forgot password

encyclopedia of health Get your personal health analysis
Welcome to the Truestar Health Encyclopedia the most comprehensive information database available on health, wellness, food, nutrition, vitamins and supplements. Use of our encyclopedia will enable you to make well-informed, responsible decisions for the promotion of your own health and wellness.
Enter search items    


Also indexed as: Bone Loss, Brittle Bone Disease


Stand tall against osteoporosis. No matter what your age, it’s never too late to stop bone loss now for better posture and fewer fractures down the road. According to research or other evidence, the following self-care steps may be helpful:

What you need to know

  • Pump it up
  • Make weight-bearing exercise a regular habit to increase bone density and prevent osteoporosis
  • Cut the caffeine
  • Avoid excessive calcium loss in the urine from by switching to healthier beverages
  • Aim for lifelong calcium and vitamin D nutrition
  • An extra 800 mg of calcium and 400 to 800 IU of vitamin D a day can help protect the bones of people at any age
  • Get your soy
  • Make tofu, soy milk, soy protein, and other sources of beneficial isoflavones a regular part of your diet
  • Fine-tune your protein
  • Too much or too little protein in your diet may increase osteoporosis risk
  • Watch the salt
  • Avoid excessive salt intake and high-salt processed and restaurant foods that may contribute to calcium and bone loss

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full osteoporosis article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About osteoporosis

Osteoporosis is a condition in which the normal amount of bone mass has decreased.

People with osteoporosis have brittle bones, which increases the risk of bone fracture, particularly in the hip, spine, and wrist. Osteoporosis is most common in postmenopausal Asian and Caucasian women. Premenopausal women are partially protected against bone loss by the hormone called estrogen. Black women often have slightly greater bone mass than do other women, which helps protect against bone fractures. In men, testosterone partially protects against bone loss even after middle age. Beyond issues of race, age, and gender, incidence varies widely from society to society, suggesting that osteoporosis is largely preventable.

Product ratings for osteoporosis

Science Ratings Nutritional Supplements Herbs



Vitamin D



Fish oil and Evening primrose oil (in combination)

Folic acid (to lower homocysteine)


Isoflavones (from red clover


Phosphorus (for elderly people taking calcium supplements)


Soy isoflavones (genistein)

Vitamin B12 (to lower homocysteine)

Vitamin K





Fish oil




Vitamin B6 (to lower homocysteine)

Vitamin B-complex

Whey protein


Black cohosh


See also:  Homeopathic Remedies for Osteoporosis
3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

What are the symptoms?

Osteoporosis is a silent disease that may not be noticed until a broken bone occurs. Signs may include diminished height, rounded shoulders, dowager’s hump, and evidence of bone loss from diagnostic tests. Symptoms may include neck or back pain.

Medical options

The most commonly used prescription medications are the bisphosphonates, including alendronate (Fosamax®), risedronate (Actonel®), and etidronate (Didronel®). Another less commonly prescribed drug is calcitonin (Miacalcin®). The drug raloxifene (Evista®), as well as those that provide hormone replacement therapy, such as estradiol (Estrace®, Estraderm®), conjugated estrogens (Premarin®), and conjugated estrogens with medroxyprogesterone acetate (Premphase®, Prempro®), are often prescribed for postmenopausal women.

Healthcare providers also recommend adequate dietary calcium intake and weight-bearing exercise.

Dietary changes that may be helpful

Studies attempting to uncover the effects of high animal protein intake on the risk of osteoporosis have produced confusing and contradictory results.1 2 3 4 5 The same is true of studies attempting to find out whether vegetarians are protected against osteoporosis.6 7 8 9 10 11 12 13 Moreover, while some studies report that protein supplementation lowers death rates and shortens hospital stays14 or reduces bone loss among people with osteoporosis,15 others have found that such supplementation is of little value.16

These conflicting findings may occur in part because dietary protein produces opposing effects on bone. On one hand, dietary protein increases the loss of calcium in urine,17 18 which should increase the risk of osteoporosis. On the other hand, normal bone formation requires adequate dietary protein, and low dietary protein intake has been associated with low bone mineral density.19 Current research shows that finding the line between too much protein and too little protein remains elusive, though extremes in protein intake—either high or low—might possibly increase the risk of osteoporosis.

Short-term increases in dietary salt result in increased urinary calcium loss, which suggests that over time, salt intake may cause bone loss.20 Increasing dietary salt has increased markers of bone loss in postmenopausal (though not premenopausal) women.21 22 23 Although a definitive link between salt intake and osteoporosis has not yet been proven, many doctors recommend that people wishing to protect themselves against bone loss use less salt and eat fewer processed and restaurant foods, which tend to be highly salted.

Like salt, caffeine increases urinary loss of calcium.24 Caffeine intake has been linked to increased risk of hip fractures25 and to a lower bone mass in women who consumed inadequate calcium.26 Many doctors recommend decreasing caffeinated coffee, black tea, and caffeine-containing soft drinks as a way to improve bone mass.

Curiously, while caffeine-containing tea consumption has been linked to osteoporosis in some studies,27 others have reported that tea drinkers have a lower risk of osteoporosis than do people who do not drink tea.28 29 Possibly, the calcium-losing effect of caffeine in tea is overridden by other constituents of tea, such as flavonoids.

People who consume soft drinks have been reported to have an increased incidence of bone fractures,30 although short-term consumption of carbonated beverages has not affected markers of bone health.31 The problem, if one exists, may be linked to phosphoric acid, a substance found in many soft drinks. In one trial, children consuming at least six glasses (1.5 liters) of soft drinks containing phosphoric acid had more than five times the risk of developing low blood levels of calcium compared with other children.32 Although a few studies have not linked soft drinks to bone loss,33 the preponderance of evidence now suggests that a problem may exist.

