10 Ways to Prevent or Reverse Osteoporosis

http://www.wallerwellness.com/health-
aging/10-ways-to-prevent-or-reverse-
osteoporosis

Half of all women will have osteoporosis by age 60. One in five women will have a hip fracture
in her lifetime, and 50% of them will never walk again. Men are not immune to this problem.
30% of osteoporosis happens in males, and 50% of men who suffer hip fractures will die within
one year.

A New Disease?
Osteoporosis which is so prevalent now, was virtually unheard of a hundred years ago. It was a
rarity until the turn-of-the-century. So what happened? Did our genes change in a hundred years?

No! Genetic material takes thousands of years to change. The only thing that changed was our
environment. Our diet and lifestyle are much different than they were hundred years ago and it
has caused an epidemic of osteoporosis. So, what do we do? How can we reverse this process?

Here are 10 ways you can prevent or reverse osteoporosis:

1. Stop the Pop!

Carbonated beverages such as soft drinks, Champagne, and sparkling water leach calcium from
your bones. A Harvard study on 16 to 20 year-old women showed that half of them were already
showing bone loss as a result of excess soft drink intake. Carbonated beverages also have excess
phosphates, which cause even more calcium loss.

2. Cut down on Protein

Excess protein intake causes acidity in the body, which in turn causes calcium to be lost in the
urine. Most people need only two to 4 ounces of lean protein, three times a day. The average
American diet contains two to three times this much.

3. Keep Your Stomach Acid!

Many people are on acid blocking drugs, such as Nexium, Protonix, Prevacid, Tagamet, and
Zantac, for problems such as heartburn and hiatal hernia. Stomach acid is necessary to absorb
minerals such as calcium, magnesium, and zinc. Blocking stomach acid significantly increases
the risk of osteoporosis.

These drugs were meant to be used for six to eight weeks at a time, not for years at a time! In
fact, most heartburn symptoms are not due to excess stomach acid. Two thirds of the patients on
acid blocking agents have too little stomach acid, not too much!

4. Cut out Caffeine!

Each cup of coffee that you drink makes you lose 150 mg of calcium in your urine. Chemically
decaffeinated coffee is not the answer either though, because it contains harmful chemicals that
interfere with the detoxification process. Naturally decaffeinated teas are a better option, but if
you must drink caffeinated coffee, at least increase your calcium intake by 150 mg for each cup
you drink.

5. Get the Right Kind of Calcium

Tums is one of the worst sources for calcium. In addition to being composed of calcium
carbonate, which is a poorly absorbed form of calcium, it decreases the stomach acid even
further. Calcium citrate and calcium hydroxyapatite are the best forms of calcium to take. They
need to be taken on an empty stomach for best absorption, and only 500 mg at a time (thats all
our bodies can absorb at one time). A total dose of 1000 to 1200 mg per day is adequate for most
menopausal women.

6. Get Some Sun!

Vitamin D deficiency is also epidemic in our society. Vitamin D helps to absorb calcium, and
put it in the bones. It is also important for immune system modulation, depression, and
autoimmune disorders. It is made in your skin when you get out in the sun. The farther you are
from the equator, the less vitamin D you make in your skin. Most supplements contain 400 to
800 IU which is inadequate for most people in northern latitudes.

Since a skin cancer is such a concern, most people use sunscreen when they go out in the sun.
Sunscreen blocks over 90% of your vitamin D production. But instead of putting yourself at risk
for skin cancer, the best solution is to take supplements. Vitamin D levels can be measured by
your physician, and the supplements can be titrated accordingly.

7. Have Your Hormones Checked

Hormonal decline is one of the most common reasons for bone loss after menopause in women.
Andropause, the male equivalent of menopause, also causes bone loss in men. Adequate levels
of estrogen, progesterone, and testosterone are important for bone maintenance.

Excess levels of cortisol, insulin and parathyroid hormone can also cause bone loss. Most
physicians never check for these levels. An elevated calcium level in the serum is a clue that
parathyroid hormone might be in excess. Excess refined sugars and starches in the diet cause
elevated insulin levels. Excess stress causes elevated cortisol levels.

8. Change Your Diet

Excess refined sugars and starches, elevate your insulin levels and cause an increase in
osteoporosis. The ideal diet is one called a low glycemic index diet. Glycemic index is a
measure of how quickly food turns into sugar in the bloodstream. Low glycemic index foods do
not raise blood sugar or insulin levels quickly, and include lean proteins, beans, vegetables, and
good fats (nuts, olives, olive oil, fish, fish oils, avocados). Increasing fiber intake is an easy way
to lower sugar and insulin levels. Fiber taken just before meals helps to slow down the
absorption of sugars and fats, and can help lower cholesterol and blood sugar levels, as much as
medication.

