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May 2006, April 2008, revised Nov 2009

QC Summary: Americans consume more calcium and dairy products than most other people of the world and should have, according to the Dairy Council, some of the strongest bones. BUT, the reality is quite the opposite, they have the weakest. There are many factors to consider, and by itself, high calcium, especially from dairy foods, might not offer as much protection as the Dairy Industry recommendations suggest. This article tells why and what does protect bones for a lifetime, namely weight-bearing exercise and fruits & vegetables.

NEW SCIENTIFIC RESULTS HAVE CHANGED BONE HEALTH THEORIES. SO WHY ARE NUTRITIONIST STILL GIVING OUT THE SAME OLD STORY THAT DOESN'T WORK???

Have you ever seem an adult gorilla drink milk? Do their bones fracture? Answer: There is plenty of calcium in their native diet. And they have a very low PRAL. More on this later. What does happen though, in zoos they are fed a different diet that can lead to osteoporosis just like humans. Animal nutritionists have to be careful in planning animal diets. Since animals are usually very active in the wild, especially fighting with each other, they do break many bones which heal back together, although not always in the proper position. Developing osteoporosis while in captivity gives important clues as to how diet and activity levels affect bone health.  

First, an important note of caution.

RightWay CAUTION
: Do not alter any current behavior or dietary programs until you have all the facts. Bone health is an extremely critical issue. The current protocol of just increasing calcium and /or vitamin D intake has not yielded many long term positive results and could be counterproductive to other body functions. Cardiovascular and kidney calcification consequences have to be considered in any bone health protocol. Also, taking calcium without enough vitamin D, or vice versa, could compromise prostate and breast health. Taking high calcium without sufficient dietary magnesium and vitamin K is also a possible factor in cardiovascular health.  And phosphorus balance with calcium is critically important, especially since it is so high in young adults' diets but maybe not in seniors. This fact is under consideration in vascular calcification. A dietitian, nutritionist, or other health professional should determine your dietary intakes before you supplement.  The factors that have to be considered include, but are not limited to: Net acid load (protein amounts,  caffeine levels, simple carbohydrates and sugar intake, phosphorus levels,  etc), salt intake, vegetable and fruit consumption, mineral intake (calcium, magnesium, zinc, manganese, fluoride, copper, boron, silicon), activity level including weight-bearing exercises, body weight (heavier is more protective),  bone size (smaller of more concern), vitamin status (A, D, K, B complex, and C), and essential fatty acid mix. The most important aspect from research if you want to benefit right now is to increase vegetables, fruits, and activity level. The following article only considers a few factors, not sufficient to alter actions.
 Be sure to discuss your situation with your health care practioner.

SIDEBAR: Phosphorus balance with calcium is critical. A ratio window has to be respected with calcium to phosphorus at between 2:1 - 1:1. With the increase in high phosphorus sodas, grains, and meats, this is getting more difficult. This factor underlines all the rest and should always be added into every other consideration, especially PRAL levels and calcium form choices and sources. In high phosphorus diets there is a higher likelyhood that more calcium will have to be taken out of bones.

OPINION: BONE HEALTH STUDIES

After reading over a thousand studies, with about as many conclusions, here is a brief review and analysis. Short term studies on extra calcium from supplements or dairy products show some enhancement of bone mineral density. But long term studies fail to show consistent fracture prevention. Three year studies reveal this trend. The first year shows great improvement in density with each additional year showing less benefit.  And after the study dosages stop, most people return to their pre-study bone density level. DENSITY IS A FACTOR OF CALCIUM STORAGE IN BONES.

Many studies are designed over a short period of time. Any bone study under 3 months will be influenced by events occurring before the study began since bone remodeling can take 120 days to complete. Surprisingly, there are very little long term research. And results are mixed, with only about 27% showing significant benefit. One would imagine it was 100% according to the messages from the Dairy Council.

Could consuming too much calcium be detrimental?
Nutritionists and health professionals keep recommending more and more calcium. When a study shows that Americans are still suffering bone fractures at record rates, they point to the fact that many people are still not consuming enough calcium. They seem to ignore the fact that there are many Countries where people consume only a third as much calcium BUT have less fractures.  ref (look at the charts) 

The common sense answer is that Calcium is not the only bone factor. Bone building is influenced by many factors which are rarely studied all at the same time. Factors other than calcium may actually hold greater benefits, with weight-bearing exercise exhibiting the most. Vitamin D and K are vital. New studies are revealing that structure and density both need to be addressed. Bones are constantly turning over, being torn down and re-built. High turnover rates mean more bone is under construction at one time which could potentially weaken bones and over a lifetime, might be responsible for the exhaustion of bone building cells. ref **(structure listed as collagen crosslinks)

Really, exhausted bone building cells, how rediculous!

