Osteoporosis in women is a growing public health challenge with an aging population. New approaches are needed to prevent and treat decreases in bone density and strength. Two recent articles present different and potentially complementary approaches.
Diet: Lanou reviews the studies on soy diets for the prevention of osteoporosis and bone fractures. Although the results are not consistent, soy based diets that are part of a diet rich in fruits and vegetables appear to be effective. Other studies have suggested that such a diet has a wide range of health promoting effects. Although there is not yet strong enough evidence to suggest that everyone become a vegetarian, at least for women, increasing the amount of fruits and vegetables and having soy in your diet, is a good idea.
Selective estrogen-receptor modulators: (SERMs) such as Evista (raloxifine) have been shown to lower the risk of some forms of osteoporosis in women after menopause. Bazedoxifene, appears to be an effective SERM that mimics the stimulating effects of estrogen on bone to produce stronger bones and lower cholesterol, whilst not having stimulant effects on breast and uterine tissue, effects which could promote cancer. It has been approved for use in Europe to reduce osteoporosis and prevent bone fractures for post- menopausal and pre-menopausal women at high risk. Concerns over serious side effects with bisphosphonates underscore the need for treament options for women who are fearful of or intolerant of the current drug menu.
With regard to vitamins- The ongoing controversy over the proper dose of Vitamin D for bone protecton in post-menopausal women added some more confusion with a recent one year study comparing usual dose vs. high dose Vitamin D supplements. There was no benefit in taking 6500 IU rather than an 800 IU dose.
Norman Marcus, MD
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