Osteoporosis & Nutrition

by Zoltan P. Rona, M.D., M.Sc.

Osteoporosis is a major health problem. About one-third of all North American women suffer from this bone demineralization condition which may ultimately result in fractures. The most frequently affected sites include the hips, vertebrae and wrists. Bone mass begins to decline after age 35 reaching its peak around the time of menopause. Bone demineralization thereafter continues at a slower rate.

The medical approach to osteoporosis treatment and prevention these days centres around estrogen, pep talks about gobbling up more diary products, Tums and prescriptions for calcium. Fluoride supplementation, although unproven and potentially toxic, is still popular in some medical circles as is megadosing with vitamin D. Despite conventional therapy and edits by dietitians and the Dairy Bureau, fractures and bone loss still occur at an alarming rate. Should we be looking into some other areas for prevention and treatment?

Natural progesterone may be more important for osteoporosis prevention and treatment than estrogen. Dr. John Lee has found the use of a natural progesterone cream applied directly on the skin will prevent bone loss even without the addition of estrogen. Natural progesterone cream is derived partially from an extract of wild yams and has no toxic effects. Better still, you do not need a doctor's prescription for it since it is available at most health food stores just for the asking.

Risk factors for the development of osteoporosis are:

- cigarette smoking

- excessive alcohol and caffeine intake

- high protein diets (encourage high mineral losses in the urine)

- low calorie weight loss diets ("Stop the insanity")

- high milk and dairy product consumption (see Diet For A New America)

- drinking exclusively distilled water (my own observation)

- having a fair complexion

- physical inactivity

- excessive physical exercise

- weightlessness for extended periods of time (avoid space shuttle trips)

- having had the ovaries removed or other causes of early menopause

- a positive family history of osteoporosis

- never having been pregnant

- diuretics (water pills)

- anti-seizure medications

- anticoagulants ("Mood thinners") antacid abuse, anti-ulcer drugs

- digestive disorders leading to trace mineral malabsorption

- overactive endocrine glands (especially hyperthyroidism)

- long term use of prescription steroids like prednisone

- numerous vitamin and mineral deficiencies

Vitamin D is required to absorb calcium from the small intestine. Deficiency can come about when there is reduced exposure to sunlight, decreased dietary intake or a malabsorption problem of one kind or another. Excess vitamin D can lead to the break down of bone but is rarely seen even in elderly patients prescribed 50,000 per month. Taking one halibut liver oil capsule daily (400 I.U. of vitamin D) is sufficient for prevention in most people with good intestinal function. It certainly can cause no harm.

Studies show that many other nutrients are involved in osteoporosis development. Bone is, after all, active, living tissue continuously forming and being broken down. It is not just an inanimate collection of calcium crystals. As with all our body tissues, hone is sensitive to diet and lifestyle habits. The typical Western diet high in refined carbohydrates, animal protein and fat, canned and processed foods has been linked to a greater incidence of osteoporosis simply because such a diet is inadequate in a large number of nutrients. It is also excessively high in phosphorus, a mineral that, in large amounts, antagonizes calcium in the body. Interestingly enough, the foods most often recommended for healthy bones, milk and dairy products, are excessively high in phosphorus and may actually promote osteoporosis. I strongly recommend avoidance of all animal proteins including eggs and dairy products. Statistics world wide support vegan diets as optimal for osteoporosis prevention and treatment. A good example of a vegan diet is the McDougall Plan.

The protein matrix upon which calcium crystallizes is called osteocalcin. Studies show that vitamin K is required by the body to make osteocalcin. Several other vitamins arc important for hone health. These include vitamin A, folic acid, vitamin B6, vitamin B12 and vitamin C. A lack of these vitamins increases osteoporosis severity because they are required in numerous biochemical reactions in hone (connective) tissue. The same can he said for minerals such as magnesium, manganese, boron, strontium, silicon, zinc and copper. Silicon, for example, is found in high concentrations in growing bone. It strengthens connective tissue and may he crucial in osteoporosis prevention.

Boron supplementation raises serum estrogen levels. One study demonstrated that boron supplementation produced estrogen blood levels identical to estrogen treated women whose diets were not supplemented with boron. Boron supplementation does not pose the same cancer-causing risks as synthetic estrogen replacement therapy (e.g. uterine or breast cancer). It is non-toxic. Unfortunately, many people are deficient in this mineral simply because of poor soil quality. Consider panax ginseng as another source of naturally occurring estrogen (estriol). Not only does ginseng help control hot flashes, it may he a very valuable adjunct to the prevention and treatment of osteoporosis.

Women all have different needs for these nutrients in order to prevent osteoporosis. It depends on your unique biochemical make-up, your activity and stress levels. Focusing only on calcium, milk, vitamin D and estrogen therapy is not enough.

To find out whether or not you have a problem with osteoporosis, ask your family doctor to order bone density studies on you. This is a non-invasive test covered by Medicare in most provinces similar to an x-ray but far more specific in being able to tell you whether or not osteoporosis is an issue in your health. Without such a test you really have no way of knowing where you stand and how far you have to go with diet and lifestyle changes. Also, consider getting blood, urine and hair mineral analysis done to determine your body's current mineral levels.


Lee, John. Osteoporosis reversal. the role of progesterone. Intern. Clin. Nutr. Rev: 384-391, 1990.

Lee, John. Osteoporosis reversal with transdermal progesterone. Lancet Vol. 336, p. 1327; Nov. 24, 1990.

McDougall, John A. and McDougall. Mary A. The McDougall Plan. New Jersey: New century Publishers, Inc. 1983.

McDougall. John A. McDougall's Medicine. A Challenging Second Opinion. New Jersey: New century Publishers, Inc. 1985.

Robbins, John. Diet for a New America, Walpole, New Hampshire: Still porn t. 1987.

Robbins, John. May All Be Fed. Diet for a New World, New York: William Morrow and Company, Inc., 1992.

Rona, Zoltan P. The Joy of Health. A Doctor's Guide to Nutrition and Alternative Medicine. Hounslow Press: Toronto, Canada. 1991.

Solomons, N.W. and Rosenberg, I.H. Absorption and malabsorption of mineral nutrients, Current Topics in Nutrition and Disease, New York: Alan R. Liss, 1984.

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