Osteoporosis is an extremely costly condition; the expense for treating osteoporosis-induced fractures reaches about $38 million per day.1 Consider this in light of the fact that calcium fortification and supplementation is at a premium. One day of shopping at Sam’s Club, as an example, leads to the realization that countless bottles of calcium are sold on a monthly basis.
What does the literature tell us regarding calcium consumption and the reduction of osteoporosis and related fractures? In short, the data demonstrates that less bone fractures occur in populations wherein women consume less calcium than females in United States.2 In other words, in spite of the modest consumption of calcium that is supported by considerable supplementation of calcium…fracture rates are higher compared with populations that ingest less calcium. While the details of this relationship are very involved and not fully understood, an emerging trend is appearing that needs to be examined more closely.
In the past, I have written columns about the importance of omega-3 (n3) fatty acids for reducing inflammation, pain, and chronic diseases like cancer, heart disease, and Alzheimer’s.3 As it turns out, n3 fatty acids can help to prevent and reduce bone loss.
Osteoporosis is a chronic inflammatory condition
It may seem a bit surprising that osteoporosis is described herein as an inflammatory condition. We typically think of inflammation in the context of our education from texts like Guyton’s Physiology and Robbins’s Pathology. The impression we get from these books is that inflammation is a frank, obvious presentation…obvious pain, swelling, and fever as an example. Well, this is not the whole story about inflammation.
Consider that heart disease, cancer and other degenerative diseases are known to be driven by chronic inflammation. I reviewed this literature in a recent article.3 As it turns out, subclinical chronic inflammation develops and persists without our awareness, and manifests clinically when sufficient fibro-proliferative changes have occurred, i.e., when a lump is found during breast exam or a heart attack occurs due to atherosclerotic plaguing. Similarly, women develop osteoporosis without symptoms; they find out about it when they fracture, or when they get X-rays in a chiropractic office, or when they have a bone density test. What women do not find out is that a subclinical chronic inflammatory state helps to drive osteoporosis in an asymptomatic fashion.
The emerging literature points to bone loss and osteoporosis being promoted by a dietary excess of omega-6 fatty acids and a deficiency of omega-3 fatty acids, which creates a subclinical chronic condition. Bruce Watkins at Purdue University is leading the research movement in this important area.4-7 For those interested, you can go to www.pubmed.gov and down load PDF files of references 6 and 7, which are excellent review articles. In brief, a diet rich in n6 fatty acids (from grains, seed oils, grain-fed animal products and eggs) stimulate osteoclasts and inhibit osteoblasts, the outcome being bone loss.
Grains may be the biggest culprit behind the insidious development of osteoporosis. While grains are not high-fat foods, their ratios of n6:n3 average about 20:1; below 4:1 is considered to be the healthy ratio. Grains are also acidic, and tissue acidity drives osteoclast activity and inhibits osteoblast activity, just like n6 fatty acids. Grains also contain phytates that bind calcium and reduce its absorption. Not surprisingly, whenever grains have become a staple food in a population’s diet, there is an increased incidence of osteomalacia, rickets and osteoporosis.8
What should yo do to help protect your patients’ bones?
Significantly reduce or eliminate grain consumption. Increase fruit and vegetable consumption, to take the place of grain reduction. Fruits and veggies have n6:n3 ratios that are 3:1 or better and they promote tissue alkalinity. Try to eat fresh fish and grass fed animal products. A visit to www.eatwild.com will allow patients to find a number of grass fed farms to choose from. Eating n3 eggs is very easy to do, as numerous eggs are available; I buy them at Super Walmart and Publix.
Particularly, supplements are omega-3 fatty acids. EPA/DHA is the supplement of choice and it is found in fish oil. In addition to the dietary focus mentioned above, I would also suggest supplementing with 1-2 grams per day of EPA/DHA. Calcium is also important; however, it should not be thought of as more important than magnesium. Magnesium supplementation has been effective in improving bone formation. When it comes to supplements, I suggest providing a 1:1 ratio of magnesium and calcium. This means up to 1000-1500 mg of magnesium per day to match the calcium. Calcium in the form of hydroxyapatite is thought to be superior for osteoporotic patients. Also, do not forget to provide a multivitamin/mineral, as all cells, including bone cells, need an appropriate nutrient supply.
These suggestions are simple to follow and will help to provide an environment that is healthy and supportive for boney tissue. Patients should not find this too challenging. TAC
Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession. He is on the faculty of Palmer College of Chiropractic Florida and on the postgraduate faculties of several other chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient. Dr. Seaman believes that chiropractors should be thinking like chiropractors, while providing nutritional recommendations. Doctors and patients who follow his programs report improved feelings of well-being, weight loss, dramatic increases in energy, and significant pain reduction. Dr. Seaman can be reached by e-mail at [email protected].
References:
1. Siris ES, Miller PD, Barrett-Connor E, et al. Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women. Results from the national osteoporosis risk assessment. J Am Med Assoc 2001;286:2815-2822
2. Hegsted DM. Fractures, calcium and the modern diet. Am J Clin Nutr 2001; 74:571-73
3. Seaman DR. The diet-induced proinflammatory state: a cause of chronic pain and other degenerative diseases? J Manipulative Physiol Ther. 2002;25(3):168-79
4. Watkins BA, Lippman HE, Le Bouteiller L, Li Y, Seifert MF. Bioactive fatty acids: role in bone biology and bone cell function. Prog Lip Res 2001; 40:125-48
5. Reinwald S, Li Y, Moriguchi T, Salem N Jr, Watkins BA. Repletion with (n-3) fatty acids reverses bone structural deficits in (n-3)-deficient rats. J Nutr. 2004; 134:388-94
6. Watkins BA, Li Y, Seifert MF. Nutraceutical fatty acids as biochemical and molecular modulators of skeletal biology. J Am Coll Nutr. 2001; 20(5 Suppl):410S-416S
7. Watkins BA, Li Y, Lippman HE, Seifert MF. Omega-3 polyunsaturated fatty acids and skeletal health. Exp Biol Med. 2001; 226(6):485-97
8. Cordain L. Cereal grains: humanity’s double edge sword. World Rev Nutr Diet 1999; 84:19-73.