Soy foods, such as tofu, soy milk, roasted soy beans, and soy protein powders, may be beneficial in preventing osteoporosis. Isoflavones from soy have protected against bone loss in animal studies.34 In a double-blind trial, postmenopausal women who supplemented with 40 grams of soy protein powder (containing 90 mg of isoflavones) per day were protected against bone mineral loss in the spine, although lower amounts were not protective.35 In a double-blind study, administration of the soy isoflavone genistein (54 mg per day) to postmenopausal women for one year reduced bone breakdown, increased bone formation, and increased bone mineral density of the hip and spine.36 The effect on bone density was similar to that of conventional hormone-replacement therapy.

The effect of dairy products on the risk of osteoporosis-related fractures is subject to controversy. According to a review of 46 studies,37 different dairy products appear to have different effects on bone density and fracture rates. Milk, especially nonfat milk, probably does more good than harm because of its relatively lower protein and salt content, as well as its higher level of calcium. Cottage cheese and American cheese, on the other hand, probably do more harm than good. Cottage cheese is high in protein and salt but low in calcium, factors which could contribute to bone loss. American cheese is extremely high in salt and high in protein. These foods are not recommended as calcium sources for the prevention of osteoporotic fractures. Although there may be better ways of getting calcium, younger women who wish to prevent osteoporosis might consider nonfat milk and nonfat yogurt to be reasonable dietary calcium sources.

Lifestyle changes that may be helpful

Smoking leads to increased bone loss.38 For this and many other health reasons, smoking should be avoided.

Exercise is known to help protect against bone loss.39 The more weight-bearing exercise done by men and postmenopausal women, the greater their bone mass and the lower their risk of osteoporosis. Walking is a perfect weight-bearing exercise. For premenopausal women, exercise is also important, but taken to extreme, it may lead to cessation of the menstrual cycle, which contributes to osteoporosis.40

Excess body mass helps protect against osteoporosis. As a result, researchers have been able to show that people who successfully lose weight have greater bone loss compared with those who do not lose weight.41 Therefore, people who lose weight need to be particularly vigilant about preventing osteoporotic fractures.

Vitamins that may be helpful

Although insufficient when used as the only intervention, calcium supplements help prevent osteoporosis.42 Though some of the research remains controversial, the protective effect of calcium on bone mass is one of very few health claims permitted on supplement labels by the U.S. Food and Drug Administration.

In some studies, higher calcium intake has not correlated with a reduced risk of osteoporosis—for example, in women shortly after becoming menopausal43 or in men.44 However, after about three years of menopause, calcium supplementation does appear to take on a protective effect for women.45 Even the most positive trials using isolated calcium supplementation show only minor effects on bone mass. Nonetheless, a review of the research shows that calcium supplementation plus hormone replacement therapy is much more effective than hormone replacement therapy without calcium.46 Double-blind research has found that increasing calcium intake results in greater bone mass in girls.47 An analysis of many trials investigating the effects of calcium supplementation in premenopausal women has also shown a significant positive effect.48 Most doctors recommend calcium supplementation as a way to partially reduce the risk of osteoporosis and to help people already diagnosed with the condition. In order to achieve the 1,500 mg per day calcium intake many researchers deem optimal, 800 to 1,000 mg of supplemental calcium are generally added to the 500 to 700 mg readily obtainable from the diet.

While phosphorus is essential for bone formation, most people do not require phosphorus supplementation, because the typical western diet provides ample or even excessive amounts of phosphorus. One study, however, has shown that taking calcium can interfere with the absorption of phosphorus, potentially leading to phosphorus deficiency in elderly people, whose diets may contain less phosphorus.49 . The authors of this study recommend that, for elderly people, at least some of the supplemental calcium be taken in the form of tricalcium phosphate or some other phosphorus-containing preparation.

Ipriflavone is a synthetic flavonoid derived from the soy isoflavone called daidzein. It promotes the incorporation of calcium into bone and inhibits bone breakdown, thus preventing and reversing osteoporosis. Many clinical trials, including numerous double-blind trials, have consistently shown that long-term treatment with 600 mg of ipriflavone per day, along with 1,000 mg supplemental calcium, is both safe and effective in halting bone loss in postmenopausal women or in women who have had their ovaries removed. Ipriflavone has also been found to improve bone density in established cases of osteoporosis in most,50 51 52 53 54 55 56 57 58 59 60 but not all,61 clinical trials. Some studies have shown that ipriflavone therapy not only stops bone loss, it also actually increases bone density and significantly reduces the number of vertebral fractures and amount of bone pain.

However, one double-blind study has failed to confirm the beneficial effect of ipriflavone. In that study, ipriflavone was no more effective than a placebo for preventing bone loss in postmenopausal women with osteoporosis.62 The women in this negative study were older (average age, 63.3 years) than those in most other ipriflavone studies and had relatively severe osteoporosis. It is possible that ipriflavone works only in younger women or in those with less severe osteoporosis.