9. Reduce Stress
Stress raises cortisol levels. If cortisol levels are high for long periods of time it can cause bone
loss. Cortisol antagonizes insulin and leads to insulin resistance, eventually raising the blood
sugar and causing calcium loss in the urine. As little as 25 teaspoons of sugar can cause calcium
to be lost in the urine.

Stress reduction can include specific activities aimed at invoking the relaxation response such
as yoga, tai chi, meditation, massage and prayer. It may also include getting more sleep, taking a
vacation, getting psychotherapy to help with toxic relationships, and making an effort not to
burn the candle at both ends.

10. Exercise More

When the muscles pull against the bones during exercise, it stimulates the bones and tells them
that they are needed. Any weight-bearing exercise such as walking, hiking, climbing stairs and
weightlifting can increase bone density. As little as 15 to 30 minutes a day can be
helpful. Weightlifting does not need to be with heavy weights either, it can be with as little as 2
5 pound hand or ankle weights. Or you can use your own body weight and let gravity to do the
job. Floor exercises such as leg lifts and sit ups, will work just fine. Exercises such as swimming
and cycling though great for muscle strength and fitness are not weight-bearing so arent the
most beneficial for your bones.
Calcium: Whats Best for Your Bones and
Health?
https://www.hsph.harvard.edu/nutritionsourc
e/calcium-full-story/

Table of Contents

Introduction
What Is Calcium, and Where Do We Get It?
Growing Healthy Bones
What Is Osteoporosis
How Can Osteoporosis Be Slowed Down?
Preventing Bone Loss in Adulthood
Should You Get Calcium from Milk?
The Bottom Line: Recommendations for Calcium Intake and Bone Health
References

Introduction

Those advertisements pushing milk as the answer to strong bones are almost inescapable. But
does got milk? really translate into got strong bones?

The pro-milk faction believes that increased calcium intakeparticularly in the form of the
currently recommended three glasses of milk per daywill help prevent osteoporosis, the
weakening of bones. Each year, osteoporosis leads to more than 1.5 million fractures, including
300,000 broken hips.
On the other side are those who believe that consuming a lot of milk and other dairy products
will have little effect on the rate of fractures but may contribute to problems such as heart disease
or prostate cancer.

Which view is right? The final answers arent in. But here is a summary of whats currently
known about calcium and its effects on the body.

What Is Calcium, and Where Do We Get It?

Calcium is a mineral that the body needs for numerous functions, including
building and maintaining bones and teeth, blood clotting, the transmission of nerve impulses, and
the regulation of the hearts rhythm. Ninety-nine percent of the calcium in the human body is
stored in the bones and teeth. The remaining 1 percent is found in the blood and other tissues.

The body gets the calcium it needs in two ways. One is by eating foods or supplements that
contain calcium. Good sources include dairy products, which have the highest concentration per
serving of highly absorbable calcium, and dark leafy greens or dried beans, which have varying
amounts of absorbable calcium. Calcium supplements often contain vitamin D; taking calcium
paired with vitamin D seems to be more beneficial for bone health than taking calcium alone.
(Read more about calcium and osteoporosis.)

The other way the body gets calcium is by pulling it from bones. This happens when blood levels
of calcium drop too low, usually when its been awhile since having eaten a meal containing
calcium. Ideally, the calcium that is borrowed from the bones will be replaced at a later point.
But, this doesnt always happen. Most important, this payback cant be accomplished simply by
eating more calcium.

Growing Healthy Bones

Bone is living tissue that is always in flux. Throughout the lifespan, bones are constantly being
broken down and built up in a process known as remodeling. Bone cells called osteoblasts build
bone, while other bone cells called osteoclasts break down bone.

In healthy individuals who get enough calcium and physical activity, bone production exceeds
bone destruction up to about age 30. After that, destruction typically exceeds production.

What Is Osteoporosis?

Osteoporosis, or porous bones, is the weakening of bones caused by an imbalance between

bone building and bone destruction. People typically lose bone as they age, despite consuming
the recommended intake of calcium necessary to maintain optimal bone health. An estimated 10
million Americans8 million women and 2 million menhave osteoporosis. Another 34
million have low bone mass, placing them at increased risk for osteoporosis. (1)

Achieving adequate calcium intake and maximizing bone stores during the time when bone is
rapidly deposited (up to age 30) provides an important foundation for the future. But it will not
prevent bone loss later in life. The loss of bone with aging is the result of several factors,
including genetic factors, physical inactivity, and lower levels of circulating hormones (estrogen
in women and testosterone in men).

