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Diet, Sunlight
and Osteoporosis
The
term osteoporosis refers to the unfortunately very common condition by which
bones become de-mineralised and reduced in strength. Also sometimes known as ”brittle
bones”, it is particularly common in the elderly population and a well
established contributory factor in the fractures, especially following falls,
which are a tragically frequent occurrence during this time of life.
Although
the symptoms and consequences of osteoporosis are at their most readily
apparent during old age, it is a condition which may develop throughout
life. But although some of principal
risk indicators for the development of osteoporosis, such as the ageing process
itself, cannot be avoided, the good news is that
altogether. And because the bones’
nutritional demands are their greatest during their growth phase, this
attention cannot begin too early in life.
The human body stores and
requires more calcium than any other mineral, and most of this is in the
bones. Not surprisingly, then, an
adequate intake of dietary calcium is essential for bone health, and a
deficiency one of the principal risk factors for osteoporosis. But although essential, a good intake of
calcium is not enough on its own.
Dietary calcium is relatively easy to obtain through milk, other dairy
produce and green vegetables, but even lavish supplies cannot be absorbed
without sufficient vitamin D, and as many as 80% of sufferers from fractures
attributed to osteoporosis have been found to be deficient in this vitamin.
Unfortunately vitamin D is
less easily obtainable through commonly consumed foods but a potentially,
though not necessarily easily, modifiable “lifestyle choice” which
may have a dramatic effect on levels of vitamin D in the body is the amount of
sunlight to which the skin is exposed.
For years medical orthodoxy was inclined to rely on the fact that
vitamin D can be synthesised within the body on exposure to sunlight as
evidence for the relatively low significance of dietary intake. And there may even have been some force in
this idea in those far away days when a significant proportion of the
population worked in outdoor occupations and children were accustomed to
outdoor play rather than TV, computer and video games.
But
nowadays most people not only work indoors but are strongly advised to cover
themselves liberally with sunblock on the rare
occasions when they do expose themselves to any natural sunlight. For those of us living more than about 37
degrees north or south of the Equator, where sunlight is in any case in very
short supply for six months of the year, this combination of circumstance makes
it doubtful that we will be able to obtain a sufficient supply of vitamin D
from sunlight. And this concern is even
more marked for the elderly, as the body’s ability to synthesise vitamin
D from sunlight reduces with advancing years.
Moreover,
it is unfortunately not particularly easy to obtain a good supply of vitamin D
from a conventional Western diet; oily fish, liver, eggs and certain cereals
being the most reliable, if unpalatable, sources. And contrary to popular belief, dairy produce
in itself is not an especially rich source unless specifically enriched with
the vitamin.
But even
when vitamin D rich foods are regularly consumed, there are still other risk
factors for osteoporosis which need to be considered when considering the
adequacy of vitamin D and calcium intakes.
Smoking and the immoderate consumption of alcohol are perhaps amongst
the more readily avoidable of these.
Less obvious, but perhaps at least as important, is the need for
physical activity, and in particular load bearing exercise or strength training.
Low
secretions of the main sex hormones, testosterone in men and oestrogen in
women, are also important precursors of osteoporosis. Declining levels of these hormones with
advancing age is one reason why older people are much more prone to this
condition, a problem which is particularly marked for women, given the dramatic
drop in oestrogen levels which follows the menopause.
But perhaps
most important is the fact that the typical modern Western diet, with its heavy
reliance on processed foods, is known to result in a high intake of sodium,
which, as well as being a cause of high blood pressure, also increases the
urinary excretion of calcium and other vital minerals with corresponding
adverse consequences for bone density.
The simplest and best solution to this problem, of course, is the
consumption of a diet rich in fresh fruit and vegetables, rather than highly
processed foods, which will in itself ensure a reduction in sodium consumption
and an increase in potassium and other minerals, ensuring the maintenance of a
healthy balance.
To ensure adequate good intakes of both vitamin D and calcium, however, it appears in the light of all of the above to be wise to take advantage of a comprehensive multi-vitamin and multi-mineral supplement.
April
2008
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