By Dr. Mercola
Osteoporosis is often thought of as a “woman’s disease,” but one-third of hip fractures occur in men. And while one in three women over the age of 50 will suffer from an osteoporosis-related fracture, so will one in five men.
In fact, a new report from the International Osteoporosis Foundation (IOF) found that the lifetime risk of men experiencing an osteoporosis-related fracture after the age of 50 is up to 27 percent, higher than the lifetime risk of developing prostate cancer (11 percent).1
Yet, because men aren’t typically viewed as “at risk” of osteoporosis, their increasingly fragile bones may go unnoticed. As a result, while hip fractures in women are expected to decrease by 3.5 percent from 2010 to 2013, hip fractures in men are expected to increase by nearly 52 percent during the same period.
Even more concerning, hip fractures appear to be deadlier in men than in women, with 37 percent of men dying in the first 12 months after such a fracture (compared to 20 percent of women).2
What Contributes to Thinning Bones in Men?
Bone weakening is a common problem associated with aging. In most people, sometime during your 30s, your bone mass will begin to gradually decline. For women, that bone loss can significantly speed up during the first 10 years after menopause, when sex hormones often decline rapidly. This is the period when osteoporosis often develops.
In men, however, testosterone levels tend to drop gradually, which is why increased bone breakdown and decreases in bone density tend to become most severe after the age of 70 (provided you're not doing anything to counteract it, that is). Those with osteoporosis are at increased risk of height loss, fractures of the hips, wrists, and vertebrae, and chronic pain.
Poor diet, nutrient deficiencies, smoking, drinking excess alcohol, and sedentary behavior are common osteoporosis risk factors in both men and women. Certain medications also increase your risk, including steroids, anti-seizure drugs, antidepressants, and hormone-deprivation therapy for prostate cancer.
Dr. Peter Ebeling, professor of medicine at the University of Monash in Australia, who authored the IOF report, also noted that fracture rates are rising as men live longer and become more urbanized in lifestyle. By 2050, he estimates that the number of men aged 60 years and over will increase 10-fold, and with it the number of osteoporosis-related fractures is expected to increase exponentially.3
Hyaluronic Acid for Bone Health
Hyaluronic acid (HA) is a key component of your cartilage, responsible for moving nutrients into your cells and moving waste out. One of its most important biological functions is the retention of water… second only to providing nutrients and removing waste from cells that lack a direct blood supply, such as cartilage cells.
HA is found in all of your bones and cartilage throughout your body, where it helps to provide resilience and rigidity to these structures. HA is particularly noted for helping to cushion your joints, however, hyaluronic acid cartilage also covers the ends of the long bones in your body, where bending occurs.
This provides a cushioning effect for your bones as well, and may help protect against wear and tear. Additionally, hyaluronic acid has been shown to reduce bone turnover and bone mineral content loss in animal studies,4 as well as induce osteoblast (cells responsible for bone formation) differentiation and bone formation in vitro.5
It’s thought that HA inhibits bone resorption and provides a protective effect on bone density. Unfortunately, the process of normal aging reduces the amount of HA synthesized by your body. Oral hyaluronic acid supplementation may effectively help most people to not only cushion their joints but also potentially protect their bone health after just 2 to 4 months.
Men Need Bone-Building Nutrients, Too
Many men think their bone health can take a backseat, but it’s just as important for you to tend to your bone health throughout your life as it is for women. No matter your gender, the formula is the same and requires attention to four nutrients, calcium, vitamin D, vitamin K2, and magnesium.
In a nutshell, calcium, vitamin D, vitamin K2, and magnesium work synergistically together to promote strong, healthy bones. Vitamin K2 is a particularly critical component here, because the biological role of vitamin K2 is to help move calcium into the proper areas in your body, such as your bones and teeth. It also helps remove calcium from areas where it shouldn't be, such as in your arteries and soft tissues.
Paying attention to your vitamin K2 intake becomes even more important if you're taking large doses of oral vitamin D3, as your body will create more vitamin K2-dependent proteins when you take vitamin D. These K2-dependent proteins are what helps move the calcium around in your body, but you need vitamin K2 to activate those proteins. If they're not activated, the calcium in your body will not be properly distributed and can lead to weaker bones and hardened arteries—the exact opposite of what you're trying to achieve.
So, it's important to maintain the proper balance between all of these nutrients: calcium, vitamin D, and K2, and magnesium. Vitamin K2 deficiency is actually what produces the symptoms of vitamin D toxicity, which includes inappropriate calcification that can lead to hardening of your arteries. And if you have too much calcium and not enough magnesium, your muscles will tend to go into spasm. This has consequences for your heart in particular. An appropriate ratio of calcium to magnesium is thought to be 1:1.