Postmenopausal women account for 80 percent of all cases of osteoporosis because estrogen
production declines rapidly at menopause. Of course, men are also at risk of developing
osteoporosis, but they tend to do so 5 to 10 years later than women, since testosterone levels do
not fall abruptly the way estrogen does in women. It is estimated that osteoporosis will cause half
of all women over age 50 to suffer a fracture of the hip, wrist, or vertebra.

How Can Osteoporosis Be Slowed Down?

Preventing osteoporosis depends on two things: making the strongest, densest bones possible
during the first 30 years of life and limiting the amount of bone loss in adulthood.

There are a number of lifestyle factors that can help with the latter:

Getting regular exercise, especially weight-bearing and muscle strengthening exercise.

Getting adequate vitamin D, whether through diet, exposure to sunshine, or supplements.
Consuming enough calcium to reduce the amount the body has to borrow from bone.
Consuming adequate vitamin K, found in green, leafy vegetables.
Not getting too much preformed vitamin A.

Preventing Bone Loss in Adulthood

Several complementary strategies can help prevent or minimize bone loss during adulthood and
old age. These include:

Getting Regular Exercise

Physical activity that puts some strain or stress on bones causes the bones to retain and possibly
even gain density throughout life. Cells within the bone sense this stress and respond by making
the bone stronger and denser. Such weight-bearing exercises include walking, dancing,
jogging, weightlifting, stair-climbing, racquet sports, and hiking.

Swimming is a useful form of exercise for the heart and cardiovascular system. But because
water supports the bones, rather than putting stress on them, its not considered a good weight-
bearing exercise for bone strength. In addition, physical activity doesnt strengthen all bones,
just those that are stressed, so you need a variety of exercises or activities to keep all your bones
healthy.
Another function of physical activity, probably at least as important as its direct effect on bone
mass, is its role in increasing muscle strength and coordination. With greater muscle strength,
one can often avoid falls and situations that cause fractures. Making physical activity a habit can
help maintain balance and avoid falls.

Getting Enough Calcium

Despite the debates surrounding milk and calcium, one thing is clear: adequate calciumboth
for bone development and for non-bone functionsis key to reducing the risk of osteoporosis.
However, the healthiest or safest amount of dietary calcium hasnt yet been established.
Different scientific approaches have yielded different estimates, so its important to consider all
the evidence.

Maximum-calcium-retention studies, which examine the maximum amount of calcium that can
be forced into bones, suggest a fairly high requirement. To ensure that 95 percent of the
population gets this much calcium, the National Academy of Sciences established the following
recommended intake levels:

1,000 milligrams/day for those age 19 to 50

1,200 milligrams/day for those age 50 or over
1,000 milligrams/day for pregnant or lactating adult women

But the maximum-calcium-retention studies are short term and therefore have important
limitations. To detect how the body adapts to different calcium intakes over a long period of
timeand to get the big picture of overall bone strengthrequires studies of longer duration.

The results from such long-term studies may be surprising to some. While they do not question
the importance of calcium in maximizing bone strength, they cast doubt on the value of
consuming the large amounts currently recommended for adults.

In particular, these studies suggest that high calcium intake doesnt actually appear to lower a
persons risk for osteoporosis. For example, in the large Harvard studies of male health
professionals and female nurses, individuals who drank one glass of milk (or less) per week were
at no greater risk of breaking a hip or forearm than were those who drank two or more glasses
per week. (2, 3) When researchers combined the data from the Harvard studies with other large
prospective studies, they still found no association between calcium intake and fracture risk. (4)
Also, the combined results of randomized trials that compared calcium supplements with a
placebo showed that calcium supplements did not protect against fractures of the hip or other
bones. Moreover, there was some suggestion that calcium supplements taken without vitamin D
might even increase the risk of hip fractures. A 2014 study also showed that higher milk
consumption during teenage years was not associated with a lower risk of hip fracture in older
adults. (27)

Additional evidence further supports the idea that American adults may not need as much
calcium as is currently recommended. For example, in countries such as India, Japan, and Peru
where average daily calcium intake is as low as 300 milligrams per day (less than a third of the
U.S. recommendation for adults, ages 19 to 50), the incidence of bone fractures is quite low. Of
course, these countries differ in other important bone-health factors as wellsuch as level of
physical activity and amount of sunlightwhich could account for their low fracture rates.

