By Dr. Andrea Hilborn, ND

Originally published in the Kingston Whig-Standard.

In the last Nature’s Way column, I promised that we would talk about osteoporosis. Until I started reading up on it for this article, I did not know that osteoporosis is more common than heart attack, stroke and breast cancer combined. Osteoporosis is an invisible disease. You have osteoporosis if your bones are a certain degree less dense than a young person’s bones of the same sex and ethnicity.

Bone mineral density (BMD) is how we measure and track osteoporosis but the thing we are really concerned about is fractures. Over the course of their lives, one in three women and one in five men will suffer an osteoporotic fracture. That is concerning because hip fractures related to osteoporosis result in death in nearly one third of cases.

You are at greater risk of experiencing a fracture if you have had a fragility fracture, your parents have had a hip fracture, you take glucocorticoids, you smoke, you drink more than three units of alcohol per day, you have rheumatoid arthritis, you weigh less then 60 kg, or you have lost than 10% of weight since age 25.

The foundation of strong bones is laid in childhood and adolescence. Your highest bone mineral density is reached around age 25, and from then on it primarily a game of maintaining what you have. This is truly a case where an ounce of prevention is worth a pound of cure. Instead of beginning to educate people about it later in life, we should be talking to kids about it!

The focus of osteoporosis treatment and prevention has been on calcium for a long time. However, studies of people in different countries have shown that we have the highest rate of fractures in North America, despite having the highest intake of calcium. Healthy bones are not created by calcium intake alone.

A well-rounded nutritious diet for bone strength should include calcium, vitamins D3 and K2, and plenty of potassium. Calcium requirements seem to increase depending on how much meat you eat — people who eat more meat need to take in more calcium. Dairy foods and bone-in fish are good sources. Many plant-based foods are high in calcium as well: sesame paste, broccoli and almonds, for example. Vitamins D3 and K2 are both found in animal fats, if the animals have been grazing on grass. High-quality supplements are available. Getting plenty of potassium is easy if you eat lots of fruits and vegetables.

If you like a morning caffeine fix, you might want to drink tea instead of coffee. Black tea consumption is associated with higher bone mineral density while coffee consumption has the opposite effect. Put down the soda as well; carbonated beverages contain a lot of acid, which causes the body to take calcium out of the bones, in order to maintain the proper pH in the body’s fluids.

Just as important as a healthy diet is lifelong exercise. Exercise has at least two effects on your risk of fracture: growing bigger muscles stimulates bone-building and having stronger muscles gives you better balance. Even mild exercise, when done consistently, has a protective effect. As you age, keep doing what you can, for as long as you can.

If you already have osteoporosis, I recommend following the above recommendations and supplementing with a variety of nutrients — calcium, magnesium, boron, vitamins D3 and K2, and perhaps even zinc, copper, manganese and strontium. There is also a supplement called Lycopene available. It’s derived from cooked tomatoes and appears to be very good for bones. Molecules called isoflavones found in soy, flax and red clover (usually taken as tea) have been found to slow the rate of bone loss, although they do not actually increase bone mineral density.

The World Health Organization has developed a tool for assessing fracture risk that they make freely available (http://www.sheffield.ac.uk/FRAX/tool.jsp?country=19 ). If you are concerned about your bone health, check your fracture risk and make an appointment with a health-care provider to make a plan for preserving your bone density.

It is never too late to start eating a healthy diet and getting in a daily dose of exercise.