Many women are aware that a high intake of calcium may help prevent osteoporosis but I’m not sure if many of them know that that adding a magnesium supplement may improve their body’s ability to absorb calcium. And fewer still are probably aware of the emerging research that shows how a vitamin B-12 supplement may also play an important role in bone health as we age.

While doctors are not sure of the reasons behind the connection, people with osteoporosis have been found also to have a vitamin B12 deficiency. Symptoms of B12 deficiency include poor balance, forgetfulness, and cognitive decline and, according to a study conducted by the Agricultural Research Service (ARS), may be linked to osteoporosis.

Researchers funded by the Agricultural Research Service (ARS) reported the findings in the Journal of Bone and Mineral Research. While vitamin B12 deficiency has been linked with low levels of markers of bone formation, the mechanism behind the relationship is not known.

The scientists examined the relationship between vitamin B12 blood levels and indicators of bone health measured in 2,576 men and women, aged 30 to 87, participating in the Framingham Osteoporosis Study. They found that those with vitamin B12 levels lower than 148 pm/l were at greater risk of osteoporosis than those with higher levels. The study found that those with vitamin B12 concentrations below 148 pm/l had significantly lower average bone mineral density–at the hip in men, and at the spine in women–than those with concentrations above.

Osteoporosis usually progresses with no outward effect until a fracture occurs. The recommended dietary allowance for vitamin B12 is 2.4 micrograms per day for both men and women. Low stomach acid and ageing can lower the ability to absorb the vitamin. This study suggests adequate vitamin B12 intake is important for maintaining bone mineral density and it would be worth having a blood test to check for a deficiency.

It is well known that green leafy vegetables such as cabbage, cauliflower, kale and broccoli are healthy foods. But did you know that these vegetables may help keep bones strong? And this isn’t merely because some of them contain calcium, but because they are fantastic sources of vitamin K.

Until recently, vitamin K has been most well known as a fat soluble vitamin that plays an important role in blood clotting. However, researchers have also found that circulating vitamin K blood levels are often low in patients with osteoporosis. While a deficiency of vitamin K is considered rare by conventional medicine, a 2006 study by University of Michigan School of Nursing researchers has found that many women in early menopause may not have enough of the vitamin in their bodies. The study suggests that the generally accepted level of vitamin K in healthy women is inadequate to maintain bone health just at the onset of menopause.

Vitamin K is an integral part of bone mineralisation. According to a study that appeared in the American Journal of Clinical Nutrition in 1999, Vitamin K is needed to make a protein that’s essential for bone formation. In the great majority of people, beneficial intestinal bacteria make much of the vitamin K needed for this purpose, which is why you hear so little about this vitamin. But to get enough K, especially to keep bones strong, you also need to eat vitamin K-rich vegetables.

In the USA, a Nurses’ Health Study followed 72,000 middle-aged women for 10 years. It was found that those who consumed moderate or high amounts of vitamin K (nearly all from vegetables) had a 30 percent lower risk of hip fractures than women consuming little or no vitamin K. This held true even when other factors affecting bone health, such as calcium and vitamin D, were taken into account.  It didn’t take much vitamin K – about 100 to 150 micrograms a day – to achieve this protective effect.

Worldwide, only a handful of researchers study vitamin K. But with the ageing of the population, this vitamin may command a bigger following as its importance to the integrity of bones becomes increasingly clear; especially as the manufacturing, farming and processing of food creates nutritional deficiencies and Vitamin K isn’t as abundant in the diet as once thought.

Vitamin K-Rich Foods

One portion:

• Cooked broccoli (90 micrograms of vitamin K)
• Cooked Brussel sprouts (230 micrograms of vitamin K)
• Coleslaw (120 micrograms of vitamin K)
• Cooked collards (370 micrograms of vitamin K)
• Iceberg lettuce (30 micrograms of vitamin K)Romaine lettuce (190 micrograms of vitamin K)

By the time you read this the UK smoking ban will be in place and any woman worried about the risk of osteoporosis at menopause will have reason to celebrate.
Many of the health problems caused by smoking and passive smoking are well known; namely heart disease, lung and esophageal cancer and chronic lung disease. Additionally, several research studies have identified smoking as a risk factor for osteoporosis and bone fractures.