The Fantastic Four for Bone Health
Lack of balance between these four nutrients (calcium, vitamins D and K2, and magnesium) is why calcium supplements have actually become associated with increased risk of heart attack and stroke. One of the best ways to ensure you're getting enough of all of them is to get regular sun exposure to optimize your vitamin D levels, and to eat a diet rich in fresh, raw whole foods, which will also maximize a wide variety of other natural minerals that support bone health. This way, your body will have the raw materials it needs to do what it was designed to do. Below are some suggestions for foods that provide these bone-building nutrients (with the exception of vitamin D, which is best obtained from sensible sun exposure or tanning bed usage):
- Calcium: Raw dairy from pasture-raised cows, leafy green vegetables, the pith of citrus fruits, carob, and sesame seeds. Homemade bone broth is another excellent source. Simply simmer leftover bones over low heat for an entire day to extract the calcium from the bones. Make sure to add a few tablespoons of vinegar. You can use this broth for soups, stews, or drink it straight.
- Magnesium: Industrial agriculture has massively depleted most soils of beneficial minerals like magnesium, so this is one instance where a supplement may be warranted, especially since most people are deficient.
It is the only mineral that I personally supplement with. That said, if you find biologically grown organic foods (grown on soil treated with mineral fertilizers), you may still be able to get a lot of your magnesium from your food.
Chlorophyll has a magnesium atom in its center, allowing the plant to utilize the energy from the sun. Seaweed and green leafy vegetables like spinach and Swiss chard can be excellent sources of magnesium, as are some beans, nuts, and seeds, like pumpkin, sunflower, and sesame seeds, and raw organic cacao. Avocados also contain magnesium.
- Vitamin K2: Sources include grass-fed organic animal products (i.e. eggs, butter, and dairy), certain cheeses such as Brie and Gouda (which provide about 75 mcg of K2 per ounce), and certain fermented foods (particularly if they’re fermented using a vitamin K2-rich starter culture). You can obtain most or all the K2 you'll need (about 200 micrograms) by eating 15 grams of natto daily, which is half an ounce. If you don't like natto, you can also get plenty of vitamin K2 from your fermented vegetables, provided you ferment your own using the proper starter culture.
- Trace minerals: Himalayan Crystal Salt, which contains all 84 elements found in your body, or other natural, unprocessed salt (NOT regular table salt!) can be used as an excellent source but there are many others especially nutrient-dense foods grown on healthy mineral-dense soils.
An Imbalanced Sodium-Potassium Ratio May Lead to Osteoporosis
Two additional nutrients that play an important role are sodium and potassium—you want the optimal ratio between these two in order to maintain your bone mass. If you eat a diet loaded with processed foods, there's a good chance your potassium to sodium ratio is far from optimal, as processed foods are notoriously low in potassium while being high in sodium.
Consider this: our ancient ancestors got about 11,000 mg of potassium a day, and about 700 mg of sodium.6 This equates to a potassium-over-sodium factor of nearly 16. Compare that to today's modern diet where daily potassium consumption averages about 2,500 mg (the RDA is 4,700 mg/day), along with 4,000 mg of sodium. An imbalanced sodium to potassium ratio can contribute to a number of diseases, including osteoporosis.
To ensure you get these two important nutrients in more appropriate ratios, simply replace processed foods with whole, unprocessed foods, ideally organically grown to ensure optimal nutrient content. This type of diet will naturally provide much larger amounts of potassium in relation to sodium, which is optimal for your bone health, and your overall health. If you find it difficult to eat the recommended amount of vegetables, give vegetable juicing a try. I would not recommend taking a potassium supplement; rather it is best to get it in your foods, primarily vegetables.
Exercise Is Crucial for Bone Health
Weight-bearing exercise is actually one of the most effective remedies against osteoporosis, because as you put more tension on your muscles, it puts more pressure on your bones, which then respond by continuously creating fresh, new bone. Resistance training and strength training are among the most popular forms of weight-bearing exercise to build your bones – and they're fine examples, but not the only ones. If you prefer, you can use bodyweight exercises to build your bones, which have the added benefit of being convenient (you can do these exercises virtually anywhere and they require no equipment).
A good weight-bearing exercise to incorporate into your routine (depending on your current level of fitness, of course) is a walking lunge, as it helps build bone density in your hips, even without any additional weights. Running and jumping are also good options. It should come as no surprise that good bone health in your later years begins in your youth, during your childhood and adolescence, as this is when skeletal growth is at its peak. Alternatively, just walking 7,000-10,000 steps a day can be another powerful strategy to not only improve your bone density but also overall health.
The time of bone development sets the stage for what's to come. Peak bone mass during childhood and adolescent years is one of the major factors that can either contribute to, or help prevent, osteoporosis down the road, so it makes sense to pay attention to building strong and healthy bones via physical activity during your early years. But what if you're a middle-aged or older adult who didn't exercise much as a kid… is it too late to build up your bones? Absolutely not!
