Osteoporosis has made its way to the forefront as a growing concern for aging adults, mostly women, in the United States. In 2004, it was reported that over 10 million individuals in the U.S. have osteoporosis in the hip with 3 times as many having low bone mass. Osteoporosis is considered the leading cause of fractures, especially in the elderly. (Office of the Surgeon General, 2004) Bone breakdown and rebuilding is a normal physiological process in the body, It is said that an adult human replaces their bones completely in about 10 years. But when the amount of bone being broken down begins to outnumber the amount of bone being built, “the bones’ protein structure and mineral content is diminished.” (Colbin, 2009) Considering that the bones are a storage facility for minerals such as calcium, magnesium, sodium, and phosphorus, it is essential that these minerals can be released through the bone remodeling process to be used in the body as needed. Calcium as long been viewed as the leading nutrient in regards to bone health. We teach our kids at a young age that milk “does a body good” as it is filled with calcium to make your bones strong; we have post-menopausal women taking calcium supplements to counteract the low estrogen levels. But calcium, although an important player, is not the only nutrient in the game. Phosphorus, Vitamin A, Protein, Vitamin D and C, Vitamin K, Magnesium, healthy fats, hormones, hydration, exercise, and stress levels all make an impact in bone the strength, density, and formation and resorption of bone in the body (Colbin, 2009)
Magnesium, is the fourth most abundant mineral found in the human body, and plays a role in over 300 metabolic processes. Of the Magnesium stored in the body, about half resides in the bone. (Volpe, 2013) Besides use in protein synthesis, energy production, nerve and muscle function, blood pressure, insulin and glucose metabolism, Magnesium is also crucial to bone integrity. (Volpe, 2013) It has been estimated that almost 80% of Americans are deficient in this important mineral. (Mercola, 2014) In particular, those with diagnosed osteoporosis show low levels of Magnesium in the body. As calcium comes into the body, Magnesium helps work as the gatekeeper to absorb and make use of the calcium in the proper channels. Magnesium helps prevent excess calcium from entering the cells, which can be dangerous and contribute to the formation of kidney stones, chest pain, arrhythmias, calcium deposits, gallstones or even hypertension. Magnesium also plays a role in osteoclast proliferation, which are the cells responsible for bone rebuilding and in the synthesis of collagen which helps form the structure of bone. (Zheng et al, 2014) When there is an abundance of calcium coming in versus magnesium, it furthers the problem of magnesium deficiency, creates less osteoclasts which are needed to form bone and calcium builds up in the body causing many of the issues listed above. (Colbin, 2009) (Lam, 2016) (Baaij et al., 2015) Bones made without enough Magnesium have hydroxyapatite crystals that are larger making the bones more brittle and increases risk of fracture. Various studies on patients with osteoporosis show improvements in bone mineral density when magnesium is added to their protocol(s). (Baaji et al., 2015)
We know that the human body is complicated and is a collection of relationships between parts working together synergistically. Although conventional and Western approaches to bone health include large amounts of calcium, one must understand that calcium is not used in isolation in the body- in a vacuum. As all relationships go, as one change is made, it has an effect on another. The balance of calcium and magnesium is one important aspect of this, yet we could keep growing from there. Vitamin D and vitamins K and A are also needed in balance, zinc, boron, folate are a few more. The point is that concentrating on one nutrient can create imbalance elsewhere. Shoveling in loads of dairy because it is high in calcium, but neglecting whole grains, fruits, vegetables high in many other necessary nutrients, may result in hard bones, but not bones that withstand fracture or breakage. In fact, often times, women need to lower their calcium supplementation and increase their magnesium in order to reap the benefits to their bones! (Lam, 2016) Dr. Lam states it, “The key is balance.” The traditional thinking of calcium supplementation alone as necessary at a certain age is outdated and suggests the idea that our bodies do not function as a whole.
As a nutritionist, I see many clients with low bone density and/or osteoporosis, is imperative to both understand the process of maintaining healthy bones in the body and how best to nutritionally support them. Food, over supplements, is the key method to obtain nutrients for healthy bones. For both clients and myself alike, focusing on variety in fruits, vegetables, whole grains, quality proteins and fats supports healthy bones. Leafy greens- dark in color are rich in magnesium, calcium, vitamin K and vitamin C. Stocks, nuts and seeds are rich in minerals; whole grains are rich in magnesium, and healthy fats help the absorption of the fat-soluble vitamins essential for bone health. But just as important as what we put in our bodies, is what we don’t. Meaning, steering away from foods that deplete the body of key nutrients- such as refined sugars, soft drinks with excessive phosphorus, or unhealthy fats that interfere with the absorption of important nutrients. In addition, moving the body- through both walking and strength and resistance helps to strengthen the bones by providing just enough strain to promote the remodeling process. Stress levels should be managed and kept low by all means possible, as the excessive levels of cortisol during stress blocks the growth of bone. (Colbin, 2009) It once again, all comes down to balance. Colbin suggests when making both lunches and dinners, it is best practice to include a whole grain, an organic protein, green vegetables, red or orange vegetables and a good quality fat. Following these simple suggestions can assist in creating healthy meals to support their bones. I would add to this the requirement of finding direct sunlight every single day! Vitamin D is hard to come by in our modern society and the best source is taking in a good long walk in the sunshine. (Colbin, 2009)
Healthy bones are about much more than drinking milk. Practicing a balanced life rich in plants, with adequate protein, low levels of stress, and some movement, is key in creating bones to last a lifetime!
References: Baaij, J. H. F. de, Hoenderop, J. G. J., & Bindels, R. J. M. (2015). Magnesium in Man: Implications for Health and Disease. Physiological Reviews, 95(1), 1–46. https://doi.org/10.1152/physrev.00012.2014 Colbin, A. (2009) The whole-food guide to strong bones. Oakland, CA: New Harbinger Publications, Inc. Lam, M. (2016) Magnesium, Calcium, and Reversing Osteoporosis. Dr. Lam Body.mind.nutrition. Retrieved from https://www.drlam.com/blog/reversing-osteoporosis/364/ Mercola, J. (2014) Magnesium may help prevent hip fractures. [article] Retrieved from https://articles.mercola.com/sites/articles/archive/2014/03/03/magnesium-drinking-water.aspx O. of the S. G. (2004). The Frequency of Bone Disease. Office of the Surgeon General (US). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK45515/ Volpe, S. L. (2013). Magnesium in Disease Prevention and Overall Health. Advances in Nutrition: An International Review Journal, 4(3), 378S–383S. https://doi.org/10.3945/an.112.003483 Zheng, J., Mao, X., Ling, J., He, Q., Quan, J., & Jiang, H. (2014). Association between serum level of magnesium and postmenopausal osteoporosis: a meta-analysis. Biological Trace Element Research, 159(1–3), 8–14. https://doi.org/10.1007/s12011-014-9961-3