One of the main concerns when dealing with menopausal health is the prevention and treatment of osteoporosis.  This condition is characterized by a decrease in bone mass with an increased likelihood for fractures.  In the industrialized nations, osteoporosis has reached epidemic levels with 25 million Americans being affected.  We now know that there are definite strategies a person can take to prevent this problem. But, we must get started immediately, because bone mass peaks at 30-35 years of age, generally deteriorating slowly from that point on.

The standard testing for measuring bone mass is with a type of x-ray machine called a DEXA scan.  However, there is another test that you should know about.  This is the Bone Resorption Assessment.  Through a urine sample, the lab is able to evaluate how rapidly bone density is increasing or decreasing.  While the former test takes a snap shot of where a person is currently, the latter one tells us in which direction he/she is headed.  Unfortunately, most MD's are not using this functional test.  Both of these tests combined can be jointly used to assess the affects of lifestyle or efficacy of treatments.

The first preventative measure most people think of is the consumption of calcium.  The media is constantly bombarding us with various types of calcium supplements disguised as everything from antacids to orange juice to chocolate chewables.  What must be made clear is that osteoporosis is not simply a calcium deficiency.  Bone is a complex, living tissue made up of many different substances and influenced by many variables.  Let's discuss some of these!

First and foremost, bone has a fight-back personality.  It always grows when and where demand is placed on it.  Thus, it is crucial important to perform weight-bearing exercises, such as weightlifting, jogging, and basketball.  Astronauts in space flight will lose a certain percentage of bone each day due to the lack of gravity's force on the bones. The take home message is that a sedentary lifestyle is a major risk factor for this condition.

Calcium is the main mineral comprising bone tissue. But, perhaps more important than the amount of calcium consumed is the rate at which calcium is being removed from the bones.  The body uses calcium from the bone in order to keep the pH of the blood finely in tune.  When we consume highly acidic foods, like animal proteins, the bones are robbed of their calcium.  Soft drinks are basically 'osteoporosis in a can'.  They contain three ingredients which force the body to utilize the bones' calcium: phosphoric acid, caffeine, and sugar.  A study appeared in the Journal of Adolescent Health clearly correlating soda consumption with lower calcium levels in the blood.  Perhaps, this is the reason they are called soft drinks, because of their ability to soften the bones.

Nomilk does not do the body good.  As matter of fact, there seems to be a direct relationship with milk consumption and osteoporosis. Anotherwords, the more dairy that a society consumes, the more incidences of osteoporosis and vice versa.

Once our foundation is in place through proper nutrition and exercise, next we should look at some vital supplements.

Calcium is crucial.  Total calcium intake, i.e. diet plus supplements should equal 1500mg for the post-menopausal women not taking estrogen.  Therefore if the diet provides, on average, 500-700mg per day, supplementation would make up the 800-1000mg. But, is all calcium created equal?

Apparently not.  The type of calcium in Tums?, calcium carbonate, is poorly absorbed since it neutralizes stomach acid, which is necessary for the absorption of calcium.  One study showed that supplementing with Tums?, was actually associated with an increase in fractures.  I recommend either calcium citrate or calcium malate at 800mg/day, assuming the diet contains some calcium-rich foods.

Many other vital nutrients should not be forgotten.  Vitamin D plays an integral role in calcium's absorption.  400 IU will suffice.  Magnesium, which in some studies rivals calcium in efficacy against osteoporosis, should be supplemented at around 400-800 mg per day.  Boron, a mineral that positively influences the body's own estrogen, has begun to shine as a star in bone health.  Most of the studies used 3mg per day.