Q. I consider myself a very healthy woman, since I have been athletic all my life and even considered training for the Olympics, but my physician is worried that I have the beginnings of osteoporosis at age 32. Could this be true?
A. Although weight-bearing exercise is one of the best ways to reduce risk of osteoporosis, exercise that is vigorous enough to stop your menstrual period increases this risk. If you exercised to that extent in the past you will need to work harder than most women of your age to stop the progression of bone loss and make up for the loss. With effort, bone loss can be stopped and sometimes reversed even in women older than you.
It goes without saying that you need to maintain a generous calcium intake, above 1,200 mg per day, but excessive calcium intake can interfere with your ability to absorb other nutrients that are just as important for bone health as calcium. Calcium taken at mealtime can interfere with absorption of zinc and copper, both needed to make strong bones, so take about 1,000 milligrams (mg) of calcium twice a day in the form of calcium citrate before breakfast and at bedtime. Use a calcium supplement that includes some magnesium, 400-600 mg per day, to maintain a balance between these minerals.
Another mineral supplement to consider is boron, one of the unusual trace minerals. U.S. Dept. of Agriculture research indicates that a supplement of 5 mg of boron per day keeps calcium soluble inside your body so that the hormones controlling its placement operate better. Boron is one of the safest trace minerals and modest supplements do not disturb the balance of other minerals.
Many other vitamins and minerals are required to build bone, so adding a good multivitamin/mineral, with additional folic acid, to the supplements above would be prudent.
Bone formation starts on a web of protein called collagen, and a low-protein diet increases risk of osteoporosis. However, the research is inconclusive on just how much and what type of protein is best for preventing osteoporosis. Excessive amounts of animal protein tend to increase urinary calcium loss, but this may relate to the phosphate in meat. Total protein intake in the range of 60-70 grams per day seems sufficient. Soy products can supply some of this protein along with nutrients called isoflavones that are helpful for sound bones, but again there is concern about overdoing it. One or two servings of soy per day can certainly be included as part of a varied diet.
If you smoke, let this threat of osteoporosis motivate you to stop. There are plenty of other reasons to stop smoking, but sometimes a clear and present danger will inspire action. Another unprofitable habit is high consumption of coffee and cola drinks. The caffeine increases urinary loss of calcium, as do the phosphates and the caffeine in cola drinks.
The sodium in soft drinks adds to the salt intake from other sources and, like caffeine, will increase urinary calcium loss. A lot of our daily salt comes from convenience foods, which seldom provide much in the way of vitamins or minerals and thus can be drastically reduced or eliminated without forfeiting any benefits.
Don’t let a concern about your prior exercise habits deter you from staying active. Walking is still considered the ideal exercise for most Americans since it is hard to overdo, although any weight-bearing exercise is acceptable.
You are actually fortunate that your physician called your attention to the danger you face, because you have the time to stop and probably reverse your condition before any bones break. Take advantage of this period of grace.
This article appears in December 21 • 2001.