Vitamin D increases calcium absorption, and blood levels of vitamin D are directly related to the strength of bones.63 Mild deficiency of vitamin D is common in the fit, active elderly population and leads to an acceleration of age-related loss of bone mass and an increased risk of fracture.64 In double-blind research, vitamin D supplementation has reduced bone loss in women who consume insufficient vitamin D from food65 and slowed bone loss in people with osteoporosis.66 However, the effect of vitamin D supplementation on osteoporosis risk remains surprisingly unclear,67 68 with some trials reporting little if any benefit.69 Moreover, trials reporting reduced risk of fracture have usually combined vitamin D with calcium supplementation,70 making it difficult to assess how much benefit is caused by supplementation with vitamin D alone.71

Impaired balance and increased body sway are important causes of falls in elderly people with osteoporosis.72 Vitamin D works with calcium to prevent some musculoskeletal causes of falls. In a double-blind trial, elderly women who were given 800 IU per day of vitamin D and 1,200 mg per day of calcium had a significantly lower rate of falls and subsequent fractures than did women given the same amount of calcium alone.73

Despite inconsistency in the research, many doctors recommend 400 to 800 IU per day of supplemental vitamin D, depending upon dietary intake and exposure to sunlight.

A preliminary trial found that elderly women with osteoporosis who were given 4 grams of fish oil per day for four months had improved calcium absorption and evidence of new bone formation.74 Fish oil combined with evening primrose oil (EPO) may confer added benefits. In a controlled trial, women received 6 grams of a combination of EPO and fish oil, or a matching placebo, plus 600 mg of calcium per day for three years.75 The EPO/fish oil group experienced no spinal bone loss in the first 18 months and a significant 3.1% increase in spinal bone mineral density during the last 18 months.

Vitamin K is needed for bone formation. People with osteoporosis have been reported to have low blood levels76 77 and low dietary intake of vitamin K.78 79 One study found that postmenopausal (though not premenopausal) women may reduce urinary loss of calcium by taking 1 mg of vitamin K per day.80 People with osteoporosis given large amounts of vitamin K2 (45 mg per day) have shown an increase in bone density after six months81 and decreased bone loss after one82 or two83 years.

Other preliminary studies have reported that vitamin K supplementation increases bone formation in some women84 and that higher vitamin K intake correlates with greater bone mineral density.85 Some doctors recommend 1 mg vitamin K1 to postmenopausal women as a way to help maintain bone mass, though optimal intake remains unknown.

In a preliminary study, people with osteoporosis were reported to be at high risk for magnesium malabsorption.86 Both bone87 and blood88 levels of magnesium have been reported to be low in people with osteoporosis. Supplemental magnesium has reduced markers of bone loss in men.89 Supplementing with 250 mg up to 750 mg per day of magnesium arrested bone loss or increased bone mass in 87% of people with osteoporosis in a two-year, controlled trial.90 Some doctors recommend that people with osteoporosis supplement with 350 mg of magnesium per day.

One trial studying postmenopausal women combined hormone replacement therapy with magnesium (600 mg per day), calcium (500 mg per day), vitamin C, B vitamins, vitamin D, zinc, copper, manganese, boron, and other nutrients for an eight- to nine-month period.91 In addition, participants were told to avoid processed foods, limit protein intake, emphasize vegetable over animal protein, and limit consumption of salt, sugar, alcohol, coffee, tea, chocolate, and tobacco. Bone density increased a remarkable 11%, compared to only 0.7% in women receiving hormone replacement alone.

Levels of zinc in both blood and bone have been reported to be low in people with osteoporosis,92 and urinary loss of zinc has been reported to be high.93 In one trial, men consuming only 10 mg of zinc per day from food had almost twice the risk of osteoporotic fractures compared with those eating significantly higher levels of zinc in their diets.94 Whether zinc supplementation protects against bone loss has not yet been proven, though in one trial, supplementation with several minerals including zinc and calcium was more effective than calcium by itself.95 Many doctors recommend that people with osteoporosis, as well as those trying to protect themselves from this disease, supplement with 10 to 30 mg of zinc per day.

Copper is needed for normal bone synthesis. Recently, a two-year, controlled trial reported that 3 mg of copper per day reduced bone loss.96 When taken over a shorter period of time (six weeks), the same level of copper supplementation had no effect on biochemical markers of bone loss.97 Some doctors recommend 2 to 3 mg of copper per day, particularly if zinc is also being taken, in order to prevent a deficiency. Supplemental zinc significantly depletes copper stores, so people taking zinc supplements for more than a few weeks generally need to supplement with copper also. All minerals discussed so far—calcium, magnesium, zinc, and copper—are sometimes found at appropriate levels in high-potency multivitamin-mineral supplements.

Boron supplementation has been reported to reduce urinary loss of calcium and magnesium in some,98 but not all,99 preliminary research. However, those who are already supplementing with magnesium appear to achieve no additional calcium-sparing benefit when boron is added.100 Finally, in the original report claiming that boron reduced loss of calcium,101 the effect was achieved by significantly increasing estrogen and testosterone levels, hormones that have been linked to cancer risks. Therefore, it makes sense for people with osteoporosis to supplement with magnesium instead of, rather than in addition to, boron.

Interest in the effect of manganese and bone health began when famed basketball player Bill Walton’s repeated fractures were halted with manganese supplementation.102 A subsequent, unpublished study reported manganese deficiency in a small group of osteoporotic women.103 Since then, a combination of minerals including manganese was reported to halt bone loss.104 However, no human trial has investigated the effect of manganese supplementation alone on bone mass. Nonetheless, some doctors recommend 10 to 20 mg of manganese per day to people concerned with maintenance of bone mass.

Silicon is required in trace amounts for normal bone formation,105 and supplementation with silicon has increased bone formation in animals.106 In preliminary human research, supplementation with silicon increased bone mineral density in a small group of people with osteoporosis.107 Optimal supplemental levels remain unknown, though some multivitamin-mineral supplements now contain small amounts of this trace mineral.

