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Osteoporosis and the Ornish Program

Osteoporosis (“porous bones”) is a weakening of the bones that increases one’s likelihood of getting a fracture.  In the United States, more than 1.3 million people experience an osteoporosis-related fracture every year, making it a major public health concern.  Although you cannot completely reverse osteoporosis, by making certain lifestyle changes, you can maintain or even improve your bone density, thereby greatly decreasing your risk of experiencing a fracture.

One’s diet can have a profound impact on osteoporosis, either for the better or for the worse.

Diet can have a profound impact on osteoporosis, either for the better or for the worse.  The Ornish Program consists primarily of a whole foods plant-based diet that minimizes meat intake. This dietary combination may slow your rate of bone density loss as you age and decrease your risk for fracture.

Most people think that osteoporosis is caused by a deficiency of calcium intake.  In reality, it’s an imbalance between calcium intake and excretion. Those eating a whole, foods plant-based diet like we recommend actually have a significantly lower risk of osteoporosis even though they may be consuming less calcium.  The reason is that when people eat a lot of meat and dairy, they excrete more calcium, so the net effect is to leach calcium from their bones.

This is why those consuming a whole foods, plant-based diet have lower rates of osteoporosis.

What are the risk factors for Osteoporosis?

Many risk factors are associated with osteoporosis. These are the the most common:

  • Age: Men and women 70 years and older have an increased rate of fracture.
  • Race: Northern European Caucasians and Asians are at higher risk.
  • Gender: Females are four times more likely than males to have osteoporosis.
  • Body habitus: Thinner individuals tend to have lower bone density.
  • Sedentary lifestyle
  • Family history: Having a parent or sibling with a history of hip fractures and/or osteoporosis increases one’s risk of developing osteoporosis.
  • Previous fracture as an adult
  • Lifestyle: Smoking, excessive alcohol use, and sedentary lifestyle increase one’s risk of developing osteoporosis.
  • Certain medications: For example, long-term use of acid inhibitors used for digestive issues, oral steroids such as prednisone, and certain anti-epileptic drugs all increase your risk of developing osteoporosis.
  • Nulliparity: No history of bearing offspring.
  • Early onset of menopause
  • Calcium or vitamin D deficiency

If you have two or more of the above risk factors and are a woman younger than age 65, you may be a candidate for early screening for osteoporosis using a DEXA scan, which is a bone mineral density test to evaluate the thickness of your bones. Otherwise, it is recommended that all women aged 65 years and older, regardless of risk factors, be screened for osteoporosis with a DEXA scan.

What lifestyle changes can I make to improve my bone health?

There are many things that you can do to prevent or slow the progression of osteoporosis:

If you are a smoker, quit smoking. Smoking tobacco contributes to calcium loss and decreases bone strength.

Exercise regularly.  Consistent weight-bearing exercise (walking, jogging, dancing, playing tennis, lifting weights) helps keep your bones strong and decreases the likelihood of you getting a fracture if you fall.

Limit caffeine to 1 cup of coffee per day.  Caffeine has a diuretic effect that causes your body to lose both water and calcium.

Limit your daily salt intake. Sodium, which is the primary ingredient in salt, increases urinary calcium loss.  You can actually significantly decrease your daily calcium requirement by reducing your overall sodium intake.  A few strategies include avoiding salty snacks, reading food labels carefully (especially canned foods) before purchasing a food item, and eating home-cooked meals more frequently (restaurants tend to add a lot of salt to their food).

Limit your alcohol consumption (ideally no more than one drink per day).  Alcohol can weaken bones when consumed in high quantities by decreasing your body’s natural production of calcitonin, a hormone important for bone protection.  One large study found that having more than 1.5 drinks per day increased one’s risk for osteoporotic fracture by about 40% compared to those having less than this amount.

Reduce animal protein intake.  Animal protein, by acidifying the blood, tends to leach calcium from the bones and lead to its excretion in the urine.  Women with higher meat intake (> or = 5 servings per week) have been shown to have a significantly increased risk for forearm fracture compared to women eating meat less than once per week.

Increase fruit and vegetable intake.  Increased fruit and vegetable intake is associated with higher bone mineral density in both men and women.(4,5) This is likely due to the bone-supporting effects of the vitamins and minerals that they carry such as calcium, potassium, magnesium, vitamin K, and folic acid.

Consume adequate calcium and vitamin D. Men and premenopausal women need about 1000 mg of calcium (no more than 500 mg at a time due to limited absorption) and 800 to 1200 units of vitamin D daily.  Postmenopausal women have slightly higher requirements — about 1500 mg of calcium and 1000 to 2000 units of vitamin D daily.  Ideally you should get most of your calcium from your diet and vitamin D from your diet and the sun. The Ornish diet, which emphasizes non-fat dairy (yogurt, milk), leafy greens, tofu, and mushrooms, has enough calcium.  If you are not meeting your daily requirements through diet alone, you can take a multivitamin or an over-the-counter calcium and vitamin D supplement.  Also aim to get 5 – 10 minutes of sun exposure everyday prior to putting on sunscreen, as this helps your body to produce vitamin D.

As you can see, with the exception of quitting smoking and exercising more, the lifestyle recommendations for preventing and treating osteoporosis are all dietary.  The Ornish Program consists primarily of a low-sodium plant-based diet that minimizes meat intake, a dietary combination that may slow your rate of bone density loss as you age and decrease your risk for fracture.



Contributed by

Ben Brown, MD
Medical Director, Ornish Lifestyle Medicine

To your best health!

in collaboration with...

Dean Ornish, MD.
Program Founder

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