oils, inhibit the production of chemicals that lead to loss of bone density. |
Thomson Healthcare, Inc.
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 Calcium supplementation was also associated with greater bone strength (Prince et al 2006). Another 5-year study in a similar number of postmenopausal women found that 1 g/day of calcium citrate taken for 5 years led to significant positive effects on bone density, including a sustained reduction in bone loss and turnover and cumulative benefits to the proximal femur. The effect on fracture risk was less certain, since fractures still occurred in both groups. |
Dr. Steve Blake
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 Calcium and Osteoporosis
Osteoporosis is a disease that involves loss of bone strength leading to an increased risk of fracture. It is well known to occur in postmenopausal women, but can also be present in other populations. Osteoporosis afflicts 25 million people in the United States, but there are no symptoms unless a bone is broken. Hip fracture in an older person is something to be avoided as it makes movement difficult and can be slow to heal. Postmenopausal bone loss is mostly due to increases in bone loss, which are more important than decreases in bone formation. |
| These proteins are vital for blood coagulation and bone strength.
Blood must flow freely and not clot unless there is a break in a blood vessel. Clotting is normally triggered by a rough edge in a blood vessel, such as a cut artery. The liver synthesizes several proteins important in blood clotting including prothrombin and fibrinogen. These two proteins circulate in blood. One of the first steps in blood clotting is triggered by the formation of thrombin from prothrombin, as seen in Figure 6-1. |
| Appendix F: Osteoporosis
Osteoporosis is a disease that involves loss of bone strength leading to an increased risk of fracture. Osteoporosis afflicts 25 million people in the United States. Women are six times more likely to have osteoporosis than men. There are no symptoms unless a bone is broken.
Osteoporosis is a long-term chronic disease that normally takes decades to develop. Proper nutrition is one of the important factors in preventing osteoporosis. Supplemental calcium cannot prevent or heal osteoporosis by itself. |
Jonny Bowden, Ph.D., C.N.S.
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 We now know that it's essential for bone strength. Sex hormones are made from the stuff. Populations that don't get much sunlight are at greater risk for multiple sclerosis. And now new research is pointing to the fact that physical performance— especially in older folks—is significantly affected by their vitamin D status. This might not be much of a problem except for the fact that more than 25 percent of the population—probably more—is vitamin D deficient.
Let me explain. As of this writing the recommended daily allowance for vitamin D is 400 IU. |
Tori Hudson, N.D.
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 Once osteoporosis has been diagnosed, many of the natural interventions such as diet, exercise, nutritional supplementation, and herbal medicines could be used aggressively in milder cases to slow bone loss and possibly improve bone density, bone strength, bone architecture, and bone health in general. In general, it is my position that in cases of diagnosed osteoporosis, natural intervention should be used to supplement an antire-sorptive therapy intended to stop or slow the rate of bone loss and reduce the rate of fractures. |
| These definitions are useful because they provide objective criteria, but they have limitations because they ignore the importance of other determinants of bone strength. The definitions also ignore other risk factors for fractures in elderly women such as a maternal history of hip fracture, age, and poor balance. For example, most postmenopausal women with fractures do not have a bone density score that meets the WHO osteoporosis criteria. |
| Most of the research and focus on osteoporosis has been around the loss of calcium from bone before and during osteoporosis, reduced bone strength, and increased risk of fractures. What has received less attention is that osteoporosis may be a marker for other serious potential health problems apart from fractures. Not only must we consider demineralization of bone, but ectopic calcification and the possible connection between ectopic calcium deposits, particularly in the arteries and kidneys, and bone decalcification. |
| Also in time, research on natural medicines can be expanded to include the role of nutrients not only in bone density, but in bone strength and bone architecture. Some of these areas could be the use of significantly higher doses of vitamin D, as well as red clover isoflavones, soy isoflavones, manganese, boron, fish oils, and more. In this way, natural therapies could play an increasingly important role in slowing bone loss and reducing fracture rates.
SEEING A LICENSED PRIMARY HEALTH-CARE PRACTITIONER
(N.D., M.D., D.O., N.P., P.A. |
Jonny Bowden, Ph.D., C.N.S.