Ideally, these issues might be resolved by randomizing a large group of adults to get different
amounts of calcium and following them to see how many would eventually break a bone. In fact,
a few such studies have been conducted, and they have not provided evidence of benefit, as
noted above. However, most of these studies were small or of short duration, so they could not
rule out the possibility of a small benefit from supplementation. Other randomized trials have
combined calcium in combination with vitamin D, which could obscure the true effects of
calcium.

To illustrate the different conclusions drawn from examining the same body of data, a British
committee that is comparable to the U.S. group that established calcium requirements here
concluded that 700 milligrams per day was enough for individuals age 19 and older.

Getting Enough Vitamin D

Vitamin D plays a critical role in maintaining bone health. When

blood levels of calcium begin to drop, the body responds in several ways. It promotes the
conversion of vitamin D into its active form, which then travels to the intestines (to encourage
greater calcium absorption into the blood) and to the kidneys (to minimize calcium loss in the
urine).

For bone health, an adequate intake of vitamin D is no less important than calcium. Vitamin D is
found in milk and vitamin supplements, and it can be made by the skin when it is exposed to
sunlight in the summertime. But not all sunlight is created equal. Above 40 degrees latitude
(north of San Francisco, Denver, Indianapolis, and Philadelphia), the winter sunlight isnt strong
enough to promote vitamin D formation. Sunscreens also prevent the formation of vitamin D,
although they are still recommended to reduce risk of sun-induced skin cancer and skin damage.

An examination of clinical trials of vitamin D for the prevention of osteoporosis found that
getting 700 to 800 IUs of vitamin D per day decreases the risk of hip and non-vertebral fractures;
(5) vitamin D may be even more effective when taken in conjunction with calcium. (6) A similar
analysis of the effect of vitamin D on falls indicated that supplementation with vitamin D
reduces the risk of falls among older individuals by more than 20 percent. (7)

Look for a multivitamin that supplies 800 to 1,000 IU of vitamin D per day. If your multi only
has 400 IU of vitamin D, consider taking an extra supplement. Many people may need 2,000 IU
per day (or more) of vitamin D for adequate blood levels, particularly if they have darker skin,
spend winters at higher latitudes (such as the northern U.S.), or spend little time in the sun. If you
fall into one of these groups, which would include most of the U.S. population, taking 2,000 IU
is reasonable and well within the safe range. As always, its a good idea to discuss use of
supplements with your doctor, and he or she may want to order a vitamin D blood test.

Getting Enough Vitamin K

Vitamin K, which is found mainly in green, leafy vegetables, likely plays

one or more important roles in calcium regulation and bone formation. Low levels of circulating
vitamin K have been linked with low bone density, and supplementation with vitamin K shows
improvements in biochemical measures of bone health. (8) A report from the Nurses Health
Study suggests that women who get at least 110 micrograms of vitamin K a day are 30 percent
less likely to break a hip than women who get less than that. (9) Among the nurses, eating a
serving of lettuce or other green, leafy vegetable a day cut the risk of hip fracture in half when
compared with eating one serving a week. Data from the Framingham Heart Study also shows an
association between high vitamin K intake and reduced risk of hip fracture in men and women,
and increased bone mineral density in women. (10, 11) Getting one or more servings per day of
broccoli, Brussels sprouts, dark green lettuce, collard greens, or kale should be enough to meet
the daily recommended target of 120 micrograms per day for men and 90 micrograms per day for
women.

Some other factors may also help lower the risk of osteoporosis:

Take care with caffeine and cola. Although the votes arent all in, there is some evidence that
drinking a lot of coffeeabout four or more cups per daycan increase the risk of fracture.
Caffeine tends to promote calcium excretion in urine. Meanwhile, the Framingham Osteoporosis
Study has found that older women who drink cola every day have lower bone mineral density
than those who drink it less than once a month. (12) This may be due to colas high levels of
phosphorous, which may alter the dietary balance between calcium and phosphorous and
thereby weaken bones.
Get enough protein, but not too much. The body needs protein to build healthy bones. But as
your body digests protein, it releases acids into the bloodstream, which the body neutralizes by
drawing calcium from the bones. Following a high-protein diet for a few weeks probably wont
have much effect on bone strength. Doing it for a long time, though, could weaken bone. In the
Nurses Health Study, for example, women who ate more than 95 grams of protein a day were
20 percent more likely to have broken a wrist over a 12-year period when compared to those
who ate an average amount of protein (less than 68 grams a day). (13) But this area of research
is still controversial, and findings have not been consistent. Some studies suggest increasing
protein increases risk of fractures; others associate high-protein diets with increased bone
mineral density. It is still unclear what level of protein intake provides the best protection
against osteoporosis, and more research is needed.
Get enough vitamin A, but not too much. Long associated with good vision, vitamin A has also
been found to direct the process of borrowing and redepositing calcium in bone. However, too
 much preformed vitamin A (also known as retinol) can promote fractures. Choose a
multivitamin supplement that has all or the majority of its vitamin A in the form of beta-
carotene, a vitamin A precursor, since beta-carotene does not increase ones fracture risk. Many
multivitamin manufacturers have already reduced the amount of preformed vitamin A in their
products.

