Protecting our bones is obviously important, but figuring out exactly how to do that in terms of our diet can be confusing. With that in mind, I contacted a few bone experts to give us the highlights and answer some of the more frequently asked questions.
This is the first of a two-part series about the impact of nutrition and diet on bone health. The first part deals with general bone health and the role played by calcium. The second part will focus on other foods and nutrients that help or hurt bone health.
What is osteoporosis, and what does it do to our bones?
"Osteoporosis or porous bones is a disease characterized by low bone mass leading to fragile bones and resulting in an increased susceptibility to fractures of the hip, spine and wrist," according to Tejaswini Rao, Ph.D., R.D., a professor of nutrition at State University of New York in Buffalo.
At what age do our bones start to deteriorate?
Our bones reach their peak level of density (or mass) in the mid-20s (on average), says Dorothy Teegarden, Ph.D., a professor of nutrition at Purdue University. "Roughly after age 35, both men and women start to lose bone at a slow rate of 1 to 2 percent per year. This bone loss is accelerated in women around and after menopause to about 5 percent per year for five to seven years.
Then the bone loss in women returns to a baseline of 1 to 2 percent per year. Men don't go through the accelerated menopausal bone loss but continue to lose bone at the rate of one to two percent per year," says Primal Kaur, M.D., director of the Osteoporosis Clinic at Temple University School of Medicine in Philadelphia.
Is osteoporosis mostly a female problem?
It's true that osteoporosis is less common in men than women, because men start out with more bone density than women and do not go through menopause, which accelerates bone loss, says Rao. But after age 65, men and women lose bone at the same rate. By age 75, one-third of men have osteoporosis as do a third of women.
What is the bone-calcium connection?
"Calcium (which is, incidentally, the most abundant mineral in the body) is the material that gives bone strength, much as bricks do for a building," says Ruth Freeman, M.D., professor of medicine at Albert Einstein College of Medicine Montefiore Medical Center. "But the bones need an underlying structure of proteins that are special for bone to hold on to the calcium.
"Basically, there are two types of cells active in bone--one, the osteoclast, makes pockets in the bone, chewing it up so that good bone can replace any damaged bone. The second type, the osteoblast, comes in and fills in the bone pockets that the osteoclast created. Over about 10 years time, all bone is replaced to remove little damaged areas. But after age 40, the osteoblasts don't adequately refill the pockets created by the osteoclast, so there is a net loss of bone. Anything, therefore, that speeds up turnover of bone, like loss of estrogen, will increase the loss of bone in people who are over age 40."
What is the link between estrogen and bone health?
Estrogen is important in maintaining bone mass in adult women; in part it slows bone remodeling (replacing old bone with new bone). And while bone remodeling is normally a good thing, it takes place over weeks and months. Therefore, it leaves a woman more susceptible to bone fracture--estrogen helps to slow this process down. So basically, the estrogen maintains the proper balance between the activity of bone-forming cells (i.e., osteoblasts) and bone-resorbing cells (i.e., osteoclasts).