Food and Exercise – The Prescription of Choice for Osteoporosis

A recent U.S. News & World Health Report stated 1 in 4 U.S. senior women aged 65 or older have a condition known as osteoporosis. Osteoporosis is the weakening of the bones, a condition that can increase one’s risk of bone fractures.

Growing Up With Dairy

Many of us have grown up drinking milk, eating cheese, and enjoying yogurt. We’re told at a young age that dairy products produce strong, healthy bones. From the milk mustaches donned by celebrities to the “happy cow” ads, it leaves no doubt in the minds of many Americans that dairy is key to avoiding brittle bones.

So why do 25% of elderly American women have osteoporosis?

Simply put, the dairy industry has purposely misled millions of Americans and others in Western cultures that dairy is good for your bones. Milk and other dairy products do not produce strong, healthy bones. They do just the opposite. They increase your risk of osteoporosis and brittle bones. This is what independent studies not paid for and published by the dairy industry state anyway.[1-4] Once again corporate profits are put before individual human health interests.

Treating Osteoporosis with Prescription Medications

In the United States, we are quick to resort to prescription medications to treat our health problems. Osteoporosis is no stranger to this approach.

One of the most common classes of medications used to treat osteoporosis is the bisphosphonate class. These drugs (Fosamax, Boniva, Reclast, Actonel, etc.) work by reducing the breakdown of bone. Hence, the reason for them improving bone mineral density scores.

However, bisphosphonates do not increase the building of new bone tissue. This can be a problem because our bones rely on the process of breaking down old worn out bone and replacing it with newly formed, healthy bone to keep our bodies strong and robust.

The bisphosphonates actually do a poor job of reducing bone fracture risk. Looking at the data, postmenopausal women who’ve never had a prior fracture before receive no benefit from using these medications. That’s right, a 0% success rate in preventing fractures. The story is only slightly better in postmenopausal women who have had a prior fracture, or who have a low bone mineral density score. The bisphosphonates reduce the risk of hip fracture by 1% and vertebral fracture by 5% after taking them for a period of three years in these women.

I think it’s also important to point out that bisphosphonates can increase the risk of stress fractures in patients using them.[5] They can also cause severe gastrointestinal distress, even having the potential to cause ulcers in some patients taking them. So, if you’re going to use these drugs be aware of both the benefits and risks before doing so, and have a conversation with your doctor or pharmacist prior to taking them.

Plant-Based Foods and Exercise for Osteoporosis

Preventing and treating osteoporosis should start with the basics—eating the right foods and exercising. An alkaline-based diet (i.e. whole foods, plant-based diet) and weight-bearing exercises can do wonders in helping to avoiding osteoporosis.[3,6] 

Plant proteins are protective against osteoporosis. Animal proteins are not, and accomplish just the opposite. By filling your plate full of fruits, vegetables, and legumes you’re doing your bones a favor in giving them the nutrients they need to perform at their best without compromising their integrity. There’s no need to worry about getting enough calcium on a plant-based diet. Dark leafy greens, green vegetables, and a variety of beans help you meet your daily requirements of calcium. You can read more about this in my article, The Calcium Myth – More is Not Better.

Exercise is also key to improving bone health. In fact, I would put this front and center in your game plan to improve your bone mineral density scores. Of course, first check with your physician to make sure you are cleared to start an exercise program. When you get the all clear then start one right away before you put it on the backburner.

Weight-bearing exercise (i.e. resistance training), in particular, is the best for improving bone mineral density scores. It helps you strengthen and tone your muscles to properly support your skeletal structure. By doing this, you can avoid falls, one of the biggest reasons for broken bones in the first place.

Resistance training includes lifting weights, performing lunges, doing pushups, and using resistance bands. Incorporate these exercises into your routine at least three days a week.

By getting back to the basics you should not only see your bone and skeletal health improve, but also your overall health as well.

Best of luck to you!
Dustin Rudolph, PharmD

1 Feskanich D, Willett WC, Colditz GA. Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr. 2003;77:504–511.
2 Fujita T, Fukase M. Comparison of osteoporosis and calcium intake between Japan and the United States. Proc Soc Exp Biol Med. 1992 Jun;200(2):149-52.
3 Frassetto LA, et al. Worldwide incidence of hip fracture in elderly women: relation to consumption of animal and vegetable foods. J Gerontol A Biol Sci Med Sci. 2000 Oct; 55(10):M585-92.
4 Abelow B, et al. Cross-cultural association between dietary animal protein and hip fracture: a hypothesis. Calcific Tissue Int. 1992; 50:14-8.
5 Schilcher J, Koeppen V, Aspenberg P, Michaëlsson K. Risk of atypical femoral fracture during and after bisphosphonate use: Full report of a nationwide study. Acta Orthopaedica. 2015;86(1):100-107.
6 Shanb AA, Youssef EF. The impact of adding weight-bearing exercise versus nonweight bearing programs to the medical treatment of elderly patients with osteoporosis. J Family Community Med. 2014 Sep;21(3):176-81.

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