Health Care For Our Bones: A Practical Nutritional Approach to Preventing Osteoporosis

Abstract

When patients and doctors think of osteoporosis, calcium immediately comes to mind. bBones contain calcium, and, therefore, take calcium to protect your bones,Q is the battle cry that we hear most often from doctors, government agencies, and media sources. This commentary will provide a story of osteoporosis beyond calcium, which is one that practitioners and researchers need to consider when treating or investigating this pervasive condition. The cost of managing osteoporotic fractures alone exceeds $14 billion per year, 1 or about $38 million per day. The extent of the osteoporotic problem becomes obvious when we consider the results of a recent study on bone mineral density (BMD), which is considered the single best predictor of fracture risk in asymptomatic postmenopausal women. Almost half of the 200,160 participants without known osteoporosis had low BMD, including approximately 7% who had osteoporosis. These results are consistent with the 50% to 68% estimated national prevalence of low-hip BMD observed among women aged 50 years or older. 1 Clearly, low BMD, osteoporosis, and related fractures are a national epidemic. Despite the availability of densitometry, osteoporosis often remains undiagnosed until a fracture occurs, which is a great concern because the size of the population aged 50 years or older will increase during the next several decades. Thus, the direct and indirect costs of fractures are expected to increase correspondingly. 1 In this commentary, I consider important nutritional issues that profoundly impact bone health. Although calcium is important, it appears to be no more important than other key nutrients, such as magnesium and omega-3 fatty acids and specific food sources in our diet. It might be that calcium supplementation is overemphasized such that supplementing with calcium creates a false sense of security in women who believe that calcium will protect their bones. Consider that less bone fractures occur in other populations wherein women consume less calcium compared with women in the United States. 2 Clearly, there is more to nutritional modulation of osteoporosis than mere calcium supplementation. Much of this information is not common knowledge among practitioners or the general population, which is most likely caused by the overemphasis on calcium above all other nutritional considerations for osteoporosis. The purpose of this commentary is to provide clinically useful information that is based on basic science, epidemiologic studies, and clinical trials.