Strontium may play a role in bone formation, and also may inhibit bone breakdown.108 Preliminary evidence suggests that women with osteoporosis may have reduced absorption of strontium.109 The first medical use of strontium was described in 1884. (Strontium supplements do not contain the radioactive form of strontium that is a component of nuclear fallout.) Years ago in a preliminary trial, people with osteoporosis were given 1.7 grams of strontium for a period of time ranging between three months and three years; afterward, they reported a significant reduction in bone pain, and there was evidence suggesting their bone mass had increased.110 More recently, in a three-year double-blind study of postmenopausal women with osteoporosis, supplementing with strontium, in the form of strontium ranelate, significantly increased bone mineral density in the hip and spine, and significantly reduced the risk of vertebral fractures by 41%, compared with a placebo.111 The amount of strontium used in that study was 680 mg per day, which is approximately 300 times the amount found in a typical diet. Increased bone formation and decreased bone pain were also reported in six people with osteoporosis given 600 to 700 mg of stable strontium per day.112   Although the amounts of strontium used in these studies studies was very high, the optimal intake remains unknown. Some doctors recommend only 1 to 3 mg per day—less than many people currently consume from their diets, but an amount that has begun to appear in some mineral formulas geared toward bone health. Strontium preparations, providing 200 to 400 mg per day, were used for decades during the first half of the twentieth century without any apparent toxicity.113 No significant side effects were observed in people taking large amounts of strontium; however, animal studies have demonstrated defects in bone mineralization, when strontium was administered in large amounts in combination with a low-calcium diet. People interested in taking large amounts of strontium should be supervised by a doctor, and should make sure to take adequate amounts of calcium. It should be noted that, although supplementing with strontium increases bone mineral density, only part of the increase is real. The rest is a laboratory error that results from the fact that strontium blocks X-rays to a greater extent than does calcium.114 People taking large amounts of strontium should mention that fact to the radiologist when they are having their bone mineral density measured, so that the results will be interpreted correctly.

Folic acid, vitamin B6, and vitamin B12 are known to reduce blood levels of the amino acid homocysteine, and homocystinuria, a condition associated with high homocysteine levels, frequently causes osteoporosis. Therefore, some researchers have suggested that these vitamins might help prevent osteoporosis by lowering homocysteine levels.115 In a double-blind study of people who had suffered a stroke and had high homocysteine levels, daily supplementation with 5 mg of folic acid and 1,500 mcg of vitamin B12 for two years reduced the incidence of fractures by 78%, compared with a placebo.116 The reduction in fracture risk appeared to be due to an improvement in bone quality, rather than to a change in bone mineral density. Whether these vitamins would be beneficial for people with normal homocysteine levels is not known. For the purpose of lowering homocysteine, amounts of folic acid and vitamins B6 and B12 found in high-potency B-complex supplements and multivitamins should be adequate.

Preliminary evidence suggests that progesterone might reduce the risk of osteoporosis.117 A preliminary trial using topically applied natural progesterone cream in combination with dietary changes, exercise, vitamin and calcium supplementation, and estrogen therapy reported large gains in bone density over a three-year period in a small group of postmenopausal women, but no comparison was made to examine the effect of using the same protocol without progesterone.118 Other trials have reported that adding natural progesterone to estrogen therapy did not improve the bone-sparing effects of estrogen when taken alone119 and that progesterone applied topically every day for a year did not reduce bone loss.120 In a more recent double-blind study, however, progesterone had a modest bone-sparing effect in post-menopausal women.121

In a preliminary trial, bone mineral density increased among healthy elderly women and men who were given 50 mg per day of DHEA as a supplement.122 It is not known if supplementation would have similar effects in people with established osteoporosis.

Some whey proteins may reduce bone loss.123 Milk basic protein (MBP) is a mixture of some of the proteins found in whey protein. A preliminary trial found that 300 mg per day of MBP improved blood measures of bone metabolism in men, suggesting more bone formation was occurring than bone loss.124 A double-blind trial found that women taking 40 mg per day of MBP for six months had greater gains in bone density compared with those taking a placebo.125 No osteoporosis-related research has been done using complete whey protein mixtures.

Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful

In a double-blind study, supplementation with isoflavones from red clover for one year reduced the amount of bone loss from the spine by 45%, compared with a placebo.126 The supplement used provided daily 26 mg of biochanin A, 16 mg of formononetin, 1 mg of genistein, and 0.5 mg of daidzein.

Horsetail is a rich source of silicon, and preliminary research suggests that this trace mineral may help maintain bone mass. Effects of horsetail supplementation on bone mass have not been studied.

Black cohosh has been shown to improve bone mineral density in animals fed a low calcium diet,127 but it has not been studied for this purpose in humans.

Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.


1. Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Protein consumption and bone fractures in women. Am J Epidemiol 1996;143:472–9.

2. Abelow BJ, Holford TR, Insogna KL. Cross-cultural associations between dietary animal protein and hip fracture: a hypothesis. Calcif Tissue Int 1992;50:14–8.

3. Moriguti JC, Ferriolli E, Marchini JS. Urinary calcium loss in elderly men on a vegetable:animal (1:1) high-protein diet. Gerontology 1999;45:274–8.

4. Munger RG, Cerhan JR, Chiu BC. Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. Am J Clin Nutr 1999;69:147–52.

5. Mannan MT, Tucker K, Dawson-Hughes B, et al. Effect of dietary protein on bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Mineral Res 2000;15:2504–12.

