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Osteoporosis: One Pill Does Not Fit All

There is no substitute for lifestyle

Dr Padma Garvey/Plant-Based Doctor Mom

Osteoporosis: One Pill Does Not Fit All

Maintaining healthy bones depends on many factors including adequate vitamin D and calcium.  Many foods are fortified with vitamin D and calcium.  There are, of course, lots of supplements available, with limited results.  The truth of the matter is that preventing osteoporosis requires more than a quick fix and one that starts when we are young.

The osteoporosis paradox refers to the finding that countries that consume no animal dairy have lower rates of osteoporosis than countries that consume  animal dairy.  But in order to understand the issues behind osteoporosis we need to take a broad approach.  People from warmer climates, where there is a lot of sunshine, have no problems making all the vitamin D they need from the sun they get.  That is how nature intended for all of us (regardless of skin color) to get our vitamin D.  Sunlight hits our skin, converting our cholesterol into vitamin D.  So sunlight helps to lower your cholesterol.  That is one reason why people from Okinawa have lower rates of heart disease and osteoporosis.  They get a lot of sun, use up a lot of their cholesterol to make vitamin D, walk outside a lot, and eat lots of calcium-rich foods like greens and beans (seaweed and tofu).  This is the prescription for avoiding osteoporosis.  Sunshine, beans and greens, and walking. People from Sweden have much less exposure to sunlight which is why they are very fair-skinned.  Their bodies use up less of their cholesterol because they can’t convert as much to vitamin D.  They tend to have fewer opportunities to walk outside, and eat fewer beans and greens.  They compensated for this lack of vitamin D by eating foods that have some vitamin D like dairy and fatty fish, but this in turn leads to higher cholesterol levels and heart disease.  

Melanoma can be deadly.  There is a melanoma paradox too.  Melanoma rates have risen as sunscreen usage has risen.  Also office workers have a higher rate of melanoma than outdoor workers of the same race. The country with the highest rate of melanoma is Australia.  This makes sense because people of Northern European ancestry (very fair-skinned) immigrated to a country with a lot of sun.  The Aborigines of Australia are not at increased risk for melanoma like the Northern Europeans are.  Even in Italy, there are marked differences in the rates of melanoma between northern Italians and southern Italians.  In our attempt to avoid skin cancer, we have gone to the other extreme and eliminated how nature intended for ALL OF US to get our vitamin D, from the sun.  If you are very fair skinned, then you don’t need as much sun as someone who has a darker complexion, but we all need some sun.  Outdoor physical activity needs to continue throughout our lives, even as we get older.  Taking a nice walk, hiking, playing tennis, bike riding, swimming, etc are a few examples of healthy outdoor physical activity.  Remember before modernization, most people were farming.  Before the advent of agriculture, most people were hunting and foraging.  Our bodies were built to deal with outdoor physical activity.  The darker you skin color, the more sun you can handle. In fact, the darker your skin, the more sun you need to avoid vitamin D deficiency.

For people living in colder climates, getting enough sun can be difficult in winter.  Sunlamps are a convenient way to ensure adequate exposure.  I purchased some sunlamps through Amazon.  They are the size of a cell phone and cost about $30.  I have one for my office and one for my treadmill.  As a rough guide, I would say that fair-skinned individuals should get 15 minutes of unblocked sun every day whereas people with darker complexions may need thirty minutes to an hour every day.  If you do not or cannot get enough outdoor physical activity then you should make sure your plant-based milks and cereals are fortified with vitamin D.  But keep in mind that any vitamin D you are getting through supplements or fortified foods is that much vitamin D your body is not making from built up cholesterol.  People with naturally healthy vitamin D levels have lower rates of heart disease because they are getting enough sun…..not because they are taking a supplement. 

Another osteoporosis paradox refers to the finding that people with lower bone density have fewer or the same number of fractures than people with higher bone density.  Asians tend to be shorter than Northern Europeans.  As a result they have less bone density than Northern Europeans, and yet less osteoporosis or no appreciable difference depending on what study you look at. 

In this country, the assumption is that the higher your bone density the better.  But this is counter to what we see around the world.  Countries with shorter heights and lower weights, have lower bone density and lower fracture rates…not higher.  There are several drugs that serve to increase bone density but they have some drawbacks.  Bone density does not seem to correlate with bone fracture across the globe.  This goes along with calcium intake as well.  Countries with higher rates of calcium intake, have higher rates of osteoporosis…not lower.  One reason may be that countries with higher calcium intake tend to be more westernized,  less physically active, less sun exposure, more meat and dairy consumption, etc.  Heathy plant-based sources of calcium include beans, especially tofu, and green-leafy vegetables. 

Hopefully you have learned from this blog that there is simply no pill for bone health.  It is a lifestyle.

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