Medical Hypothesis

Volume 65, Issue 3, Pages 552-558 (2005)

 

Lifetime high calcium intake increases osteoporotic fracture risk in old age

 

 

 

. published online 10 June 2005.

Caloric restriction prolongs life span. Calcium restriction may preserve bone health.

In osteoporosis, bone mineral density (BMD) has significantly decreased, due to a lack of osteoblast bone formation. Traditional osteoporosis prevention is aimed at maximizing BMD, but the lifetime effects of continuously maintaining a high BMD on eventual bone health in old age, have not been studied. Strikingly, in countries with a high mean BMD, fracture rates in the elderly are significantly higher than in countries with a low mean BMD. Studies show that this is not based on genetic differences. Also, in primary hyperparathyroidism, on the brink of osteoporosis, BMD levels may be significantly higher than normal.

Maybe, BMD does not represent long term bone health, but merely momentary bone strength. And maybe, maintaining a high BMD might actually wear out bone health.

Since osteoporosis particularly occurs in the elderly, and because in osteoporotic bone less osteoblasts are available, the underlying process may have to do with ageing of osteoblastic cells.

In healthy subjects, osteoblastic bone cells respond to the influx of calcium by composing a matrix upon which calcium precipitates. In the process of creating this matrix, 50–70% of the involved osteoblasts die. The greater the influx of calcium, the greater osteoblast activity, and the greater osteoblast apoptosis rate. An increased osteoblast apoptosis rate leads to a decrease in the age-related osteoblast replicative capacity (ARORC). In comparison to healthy bone, in osteoporotic bone the decrease in the replicative capacity of osteoblastic cells is greater. Due to the eventual resulting lack of osteoblast activity, micro-fractures cannot be repaired. Continuously maintaining a high BMD comes with continuously high bone remodeling rates, which regionally exhaust the ARORC, eventually leading to irreparable microfractures.

Regarding long time influences on bone health, adequate estrogen levels are known to be protective against osteoporosis. This is generally attributed to its inhibiting influence on osteoclast activity. Instead, its net effects on osteoblast metabolism may be the key to osteoporosis prevention. Adequate estrogen levels inhibit osteoblast activity, calcium apposition and osteoblast apoptosis rate, preserving the ARORC.

HERE is part of the summary of a complex article on bone pathogenesis. "Changes in the birth rate and/or apoptosis of bone cells may account for previously unexplained bone diseases, such as the osteoporosis caused by sex steroid deficiency, old age, and glucocorticoid excess. Moreover, attenuation of the rate of apoptosis (death) of osteoblastic cells may be a key mechanism for the effects of anabolic agents, such as PTH. Proof of the principle that the work performed by a cell population can be increased by suppression of apoptosis provides clues for the development of novel pharmacotherapeutic strategies for pathological conditions such as osteoporosis in which tissue mass diminution has compromised functional integrity. Nevertheless, changes in cell birth and death, as well as other mechanisms including changes in bone cell activity, need to be investigated in humans more extensively before definitive conclusions on the pathogenesis of the various causes of bone loss and the development of osteoporosis can be reached."   from 2000 in the following site:
http://edrv.endojournals.org/cgi/content/full/21/2/115  

Now, that is some interesting news that has not yet joined the public discussion. There actually is quite a lot of research on this topic. The "replicative capacity" or "proliferative capacity" of cells simply means that cells have a set number of times they divide before they die (Hayflick's Limit). And they have different activity levels during their life spans as well. Surprisingly, this just makes more sense than any other protocol medicine is attempting to use to explain the many controversial bone study facts.

