A review published in a recent issue of the journal Nutrients concludes that calcium and vitamin D supplements should be tried before resorting to bone building drugs to help maintain normal bone density.
For their review, Karen Plawecki and Karen Chapman-Novakofski of the University of Illinois at Urbana-Champaign selected 62 human studies conducted over the past decade that evaluated the impact on bone health of calcium and vitamin D from food, calcium and vitamin D from supplements, other bone health-related nutrients (including protein, sodium, soy and vitamin K), and portfolio diets, such as the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets, which provide a number of nutrients. The researchers confirmed a benefit for supplements, food-based interventions and educational strategies on bone health. The findings suggest nutrition therapies as first-line treatments for postmenopausal women and others at risk of osteoporosis, particularly in light of the side effects associated with pharmaceutical agents used to treat the condition.
"For many people, prescription bone-building medicines should be a last resort," stated Dr Chapman-Novakofski, who is a professor of nutrition at the University of Illinois. "Bisphosphonates, for instance, disrupt normal bone remodeling by shutting down the osteoclasts—the cells that break down old bone to make new bone. When that happens, new bone is built on top of old bone. Yes, your bone density is higher, but the bone's not always structurally sound . . . Although the test reports that you're fine or doing better, you may still be at risk for a fracture."
"I suspect that many doctors reach for their prescription pads because they believe it's unlikely that people will change their diets," she remarked.
Concerning the effect of nutrients other than calcium and vitamin D were examined in this review, Dr Plawecki observed that "Following a low-sodium diet does seem to have a positive effect on bone density."
"Some people have the habit of adding a generous sprinkle of salt to most foods before eating, but there's more involved here than learning not to do that," she noted. "You have to choose different foods."
Dr Plawecki, who is the director of the University of Illinois' dietetics program, recommends adopting a portfolio diet that provides numerous beneficial nutrients, including high amounts of magnesium and potassium in addition to calcium. Additionally, Drs Plawecki and Chapman-Novakofski stress that increased physical activity is needed to help maintain bone and muscle strength, as well as balance and flexibility.