6. Ellis FR, Holesh S, Ellis JW. Incidence of osteoporosis in vegetarians and omnivores. Am J Clin Nutr 1972;25:555–8.

7. Marsh AG, Sanchez TV, Midkelsen O, et al. Cortical bone density of adult lacto-ovo-vegetarian and omnivorous women. J Am Diet Assoc 1980;76:148–51.

8. Marsh AG, Sanchez TV, Chaffee FL, et al. Bone mineral mass in adult lacto-ovo-vegetarian and omnivorous males. Am J Clin Nutr 1983;37:453–6.

9. Hunt IF, Murphy NJ, Henderson C, et al. Bone mineral content in postmenopausal women: comparison of omnivores and vegetarians. Am J Clin Nutr 1989;50:517–23.

10. Lloyd T, Schaeffer JM, Walker MA, Demers LM. Urinary hormonal concentrations and spinal bone densities of premenopausal vegetarian and nonvegetarian women. Am J Clin Nutr 1991;54:1005–10.

11. Tesar R, Notelovitz M, Shim E, et al. Axial and peripheral bone density and nutrient intakes of postmenopausal vegetarian and omnivorous women. Am J Clin Nutr 1992;56:699–704.

12. Tylavsky FA, Anderson JJ. Dietary factors in bone health of elderly lactoovovegetarian and omnivorous women. Am J Clin Nutr 1988;48(3 Suppl):842–9.

13. Lau EMC, Kwok T, Woo J, Ho SC. Bone mineral density in Chinese elderly female vegetarians, vegans, lacto-vegetarians and omnivores. Eur J Clin Nutr 1998;52:60–4.

14. Tkatch L, Rapin CH, Rizzoli R, et al. Benefits of oral protein supplementation in elderly patients with fracture of the proximal femur. J Am Coll Nutr 1992;11:519–25.

15. Schürch MA, Rizzoli R, Slosman D, et al. Protein supplements increase serum insulin-like growth factor-I levels and attenuate proximal femur bone loss in patients with recent hip fracture. A randomized, double blind, placebo-controlled trial. Ann Intern Med 1998;128:801–9.

16. Espauella J, Guyer H, Diaz-Escriu F, et al. Nutritional supplementation of elderly hip fracture patients. A randomized, double-blind placebo-controlled trial. Age Aging 2000;29:425–31.

17. Heaney RP. Nutrient interactions and the calcium requirement. J Lab Clin Med 1994;124:15–6 [editorial/review].

18. Kerstetter JE, Allen LH. Dietary protein increases urinary calcium. J Nutr 1990;120:134–6.

19. Kerstetter JE, Looker AC, Insogna KL. Low dietary protein and low bone density. Calcif Tissue Int 2000;66:313.

20. Zarkadas M, Geougeon-Reyburn R, Marliss EB, et al. Sodium chloride supplementation and urinary calcium excretion in postmenopausal women. Am J Clin Nutr 1989;50:1088–94.

21. Evans CE, Chughtai AY, Blumsohn A, et al. The effect of dietary sodium on calcium metabolism in premenopausal and postmenopausal women. Eur J Clin Nutr 1997;51:394–9.

22. McParland BE, Boulding A, Campbell AJ. Dietary salt affects biochemical markers of resorption and formation of bone in elderly women. Br Med J 1989;299:834–5.

23. Devine A, Criddle RA, Dick IM, et al. A longitudinal study of the effect of sodium and calcium intakes on regional bone density in postmenopausal women. Am J Clin Nutr 1995;62:740–5.

24. Kynast-Gales SA, Massey LK. Effect of caffeine on circadian excretion of urinary calcium and magnesium. J Am Coll Nutr 1994;13:467–72.

25. Hernandez-Avila M, Colditz GA, Stampfer MJ, et al. Caffeine, moderate alcohol intake, and risk of fractures of the hip and forearm in middle-aged women. Am J Clin Nutr 1991;54:157–63.

26. Harris SS, Dawson-Hughes B. Caffeine and bone loss in healthy postmenopausal women. Am J Clin Nutr 1994;60:573–8.

27. Kanis J, Johnell O, Gullberg B, et al. Risk factors for hip fracture in men from southern Europe: the MEDOS study. Mediterranean Osteoporosis Study. Osteoporos Int 1999;9:45–54.

28. Hegarty VM, May HM, Khaw KT. Tea drinking and bone mineral density in older women. Am J Clin Nutr 2000;71:1003–7.

29. Kao PC, P’eng FK. How to reduce the risk factors of osteoporosis in Asia. Chung Hua I Hsueh Tsa Chih (Taipei) 1995;55:209–13 [review].

30. Wyshak G, Frisch RE. Carbonated beverages, dietary calcium, the dietary calcium/phosphorus ratio, and bone fractures in girls and boys. J Adolescent Health 1994;15:210–5.

31. Smith S, Swain J, Brown EM, et al. A preliminary report of the short-term effect of carbonated beverage consumption on calcium metabolism in normal women. Arch Intern Med 1989;149:2517–9.

32. Mazariegos-Ramos E, Guerrero-Romero F, Rodríquez-Morán F, et al. Consumption of soft drinks with phosphoric acid as a risk factor for the development of hypocalcemia in children: a case-control study. J Pediatr 1995;126:940–2.

33. Kim SH, Morton DJ, Barrett-Connor EL. Carbonated beverage consumption and bone mineral density among older women: the Rancho Bernardo Study. Am J Public Health 1997;87:276–9.

34. Anderson JJ, Ambrose WW, Garner SC. Biphasic effects of genistein on bone tissue in the ovariectomized, lactating rat model (44243). Proc Soc Exp Biol Med 1998;217:345–50.