 

ANALYSIS of Results from the WHI

Here are some of the results for the Women Health Initative on calcium and vitamin D. If you read it carefully, only 2 less hip fractures for every 1000 people in the calcium vitamin D taking group compared to control group, a finding without significance. But the researchers looked at a subgroup of people who complied and took all the supplements regularly, they found a 29% reduction. In absolute terms that is 4.8 less fractures for 1000 treated. Still not really numbers to get excited about. 

http://www.sciencedaily.com/releases/2006/02/060224104353.htm

Author's NOTES:  When new "theories" are presented, they gain in credibility if related facts support them. Looking at how calcium is absorbed into the body does support this theory to some extent. First, calcium is absorbed in the first part of the small intestines using an energy intensive active process. Calcium is the only mineral with an active transport mechanism. This process is controlled by messengers from the body supported by active vitamin D that relay the need for more or less calcium. Any calcium that is left over after leaving this section of the small intestines can be further absorbed by simple passive gradient flows into the cells, depending upon the strength of the gradient and the amount of competing minerals. Thus a little will enter by this route but does so not under the body's control. Thus, taking extra calcium all the time could overwhelm this passive absorption process and some of the other needed minerals could be blocked out of absorption. Also, as calcium is being eliminated out of the body by the colon, messengers can call it back to be re-used which explains how people can survive on very low calcium intakes. The body just doesn't like to get rid of it unless it knows storage levels are full. Another piece of the puzzle.

CALCIUM intake on DENSITY, AND FRACTURES

 SIDEBAR:  Most Americans have seen a lake formed by building a dam. When it rains or snow melts and water enters the lake, it either fills up the lake if it is low or if the lake is already at the desired level, water is released by gates in the dam and to let the water continue downstream to the ocean. There is usually a reserve amount of capacity the dam could hold back if more rain water enters than normal giving an extra safety margin.

This is very similar to what happens when calcium enters the body. If blood levels are normal, only the amount needed to replace what is spilling out of the body is actively absorbed. If blood calcium is low from higher demands of the cells, more is absorbed from processes set in motion by the hormones of the parathyroid gland. If not enough calcium is consumed to cover the amount eliminated, calcium is removed from storage in bones to maintain blood levels and is later replaced unless shortages continue. Yes higher levels of calcium can increase bone density in the short term, but this is a forced storage and the increased level will return to normal when the amount in the diet is reduced similar to how a dam would release extra water over a period of time to return the lake to the desired level. The correct body calcium levels would be easier to maintain if there were not so many other factors also influencing calcium roles in the body. See BoneWorks.

For Americans, the amount of calcium needed in the diet on a daily basis has been determined to be between 450 to 500, with one report showing up to 840 mg. This level varies depending upon the factors mentioned in BoneWorks. Vegetarians might have lower requirements than meat eaters due to protective elements from vegetables, namely potassium, the preferred acid buffer. Remember these amounts are from adding food sources with supplement amounts. The following study shows balance at just 741 mg of calcium per day- ref  

A small margin of extra is wise, but consuming excess calcium may not be without consequences. A lifetime of excess dietary calcium is now under consideration from a process called replicative capacity that literally burn out bone building cells too soon. Why is calcium showing up in artery walls as part of plaque or as kidney stones? New research is discovering some startling results. Cardio link-  ref  ref 

KEY FACTOR 11-09: This is a vital missing link in the bone health paradox. High intake of calcium over time depletes life span of bone building cells while bone tearing down cells are still working at the same fast rate. The natural result is loss of bone mass. This concept is called cell replicative capacity. This capacity is pre-programmed and is literally used up too quickly by habitual excess calcium consumption. The bone building cells literally age and die quicker. This important process will be discussed in BoneWorks.  

NEW STUDY: Research wanted to find the minimum balance point for calcium in different amounts of animal protein and sodium levels from salt. The regular American fare of high animal protein and high salt needed 840 mg to balance. Lowering animal protein reduced to only 650 mg. Lowering both animal protein and sodium levels required only 450 mg to balance. This is just to show that diet influences requirements. There are other factors that also may influence YOUR balance point, including exercise which dramatically increases calcium efficiency toward bone building. Here is a conclusion from a Netherlands study in 1995: "CONCLUSIONS--This cross sectional study in children aged 7 to 11 years suggests that an increased bone mineral content is found only in those with a high level of physical activity. This association is most pronounced in the more mature children. No evidence was found for an association between daily calcium intake and bone mineral content in childhood."

http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=ANM2005049005312

Harvard school of public health recently questioned the dairy industry's slogan: Milk builds strong bones.

DOES MILK BUILD STRONG BONES?