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| In animal studies, magnesium deficiency causes decreased bone strength and volume, poor bone development, and dysfunctions in bone formation and resorp- m tion (the process by which bone cells break !J] down bone and release minerals like calcium l! into the blood). [>
Magnesium supplements are more impor- ? tant than calcium in reversing bone loss in post- c
70 menopausal women, one of the most vulnerable m populations for osteoporosis, according to a May 1990 report in the Journal of Reproductive Medicine. |
Mehmet C. Oz., M.D. and Michael F. Roizen, M.D.
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 In Favor: Besides improvements in the areas most associated with testosterone (libido, muscle mass, bone strength), testosterone therapy has been shown to decrease levels of lousy LDL cholesterol and improve insulin sensitivity, so your chance of suffering diabetes decreases.
The Knock? The main criticism of testosterone therapy has been its reported links to prostate cancer. |
| Vegetarian protein, interestingly, negatively affects bone strength. All high-protein meals tend to increase the removal of calcium from bones, underscoring the importance of supplementing with calcium whether you get your protein from turkey or tofu. Another big calcium buster: salt. Sodium influences calcium balance by increasing its excretion.
YOU Tip: Know Whaf s Bad to the Bone. Sledgehammers aren't your only skeletal enemies. The others: excessive alcohol, cigarettes, and vitamin A. Having more than 2,500 milligrams of vitamin A in supplements a day could hurt bone formation. |
| It's true that soy products do contain more than fifty estrogenlike substances (phytoestrogens) that can influence the three estrogen receptors for uterine and breast health, bone strength, and artery stabilization. So it would seem to make sense: Pop a few more hunks of tofu, and you can turn back hormonal time. But here's the deal: Soy is as unpredictable as a morning DJ's mouth. |
| And +r>o women who took estrogen also had higher prtT fgooo1) cholesterol, increased bone strength, and substantially decreased menopausal symptoms. Hot flashes, mood swings, and insomnia practically disappeared.
These early studies made es^ogen seem truly beneficial, but with time, women on estrogen replacement also suffered a buildup of uterine tissue that led to an increase in viterine cancer, as well as a proliferation of breast tissue, associated with an inrrea^e in breast cancer. |
| But when the dust settles in twenty or so years, we believe that women who use HT (in the form of bioidentical estrogen and micronized progestin) along with aspirin to reduce clotting risks will experience a prolonged higher quality of life, including a decrease in heart disease, arterial aging, and memory loss, and an increase in bone strength. The downside: We'll see a slight increase in breast cancer. (That's because estrogen helps estrogen-sensitive breast tissue grow. |
| Because peak bone mass is reached in your twenties, your calcium bank needs to be filled in your youth to ensure maximum bone strength and mass (and prevent fractures, especially if you plan on extending your warranty past menopause and andropause). Since genetics drives a lot of osteoporosis, the entire family can play the bone-building game. It's never too early to start. The ideal high-calcium diet sources are fortified low-fat yogurt or milk, soy milk, pink wild salmon (215 milligrams per 4 ounces), kale, spinach (180 milligrams per cup), and tofu (155 milligrams per cube). |
Marshall Editions
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 Ipriflavone has been shown to help bone strength when combined with calcium and vitamin D. Take 600 mg a day with food. Take 250-350 mg of magnesium twice a day as it is required for proper calcium metabolism. Fish oils can also improve calcium absorption and deposition into bones when taken at 4 g a day. Boron is a mineral that activates vitamin D and supports estrogen levels of effective calcium metabolism. Take 3-5 mg daily. Vitamin C, among its many other healthy functions, synthesizes collagen, an important component of bone. |
Bottom Line Health
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| Other evidence suggests that isoflavones do promote bone strength. The US Department of Agriculture (USDA) and the National Institutes of Health (NIH) are currently allotting significant resources—approximately $10 million—for studies to determine whether isoflavones play a role in bone health.
•Breast cancer. Asian studies indicate that women who eat soy foods three or more times weekly have a reduced risk of breast cancer.
However, some researchers believe that soy may raise the risk of breast cancer. Most breast tumors are stimulated by estrogen. |
Tori Hudson, N.D.