35. Potter SM, Baum JA, Teng H, et al. Soy protein and isoflavones: their effects on blood lipids and bone density in postmenopausal women. Am J Clin Nutr 1998;68(Suppl):1375–9S.

36. Morabito N, Crisafulli A, Vergara C, et al. Effects of genistein and hormone-replacement therapy on bone loss in early postmenopausal women: a randomized double-blind placebo-controlled study. J Bone Miner Res 2002;17:1904–12.

37. Weinsier RL, Krumdieck CL. Dairy foods and bone health: examination of the evidence. Am J Clin Nutr 2000;72:681–9 [review].

38. Hopper JL, Seeman E. The bone density of female twins discordant for tobacco use. N Engl J Med 1994;330:387–92.

39. Chow R, Harrison JE, Notarius C. Effect of two randomised exercise programmes on bone mass of healthy postmenopausal women. Br Med J 1987;295:1441–4.

40. Lloyd T, Triantafyllou SJ, Baker ER, et al. Women athletes with menstrual irregularity have increased musculoskeletal injuries. Med Sci Sports Exercise 1986;18(4):374–9.

41. Salamone LM, Cauley JA, Black DM, et al. Effect of a lifestyle intervention on bone mineral density in premenopausal women: a randomized trial. Am J Clin Nutr 1999;70:97–103.

42. Reid IR, Ames RW, Evans MC, et al. Long-term effects of calcium supplementation on bone loss and fractures in postmenopausal women: a randomized controlled trial. Am J Med 1995;98:331–5.

43. Hosking DJ, Ross PD, Thompson DE, et al. Evidence that increased calcium intake does not prevent early postmenopausal bone loss. Clin Ther 1998;20:933–44.

44. Owusu W, Willett WC, Feskanich D, et al. Calcium intake and the incidence of forearm and hip fractures among men. J Nutr 1997;127:1782–7.

45. Rulm LA, Sakhaee K, Peterson R, et al. The effect of calcium citrate on bone density in the early and mid-postmenopausal period: a randomized, placebo-controlled study. Am J Ther 1999;6:303–11.

46. Nieves JW, Komar L, Cosman F, Lindsay R. Calcium potentiates the effect of estrogen and calcitonin on bone mass: review and analysis. Am J Clin Nutr 1998;67:18–24.

47. Bonjour JP, Carrie AL, Ferrari S, et al. Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial. J Clin Invest 1997;99:1287–94.

48. Welten DC, Kemper HC, Post GB, et al. A meta-analysis of the effect of calcium intake on bone mass in young and middle aged females and males. J Nutr 1995;125:2802–13.

49. Heaney RP, Nordin BEC. Calcium effects on phosphorus absorption: implications for the prevention and co-therapy of osteoporosis. J Am Coll Nutr 2002;21:239–44.

50. Agnusdei D, Bufalino L. Efficacy of ipriflavone in established osteoporosis and long-term safety. Calcif Tissue Int 1997:61:S23–7 [includes review].

51. Head KA. Ipriflavone: an important bone-building isoflavone. Altern Med Rev 1999;4(1):10–22 [review].

52. Avioli LV. The future of ipriflavone in the management of osteoporotic syndromes. Calcif Tissue Int 1997;61(Suppl 1):S33–5 [review].

53. Adami S, Bufalino L, Cervetti R, et al. Ipriflavone prevents radial bone loss in postmenopausal women with low bone mass over 2 years. Osteoporos Int 1997;7:119–25.

54. Nozaki M, Hashimoto K, Inoue Y, et al. Treatment of bone loss in oophorectomized women with a combination of ipriflavone and conjugated equine estrogen. Int J Gynaecol Obstet 1998;62(1):69–75.

55. Gennari C, Adami S, Agnusdei D, et al. Effect of chronic treatment with ipriflavone in postmenopausal women with low bone bass. Calcif Tissue Int 1997;61(Suppl 1):S19–22.

56. Gennari C, Agnusdei D, Crepaldi G, et al. Effect of ipriflavone—a synthetic derivative of natural isoflavones—on bone mass loss in the early years after menopause. Menopause 1998;5(1):9–15.

57. Ohta H, Komukai S, Makita K, et al. Effects of 1-year ipriflavone treatment on lumbar bone mineral density and bone metabolic markers in postmenopausal women with low bone mass. Horm Res 1999;51:178–83.

58. Melis GB, Paoletti AM, Bartolini R, et al. Ipriflavone and low doses of estrogens in the prevention of bone mineral loss in climacterium. Bone Miner 1992;19 (Suppl 1):S49–56.

59. Gambacciani M, Ciaponi M, Cappagli B, et al. Effects of combined low dose of the isoflavone derivative ipriflavone and estrogen replacement on bone mineral density and metabolism in postmenopausal women. Maturitas 1997;28:75–81.

60. Hanabayashi T, Imai A, Tamaya T. Effects of ipriflavone and estriol on postmenopausal osteoporotic changes. Int J Gynaecol Obstet 1995;51:63–4 [letter].

61. Alexandersen P, Toussaint A, Christiansen C, et al. Ipriflavone in the treatment of postmenopausal osteoporosis: a randomized controlled trial. JAMA 2001;285:1482–88.

62. Alexandersen P, Toussaint A, Christiansen C, et al. Ipriflavone in the treatment of postmenopausal osteoporosis: a randomized controlled trial. JAMA 2001;285:1482–8.

63. Brot C, Jorgensen N, Madsen OR, et al. Relationships between bone mineral density, serum vitamin D metabolites and calcium: phosphorus intake in healthy perimenopausal women. J Intern Med 1999;245:509–16.