Yes, there are many studies that show benefits. More on possibly why in a moment? BUT, some research studies have hinted at just the opposite. One of the largest and most respected ongoing studies, the 78,000 Nurses' Health Study, found that after many years heavy milk drinkers had more bone fractures or showed no extra protection against fractures than non-milk drinkers. It's hard to argue with the facts from such a large size study, but don't hold your breath for the dairy industry to accept these findings. While there certainly are other related factors, this is pretty powerful stuff. ref 

...milk drinkers did not have increased protection...

The biggest part of this website will be to answer the "why" or "how" behind study results. In this case, while there are many possible factors, here are two factors that need considering. The first, milk upsets the calcium to magnesium balance of nature. When you know the function of each mineral, the mystery is solved. For an infant, breast milk supplies the high calcium needed to "solidify" the cartilage bending bones (necessary for safe travel through the birth canal) into the solid strong bones needed to support upright walking as body weight increases. Milk's  10 to 1 calcium to magnesium ratio works quite well here. For adults however, this unbalanced ratio only gets in the way of health. Not only bone health, but possibly cardiovascular as well. Not counting dairy, the balance in most foods is between 3 to 1 all the way to reversed at 1 to 2. This food average of nearly 1 to 1 may be closer to the ideal than milk's 10 to 1. Not enough high magnesium foods are available to balance if dairy foods at 10 to 1 play a significant part in the diet.

How could the health professionals not see something so obvious? In their defense, there are many other factors that come into play about bone health, including the high fat content and high animal protein levels of milk. But not many professionals are talking about the calcium magnesium ratio levels. ref

Sidebar: Vitamins formulated for doctors have evolved to have a one to one ratio of calcium to magnesium, possibly because doctors see so many cardiovascular disease cases where a higher magnesium lower calcium level is FAVORABLE. Most revealing!
 
Sidebar:  Latest studies point out another critical factor involving pH, the acid alkaline balance in blood. From animal studies, the pH influcences the level of 1,25 (OH)2D3, the active form of vitamin D. A slightly acid blood reduces the production of the active vitamin D even when conditions in the body say it should be produced at higher amounts. Slightly higher alkaline levels increase production, mainly form vegetables and fruits. Could this be why vegetables and fruits are mentioned with weight-bearing exercise as the only two factors consistently showing value for bone building.

WHY BLOCK CALCIUM?

Here is the question that started this research; Why do doctors put heart attack patients on calcium channel-blocking drugs? These drugs stop blood vessel constricting calcium from entering artery wall cells. This relaxes the arteries and increases blood circulation. Imagine my surprise when I read that magnesium acted as a natural calcium channel-blocker. Could it be that heart attack victims are low in magnesium which allows too much calcium to enter cells and cause blood vessel constriction? This apparently happens independent of calcium intake amounts. It appears from a search of the studies, that magnesium has been looked at and used in some research with somewhat mixed results so far. Magnesium is found in three areas of the body. One in blood, where it is maintained at a constant level, two in bones, and the other is in the cells. Just measuring blood levels of magnesium might not be an accurate measure of cellular levels. It has been shown that blood levels can test normal while the cells are low.

FACTOR TWO 

NOW! It's time to get to the heart of the current situation. Here is one possible theory in how to save bone and prevent fractures. Previously, a term was guietly slipped in that forms the bottom line concept: NET ACID LOAD or PRAL -potential renal acid load. Your overall diet contains foods with both acid-forming elements and base, or alkaline, forming elements. While the body has a very elaborate program to always keep the body at the proper acid-base balance regardless of the diet, the energy and elements needed to accomplish this pH balance can hinder other important functions, such as bone minerals. ref

Before the kidneys can eliminate these excess acids, they have to be neutralized to no higher an acidity amount than pH 5 (weak) or the acids would eat up the cells lining the bladder. Scientists talk about the body's "alkaline reserve" as a measure of protection against the net acid load. Vegetables and fruits primarily build up this reserve and that is why they are mentioned so often as important disease fighters and bone savers. ref

From historical research, both types of diets were found in different parts of the world with healthy results. The acid-forming diets must have contained an abundance of neutralizing and compensating minerals to still perform all of their other functions. One of the biggest problems today is the high sodium to potassium ratio from salt usage. This ratio is reversed in natural foods where potassium is sometimes as high as 100 times greater than sodium. http://jn.nutrition.org/cgi/content/abstract/138/1/172S

