Building bone vitality: An alternative approach to osteoporosis prevention

Background: An estimated 10 million Americans have osteoporosis. Most approaches to treatment and prevention focus calcium supplementation and the use of one or more pharmacologic agents, most commonly bisphosphonates and are marginally effective at best and may have serious side effects. Other primary strategies for building bone vitality are warranted. Methods and Results: A qualitative review of the growing body of research addressing dietary and lifestyle factors that impact bone health was conducted to identify a set of evidenced-based strategies for building better bones. In epidemiologic comparisons, people in Asian countries tend to have 50 percent lower osteoporotic fracture risk than individuals in North America although calcium intake is much higher in these countries. Of the 86 human trials testing whether milk, dairy, or calcium pills reduce fracture risk, 62 studies (72%) show no benefit. Diets high in animal protein have been found to increase calcium excretion. In addition, diets with a higher ratio of foods from plant sources compared with foods from animal sources have been linked to better bone outcomes. Eighty-seven percent of the 86 studies on exercise and fracture risk show roughly a 50% reduction in risk between the least and most active participants. Many nutrients found in plant foods play a role in bone health, notably, potassium and magnesium and vitamins C and K. Conclusion: Research indicates a dietary pattern built largely from nutrient-dense whole plant foods and limited in foods from animal sources along with daily moderate exercise provides a safe, effective, alternative or complementary approach to osteoporosis prevention and treatment.