Article

Food and Our Bones
by Annemarie Colbin, Ph.D.

Osteoporosis has been talked about at length since the early 1980's, when studies found it to be a public health issue.  It is estimated that over 25 million people in the United States are affected by this condition.  However, it is not osteoporosis, or thinning of the bones, that is the problem, but the risk of fracture, especially in the elderly.  In the US, some 40% of women and 13% of men may sustain a fracture after age 50.  More than 1.3 million fractures annually are attributed to osteoporosis.  Among them are some 500,000 vertebral or spine fractures, 250,000 hip fractures, and 240,000 wrist fractures.  The numbers are different in different countries:  reported incidences of hip fractures are highest in the US and Northern Europe;  intermediate in Mediterranean and Asian countries, and lowest in South Africa, particularly in the areas where people follow traditional ways of life.  There are more fractures among city dwellers than among country folk.  Over the past 40 or 50 years, the incidence of hip fractures has risen significantly worldwide.

Calcium, especially from milk products, has been universally recommended as the one main element needed to reduce the risk of fractures.  However, that may be the wrong approach:  there are more fractures in regions that consume milk products (US, Great Britain, Canada, Northern Europe), than in those that don’t (traditional Africa, China).   The extensive Nurses Study at Harvard, which followed 78,000 nurses for more than 12 years, found that those who drink two or more glasses of milk per day have twice the risk of hip fracture than those who drink a glass a week or less.  In fact, the authors of the study conclude that “it is unlikely that high consumption of milk or other food sources of calcium during mid-life will confer substantial protective effects against hip or forearm fractures.” [1]   There are several other large-scale studies that show that high calcium intakes double the risk of hip fracture. [2]     After all we’ve been told, how could this be? 

The explanation for this confused state of affairs lies in understanding the structure and function of bones better.  At this time, most people, including health professionals,  think bone=calcium, so the solution seems obvious.  But that is too simplistic.   Physiologically,  bones are composed of calcium phosphate salts (65%) for hardness, and a collagen matrix (35%), for flexibility.  If  a bone is placed in an acid bath and all the calcium is removed from it, leaving just the collagen matrix, when subjected to stress it will bend, not break.  Conversely, if the collagen matrix is removed and all that remains are the calcium salts, when subjected to stress it will shatter.  In other words:  a bone with zero calcium will bend, not break, whereas a high calcium/low collagen-matrix bone would break easily.  This is why excess calcium can indeed increase the risk of fracture!  For good bone health, we need many other synergistic nutrients, what Ann Louise Gittelman, author of Supernutrition for menopause, calls “the bone-building nutrient team”:  magnesium, phosphorus, boron, copper, manganese, zinc, plus the vitamins C, D, K, B6,  and folic acid.  In addition, we need sufficient amounts of protein for the collagen matrix, and healthful fats for Vitamin D absorption and protection against bone-destroying free radicals.  To obtain Vitamin D, we need 30 minutes or more of sunlight, or at least daylight, every day, without sunscreen.  That is because a SPF of 8 blocks 95% of the production of Vitamin D, on the skin, and anything higher blocks it all [3] .

Here is my dietary approach to good bone health:  plenty of vegetables, especially leafy greens (remember what the cows, horses, and elephants eat!), certainly five to seven portions daily including parsley, roots, and cruciferous vegetables like cauliflower and cabbage;  cooking with stocks made with vegetables and a stick of kombu seaweed, or with fish, chicken or beef bones and a tablespoon of vinegar to liberate the minerals;  sunflower and pumpkin seeds for the minerals and natural fats;  modest amounts of whole grains for the fiber and complex carbohydrates;  beans and naturally raised animal foods for the protein;  butter, extra virgin olive, flaxseed, and unrefined sesame oils for the essential fatty acids. 

The following foods are best avoided because they cause an acid condition that leaches minerals out of the bones:  refined sugars, honey, and white flour,  including pasta, white bread, muffins, and of course baked flour desserts.  Based on epidemiology and the studies mentioned above, avoiding milk products may also prevent bone fractures!  Last but certainly not least, walking and weight bearing exercise for at least 30 minutes every other day, or more often, are essential to keep the bones in good working order.  Gravity is good for us!

Here is a recipe out of my forthcoming book, Food and Our Bones:  The Natural Way to Prevent Osteoporosis (Dutton, July 1998).

CHICK PEA TABOULI

1 cup dry chickpeas, soaked overnight and drained

4 cups water or vegetable stock

1 4" piece of kombu seaweed

½ teaspoon sea salt

1 medium onion, diced medium (about 1 cup)

1 cup minced parsley

LEMON DRESSING

1 ½ tablespoon lemon juice

1 ½ tablespoon extra virgin olive oil

1 ½ tablespoon flax seed oil

1 teaspoon umeboshi vinegar (optional)

1. Cook chickpeas in a pressure cooker with the kombu, the water, and the salt, for 45 minutes, or until soft.

2. Place the onions in a large serving bowl.  With a mesh strainer, remove and drain the chickpeas from the water, leaving the kombu behind, and add them to the onions while still hot. 

3. The kombu should be easily disintegrated.  Tear it with a fork or knife, remove with the mesh strainer, and add to the chickpeas.  Reserve the water for your next soup.

4. Mix all dressing ingredients in a separate bowl, and pour over the chickpeas.  With a fork, mix the chickpeas, dressing and onion until well intermixed.  Cool to room temperature, add the parsley and toss.  Serve at room temperature or chilled.  Makes about  4-6 servings.

References

[1] . Feskanich D, Willet WC, Stampfer MJ, Colditz GA, “Milk, dietary calcium, and bone fractures in women:  a 12-year prospective study.  Am J Public Health  1997 June(87):992-997

[2] . Cumming RG, Cummings SR, et al, “Calcium intake and fracture risk:  results from the study of osteoporotic fractures.”  Am J Epidemiol  1997(145):926-934.  Kreiger N, Gross A, Hunter G, “Dietary factors and fracture in post-menopausal women:  a case-control study.”  Int J Epidemiol  1992(21):953-8.

[3] . Nutrition Action Health Letter, “Vitamin D deficiency:  the silent epidemic.”  Center for Science in the Public Interest, Volume 24, number 8, October 1997.

© 2001 by Annemarie Colbin, Ph.D.