Today's diet is acid-forming and lacking in vital protective minerals, mainly potassium. This creates a chronic low-grade metabolic acidosis condition. This puts added stress on the kidneys. The kidneys are responsible for neutralizing and eliminating this excess acid and the degree that they perform this function is called the PRAL. Potassium from fruits and vegetables combines with bicarbonate to neutralize these acids in cells. In the absence of preferred potassium, which only averages in the diet about half of the recommended amount, the body will use circulating calcium, magnesium, or even sodium. This could set in motion the dissloving of bone to quickly release calcium and magnesium back into the blood to maintain the necessary critical 1% calcium level. You can limit this aspect with a more base forming diet containing lots of vegetables and fruits as potassium suppliers.  ref A recent US Dept of Agriculture study revealed that vegetarian women and meat eating women lost the same amount of bone, which was a surprise.  BUT the vegetarian women built more bone even with less calcium consumed which was not an expected finding. Another study just finished showed that adding potassium citrate instead of potassium chloride increased bone mass of the spine over a years time. This would indicate a lower acid build up response. ref Plus, here is a chart on animal protein to calcium intake levels for different Countries.

Cautionary note: Do not take high potassium supplementation unless under a doctor's care. Potassium in pill form is irritating to the intestinal tract cells at high amounts. This is why the government has limited it to only 99 mg per tablet which is less than 3% of recommended dietary amount. Use vegetables and fruits, especially avocados, bananas, potato skins, and nuts and seeds.

Government nutritional recommedations have just increased the potassium requirement to 4700 milligrams. This is 4 times greater than the calcium level at 1200 mg.  The reality is that the potassium intake level of the Standard American Diet (SAD) averages less than 2500 mg, 40% short. Many people consume far less. The mineral sodium hinders potassium uptake and it's requirement has been down-graded to just 1500 mg because of this anti-potassium action, water holding action, and increasing calcium elimination. The current dietary level of sodium is well over 4000 mg. Too much salt. You should be starting to see the picture of why today's dietary patterns are counter to health. chart   ref   chart

TURN A PAGE

Another factor in considering bone protection is rarely mentioned. This factor is called the BONE TURNOVER RATE. Higher turnover rates are associated with weaker bones. In fact, Fosamaxtm, one of the drugs doctors might give to treat osteoporosis, is designed to slow down this rate. Scientists have been busy studying how to test for the turnover rate and have found elements called bone metabolic markers that show up in urine. Higher levels could mean more bone density is being lost each year, 3-4% instead of the usual 1-2%. Methods are being developed to incorporate these tests into medical practice.

Not everyone with low bone density has a high bone turnover rate. Vegetarians who do not consume dairy have lower bone density, but they could also have lower bone turnover rates and thus lower fracture rates than many milk drinkers and meat eaters. High turnover rates indicate a more aggressive treatment protocol is needed. The point is to find ways to naturally lower this rate when it is high, but not too low.  A study of young boys at peak bone forming ages showed that even though they measured normal magnesium levels, giving extra magnesium slowed down their bone turnover rates. The DASH diet; high vegetable and fruit, high fiber, some low fat dairy, low sugar, and low animal protein fat, also lower this rate. ref  ref

THEORY OF CALCIUM EXCESS

Of special note on a possible theory as mentioned above: If you consume a lifetime of extra calcium from dairy or supplements above normal replacement levels, the body is forced to take it out of the blood stream as quickly as possible. Remember it is critical that the calcium level in blood has to remain at the 1% level for proper muscle and nerve functioning. One place the body temporarily stores it is in bone until the elimination channels of the body can catch up and remove the excess. This would give the appearance of building bone density and might explain short term increases and some protection against fractures. But, continued excess intake simply drives the body to increase calcium elimination and put the brakes even on absorption. Could this bone building aspect of constantly storing extra calcium simply wear out the building cells faster compared to the bone tearing down cells (called bone remodeling). It looks more and moe like this is what is happening. Future studies will verify when this theory is tested.

Also extra dietary calcium influences the body's ability to activate the non-active vitamin D into the high acting hormone form. During elevated calcium blood levels, the body shuts down the activation of vitamin D. While the excess levels of calcium are present in the blood, other elements help build bone. But if this reduced level of the active form of vitamin D is perpetual, the many other roles vitamin D plays in the body could be compromised, such as prostate tissue protection. PLus, the new pH factor for vitamin D activation is involved here.  http://www.news.harvard.edu/gazette/2007/03.22/01-vitaminD.html

Are Nutritionists' Recommendations Creating Bones that Fracture?

