Integrative Approaches to Bone Health: Preventing and Managing Osteoporosis
Maintaining strong, healthy bones is crucial to maintaining strength, agility, independence and overall wellbeing. This is particularly important as we age, or are confronted with factors that may affect our bone density. At Papaya Clinic, we take an integrative healthcare approach to bone health, combining evidence-based conventional strategies with complementary therapies. This article explores how an integrative healthcare approach can help prevent and manage osteoporosis.
Understanding Osteoporosis
Bone tissue is continuously being laid down and reabsorbed by different cells in the body. When the rate of reabsorption outpaces the rate at which bone is being laid down, then osteoporosis develops.
Additionally, nutrition deficiencies can cause a decrease in the mineralisation of the bone, making them more fragile and brittle. So what are the things that we can do to encourage healthy mineralisation of the bones and deposition of new bone tissue?
An Integrative Approach to Bone Health
An evidence-based, integrative healthcare approach to bone health includes exercise & fall prevention, lifestyle modification & stress reduction, nutrition, and supplementation as needed, in addition to any conventional medicine that may be deemed necessary.
1. Exercise & fall prevention
Exercise is an effective way to manage osteoporosis, strengthening muscles, improving bone density, and reducing fall risk. Not all exercises are equal when it comes to bone health as there must be enough muscular contraction to stimulate bone strength.
Progressive resistance training, which gradually increases resistance, is great for building bone strength.
Weight-bearing exercises like walking and running also stimulate bone formation.
Onero is a high-intensity exercise program designed to boost bone density, improve posture, and reduce fall risk. Research shows Onero's effectiveness in increasing bone mass at the spine and hips. High-intensity training is more effective than low-intensity exercises for bone health. Supervision by a trained professional ensures safety and effectiveness in such programs.
Balance exercises help prevent falls, even though they don't directly impact bone density. With osteoporosis, bones become more fragile, so a fall can lead to serious fractures, making balance training essential for maintaining safety.
Regular practice of balance exercises, such as standing on one foot or walking heel-to-toe, can significantly lower the risk of falls by improving reaction times and muscle strength.
Our Clinical Pilates classes with the focus on Bone Health is excellent. We mix in strength, jumping (safely) and balance exercises to ensure adequate loading for bone density.
Tai Chi has been shown to be a valuable practice to improve balance and in the prevention of falls.This becomes increasingly important when balance is decreased for reasons such as aging, due to certain medical conditions, or as a side effect of medication. There are often plenty of Tai Chi lessons available in the community, ranging from paid lessons, to donation-based, and free sessions.
By incorporating balance training into a daily routine, individuals with osteoporosis can feel more confident and secure in their movements, ultimately preventing dangerous accidents.
2. Lifestyle modifications
Dial down inflammation
Chronic inflammation promotes bone reabsorption AND can reduce the number and activity of cells that are responsible for laying down bone, shifting the equation above towards greater imbalance. Additionally, the oxidative stress of inflammation can directly damage bone-promoting cells and the bone itself. Indirectly, chronic inflammation may mean that your activity levels are reduced, which is, of course, a risk factor for osteoporosis.
Lifestyle changes to reduce inflammation and support bone health include:
Quit smoking
Smoking increases inflammation, so quitting can help reduce inflammatory markers and benefit your bone health.Avoid inflammatory foods
Reduce intake of sugar, refined carbohydrates, fried foods, red and processed meats, and processed foods.Limit alcohol consumption
Alcohol is pro-inflammatory, so limiting or avoiding alcohol can be beneficial for bone health.Consume an anti-inflammatory diet
Consume more fruits, vegetables, whole grains, and omega-3 rich foods. Particularly beneficial are cherries, berries, citrus fruits, and leafy greens. Mediterranean or DASH diets are great examples of this type of cuisine.Maintain a healthy weight
Excess weight can contribute to chronic systemic inflammation, so achieving a healthy weight can be an important strategy in protecting your bone health.Manage stress
Stress produces pro-inflammatory chemicals both through the Hypothalamus-Pituitary-Adrenal (HPA) axis, and through the overactivation of the sympathetic nervous system. Practicing stress-reduction techniques like meditation, yoga, or spending time in nature is lovely AND is anti inflammatory.Ensure adequate sleep
Poor sleep can increase inflammation, so getting enough quality sleep is crucial.
3. Nutrition
A balanced diet is always health-promoting. A diet rich in bone-supporting nutrients is essential. Key recommendations include:
Consuming adequate calcium through food sources
Consuming adequate amounts of protein. Eating an adequate amount of protein may protect the bone mineral density.
Eating soy products daily. Both soy protein and soy isoflavones seem to protect bone mineral density, especially in post-menopausal women, although there is evidence of it also benefitting men. We would recommend consuming organic soy products where possible.
Limit caffeine intake. Caffeine interferes with calcium absorption, and in high amounts increases the loss of calcium through the urine. An association between high caffeine intake and reduced bone mineral density has been found in some studies.
Avoiding excessive alcohol consumption.
Following anti-inflammatory diets like the Mediterranean or DASH diet
4. Dietary Supplements
While obtaining nutrients from food is ideal, supplements that may help fill gaps:
Calcium: Aim for the 1300mg through a combination of food and supplements
Vitamin D: 700-800 IU of D3 daily has been shown to reduce fracture risk.
Vitamin K: Vitamin K1 or K2
Magnesium
Potassium
Recommended supplement dosages vary due to many variables, including race, genetics, sex, weight, dietary intake, and your microbiome status. This variation is even more marked if you have other chronic conditions or diseases. It is advised to seek consultation with a nutritionist or naturopath, like our very own Lauren Lee (Clinical Naturopath) to ascertain the combination and dosages of supplements needed.
5. A note on medications
Several medications have been associated with an increased risk of osteoporosis and bone loss. Some of these have good alternatives, and some don’t. Discuss the risk of osteoporosis associated with the prolonged use of these medications with your doctor, and things that you may be able to do to mitigate your risk.
Corticosteroids. Used to treat conditions such as asthma, arthritis, and lupus.
Proton pump inhibitors (PPIs), such as Losec, Zoton, Somac & Pariet used for gastroesophageal reflux & heartburn.
Selective serotonin reuptake inhibitors (SSRIs) such as Zoloft, Lexapro, Celexa and Prozac used in the treatment of depression.
Depo-Provera. Used for long-term contraception.
Gonadotropin-releasing hormone (GnRH) agonists. Used for treating endometriosis, prostate cancer, and in IVF.
Some medications used in diabetes management.
Heparin. Used for preventing blood clots.
Anticonvulsants. Certain medications used for epilepsy.
Aromatase inhibitors. Used in breast cancer treatment.
Conclusion
An integrative healthcare approach to bone health combines the best of conventional and complementary medicine. At Papaya Clinic, we’re happy to be part of your healthcare team to provide you with evidence-based strategies to optimise your health and wellbeing. We provide treatments in Newtown, in Sydney’s inner west.
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