Evidence from the nutritional sciences suggests that many diseases are caused by low quality diet. Research has traditionally focused on individual micro- and macronutrients and their effects on health outcomes, but increasingly studies are considering the whole diet in relation to disease risk. The Mediterranean diet is considered a high quality diet because of its emphasis on whole grains, green leafy vegetables, fruit and oily fish, in combination with low intakes of sugar, processed oils, and refined carbohydrates. Many similar diets that place an emphasis on whole unprocessed foods could also be considered of high quality. Generally, high quality diets have micronutrient dense foods that supply higher than recommended levels of vitamins and minerals. Low levels of vitamins and minerals are known to cause disease, and research is starting to show that modern Western diets can lead to deterioration in health because of chronic micronutrient insufficiencies.
Osteoporosis is a condition of abnormal bone growth that results in structural weakness. Evidence suggests that osteoporosis is caused by low quality nutrition that results in acidification of the blood (here). This acidification leads to bone resporption, a process whereby minerals from bone are used to buffer the pH decrease of the blood. Osteoporosis is slow to develop and may require decades of consuming a low quality diet until demineralisation of the bone tissue is sufficient to weaken its structure. Despite the poor results from clinical trials that have attempted to treat osteoporosis with calcium supplements, huge research resources continue to be wasted by obsessive clinging to the notion that low dietary calcium intakes are the cause of osteoporosis. Abandoning this notion that a single micronutrient deficiency is the cause of osteoporosis, is the first step in successfully understanding the underlying aetiology.
Despite the general fixation with calcium, some research is beginning the shift towards a broader focus of the effects of diet as a whole, when considering osteoporosis. For example, research published in the Journal of the American College of Nutrition1 investigated the effects of diet on the general bone health in 434 women with a mean age greater than 65 years. The authors used computed tomography to assess the bone density in the tibia and nutritional intake was calculated from the results of a questionnaire. When the researchers split the subjects into two clusters based on their micronutrient intakes, they found that over the 6 year follow-up, the cluster with higher intakes of micronutrients was less likely to have cortical demineralisation of the tibia. However, non-nutritional factors were not associated with bone mineral density of the tibia, and other areas of the tibia were not significantly different between clusters.
These results suggests that diets higher in micronutrients may be associated with increased bone mineral densities. The subjects with the higher micronutrient intakes had higher intakes of total calories, protein, calcium, phosphorus, vitamin D, magnesium, folic acid, polyunsaturated fatty acids and alcohol (all nutrients measured). Further, the cluster with the higher mineral intakes were consuming above the recommended daily allowance. A higher micronutrient content of the diet argues for the consumption of a higher quality diet as a whole, which may have included higher intakes of fruits and vegetables. Fruits and vegetables are known to decrease the pH of the blood because they form potassium salts following digestion. This may explain the association seen in the high micronutrient consuming subjects. Evidence from other studies suggests that the high intakes of calcium, vitamin D, magnesium and phosphorus were unlikely to be the reasons for the improvements in bone mineral density seen.
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