Postmenopausal women may also want to talk to a health care provider about taking a
medication that can strengthen bones. The estrogen in postmenopausal hormones can
compensate for the drop in estrogen levels after menopause, helping to preventand perhaps
even partially reversebone loss. However, hormone replacement therapy has fallen from grace
as the mainstay for preventing osteoporosis after results from several studies showed that it
increased the risk of breast cancer, stroke, and blood clots. (14) Other medications such as
alendronate (Fosamax), risedronate (Actonel), calcitonin (Miacalcin), raloxifene (Evista), and
parathyroid hormone (Forto) have been approved for the prevention or treatment of
osteoporosis.

Should You Get Calcium from Milk?

When most people in the United States think of calcium, they immediately think of milk. But
should this be so? Milk is actually only one of many sources of calciumdark leafy green
vegetables and some types of legumes are among the other sourcesand there are some
important reasons why milk may not be the best source for everyone.

These reasons include the following:

Lactose Intolerance

Many people have some degree of lactose intolerance. For them, eating or drinking dairy
products causes problems like cramping, bloating, gas, and diarrhea. These symptoms can range
from mild to severe. Certain groups are much more likely to have lactose intolerance. For
example, 90 percent of Asians, 70 percent of blacks and Native Americans, and 50 percent of
Hispanics are lactose intolerant, compared to only about 15 percent of people of Northern
European descent.

One alternative for those who are lactose intolerant but who still enjoy consuming dairy products
is to take a pill containing enzymes that digest milk sugar along with the dairy product, or to
consume milk that has the lactase enzyme added to it.

High Saturated Fat Content

Many dairy products are high in saturated fats, and a high saturated fat intake is a risk factor for
heart disease. And while its true that most dairy products are now available in fat-reduced or
nonfat options, the saturated fat thats removed from dairy products is inevitably consumed by
someone, often in the form of premium ice cream, butter, or baked goods.

Strangely, its often the same people who purchase these higher fat products who also purchase
the low-fat dairy products, so its not clear that theyre making great strides in cutting back on
their saturated fat consumption. (For more information on dietary fats, read the Nutrition Source
article Fats and Cholesterol: Out with the Bad, In with the Good.)

Possible Increased Risk of Ovarian Cancer

High levels of galactose, a sugar released by the digestion of lactose in milk, have been studied
as possibly damaging to the ovaries and leading to ovarian cancer. Although such associations
have not been reported in all studies, there may be potential harm in consuming high amounts of
lactose. A recent pooled analysis of 12 prospective cohort studies, which included more than
500,000 women, found that women with high intakes of lactoseequivalent to that found in 3
cups of milk per dayhad a modestly higher risk of ovarian cancer, compared to women with
the lowest lactose intakes. (15) The study did not find any association between overall milk or
dairy product intake and ovarian cancer. Some researchers have hypothesized, however, that
modern industrial milk production practices have changed milks hormone composition in ways
that could increase the risk of ovarian and other hormone-related cancers. (16) More research is
needed.

Probable Increased Risk of Prostate Cancer

A diet high in calcium has been implicated as a probable risk factor for prostate cancer. (17) In a
Harvard study of male health professionals, men who drank two or more glasses of milk a day
were almost twice as likely to develop advanced prostate cancer as those who didnt drink milk
at all. (18) The association appears to be with calcium itself, rather than with dairy products in
general: A more recent analysis of the Harvard study participants found that men with the
highest calcium intakeat least 2,000 milligrams a dayhad nearly double the risk of
developing fatal prostate cancer as those who had the lowest intake (less than 500 milligrams per
day). (19)

Clearly, although more research is needed, we cannot be confident that high milk or calcium
intake is safe.

The Bottom Line: Recommendations for Calcium Intake and Bone Health

Adequate, lifelong dietary calcium intake is necessary to reduce the risk of osteoporosis.
Consuming adequate calcium and vitamin D and performing regular, weight-bearing exercise are
also important to build maximum bone density and strength. After age 30, these factors help
slow bone loss, although they cannot completely prevent bone loss due to aging.
Milk and dairy products are a convenient source of calcium for many people. They are also a
good source of protein and are fortified with vitamins D and A. At this time, however, the
optimal intake of calcium is not clear, nor is the optimal source or sources of calcium. As noted
earlier, the National Academy of Sciences currently recommends that people ages 19 to 50
consume 1,000 milligrams of calcium per day, and that those age 50 or over get 1,200 milligrams
per day. Reaching 1,200 milligrams per day would usually require drinking two to three glasses
of milk per dayor taking calcium supplementsover and above an overall healthy diet.

