It is estimated that over 25 million people in the United States are affected by osteoporosis, or thinning of the bones. The condition increases the risk of bone fracture, especially in the elderly. In the US, some 40 per cent of women and 13 per cent of men may sustain a fracture after the age of 50. More than 1.3 million fractures annually are attributed to osteoporosis. Among them are some 500,000 vertebral or spine fractures, 250,000 hip fractures and 240,000 wrist fractures. Figures vary from country to country: reported incidences of hip fractures are highest in the US and Northern Europe, intermediate in Mediterranean and Asian countries, and lowest in South Africa. There are more fractures among city dwellers than among country folk. Over the past 40 or 50 years, the incidence of hip fractures has risen significantly worldwide.
Calcium, especially from milk products, has been universally recommended as the main element needed to reduce the risk of fractures. However, that may be the wrong approach: there are more fractures in regions that consume milk products (US, Great Britain, Canada, Northern Europe), than in those that don't (traditional Africa, China). The extensive Nurses Study at Harvard, which followed 78,000 nurses for more than 12 years, found that those who drink two or more glasses of milk per day have twice the risk of hip fracture as those who drink a glass a week or less. The authors of the study conclude that: "It is unlikely that high consumption of milk or other food sources of calcium during mid life will confer substantial protective effects against hip or forearm fractures" (Am J Public Health, 1997; 87: 992-7). There are several other large scale studies that show high calcium intakes double the risk of hip fracture (Am J Epidemiol, 1997; 145: 926-934; Int J Epidemiol, 1992; 21: 953-8). After all we've been told, how could this be?
The explanation is that most people including health professionals place too much emphasis on the role of calcium. Physiologically, bones are composed of calcium phosphate salts (65 per cent) for hardness, and collagen matrix (35 per cent) for flexibility. If a bone is placed in an acid bath and all the calcium is removed from it, leaving just the collagen matrix, when subjected to stress it will bend, not break. Conversely, if the collagen matrix is removed and all that remains are the calcium salts, when subjected to stress it will shatter. This is why excess calcium can indeed increase the risk of fracture! For good bone health, we need many other synergistic nutrients what Ann Louise Gittelman, author of Supernutrition for Menopause, calls "the bone building nutrient team": magnesium, phosphorus, boron, copper, manganese, zinc, plus the vitamins C, D, K, B6 and folic acid. In addition, we need sufficient amounts of protein for the collagen matrix, and healthful fats for vitamin D absorption and protection against bone destroying free radicals.
Here, then, is my dietary approach to good bone health: plenty of vegetables, especially leafy greens, certainly five to seven portions daily; cooking with stocks made with vegetables and a stick of kombu seaweed, or with fish, chicken or organic beef bones and a tablespoon of vinegar to liberate the minerals; sunflower and pumpkin seeds, for minerals and natural fats; modest amounts of whole grains for fibre and complex carbohydrates; beans and naturally raised animal foods for protein; butter, extra virgin olive, flaxseed and unrefined sesame oils for essential fatty acids.
Foods best avoided because they cause an acid condition that leaches minerals out of the bones include: refined sugars, honey and white flour. Based on epidemiology and the studies mentioned above, avoiding milk products may also prevent bone fractures!
For cases of osteoarthritis or pains and stiffness in the joints, many people have found help by avoiding the nightshade vegetables: potatoes, tomatoes, eggplant and peppers of all kinds (Norman Childers, Arthritis, The Nightshades and Ill Health, Florida: Horticultural Publications, 1995).
We also need 30 minutes or more of sunlight or at least daylight everyday, without sunscreen. A sunscreen SPF of 8 blocks 95 per cent of the production of vitamin D on the skin, and anything higher blocks it all; vitamin D is needed to absorb calcium from the intestines into the bloodstream (Nutr Act Health Lett, 1997; 24: 8). Last, but not least, walking and weight bearing exercise for at least 30 minutes every other day or more often are essential to keep the bones in good working order.
Annemarie Colbin, a certified health education specialist, and founder of the Natural Gourmet Cookery School, is the author of a number of books including Food and Healing and the soon to be released Food and our Bones (New York: Dutton/Plume, 1998).