This is not the intent or design of nature. Nature is designed for variety and ups and downs in nutrient delivery. A concept RightWay Vitamins has coined into "stimulus variation." While excesses can be handled for often long periods of time without obvious symptoms, there are often costs paid by other body systems that are often overlooked as being related. It is possible that excess calcium eventually participates in artery calcification with undesirable outcomes. This is not a factor of just calcium excesses, but rather synergistic levels with other nutrients. Current research is linking calcium and vitamin D to cardiovascular, cancers, and dementia as well as bone health. Look for vitamin K to especially be of influence here by regulating matrix GLA proteins in artery wall cells. Until more research reveals the proper course, the prudent action is precautionary and a balanced calcium amount. http://www.ncbi.nlm.nih.gov/pubmed/18200565

SIDEBAR: Vitamin D is growing in stature in health circles. First, it is NOT a vitamin. It is in fact a steroid hormone that exists in many forms, some more active than others. It is made in the body from cholesterol, just like many other steroids and hormones. Since human growth hormone HGH and hormone replacement therapy HRT usage have proved to be quite controversial, might not the "hormone" vitamin D usage prove to be just as controversial? New research is quite shocking.

Of interest here is how bone is built. First, a quick woven matrix is built into fractures or in small sections of regular bone cleaned out for rebuilding. This woven bone is very weak consisting of only a few collagen fibers. Over a period of time, stronger bone is substituted for this woven bone that is layered and crisscrossed making it quite strong from the increasing mineral content. A high turnover rate would mean a larger amount of this weak woven bone exists at the same time.

ARE NUTRITIONAL CALCIUM GUIDELINES INCREASING Cardiovascular Disease?

Why did it take over thirty years to figure this out? A faulty assumption thought that milk had a 2 to 1 calcium to magnesium ratio, the same ratio that is found in most vitamin supplements. Nutritionists' today are recommending a 3 to 1 ratio, even up to a 4 to 1 ratio (1200 calcium to 350 magnesium). A top end healthy ratio is about 2 to 1; a 3 to 2, or even a 1 to 1, may be better for some individuals. With the amount of calcium-fortified foods coupled with limited magnesium containing foods, a ratio of 3 to 1 or more is commonplace. On a chart comparing the rate of cardiovascular disease (CVD) to the ratio of calcium to magnesium consumed in different countries, the UNITED STATES with a 3 1/2 to 1 ratio is near the top with the highest CVD. Japan, with only a 1 to 1 ratio, had the lowest disease rate. Greece, with a 3 to 1 ratio was also very low, possibly due to olive oil protection. Could it really be as simple as this ratio chart depicts? ...Rarely are things as simple as they appear, especially in body processes. There are always exceptions or other influencing factors. But it is food for thought! ref  chart

Cautionary Note: Do not increase magnesium by yourself without first knowing your dietary intake of calcium, phosphorus, and magnesium; A nutritionist or dietitian would be of help here. This can be dangerous for certain individuals, especially with thyroid or kidney malfunctions. The intelligent use of supplements is to correct unbalanced levels, not to create them. 

A QUICK LOOK AT hGH and HORMONES for BONE HEALTH  (copied textbook from this ref, excellent material covered for bone growth and fracture repair)

"Hormones

     a. Insulin-like growth factors (IGFs) produced in response to hGH (human growth hormone)--pituitary gland--general growth of all tissues--great effect on height. This hormone causes cells to produce insulinlike growth factors, which promote osteoblast production and protein synthesis. Even after we have achieved full growth, this hormone plays a major role in bone maintenance.

     b. Sex hormones (estrogens/testosterone)--appear in large amounts at puberty and promote activity in the epiphyseal plate--but after a period of rapid growth the cartilage cells "burn out" and all die--epiphyses then fuse. In mature individuals the sex hormones promote bone maintenance and replacement. In females, estrogen production tapers off beginning in the thirties, and this is one reason for the problems with osteoporosis."

