Osteoporosis is characterised by a slow and insidious demineralisation of the bone, leaving it weakened and more likely to fracture. Women are more prone to osteoporosis and this relates to hormonal changes following the menopause which alters the resorption rates of bone. Further, the lower bone masses of women compared to men, result in them having less bone to lose before a critical threshold of disease is reached. As bone loss in osteoporosis takes decades to manifest as disease, the elderly are more likely to show symptoms and incur fractures compared to younger individuals. There is no doubt some genetic component to osteoporosis. However this can be said about all diseases as we all have different biochemical individualities that react in different ways to the environments. For example, it is likely the genetically programmed decrease in testosterone and oestrogen that occurs during the normal course of ageing contributes to the increased rate of bone demineralisation.
Increasingly diet is being seen as a causative factor in the development of osteoporosis. Traditional views of osteoporosis have centred on the role played by calcium in the diet. Many studies have investigated calcium intakes in relation to osteoporosis, but the results of such studies have been inconsistent. Addition of vitamin D to calcium may increase the effectiveness of the calcium to inhibit bone demineralisation, and this has been investigated, however, the results of such studies are also fairly inconsistent. These results suggest that osteoporosis is caused by something other than a calcium deficiency in isolation. More recently focus on the whole diet has entered nutritional research, and in this regard high quality diets have been shown to improve the outcomes of patients with osteoporosis and to inhibit bone loss. This may relate to the way that poor quality diets acidify the blood, leading to the leaching of minerals from the bone to neutralise the low pH of the blood and maintain homeostatic balance.
It is possibly not surprising therefore that a number of foods that are considered of high quality are associated with a reduction in the risk of osteoporosis. This may not be because individual foods are protective of osteoporosis, but more because they are markers of a high quality diet being eaten by the individual. For example, in a recent study1, researchers analysed the association between the intakes of fatty acids and fish oil consumption in midlife and later life, on the osteoporotic fracture risk in men and women. The results of the study showed that there was a reduced risk of fractures in those with the highest intakes of polyunsaturated fatty acids. In women, polyunsaturated intakes tended to be inversely associated with fracture risk, but this was not a clear association. Daily fish oil consumption in later life and midlife, was associated with a reduced fracture risk in men and women, respectively. These results therefore highlight further differences in osteoporosis risk between men and women in terms of fatty acid consumption.
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