Healthy strategies for bone and joint health
Gillian Flower, ND
Strong bones and joints are important to prevent diseases such as osteoporosis and osteoarthritis. Natural treatments are part of a good preventive strategy.
Australians are living longer than ever before, with average life expectancy now topping 80 years. Implicit in our desire to live longer is a need to lead healthier lives, free of pain and illness for as long as possible.
Osteoporosis and osteoarthritis are two conditions that occur more often as we age. Both can cause significant pain and loss of function, compromising the quality of our lives in later years. By making the right dietary and lifestyle choices now, we may be able to diminish the impact of osteoporosis and osteoarthritis in the future.
Our bones undergo a constant, dynamic process of cellular breakdown and rebuilding. We achieve peak bone mass sometime between our late teens and early thirties. From this point onward, bone breakdown starts to happen more quickly than the rebuilding process. Osteoporosis is diagnosed if this imbalance leads to significant decreases in bone density, bringing with it an increased risk of fracturing the spine, hips and other bones.
What we can’t change
Many considerations affect our osteoporosis risk. Factors that we cannot change include ageing, family history, having small bones to begin with and being female. Medications taken for other conditions including steroids, anti-seizure drugs, diuretics, proton pump inhibitors and blood thinners can all deplete bone density. Cancer therapies that block the production of oestrogen or testosterone can contribute to bone loss as well.
Digestive issues leading to poor absorption of calcium also increase the chance of developing osteoporosis. Two-thirds of individuals with coeliac disease have low bone density at diagnosis, and digestive surgery can further compromise calcium absorption.
Hormones play an important role in bone health. The increased risk of osteoporosis faced by women at menopause is attributed to declining levels of bone-preserving oestrogen. Likewise, cortisol and natural or synthetic thyroid hormones wreak havoc on bone density when present in high levels. Evaluate your osteoporosis risk with your health care practitioner if you have a prescription, medical condition or hormonal concern that could compromise your bone health.
Do I have osteoporosis?
Called “the silent thief,” osteoporosis may progress unnoticed until bones break under normal stress. Eighty per cent of fractures in people over the age of 50 are caused by osteoporosis. Symptoms associated with weakened bones include loss of height, backache and stooped posture. Sadly, we may not realise that we are at risk until a fracture occurs.
Consulting a health care practitioner
Osteoporosis risk should be discussed with your health care practitioner at age 50, and your height should be measured annually. If you are at risk of osteoporosis, a bone density test can be conducted to see if any bone loss has occurred. This important test is advisable for all individuals over the age of 65.
What’s the good news? There are many steps that we can take to prevent osteoporosis and slow its progress if it has already been diagnosed.
Calcium is a bone health all-star, and inadequate levels of this nutrient (under 1200 mg per day) are implicated in the development of osteoporosis. Besides milk products and fortified foods, good sources of calcium include leafy greens, blackstrap molasses, canned fish with bones, almonds and beans.
Vitamin D also aids in calcium absorption, and bone loss can occur when our blood levels are insufficient. Many foods such as milk, milk alternatives and juices have vitamin D added to them. Natural sources of this vitamin include eggs and fish such as eel, mackerel, salmon, herring and sardines.
It may be necessary to supplement both calcium and vitamin D to make sure that you are getting enough every day.
Magnesium, zinc and vitamin K are other important factors in bone health, though their precise role is still being studied. In doses exceeding 1800 mg per day, magnesium shows promise as an important treatment alongside calcium and vitamin D. A nourishing diet with a focus on fruits and vegetables will also provide a nutritional foundation for the bone-building process.
Some foods and drinks are harmful to our bone health. A diet based on snacks and processed foods will deplete bone density, while daily intake of caffeine, soft drinks and more than 1600 mg of salt will draw calcium from the bones. Alcohol in moderation may protect bones, but more than two drinks per day will speed bone breakdown. Smoking is another well-known risk factor for osteoporosis.
Choose foods and drinks that will support rather than deplete your calcium stores.
Regular exercise is known to offer some protection against bone loss, and 30 minutes of activity is recommended on most days of the week.
Any exercise that works against gravity will put a controlled load on the bones, promoting bone strength. Try walking, hiking, running, jumping and any sports that incorporate these activities. If you are at risk of a fracture, opt for low-impact exercises such as walking and elliptical workouts that do not jolt the bones. Yoga postures may help slow bone breakdown, though people at risk should be cautious when bending and stretching.
If you find that either your diet or your body is deficient in bone-building nutrients, it may be time to supplement. Levels listed below are recommended daily (or adequate) intakes, but higher levels may be used if you are starting from a state of deficiency.
Calcium (dietary and supplemental combined):
Osteoarthritis is the most common form of more than 100 related conditions that profoundly impact joint function. It is distinct from arthritis related to an autoimmune process (rheumatoid arthritis), infection (septic arthritis) or other chronic illness.