64. Sahota O. Osteoporosis and the role of vitamin D and calcium-vitamin D deficiency, vitamin D insufficiency and vitamin D sufficiency. Age Ageing 2000;29:301–4.

65. Dawson-Hughes B, Dallal GE, Krall EA, et al. Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Ann Intern Med 1991;115:505–12.

66. Adams JS, Kantorovich V, Wu C, et al. Resolution of vitamin D insufficiency in osteopenic patients results in rapid recovery of bone mineral density. J Clin Endocrinol Metab 1999;84:2729–30.

67. Nordin BE, Baker MR, Horsman A, Peacock M. A prospective trial of the effect of vitamin D supplementation on metacarpal bone loss in elderly women. Am J Clin Nutr 1985;42(3):470–4.

68. Lips P, Graafmans WC, Ooms ME, et al. Vitamin D supplementation and fracture incidence in elderly persons. Ann Intern Med 1996;124:400–6.

69. Komulainen M, Tupperainen MT, Kröger H, et al. Vitamin D and HRT: no benefit additional to that of HRT alone in prevention of bone loss in early postmenopausal women. A 2.5-year randomized placebo-controlled study. Osteoporos Int 1997;7:126–32.

70. Droisy R, Collette J, Chevallier T, et al. Effects of two 1-year calcium and vitamin D3 treatments on bone remodeling markers and femoral bone density in elderly women. Curr Ther Res 1998;59:850–62.

71. Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med 1992;327:1637–42.

72. Maki BE, Holliday PJ, Topper AK. A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol 1994;49:M72–84.

73. Pfeifer M, Begerow B, Minne HW, et al. Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Mineral Res 2000;15:1113–8.

74. Van Papendorp DH, Coetzer H, Kruger MC. Biochemical profile of osteoporotic patients on essential fatty acid supplementation. Nutr Res 1995;15:325–34.

75. Kruger MC, Coetzer H, de Winter R, et al. Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis. Aging 1998;10:385–94.

76. Hart JP. Circulating vitamin K1 levels in fractured neck of femur. Lancet 1984;ii:283 [letter].

77. Tamatani M, Morimoto S, Nakajima M, et al. Decreased circulating levels of vitamin K and 25-hydroxyvitamin D in osteopenic elderly men. Metabolism 1998;47:195–9.

78. Feskanich D, Weber P, Willett WC, et al. Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr 1999;69:74–9.

79. Booth SL, Tucker KL, Chen H, et al. Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women. Am J Clin Nutr 2000;71:1201–8.

80. Knapen MH, Hamulyak K, Vermeer C. The effect of vitamin K supplementation on circulating osteocalcin (Bone Gla protein) and urinary calcium excretion. Ann Intern Med 1989;111:1001–5.

81. Orimo H, Shiraki M, Fujita T, et al. Clinical evaluation of Menatetrenone in the treatment of involutional osteoporosis—a double-blind multicenter comparative study with 1–alpha-hydroxyvitamin D3. J Bone Mineral Res 1992;7(Suppl 1):S122.

82. Iwamoto I, Kosha S, Noguchi S, et al. A longitudinal study of the effect of vitamin K2 on bone mineral density in postmenopausal women a comparative study with vitamin D3 and estrogen–progestin therapy. Maturitas 1999;31:161–64.

83. Shiraki M, Shiraki Y, Aoki C, Miura M. Vitamin K2 (menatetrenone) effectively prevents fractures and sustains lumbar bone mineral density in osteoporosis. J Bone Miner Res 2000;15:515–21.

84. Craciun AM, Wolf J, Knapen MH, et al. Improved bone metabolism in female elite athletes after vitamin K supplementation. Int J Sports Med 1998;19:479–84.

85. Feskanich D, Weber P, Willett WC, et al. Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr 1999;69:74–9.

86. Cohen L, Laor A, Kitzes R. Magnesium malabsorption in postmenopausal osteoporosis. Magnesium 1983;2:139–43.

87. Cohen L, Kitzes R. Infrared spectroscopy and magnesium content of bone mineral in osteoporotic women. Isr J Med Sci 1981;17:1123–5.

88. Geinster JY, Strauss L, Deroisy R, et al. Preliminary report of decreased serum magnesium in postmenopausal osteoporosis. Magnesium 1989;8:106–9.

89. Dimai HP, Porta S, Wirnsberger G, et al. Daily oral magnesium supplementation suppresses bone turnover in young adult males. J Clin Endocrinol Metab 1998;83:2742–8.

90. Stendig-Lindberg G, Tepper R, Leichter I. Trabecular bone density in a two year controlled trial of peroral magnesium in osteoporosis. Magnesium Res 1993;6:155–63.

91. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503–7.

92. Sahap AO. Zinc and senile osteoporosis. J Am Geriatr Soc 1983;31:790–1.

93. Relea P, Revilla M, Ripoll E, et al. Zinc, biochemical markers of nutrition, and type I osteoporosis. Age Ageing 1995; 24:303–7.

94. Elmståhl S, Gullberg B, Janzon L, et al. Increased incidence of fractures in middle-aged and elderly men with low intakes of phosphorus and zinc. Osteoporos Int 1998;8:333–40.

95. Strause L, Saltman P, Smith KT, et al. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. J Nutr 1994;124:1060–4.

96. Eaton-Evans J, McIlrath EM, Jackson WE, et al. Copper supplementation and bone-mineral density in middle-aged women. Proc Nutr Soc 1995;54:191A.

