Lifestyle Medicine Solutions 37 Osteoporosis Building Better Bones 2 of 3

REVIEW: In our last health column we defined osteoporosis, discussed its risk factors and offered several treatments, such as Estrogen Therapy, Vitamin D, Calcium, and Exercise.  Treatments Continued: 1. No more smoking. If you smoke, stop! It will do your bones a big favor. 2. Reduce the amount of animal protein, salt, and caffeine in the diet. Osteoporosis appears to be a disease of affluence and excess, rather than one of deficiency. Osteoporosis is a rather complex disease largely related to our dietary lifestyle. The Standard American Diet (SAD), high in animal protein, salt, phosphorus (meat, certain soft drinks), and caffeine causes calcium to be leached from the bones (as a result of metabolic acidosis) and excreted in the urine. These lifestyle-induced calcium losses seem to override any amount of calcium consumed or swallowed. What’s the evidence for this connection? Eskimos consume diets extremely high in both protein (250 to 400 grams/day) and calcium (1,500 to 2,500 mg/day). In spite of their high calcium intake and the very active lives they lead they have one of the highest rates of osteoporosis in the world. The Bantu tribes in Africa, on the other hand, consume an average of 47 gm of protein and less than 400 mg of calcium a day, predominantly from plant foods. Yet, even though Bantu women bear an average of 10 children, which makes special demands on calcium reserves, they are essentially free of osteoporosis. In contrast, relatives of the Bantu who have migrated to South Africa or the United States and adopted the richer Western dietary lifestyle eventually experience a rate of osteoporosis comparable to that of the rest of the host country's population. Protein is an essential component of a healthy diet. But when we eat too much of it—especially animal protein—then it can be harmful. How about prevention? Many populations around the world average less than 500 mg of calcium a day without any evidence of osteoporosis. It’s strangely paradoxical that osteoporosis has become epidemic in the United States, where the consumption of calcium-rich dairy products and calcium supplements is the highest in the world. Most Americans eat twice as much protein than they need. Reducing protein intake to the Recommended Daily Intake (RDI) of 50 to 60 grams a day along with daily active exercise and a healthful diet low in salt, phosphorus, and caffeine, holds promise of turning the tide in the battle against brittle bones.