Should you be taking calcium to prevent osteoporosis?

You may be wondering if you need to be getting in more calcium in the form of a supplement to prevent osteoporosis.

 Adequate calcium intake has an established role in bone health; however, calcium alone provides very little protection against osteoporosis. In addition, taking calcium supplement can increase your risk of cardiovascular events.

 Most nutrients have a synergistic relationship with each other, and this is true for calcium to protect against osteoporosis, it needs Vitamin D, A, K, Phosphorus, and other nutrients. When you don’t have sufficient Vitamin D you cannot absorb calcium and phosphorus so well from foods.

 Too much calcium, phosphorus & vitamin D from supplementation can result in calcium going to the soft tissue, where it can cause calcification resulting in hardened arteries and kidney stones. Vitamin A & K can help protect against this as it directs the calcium to the bones. Equally, large doses of supplemental calcium can inhibit the absorption of magnesium and other minerals, because some nutrients have antagonistic relations ships with each other.

So how can you ensure you are getting what you need to protect your bones?

You start with diet and lifestyle. You ensure you are getting enough calcium, phosphorous, vitamin D, K, and A though diet. You Get plenty of safe sun exposure without sunblock/sun lotion (Use the D-Minder App to help you). And you do weight baring, or resistance training to build muscle.

Calcium

Chinese mustard greens, bok choy, kale, broccoli, white beans, pinto beans, dairy, canned fish with bones, are some good sources (we need 1200mg a day). The osteonecrosis society have a calculator to help you determine if you are eating enough calcium in your diet, and then you can work with a practitioner to help you increase intake or do some carful low dose supplementing if you are low. https://www.osteoporosis.foundation/educational-hub/topic/calcium-calculator

 Phosphorous

It is in most foods, so insufficiency is very rare, and in fact it can be more common to get too much, especially if lots of sodas and processed foods are consumed, so you may consider cutting back on these for bone health.

Vitamin D

I would only consider supplementation if your blood levels were below 50 ng/ml, and you are working with a practitioner to monitor levels. Little known to many Vitamins D is a hormone, and toxicity can cause big problems. If you are supplementing do ensure you take a formulation that includes K2, for the same reasons as above it protects against calcification. And test your blood levels every 3 months, a healthy level of 25-OH vitamin D is 50-90 ng/ml.

Although it is argued that we can’t get sufficient Vitamin D via the diet, some great sources to add to your diet to help keep levels healthy are fatty fish, eggs, butter, and other animal proteins. I read a very interesting article recently that proposed those who eat a purely animal based diet can get enough Vitamin D from their diet alone. From an evolutionary perspective this would make sense as evidence shows we got most of our calories from animals and topped up with plant foods when sources were scarce.

Vitamin K

There are different forms of Vitamin K.

Vitamin K1 is found in plant foods, and is involved in blood clotting, and less with bone health

Vitamin K2 , which is further divided into MK-7 and MK-4 is found in animal foods, or in fermented foods, regardless of whether the fermented foods are from animal or plant origin. MK-7 is much more effective than K1 at reaching bone, where is helps produce a hormone known as osteocalcin, which improves metabolic and hormonal health and increases exercise performance. In addition, MK-7 stays active in the liver for much longer than K1 before it is broken down; meaning it is also better than K1 at supporting blood clotting. Finally, MK-4 seems to be less effective than MK-7 at reaching liver and bone but more effective at reaching most other tissues. So, if you are eating a diverse range of grass-fed meat including organ meats, and fats, eggs, and dairy, plus eating fermented foods, like natto, you should be getting all the forms of vitamin K.

Vitamin A

Although we get it from both plant and animal foods, Vitamin A in animal foods is already in the form our body needs to be able to utilise it, called preformed vitamin A (retinol, retinyl esters). The form in plant foods, called beta carotene and  provitamin A, this needs to be converted into retinol for out bodies to use. Some people are better at this than others and this is genetically influenced. If you have certain SNPs that slow down this conversion and eat a predominantly plant-based diet, you can be at risk of deficiency.

The bottom line

In summary, if you are eating a well-balanced whole foods diet, getting strength ting or weight baring exercise at least 3 times per week and plenty sun exposure without sunblock, you are probably ok.

If you are concerned you aren’t and would like to investigate your diet or do blood tests, or you have osteopenia get in contact to chat about how we can help.