Once peak bone mass is achieved, it begins a slow decline, but exercise can help you to maintain healthy bone mass even as you get older. Physical activity during aging can help you to reduce skeletal structural decay7 and much more. A series of studies in the Scandinavian Journal of Medicine & Science in Sports, for instance, revealed that older men who stayed active by playing soccer reaped numerous rewards (even if they were previously inactive). For instance:
- Sixteen weeks of soccer and strength training for older, inactive men improved functional ability and physiological response to submaximal exercise8
- Soccer also elevated the men's maximal aerobic fitness and exhaustive exercise performance9
- Four months of recreational soccer for elderly men improved bone mineral density, increased bone turnover, and improved bone formation10
If You’re Concerned About Bone Density, Try Whole Body Vibrational Training
Whole Body Vibrational Training (WBVT) using a Power Plate, is another safe, natural way to improve bone strength and density, thereby warding off osteoporosis. Best of all, it's gentle enough even for the disabled and elderly, who may not be able to engage in exercises like leaping, hopping, sprinting, or weight lifting. The Power Plate platform vibrates in three planes: vertical, horizontal, and sagittal, meaning front to back. (There is equipment out there that only moves in two planes but the three-plane movement devices seem superior.)
These micro-accelerations force your muscles to accommodate, resulting in dramatic improvement in strength, power, flexibility, balance, tone, and leanness. The technology was actually first developed by Soviet scientists looking for a way to heal cosmonauts from the effects of being in a weightless environment. Research supporting the use of WBVT for the prevention and treatment of brittle bones include, but is not limited to, the following:
- In one six-month study, WBVT was found to produce a significant increase in hip area bone density in postmenopausal women, while conventional training was only able to slow the rate of deterioration.11
- A 2013 study found that postmenopausal women who used a vibration platform for five minutes, three times a week for six months, increased their lumbar spine bone density by 2 percent. The control group, which did not engage in WBVT, lost about 0.5 percent of theirs in that same timeframe.12
Also of note, WBVT can increase your body's natural production of human growth hormone (HGH), which plays a role in bone density development (as well as much more, such as muscle growth, brain function, metabolism, and tissue repair). Studies suggest WBVT may lead to increases in HGH of more than 400 percent,13 with at least one study showing it may increase HGH production by 2,600 percent.14
7 Healthy Bone Habits for Men and Women
What you’ll notice about bone health is that if you’re leading a healthy lifestyle, you’ll automatically be extending protection to your bones – with a balanced, whole-foods diet, exercise, and sunlight exposure being key to both. For further detail, read through the seven additional habits below, which will help men and women alike to maintain and even increase bone strength at virtually any age:
- Avoid processed foods and soda, which can increase bone damage by depleting your bones of calcium. By ditching processed foods, you're also automatically eliminating a major source of refined sugars and processed fructose, which drive insulin resistance. It will also provide you with a more appropriate potassium to sodium ratio for maintaining bone mass.
- Increase your consumption of raw, fresh vegetables, ideally organic. Vitamin C is necessary to form embryonic bone, which is made of collagen. As mentioned, vegetable juicing can help you to increase your vegetable intake significantly.
- Optimize your vitamin D levels, ideally from appropriate sun exposure or a high-quality tanning bed. Vitamin D builds your bone density by helping your body absorb calcium. If you use an oral supplement, make sure you're using vitamin D3 (not D2), and that you're also increasing your vitamin K2 intake and monitoring your levels for safety.
- Consider making your own fermented vegetables using a special vitamin K2-producing starter culture, or supplementing with vitamin K2 if you're not getting enough from food alone. Vitamin K2 serves as the biological "glue" that helps plug the calcium into your bone matrix. Also remember to balance your calcium and magnesium (1:1 ratio).
- Maintain a healthy balance between omega-6 and omega-3 fats in your diet by taking a high-quality, animal-based omega-3 supplement like krill oil, and reducing your consumption of processed omega-6, found in processed foods and vegetable oils like soy, corn, and canola.
- Engage in strength training, which produces a number of beneficial changes at the molecular, enzymatic, hormonal, and chemical levels in your body, helping to slow down and even reverse many of the diseases caused by a sedentary lifestyle, including osteoporosis. Make sure that, regardless of how many sets you do, your last rep is challenging.
In other words, you fully fatigue that muscle—you still maintain control of the weight, but you feel like you might not be able to make it the rest of the way. As your fitness progresses, you'll want to carry each exercise to "muscle failure"—where you just can't complete all of the last rep.
You can significantly increase the effectiveness and intensity of strength training by using the super-slow technique, which shortens your sessions to 12 to 15 minutes just a couple days a week.
- Walk for 7,000 to 10,000 steps a day. This is one of the simplest weight-bearing exercises there is, and will help to maintain your bone density while also counteracting the effects of excess sitting. This should be in addition to your regular exercise. Walking is in addition to, not in place of, your normal exercise program.