In osteoarthritis, the protective cartilage covering the ends of bones gradually wears away, leading to painful bone-on-bone contact within joints of the hands, spine, hips and knees. Areas of overuse or previous injury are especially prone to the development of arthritis in later years. As with osteoporosis, women may be slightly more susceptible to this condition, though risk increases in both sexes with age.
Obesity is one of the most important risk factors for the development of osteoarthritis. Carrying extra weight on our bodies puts added strain on our joints, accelerating the process of cartilage breakdown. Keep your weight within a healthy range (body mass index under 25) to ensure happy joints into the future.
Do I have osteoarthritis?
Classic symptoms of osteoarthritis include pain (especially after activity), stiffness after periods of inactivity and loss of joint flexibility and strength. Joints may be tender to the touch, creak when moved and develop small bumps as the condition progresses.
Consulting a health care practitioner
If you have had joint pain or stiffness for more than a few weeks, have your symptoms evaluated by a health care practitioner. An X-ray may show reduced space inside the affected joints and areas of bone overgrowth (bone spurs).
Evidence relating to the prevention of osteoarthritis is sparse, as the specific causes of this condition are not well understood; however, a few important strategies may afford some protection.
Prevent joint injuries in your daily life through regular exercise. Build and tone joint-supporting muscles to avoid putting too much stress on the joint itself. If you find yourself in pain, listen to your body and rest the affected joints. Pushing through pain can cause injury, leaving you at higher risk of developing osteoarthritis down the road.
If you are heavier than you would like to be, commit to weight loss for the sake of your joints. Make use of the resources at your disposal: health care practitioners, family and friends, and that gym membership you keep meaning to use. Book a few individual sessions with a personal trainer or enrol in an organised sport. A healthy weight is essential for good joint health.
A plant-based diet protects against osteoarthritis, and specific foods such as garlic and non-citrus fruits may be particularly helpful. This benefit may come from the anti-inflammatory effects of fruits, vegetables and whole grains, as compared to the pro-inflammatory properties of highly processed, sweetened and animal-based foods. As a bonus, plant-based diets are an excellent way to maintain a healthy body weight.
Omega-3 fatty acids are well known for their anti-inflammatory properties, and while their effect on osteoarthritis is still being explored, they have the potential to slow the progression of this condition. Include cold water, oily fish such as salmon, herring, mackerel, sardines and anchovies in your diet for an omega-3 boost.
Spice it up!
Extracts made from ginger and turmeric show promise as healthy helpers in controlling osteoarthritis-related pain, though their preventive role is largely unknown. Try incorporating these spices into your recipes, and notice if there is any change in osteoarthritis symptoms. Green tea may also prove to be helpful in the prevention and treatment of arthritis.
Treating osteoarthritis through exercise
Although over-exertion may intensify the pain of arthritis, it is vitally important to keep your joints moving every day. Exercise can help prevent cartilage loss in joints affected by osteoarthritis and even promote repair. Exercises targeting the following areas are recommended.
Range of motion: move your joints through their normal range to reduce stiffness and promote flexibility.
Muscle strengthening: gently build muscles around affected joints to relieve strain and promote stability.
Cardiovascular health: increase your heart rate to strengthen this vital organ and promote weight loss.
As with osteoporosis, aim to engage in some form of exercise on most days of the week for maximum benefit. Consult a physiotherapist to get the most out of your exercise regime.
Understanding and addressing the risks that contribute to osteoporosis and osteoarthritis will help us enjoy strong bones and joints for a long and healthy life.
Natural treatments for arthritis
Already have arthritis? Consider these treatments in consultation with your health care practitioner.
|chondroitin sulphate||component of joint cartilage—may improve cartilage volume and preserve joint space||500 mg two times per day|
|glucosamine sulphate||component of joint cartilage—may delay arthritis progression, reduce pain and improve joint function||500 mg three times per day|
|eggshell membrane||natural substance containing factors that contribute to joint tissues—may increase flexibility and decrease pain||500 mg per day|
|curcumin||anti-inflammatory plant extract from turmeric—may decrease arthritis symptoms and blood markers of inflammation||500 mg two times per day|
|acupuncture||the application of needles to specific points along energetic meridians—may increase joint function and reduce pain||variable based on severity and response to treatment, but some improvement should be expected after one to three treatments per week over several weeks|
|methylsulfonylmethane (MSM, or otherwise known as dimethyl sulfone)||anti-inflammatory molecule occurring naturally in the body—may improve pain and function scores in osteoarthritis||3000 mg per day|
|Boswellia serrata||Ayurvedic herb—may improve joint function and decrease frequency of flare-ups||1000 mg per day|