HEART MATTERS

Calcification of arteries and kidneys also has to be considered when addressing bone health. It appears from current research that vitamin K plays a beneficial role in keeping calcium in bones and out of arteries. ref

SIDEBAR: Vitamin K has also proven effective against artery calcification, a condition that has now been found to be linked with osteoporosis. At the same time bones lose calcium and density, arteries are taking up calcium. The common factor appears to be low vitamin K. ref

This is a new finding: From the University of Michigan comes a rather interesting development. As a woman's hormones begin decreasing, vitamin K functions become impaired. They have determined that the previously accepted level of vitamin K considered adequate for healthy women may not be enough to overcome this vitamin K impairment. Their recommendation: Eat more green leafy vegetables. ref A new supplement is now available called MK-7, a form of vitamin K2 from a fermented soy food, NATTO, that is proving to be more active in bone and artery health than the vitamin K1 from plants.

Of special interest on vitamin K's role in bone health; K activates a vitamin D produced protein called Osteocalin. The function of Osteocalin is to bind calcium to bone, but after the vitamin D production, Osteocalin is not in an active form. Vitamin K is needed to activate. It now has been found that this protein, actually a hormone, is needed to help balance insulin production and sensitivity with the help of a fat cell produced hormone called Adiponectin.

Of critical importance, a balance is needed between the active and now active Osteocalcin forms for proper action of this complex system for insulin regulation, bone building, and preverntion of artery calcification. It is paramount for sceince to find this balance as animal and human studies can arrive at different results. BALANCE is vital.

MORE on PRAL 

The aboved mentioned changes also have a beneficial effect on how protein behaves in bone health as well. In a net acid load diet, protein would increase the acid load and further harm bone density. In a neutral or base load diet, protein, which helps increase bone strength by forming the important bone matrix, will not be an acid load factor because the protection from the base load diet is high enough to compensate. You should reread this paragraph. It is of the utmost importance in many areas of health.

Of special interest here is that vegetable source proteins put less stress on the body's acid load than animal proteins. This is due to the combination of high levels of sulfur containing amino acids in animal sources coupled with low bicarbonates and base minerals. Check out this significant study from the US Department of Agriculture. While it puts a different spin on the way animal proteins hinder bone health, the conclusions are the same.

In addition to increased vegetables and fruits as sources for potassium, these also influence PRAL: lower animal proteins, lower simple carbohydrates; sugars, refined grains, fats and oils which are all acid-producing. Plant proteins have a lower acid load affect than animal proteins since they usually are present in foods with more base load elements (base minerals). Remember that it is the balance of the overall diet and not the complete elimination of all acid load foods that is important. You do need some.

Hopefully, you can now see that just taking supplements or adding calcium by increasing dairy foods might not be as beneficial if you are consuming a net acid load diet. Most people are. Going back to RightWay's health premise, FOOD FIRST, is where you have to start.

FRACTURE PROOF BONES

So, if you want to have healthy strong bones, all you have to do is lower your net acid load, increase your base reserve by eating more vegetables and fruits, consume enough calcium to prevent any "borrowing" from bones, and increase your activity level, especially weight bearing esercise. These are the most consistent factors showing up in studies. A three year study also showed that vitamin D with calcium, magnesium, and zinc was not effective until VITAMIN K was also added. K is supplied by green-leafy vegetables and intestinal bacteria.

More on Net Acid Load Reduction  

SIDEBAR: Rarely mentioned bone health factor, a high fiber diet, especially the indigestible fibers, aids mineral absorption for bone building. It seems that these fibers feed the friendly probiotic bacteria in the intestinal tract creating favorable mineral absorption conditions for calcium, magnesium, zinc, and iron. The standard American diet is sadly lacking in fibers. Of note here is that Phytates are also found in whole grains and legumes such as soy which combine with minerals and hinder absorption. This could be another avenue of natural control of mineral absorption and balance. But one that obviously needs to be balanced by consuming a variety of foods instead of limited choices.

CONTROVERSY! 

There are scientists that do not accept these concepts, but are short on other alternatives. They like to cite the high acid load Eskimo diet as an example. And they say you can't change the pH of body fluids through diet since the body has such elaborate balancing mechanisms; or simply that your body could not function if the fluids did change even a small amount. Blood has to be about 7.4 (slightly alkaline) but can't vary past 7.2 - 7.6. 

