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Osteoporosis / Osteopenia / Bone Loss is one of the four hallmarks of Aging. The other three being loss of muscle ( sarcopenia ) , gain of fat mass and development of inflammatory degeneration in joints ( osteoarthritis ). 

Healthy lifestyle, diet and exercise are the fundamentals to slow these processes but supplementation can also help, particularly in patients who follow a restrictive diet ( eg Vegan). 

The most effective exercises for osteoporosis prevention include resistance training ( weights ) and plyometric exercises ( jumping jacks and skipping ) . Those who wish to consider addition protein and other supplements to aid muscle growth should refer to a separate blog on that topic. Isometric exercises such as Yoga can also help however with all forms of exercises it is very important to maintain a straight and upright back posture, to avoid the risk of suffering a vertebral collapse fracture ( this kind which causes kyphosis or forward bending of the spine with age ) 

Addition of regular fermented dairy into the diet including yogurt, soft cottage cheese, kefir, paneer etc will ensure adequate consumption of calcium as well as a healthy metabolism due to gut microbiome benefits of fermented foods. 

In addition it is also important to not smoke and reduce consumption of alcohol.

 

1. Calcium

Calcium Carbonate 

Recommended intake of Calcium for bone health is 1,200 mg per day. A single serving of fermented probiotic dairy would provide approx 300 mg of this. Those who are unable to ingest adequate amounts may wish to supplement their diet with a tablet. Equally, it is important to not consume excessive amounts of calcium . Take sources of calcium at varying times of the day since the body can only absorb a fixed amount of calcium at a time through the gut. 

Calcium Citrate

This supplement contains a better absorbed form of Calcium ( citrate ) along with Magnesium. Note that each tablet contains 300 mg which is equal to a serving size of probiotic fermented dairy so depending upon you diet you may need none to four a day aiming for 1,200 mg a day of calcium total. 

 

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Again, aim for obtaining most of the calcium requirement of 1200 mg per day through diet and use supplements to cover the shortfall. One serving of fermented probiotic dairy for instance would contain approximately 300 mg of dairy. 

 

Wide Spectrum Multivitamin

 

In order to cover more nutrients it would make sense to get 200 mg of calcium intake using a wide ranging Multivitamin as well 

 

2. Centrum Multi Vitamin & Multi Mineral with antioxidants Lutein & Lycopene

Those who are ingesting adequate amounts of Calcium through diet may wish to instead supplement with a mutivitamin which has less calcium overall ( 200 mg )  but a broader list of other minerals and vitamins along with antioxidant food extracts such as Lutein and Lycopene

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3. Vitamin D3 with Vitamin K:

90 % of  Vitamin D3 is obtained through sun exposure. It can also be found in fatty fish and eggs. Vitamin K, found in fermented foods and cheese, also plays a role in the development of new, stronger bone. I recommend that clients age 50 plus are recommended to add Vitamin K to D3 to ensure that Vitamin D3 and Calcium are shuttled more effectively into bones.

Vegan Option

 

 

4. Supplements which increase muscle mass 

Increased protein intake is associated with stronger bones. Conversely restrictive diets which lack protein have been shown to be associated with lower bone density scores. It is unclear whether this is independent of resistance exercise however it should be considered as a given that those who supplement with sources of protein will also do resistance exercises in order to see gains. Protein can be supplemented as Collagen powder and or Protein powder and have different properties as detailed below. Creatine is an amino acid derivative which can improve gains associated with resistance training. 

While it certainly is possible to obtain adequate protein through diet, this can come with trade offs which may or may not be beneficial for the client. Excess calories, fats and carbs can be avoided when a purified protein source is used. 

Collagen Powder: To Strengthen Connective Tissue

Marine Collagen is more bioavailable than Bovine Collagen, and this product is even more bioavailable since it is derived from the scales of fish (which is better than products derived from skin). Collagen Powder contains amino acids including Glycine, Proline, and Hydroxyproline, which further stimulate the production of Hyaluronic Acid.

 

Protein Powder: to increase muscle mass 

Protein powders include a wide array of essential as well as non essential amino acids. Branch chain amino acids are most important for anabolism and include Leucine, Valine and Isovaline. 

Meal Replacement Shake, Vegan Protein Powder Purely Inspired Organic All In One Plant Based Protein Powder for Women & Men Organic Protein Powder Vegan Friendly, Vanilla 

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Creatine: to increase effectiveness of resistance training

Creatine is a molecule created in the body from amino acids arginine and glycine. This has been shown to not just increase ATP/Energy synthesis in muscles but also improve cognitive function from adolescents to the elderly.

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Additional Consideration:

 

5. Phytoestrogens or Plant based Estrogen mimicking molecules

 

It is well documented that bone loss accelerates during peri and post menopause. While menopause hormone therapy may well be safe and effective some clients ( which they should discuss with their physician / OBYGN) , plant based phytoestrogens also have some data to demonstrate slowing down of bone loss with their use.

 

Soy Isoflavones

Soy isoflavones are plant-derived compounds with estrogenic activity, which can help balance hormone levels in wome. They have been shown to improve insulin sensitivity and reduce inflammation as well.

Dietary Sources: Soybeans, tofu, tempeh, soy milk, and edamame.

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Peri Menopause and Menopause

Herbal compounds including soy isoflavones and black cohosh aleviate symptoms of estrogen deficiency. 

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6. Hyaluronic Acid and Vitamin C: 

To Support Cartilage, Skin, and Synovial Fluid Within Joints

Vitamin C is an essential cofactor for production of collagen and this capsule contains hyaluronic acid with 150 mg Vitamin C. This is sourced from bacteria and is therefore Vegan. This works as a good partner with Collagen , particularly since clients with osteoporosis ( weak bones ) will also be developing arthritic conditions such as Osteoarthritis ( wearing down of cartlidge within joints ).