97. Baker A, Turley E, Bonham MP, et al. No effect of copper supplementation on biochemical markers of bone metabolism in healthy adults. Br J Nutr 1999;82:283–90.

98. Nielson FH, Hunt CD, Mullen LM, Hunt JR. Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. FASEB J 1987;1:394–7.

99. Meacham SL, Taper LJ, Volpe SL. Effect of boron supplementation on blood and urinary calcium, magnesium, and phosphorus, and urinary boron in athletic and sedentary women. Am J Clin Nutr 1995;61:341–5.

100. Hunt CD, Herbel JL, Nielsen FH. Metabolic responses of postmenopausal women to supplemental dietary boron and aluminum during usual and low magnesium intake: boron, calcium, and magnesium absorption and retention and blood mineral concentrations. Am J Clin Nutr 1997;65:803–13.

101. Nielson FH, Hunt CD, Mullen LM, Hunt JR. Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. FASEB J 1987;1:394–7.

102. Gold M. Basketball bones. Science 1980;80:101–2.

103. Raloff J. Reasons for boning up on manganese. Science News 1986;Sep 27:199 [review].

104. Strause L, Saltman P, Smith KT, et al. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. J Nutr 1994;124:1060–4.

105. Carlisle EM. Silicon localization and calcification in developing bone. Fed Proc 1969;28:374.

106. Hott M, de Pollak C, Modrowski D, Marie PJ. Short-term effects of organic silicon on trabecular bone in mature ovariectamized rats. Calcif Tissue Int 1993;53:174–9.

107. Eisinger J, Clairet D. Effects of silicon, fluoride, etidronate and magnesium on bone mineral density: a retrospective study. Magnes Res 1993;6:247–9.

108. El-Hajj Fuleihan G. Strontium ranelate—a novel therapy for osteoporosis or a permutation of the same? N Engl J Med 2004;350:504–6 [Editorial].

109. Ferrari S, Zolezzi C, Savarino L, et al. The oral strontium load test in the assessment of intestinal calcium absorption. Minerva Med 1993;84:527–31.

110. McCaslin FE, Janes JM. The effect of strontium lactate in the treatment of osteoporosis. Proc Staff Meetings Mayo Clinic 1959;34(13):329–34.

111. Meunier PJ, Roux C, Seeman E, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 2004;350:459–68.

112. Gaby AR. Preventing and Reversing Osteoporosis. Rocklin, CA: Prima Publishing, 1994, 88–9 [review].

113. Skoryna SC. Effects of oral supplementation with stable strontium. Can Med Assoc J 1981;125:703–12.

114. Reginster JY, Deroisy R, Dougados M, et al. Prevention of early postmenopausal bone loss by strontium ranelate: the randomized, two-year, double-masked, dose-ranging, placebo-controlled PREVOS trial. Osteoporos Int 2002;13:925–31.

115. Gaby AR. Preventing and Reversing Osteoporosis. Rocklin, CA: Prima Publishing, 1994, 88–9 [review].

116. Sato Y, Honda Y, Iwamoto J, et al. Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial. JAMA 2005;293:1082–8.

117. Prior JC. Progesterone as a bone-trophic hormone. Endocr Rev 1990;11:386–98.

118. Lee JR. Osteoporosis reversal: the role of progesterone. Int Clin Nutr Rev 1990;10:384–91.

119. Riis BJ, Thomsen K, Strom V, Christiansen C. The effect of percutaneous estradiol and natural progesterone on postmenopausal bone loss. Am J Obstet Gynecol 1987;156:61–5.

120. Leonetti HB, Longo S, Anasti JM. Transdermal progesterone cream for vasomotor symptoms and postmenopausal bone loss. Obstet Gynecol 1999;94:225–8.

121. Lydeking-Olsen E, Beck-Jensen JE, Setchell KD, Holm-Jensen T. Soymilk or progesterone for prevention of bone loss: a 2 year randomized, placebo-controlled trial. Eur J Nutr 2004;43:246–57.

122. Villareal DT, Holloszy JO, Kohrt WM. Effects of DHEA replacement on bone mineral density and body composition in elderly women and men. Clin Endocrinol (Oxf) 2000;53:561–8.

123. Toba Y, Takada Y, Yamamura J, et al. Milk basic protein: a novel protective function of milk against osteoporosis. Bone 2000;27:403–8.

124. Toba Y, Takada Y, Matsuoka Y, et al. Milk basic protein promotes bone formation and suppresses bone resorption in healthy adult men. Biosci Biotechnol Biochem 2001;65:1353–7.

125. Aoe S, Toba Y, Yamamura J, et al. Controlled trial of the effects of milk basic protein (MBP) supplementation on bone metabolism in healthy adult women. Biosci Biotechnol Biochem 2001;65:913–8.

126. Atkinson C, Compston JE, Day NE, et al. The effects of phytoestrogen isoflavones on bone density in women: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 2004;79:326–33.

127. Kadota S, Li JX, Li HY, et al. Effects of cimicifugae rhizome on serum calcium and phosphate levels in low calcium dietary rats and on bone mineral density in ovariectomized rats. Phytomed 1996/97;3(4):379–85.

All Indexes
Health Issues Men's Health Women's Health
Health Centers Cold, Flu, Sinus, and Allergy Diabetes Digestive System Pain and Arthritis Sports Nutrition
Safetychecker by Drug by Herbal Remedy by Supplement
Homeopathy by Remedy
Herbal Remedies by Botanical Name
Integrative Options
Foodnotes Food Guide by Food Group Vitamin Guide
Become a Sales Superstar
Learn how to earn more by selling
more and closing with higher ratios