However, these recommendations are based on very short-term studies, and are likely to be
higher than what people really need. Currently, theres no good evidence that consuming more
than one serving of milk per day in addition to a reasonable diet (which typically provides about
300 milligrams of calcium per day from nondairy sources) will reduce fracture risk. Because of
unresolved concerns about the risk of ovarian and prostate cancer, it may be prudent to avoid
higher intakes of dairy products.

At moderate levels, though, consumption of calcium and dairy products has benefits beyond
bone health, including possibly lowering the risk of high blood pressure and colon cancer. (20
25) While the blood pressure benefits appear fairly small, the protection against colon cancer
seems somewhat larger, and most of the latter benefit comes from having just one or maybe two
glasses of milk per day in addition to what we get from other foods in our diet. Getting more than
this doesnt seem to lower risk further.

For individuals who are unable to digestor who dislikedairy products and for those who
simply prefer not to consume large amounts of such foods, other options are available. Calcium
can also be found in dark green, leafy vegetables, such as kale and collard greens, as well as in
dried beans and legumes.

Calcium is also found in spinach and chard, but these vegetables contain oxalic acid, which
combines with the calcium to form calcium oxalate, a chemical salt that makes the calcium less
available to the body. A variety of calcium-fortified foods, such as orange juice and soy milk, are
now on the market.

Calcium can also be ingested as a supplement, and if you do go the supplement route, its best to
choose one that includes some vitamin D. Research suggests that calcium-only supplements do
not protect against fractures, and may in fact increase risk of fractures. (4) Theres also some
emerging evidence that taking calcium-only supplements may possibly increase the risk of heart
attacksanother reason to avoid calcium-only supplements. (26) Men may want to avoid
calcium supplements because of questions about possible risks of prostate cancer; if men do take
a calcium supplement, limiting supplement intake to 500 milligrams of calcium per day seems
prudent.
Antacids contain calcium, but do not contain vitamin D. So if you choose antacids as a calcium
source, you may want to consider taking a separate vitamin D supplement. Discuss your options
with a health care provider. (Read more about vitamin D and health.)

Here is a list of foods that are good sources of calcium.

References

1. Osteoporosis: fast facts. National Osteoporosis Foundation. Accessed January 24, 2008.

2. Owusu W, Willett WC, Feskanich D, Ascherio A, Spiegelman D, Colditz GA. Calcium intake
and the incidence of forearm and hip fractures among men. J Nutr. 1997; 127:178287.

3. Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Milk, dietary calcium, and bone fractures
in women: a 12-year prospective study. Am J Public Health. 1997; 87:99297.

4. Bischoff-Ferrari HA, Dawson-Hughes B, Baron JA, et al. Calcium intake and hip fracture risk
in men and women: a meta-analysis of prospective cohort studies and randomized controlled
trials. Am J Clin Nutr. 2007; 86:178090.

5. Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B.

Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled
trials. JAMA. 2005; 293:225764.

6. Boonen S, Lips P, Bouillon R, Bischoff-Ferrari HA, Vanderschueren D, Haentjens P. Need for

additional calcium to reduce the risk of hip fracture with vitamin D supplementation: evidence
from a comparative meta-analysis of randomized controlled trials. J Clin Endocrinol Metab.
2007; 92:141523.

7. Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, et al. Effect of vitamin D on falls: a

meta-analysis. JAMA. 2004; 291:19992006.

8. Weber P. Vitamin K and bone health. Nutrition. 2001; 17:88087.

9. Feskanich D, Weber P, Willett WC, Rockett H, Booth SL, Colditz GA. Vitamin K intake and
hip fractures in women: a prospective study. Am J Clin Nutr. 1999; 69:7479.

10. Booth SL, Tucker KL, Chen H, et al. Dietary vitamin K intakes are associated with hip
fracture but not with bone mineral density in elderly men and women. Am J Clin Nutr. 2000;
71:120108.

11. Booth SL, Broe KE, Gagnon DR, et al. Vitamin K intake and bone mineral density in women
and men. Am J Clin Nutr. 2003; 77(2):512-16.
12. Tucker KL, Morita K, Qiao N, Hannan MT, Cupples LA, Kiel DP. Colas, but not other
carbonated beverages, are associated with low bone mineral density in older women: the
Framingham Osteoporosis Study. Am J Clin Nutr. 2006; 84:93642.

13. Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Protein consumption and bone fractures
in women. Am J Epidemiol. 1996; 143:47279.

14. Manson JE, Hsia J, Johnson KC, et al. Estrogen plus progestin and the risk of coronary
heart disease. N Engl J Med. 2003; 349:52334.

15. Genkinger JM, Hunter DJ, Spiegelman D, et al. Dairy products and ovarian cancer: a
pooled analysis of 12 cohort studies. Cancer Epidemiol Biomarkers Prev. 2006; 15:36472.

16. Ganmaa D, Sato A. The possible role of female sex hormones in milk from pregnant cows in
the development of breast, ovarian, and corpus uteri cancers. Med Hypotheses. 2005; 65:1028
37.

17. World Cancer Research Fund, American Institute for Cancer Research. Food, nutrition,
physical activity, and the prevention of cancer: a global perspective. Washington DC: AICR,
2007.

18. Giovannucci E, Rimm EB, Wolk A, et al. Calcium and fructose intake in relation to risk of
prostate cancer. Cancer Res. 1998; 58:442447.

19. Giovannucci E, Liu Y, Platz EA, Stampfer MJ, Willett WC. Risk factors for prostate cancer
incidence and progression in the Health Professionals Follow-up Study. International Journal of
Cancer. 2007; 121:157178.

20. Larsson SC, Bergkvist L, Rutegard J, Giovannucci E, Wolk A. Calcium and dairy food
intakes are inversely associated with colorectal cancer risk in the Cohort of Swedish Men. Am J
Clin Nutr. 2006; 83:66773; quiz 72829.

21. Cho E, Smith-Warner SA, Spiegelman D, et al. Dairy foods, calcium, and colorectal cancer:
a pooled analysis of 10 cohort studies. J Natl Cancer Inst. 2004; 96:101522.

22. Martinez ME, Willett WC. Calcium, vitamin D, and colorectal cancer: a review of the
epidemiologic evidence. Cancer Epidemiol Biomarkers. Prev 1998; 7:16368.

23. Hyman J, Baron JA, Dain BJ, et al. Dietary and supplemental calcium and the recurrence of
colorectal adenomas. Cancer Epidemiol Biomarkers Prev. 1998; 7:29195.

24. Dickinson HO, Nicolson DJ, Cook JV, et al. Calcium supplementation for the management of
primary hypertension in adults. Cochrane Database Syst Rev. 2006:CD004639.
Should Drink Milk to Prevent Osteoporosis ...?
By: dr.Reni Indrastuti. Regular exercise and Ultra Violet rays in the morning and evening one of
the keys to maintaining bone health, in addition to calcium milk that is displayed in various media.
THE ADVERTISING advertisements that broadcast invitations to drink high calcium milk in various
media are quite attractive and successfully attract consumers to spend their money in pursuit of
density bone and prevent the arrival of osteoporosis.

A portrait depicting a segment of Indonesian society that is already aware of health. This is in line
with the fact that the incidence of osteoporosis is quite high. Based on the International
Osteoporosis Foundation research, 1 out of 3 Indonesian women at risk of osteoporosis. While
in men this ratio occurs in 1 in 5.

Based on data from the Ministry of Health 2006, two out of 5 Indonesians are at risk for
osteoporosis. While the results of studies in the world, the number is similar to in Indonesia, that
1 in 3 women over 50 years suffering from osteoporosis. Worldwide osteoporosis rates have
reached 200 million people.

Producers are observant, the facts above research can be a capital to market milk products
formulanya plus Indonesian people are still considered low in the level of consuming milk. Is high
calcium dairy products a true solution to the health problems of osteoporosis threats?

Is that the fact when drinking high calcium milk with the recommended to 1000 milligrams (mg)
per day will guarantee the body absorb calcium a number of 1000 mg as it appears on the carton
or milk can? Should consume special formula milk high calcium ..?

In contrast to the opinion of Hiromi Shinya, a professor and surgeon digesti derived from Japan
who devoted his knowledge in America, in his book with the Indonesian translation The Miracle
Enzym of Self Healing (2005). According to him, when drinking milk (high calcium), calcium in the
blood suddenly increased (human blood calcium levels are usually pegged at 9-10 mg), then the
body will try to restore the normal state by removing calcium from the kidney through urine
(urine) .

