Just a few short years ago, the bulk of dietary recommendations for osteoporosis revolved around calcium. But, over the past number of years, new players have come onto the field and calcium is now taking somewhat of a backseat when it comes to importance.
Vitamin D is the “sunshine vitamin”. While exposure to sunlight provides vitamin D, Canadians are at risk of seasonal vitamin D deficiency because winter sunlight in northern latitudes above 35º does not contain enough ultraviolet B for vitamin D production. Osteoporosis Canada’s new guidelines (July 2010) recommend daily supplements of 400 to 1000 IU for adults under age 50 without osteoporosis or conditions affecting vitamin D absorption. For adults over 50, supplements of between 800 and 2000 IU are recommended. I feel that everyone (especially those with osteoporosis) should have their vitamin D levels check (ask for 25-hydroxyvitamin D). This allows for individualized supplementation.
In my experience, most people in Nova Scotia need more than the recommended amounts to maintain optimal levels of vitamin D.
Magnesium is a very important mineral, and vitamin D’s most important cofactor. In fact, it has been shown that low levels of magnesium inhibit formation of the active form of Vitamin D.
Food sources of magnesium include:
- Seeds, especially pumpkin and toasted sesame
- Beans, especially pinto and black
- Plantain, raw
- Nuts, especially Brazil nuts, almonds, peanuts
Magnesium oxide is the most common form of magnesium sold, but only about 4% is absorbed, making it ineffective at providing the body’s magnesium needs. Magnesium taurate, glycinate, citrate, and gluconate have demonstrated higher absorption and bioavailability. Magnesium malate and glycinate are considered by many to be even more effective supplemental forms.
This vitamin, once only known for it’s role in blood clotting is thought to be as important as Vitamin D and Calcium in maintaining bone health. Unlike other fat-soluble nutrients, vitamin K is not stored in the body and must be received daily through diet or supplementation. In fact, research indicates one can become deficient in vitamin K in as little as 7 days. While there are 3 types of vitamin K, K2 is an important cofactor for Vitamin D.
Green leafy vegetables are the best source of vitamin K – another good reason to eat them!
Boron is a trace mineral, recently found to be important in bone health. It is found in many foods, but concentrated in:
- fresh fruits and vegetables
- dried prunes
So what about Calcium? Do I still need to take it?
Calcium is still a very important mineral in preventing and treating osteoporosis. However, most of the recent research seems to indicate that you can get too much of a good thing, and that less is more when it comes to calcium. A recent study, which analyzed data from the WHI (Women’s Health Initiative) found that women who started taking calcium and vitamin D had increased risk for heart attack and stroke. But, dietary sources of calcium aren’t a problem – so be sure to include good sources of calcium every day. And, discuss the need for calcium supplements with your ND or MD.
M. J. Bolland, A. Grey, A. Avenell, G. D. Gamble, I. R. Reid. Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ, 2011; 342 (apr19 1): d2040 DOI: 10.1136/bmj.d2040