The issue is not so much the change; it is the maintaining of the "alkaline reserve" and the processes the body has to use to maintain the proper pH levels that are the critical issues. A low reserve means the body would have to draw on alkalizing minerals, MAYBE from the bones to help out. Sort of a robbing Peter to pay Paul situation. The government's nutrient guideline, an abundance of scientific research, and observable effects of people on this type of diet are all very supportive. Until someone explains the facts better, this will have to do. Americans consume the most dairy and have one of the highest calcium intake levels in the world, yet they have one of the highest osteoporosis rates as well. 

The practical reality of this high net acid load is the reason the government has to set the calcium intake so high. Much of the calcium intake is being flushed out of the body. In fact, about 450 milligrams are excreted daily. This is more than the daily average intake for many countries WITHOUT bone problems. Sun-block lotions, hats, and low fat foods are limiting natural vitamin D intake. Sun lotions can block up to 90% of vitamin D production. High dietary calcium also shuts down vitamin D activation, which is necessary to increase calcium uptake. 75% of magnesium is processed out of whole wheat in making white flour. Good sources of magnesium are nuts and seeds, foods that have been limited in the diet due to their high fat content. Perhaps the nutritional advice Americans are getting needs to be updated and based on correct concepts.

ESKIMO'S HEALTHY DIET

Now, let's look at just what the Eskimo diet contains. This report comes from Vilhjalmur Stefansson who lived with the Inuits for many years in the early 1900's. Primarily they ate very low boiled seal meat and bones, raw seal fat, a seal blood soup carefully prepared not to boil, raw and cooked fish, and in summer, caribou and a few plants that grew wild. This may have supplied all  the nutrients needed for a somewhat healthy bone diet. Even though it is a very high fat, high protein, high cholesterol, and a low carbohydrate diet, the Eskimos have very low blood levels of cholesterol with high HDL's and heart disease was not a factor. Possibly their high activity levels and very high omega 3/6 ratio were quite protective. Unfortunately, this omega ratio did lead to a very high rate of strokes. The raw fish supplied enough vitamin C and from the low boiled bones they could get plenty of minerals, not to mention the neutral pH blood soup. The high fat provides ample energy to survive the harsh temperature extremes. This diet worked well for this environment. As Western type foods, especially white flour and sugar, found their way into the Eskimo's diet, they began to suffer from all of the American degenerative diseases. Surviving on what looks like it should be a high net acid load diet might not really be that high after all when you really analyze the total picture. The Eskimo's "alkaline reserve" may not have been so far off. While they did measure lower bone density, the high weight bearing activities may have prevented bone fractures. Or maybe without the empty calorie "junk" foods, a net acid load diet might be OK if overall minerals are plentiful enough to serve their functions. OR, maybe the early Eskimo's didn't live long enough for bone diseases to show up, a real possibility.

 ***IMPORTANT CLARIFICATION FROM RESEARCH: It appears that a net acid load diet in healthy individuals can be offset by an equal kidney net acid excretion amount. The body attempts to compensate and stay in balance. This research points out that another factor has to also be present for the acid load to draw minerals out of bones. This might also help explain why the healthy Eskimo's acid load diet did not exhibit bone problems. More on this other factor in a future story.

The Soda/Phosphate Connection 

Research is finding that high phosphorus to calcium levels such as supplied by drinking sodas such as coke are one possible link to vascular calcification and thus cardiovascular disease. More on this is coming.  

Check out these two sites for vitamin D actions:

http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/otherendo/vitamind.html 

http://bacteriality.com/2007/09/15/vitamind/#footnote_1_53

ajcn.org/cgi/content/full/82/5/921   Dietary Protein and the diet's net acid load opposing effects on Bone Health. Anthony Sabastian. UC San Francisco  Year 2005, vol 82, page 921

www.hsph.harvard.edu/  This site from the Harvard School of Public Health is a must goto.  Click on NUTRITION SOURCE. Calcium and Milk puts everything into perspective. Have some fun checking out the referenced studies listed in support. 

calciuminfo.com/pdf/sg_report_3pg_summary.pdf         This is a report from the Surgeon General Richard Carmone in 2004 on bone health. A drug company put up this site since the report was favorable to their products. You will see which two. For you dial-ups, this takes some time.

ajcn.org/cgi/content/full/76/6/1308    Acid-base estimation of pre-agricultural diets on health today.

WRAP UP: Some of the topics covered in this extremely critical issue are controversial and not accepted by all in mainstream medicine. Until they offer a better protocol that "fits" the established facts, this appears to be one of the most prudent options.

 

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