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| The role of essential fatty acids has largely been ignored in relation to osteoporosis despite animal and human studies indicating that EFAs enhance calcium absorption, enhance the effects of vitamin D, reduce urinary calcium excretion, increase bone calcium, reduce ectopic calcification elsewhere, and increase bone protein synthesis and bone strength.
The first published paper that clearly described the relevance of EFAs on calcium showed that in EFA-deficient animals, the kidneys became highly calcified, apparently because of a shift of calcium from the bones. |
Ann M. Coulston and Carol J. Boushey
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 The increased incidence in fracture with excessive body weight in children has been hypothesized to occur because of greater force being placed on bones such as the radius during falls, lower bone mass and bone strength with increasing body fat even when adjusted for total body weight, and impaired mobility [21, 23-28]. Changes in bone geometry that accompany increases in bone size throughout childhood include increases in cortical thickness and bone diameter [29]. Bone diameter and cortical thickness are less in children with excess body fat [28]. |
| Several diverse qualitative characteristics have been described that directly influence bone strength. The more important factors, bone geometry, microarchitectural integrity, mineralization state, and remodeling rate, are briefly considered here. For more detailed information, the reader may consult Seeman and Delmas [65]. The first factor is overall bone geometry. A bone of greater diameter is better able to withstand either a compressive or a bending force than a smaller bone. |
Ann N. Martin
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 He cites one experiment where "18 dogs were killed so their bones could be harvested for research on bone strength."13
The Executive Director of API, Alan Berger, has lobbied for the pet food industry to adopt stringent guidelines for future research in order to prevent the needless suffering of animals. "While such guidelines would not be necessarily binding to manufacturers, they would set a reasonable standard for ethical, humane research and hopefully put an end to what can only be considered a disgraceful contradiction," stated Berger. |
Elaine Magee
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 Calcium is a key mineral that helps regulate blood pressure and boost bone strength, and protein is the building block for many enzymes and hormones, as well as muscle tissue, in the body. Unfortunately, ice cream falls a bit short on these two nutrients, but low-fat milk, yogurt, cottage cheese, and reduced-fat cheese pack a protein-and-calcium punch in every serving. Just a cup of fat-free yogurt, for example, gets you a third of the way to your daily recommended calcium intake, along with adding 17 percent of your estimated daily protein. |
J. Douglas Bremner
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| The best predictor of bone strength in later life is bone buildup in childhood; therefore, these depot forms of contraceptive are not recommended for adolescents. Other serious but uncommon side effects are liver damage and allergic reactions.
Progestasert is a long-acting intrauterine device that releases progesterone that is inserted in the uterus and provides one year of contraceptive protection. Mirena is another intrauterine device that releases levonorg-estrel for up to five years. These devices are 97% to 98% effective in preventing pregnancy. |
| And the good news is that it builds up bone strength more effectively than bisphosphonates. Rather than randomly laying down calcium in parts of the bone that may not greatly enhance the strength of the bone, as bisphosphonates do, this type of exercise results in a laying down of calcium in the parts of the bone that matter. And what's more, the effects don't wear off after five years.
While good for your cardiovascular system and overall health, aerobic exercises such as biking and swimming do not strengthen the bones. |
Ann M. Coulston and Carol J. Boushey
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| Acquiring Peak Bone Mass and bone strength 833
III. Skeletal Fragility in Children 835
IV. Nutrition and Development of Peak Bone Mass 837
V. Conclusion 847 References 847
I. INTRODUCTION
The risk of developing osteoporosis is largely determined by the mass and size of bone acquired by adulthood known as peak bone mass [1]. The greater the skeletal mass at its peak and the stronger the geometry, the greater the amount of loss that can occur before entering the fracture risk zone. An interplay between heritable factors and environmental factors determine peak bone mass (Figure 1). |
J. Douglas Bremner
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| University of Washington and a specialist in the area of bone physiology and osteoporosis, wrote a letter to the Journal of Clinical Endocrinology & Metabolism in which she said, "There is no doubt that alendronate increases bone strength and decreases fracture rate during the first four years of use, but after that the profound suppression of the bone formation rate may begin to have a negative effect." In other words, after five years they seem to stop working. How could this be?
Again, bisphosphonates act by inhibiting osteoclasts, the cells that break down bone. |
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