Osteoporosis is a condition in which bones weaken and are more likely to fracture (break). Fractures from osteoporosis can result in pain, disability, and sometimes death. Osteoporosis is a major health threat for women, and, in addition to smoking, risk factors include:

• Being thin or having a small frame
• Having a family history of the disease or of fractures after the age of 50
• Being postmenopausal or having had an early menopause
• Having an abnormal absence of menstrual periods
• Using certain medications e.g. steroids
• Not getting enough calcium and other nutrients like vitamin D and magnesium
• Not getting enough physical activity
• Drinking too much alcohol

Osteoporosis is a “silent” disease: it can progress for many years without symptoms until a fracture occurs. Fortunately, it can be prevented and it is never too late to adopt new habits for healthy bones.

Cigarette smoking was first identified as a risk factor for osteoporosis more than 20 years ago. Recent studies have now shown a direct relationship between tobacco use and decreased bone density. Here’s a round up of what researchers have uncovered:

• The longer you smoke and the more cigarettes you consume, the greater your risk of fracture in old age.
• Smokers who fracture may take longer to heal than non-smokers and may experience more complications during the healing process.
• Significant bone loss has been found in older women who smoke.
• At least one study suggests that exposure to second-hand smoke during youth and early adulthood may increase the risk of developing low bone mass.
• Women who smoke often produce less oestrogen (a sex hormone) and tend to experience menopause earlier than non-smokers, which may lead to increased bone loss. This is also important for women aiming to conceive because smoking will push them towards the menopause quicker.
• Quitting smoking appears to reduce the risk of low bone mass and fractures.

To sum up, the best thing a smoker can do to protect her bones is to quit smoking and the best thing non-smokers can do is to stay away from smokers and smoky atmospheres; as the effects of passive smoking can be equally dangerous. In addition to avoiding smoking and places where people smoke the following self-help measures will also reduce your risk of osteoporosis:

Eat a well-balanced diet rich in calcium and vitamin D: Good sources of calcium include organic yogurts, dark green, leafy vegetables and sesame seeds. Also, supplements can help ensure that you get adequate amounts of calcium each day.

Vitamin D plays an important role in calcium absorption and bone health. Vitamin D can be obtained naturally through exposure to sunlight and through various foods and supplements. A good ‘bone’ supplement I use in the clinic which contains calcium, magnesium, vitamin D, zinc, boron and digestive enzymes is Osteoplus. Food sources of vitamin D include egg yolks and oily fish.

Exercise for your bone health: Like muscle, bone is living tissue that responds to exercise by becoming stronger. Weight-bearing exercise that forces you to work against gravity is the best exercise for bone. Some examples include walking, stair climbing, dancing, and lifting weights. Regular exercise such as walking may help prevent bone loss and will provide many other health benefits.

Avoid excessive use of alcohol: Chronic alcohol use has been linked to an increase in fractures of the hip, spine, and wrist. Drinking too much alcohol interferes with the balance of calcium in the body. It also affects the production of hormones, which have a protective effect on bone; and of vitamins, which we need to absorb calcium. Excessive alcohol consumption can also lead to more falls and related fractures.

Talk to your doctor about a bone density test: Bone mineral density (BMD) tests measure bone density in various sites of the body. These tests can detect osteoporosis before a fracture occurs and can predict your chances of fracturing in the future.

If you are a current or former smoker, you may want to ask your doctor whether you are a candidate for a bone density test. If you can get to the Tunbridge Wells clinic then you can come in for a bone ultrasound scan which includes a 30 minute consultation with dietary, supplement and exercise recommendations (for more information call 01892 515905).