Osteoporosis (OP)

An Overview of Osteoporosis

Osteoporosis (OP) is the most common bone disease in both the U.S. and across the globe, affecting the elderly, specifically postmenopausal women. Osteoporosis is characterized by low bone density and mass that weakens bones and increases risks of fractures and breaks. As we age, the regulation of osteoblasts – cells that form new bone and osteoclasts – cells that breakdown bone tissue can become imbalanced. With the development of OP, abnormal activation of osteoclasts outweighs the production of osteoblasts. Osteoporosis can negatively affect an individual’s quality of life in many ways. Chronic pain, bone fractures, balance issues, and mental health concerns regarding anxiety and depression around fears of falling. Aging alone is not the only factor in the development of OP. For example, the decrease in estrogen levels associated with post-menopausal women can cause an imbalance in bone metabolism. Other factors including lack of exercise and movement, increased inflammation, vitamin D deficiency, consumption of alcohol, smoking, poor diet, and use of medications such as corticosteroids also increases risk of developing OP.  

A physician may order a DEXA scan which examines bone density in comparison to the healthy population by providing a T-score. A T-score of -2.5 or below indicates low bone density associated with osteoporosis.   

 Therapeutic Foods for Osteoporosis

Building strong, healthy bones should begin at a young age. Most people reach their peak bone mass between 18-30 years of age. Bone loss gradually begins after reaching peak bone mass. However, we can optimize our nutrition with a balanced diet of fruits, vegetables, whole grains, fiber, lean protein, nuts/seeds, and legumes. More specifically, there are key nutrients we should aim to consume to improve our bone health such as, vitamin D, calcium, vitamin K, magnesium, protein, vitamin C, and essential fatty acids (omega-3s and 6s).

Foods to Include:

• Vitamin D

  Cod liver oil, salmon, sardines, mackerel, eggs, fortified dairy products, beef liver, mushrooms

• Calcium

  Milk, cheese, yogurt, fortified plant-based milks, tofu, leafy greens, oranges, fortified orange juice, fortified cereals, bananas

• Vitamin K

  Green leafy vegetables, cruciferous vegetables, beef liver, ground beef, blueberries, grapes, kiwi, pumpkin, olive oil, onions, sauerkraut, peas

• Magnesium

  Almonds, bananas, cashews, Brazil nuts, black beans, dark chocolate, pumpkin seeds, chia seeds, potatoes, milk, avocado, spinach, brown rice, edamame, leafy greens, tofu, yogurt

• Protein

  Eggs, tofu, cottage cheese, lentils, beans, Greek yogurt, lean beef, nuts, poultry, fish

• Vitamin C

  Oranges, grapefruits, lemons, limes, bell peppers, cruciferous vegetables, strawberries, kiwi, cantaloupe, potatoes, tomatoes

• Omega-3

  Salmon, mackerel, sardines, trout, walnuts, chia seeds, edamame, hemp seeds, soybeans, legumes

• Omega-6

  Walnuts, sunflower seeds, pumpkin seeds, peanut butter, poultry, avocado, eggs, poultry

Beneficial Dietary Supplements

Vitamin D is crucial for skeletal health. Vitamin D deficiency can lead to osteomalacia which increases the risk of developing osteoporosis, fractures and breaks. Vitamin D plays an important role in the absorption of calcium, phosphate, and magnesium. The dosage of vitamin D supplementation is dependent on a person’s serum vitamin D level. Research has shown that those with skeletal disorders and low bone density take 1,000IU of vitamin D3 per day.

Vitamin K works together with vitamin D to stimulate bone mineralization. Vitamin K supplementation is also beneficial for people with low bone density. Vitamin K is a fat-soluble vitamin that can be found in two forms, K1 and K2. Vitamin K1 is mainly found in green leafy vegetables and fruits. Vitamin K2 found in fermented foods, animal products and dairy. Research has shown that vitamin K2 is more bioavailable, which is crucial for quality supplementation. Vitamin D3 and K2 can be found in combination within one supplement. Vitamin D and K are both fat-soluble and need to be consumed with a source of dietary fat.

Self-Management with Osteoporosis 

There are many lifestyle modifications that you can implement to manage OP. Chronic inflammation can increase the risk of developing many chronic diseases related to aging including OP. Implementing stress management techniques, increasing intake of omega-3 fatty acids, and participating in routine exercise is important to reduce stress and chronic inflammation. Strength and resistance training are important forms of exercise to build strong bones. There are many free resources online or through mobile apps that provide on-demand strength workouts, yoga, stretching, and mindfulness meditations. Local senior centers often provide adapted exercise classes such as chair/seated yoga, water aerobics, etc. that are not only great for movement but promote socialization among community and a sense of belonging. Other lifestyle factors of smoking along with excess alcohol and caffeine consumption increases risk of developing OP and low bone density.

Other Healthcare Professionals

It is important to have a team of healthcare professionals to help you manage FM and reduce symptoms. Along with a nutritionist and orthopedic specialists, working with a physical therapist can be beneficial in supporting physical exercise. Physical therapy can improve bone health, posture and balance by strengthening muscle and bone through resistance training. Physical therapists will create personalized care plans that take into account pain levels, range of motion, and ability.

Conclusion

In conclusion, OP is a chronic musculoskeletal disease that can worsen quality of life. Fueling the body with foods high in vitamin K, vitamin D, calcium, protein, magnesium, vitamin C and essential fatty acids can improve bone health. Staying active with routine exercise, specifically resistance training builds and maintains strong bones. Supplementation of both vitamin D3 and K2 work together to improve bone mineralization.

References

1. Osteoporosis Fast Facts. Bone Health and Osteoporosis Foundation. Accessed December 15, 2024. https://www.bonehealthandosteoporosis.org/wp-content/uploads/Osteoporosis-Fast-Facts-2.pdf

2. Rakel, D. Integrative Medicine. 5th ed. Elsevier; 2023.

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7. Chevalley T, Brandi ML, Cashman KD, et al. Role of vitamin D supplementation in the management of musculoskeletal diseases: update from an European Society of Clinical and Economical Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) working group. Aging Clin Exp Res. 2022;34(11):2603-2623. doi:10.1007/s40520-022-02279-6

8. Fusaro M, Cianciolo G, Brandi ML, et al. Vitamin K and Osteoporosis. Nutrients. 2020;12(12):3625. Published 2020 Nov 25. doi:10.3390/nu12123625

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