Our hope of consuming milk is to get enough calcium to meet the needs of the body especially
to prevent osteoporosis, but the mechanism according to Hiromi just shows conflicting results.
On the other hand infant formula includes acid forming or contributes to form a high degree of
acidity (pH) in the body, while the normal body pH is around 7.45.

When drinking a lot of milk, then the body's response is to neutralize the acidity it formed with
substances that are alkaline, that is with the body's calcium reserves. Calcium body used to
neutralize this is taken from the calcium bone stock, consequently the bone will decrease in
density, reduced density or bone density will result in osteoporosis.
Osteoporosis is a bone disease characterized by a reduction in bone mass density / density so
that the bones are brittle (porous) and easily broken. Osteoporosis is also dubbed the silent
disease, because osteoporosis is almost asymptomatic at first until it is known to be at an
advanced level characterized by fractures, an increasingly stooped back called the Dowagen
hump, back pain due to spinal collapse due to reduced bone density, and reduced height .

Risk factor
The cause of osteoporosis is only 5 percent associated with certain conditions (certain diseases
such as hyperthyroidism, hyperparathyroid etc.), 95 percent of the causes of osteoporosis are
not known with certainty. But in the general assumption, osteoporosis is mitigated because of
calcium deficiency.
Is it really true ..? Certain risk factors, unhealthy diet, dependence on drugs, and rarely exercise
are more at risk of losing more calcium.

Risk factors for susceptible to osteoporosis are sex, women are more vulnerable than men, older
factors, body shape, lean body are more vulnerable, and race factors, white people and Asian
people are more vulnerable.
Genetic factors are not possible to change, but this contributes only a quarter to cause
osteoporosis, three osteoporosis arise due to factors we can actually control. These factors are
lifestyles with smoking habits, alcoholics and caffeine, eating lots of meat, carbonated soft drinks
(sodas), and lazy exercising, as well as diets with low calcium nutrients.
The food menu is constantly lack of calcium, making the body will release hormones that will
take calcium from other body parts of bone.
Certain medications (corticosteroids / asthma medications, mantacid, antidepressants,
antikejang, heparin), decrease bone mass by inhibiting osteoblast formation.

Consuming lots of calcium milk is prone to osteoporosis ...

Such is the controversial opinion of Hiromi Shinya. This opinion is much debated among various
circles. Regardless of milk issues related to the interests of many parties, it is necessary to take a
middle ground. Actually what benefits of milk we take to prevent osteoporosis ..? Calcium. How
much do we need calcium in a day to anticipate the onset of osteoporosis? The recommended
amount of calcium in the daily menu is as follows:

Age 1 year = 210-270 mg

1-3 years = 500 mg

4-8 years = 800 mg

9-18 years = 1300 mg

19-50 years = 1000 mg

Age-50 years = 1200 mg

If you still feel less mengasup calcium from food sources daily may take calcium supplements no
more than 2500 mg / day. But if our menu has varied, diverse every day we do not peru worry
calcium deficiency. Food sources rich in calcium are found in broccoli, peas, green vegetables,
especially almonds, seaweed, fish eaten with bones, anchovies, reinforced salmon, sardines,
sesame seeds, garlic, onions. Calcium in grains 14 times more than cow's milk processed.

Vegetables:
Calcium consumed singly can not be absorbed by the body optimally, he needs the help of
vitamins and other minerals. Without magnesium, calcium can not form strong bones.
Magnesium is useful for processing calcium in bone. In processed cattle milk the ratio of calcium-
magnesium (Ca-Mg) is very small.
Trace elements, vitamins and minerals that help the absorption of calcium besides magnesium
are:
Vitamins: A, C, D, E, K.

Food Sources:
1. Magnesium, fruit, green vegetables, whole grains, beans, bananas and apricots.
2. Boron, apples, almonds, pears, vegetables and greens.
3. Manganese, namely Ginger, wheat, oats and pineapple.
4. Vitamin A (beta-carotene) star fruit, pineapple, carrots, red peppers and broccoli.
5. Vitamin C, ie almost all fruits, especially guava red.
6. Vitamin D ie, ultra violet rays before 9 am and after 4 pm, pure orange juice, pure yoghurt,
fish oil, tuna and egg yolks.
7. Vitamin E ie, soy milk, grains, beans, avocados, passion fruit, olive oil, sprouts and lettuce.
8. Vitamin K ie, spinach, low-fat cheese, fermented soybeans.
In addition to minerals and vitamins in the diet as well as sunlight, an important factor for
maintaining bone health is exercise. Exercise regularly from an early age, continuously
throughout life is good for bone health. The key to maintaining bone health throughout life is to
apply healthy life behaviors both in maintaining a natural and diverse diet and getting used to
exercise