Osteoporosis

What is osteoporosis?
Osteoporosis is a gradual loss of bone density and bone strength.  It used to be assumed to be associated with older women and if not picked up in bone scans made itself felt only when a hip, wrist, rib or spine cracked following a sudden unaccustomed movement such as a fall or even a cough. 

Now we find that osteoporosis occurs in men (one in three men over 50 years of age) as well as women (one in every two) and it also affects much younger people, especially women who have had their limited skeletal calcium depleted through childbirth.  But we also know that osteoporosis is not inevitable and that it can be prevented.

What causes osteoporosis?
Fundamentally, the incidence of osteoporosis increases the further people locate themselves from a Paleo activity profile and a Paleo diet.  It appears there is a genetic component as well, although whether the way parental incidence of osteoporosis manifests itself in their children reflects the way children tend to follow the dietary and activity patterns of their parents or whether there is a strict inheritance of an osteoporotic propensity has not been determined conclusively.

Physical activity profiles as causes of osteoporosis
Throughout the last 5m years of human evolution until very recent times, people did hard physical work almost every day.  Their survival depended upon it.  Carrying, sprinting, wrestling, grappling, climbing, building, lifting, dancing and showing off – all were likely daily activities and they were often carried out with what we 21st century gym users refer to as “max” , or maximum weights shifted at maximum speed.  A recent study of professional tennis players found their ‘playing arm’ had 35 per cent greater bone density (The Australian, 6 July 2002).  ‘Gentle exercise’ did not exist, nor did osteoporosis.  Even in the developing world today, where dietary calcium intake is well below Western levels, but where hard work is common, osteoporosis is much rarer than in the West.

Strength training three times a week can increase bone density by up to 2 per cent a year, even in people over 65 years of age.  Even the most advanced drug-based bone-building therapies increase bone density by up to 3 per cent and they do not have the added benefits of building muscle strength, balance, coordination and confidence so that fracture-causing falls are less likely in the first place.  For some with osteoporosis, vigorous strength training can help ease the pain of osteoarthritis and reduce depression.

Dietary causes of osteoporosis
Some foods, especially coffee and manufactured foods which produce a net acid load on the kidneys leech calcium from the bones.  This leaching results from the body excreting more calcium than it absorbs.  Our skeletons is not merely the framework of our bodies: our bones are also our calcium store which is drawn upon to neutralize acidity in the digestive process.  Cereals, legumes and high protein foods especially hard cheeses (despite their significant calcium content) and meat also exert a net acid load.  On a Paleo diet, the net effect of eating acid-producing foods is neutralized (or buffered) by alkaline-producing foods such as fresh vegetables and fruit.

Child and adolescent causes of osteoporosis
Bone building is most intense during puberty and through adolescence.  Young people who drink carbonated drinks, coffee and who eat high starch snack foods can be building up a personal osteoporosis time bomb.  Although strength training in later life can reduce the risk of osteoporosis, far more can be done during adolescence in terms of both diet and physical activity to lay down the best possible skeletal structure.

Dietary salt – sodium chloride – is another cause of osteoporosis.  In this case it is the chloride rather than the usual suspect – the sodium – which contributes most to dietary acidity.

Mainstream treatment of osteoporosis by the medical profession
Treatment of fractures resulting from osteoporosis is dominated by orthopaedic surgeons whose formula is similar for all fractures: apply a plaster cast, prescribe a drug and ask the patient to come back in six weeks to check the healing.  Only rarely is any thought given to preventing future fractures.

Drug-induced osteoporosis
From The Australian, 6 July 2002: ‘The most catastrophic examples of osteoporosis occur in people on long-term doses of drugs such as the anti-inflammatory steroids prednisone and cortisone, which leech calcium from the skeleton.  Nobody should be on prednisone without being prescribed a weight-training program.  Frequent use of asthmatic puffers such as Ventolin also accelerates bone loss.’

Epidemiological factors
In the west, the incidence of osteoporosis in women may exceed that of cancers of the breast, uterus and cervix, but the mobilization of public interest, information and prevention has been far less apparent than the risk would imply.  GPs regularly advise women to undergo mammograms but relatively few recommend a bone density test, despite the incidence of osteoporosis exceeding that of breast cancer.
Hip fractures alone cost about $AU50 per person annually in the West: $AU1bn in Australia, one billion pounds in the UK and $US8bn in the US and unless the increasing incidence of osteoporosis is turned around, this will triple by 202 on present demographic trends.  About 20 per cent of hip fractures lead to death (through infection) and a further 50 per cent of cases require full-time nursing care.

References:

Loren Cordain, The Paleo Diet
The Australian, article 'Close to the Bone' 6 July 2002

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