Gillian Sanson’s 16-year old daughter was told she had the bones of an 80-year-old, and eight members of her family, including herself, had varying degrees of low bone mineral density (BMD). Some of them were diagnosed with osteoporosis and the rest with osteopenia, which is a lesser degree of the latter. Thus she felt herself obliged to find accurate information on the subject.

She found out that we have all been exposed to misinformation about osteoporosis, and that healthy women are filled with unnecessary drugs to deal with problems that they perhaps never had in the first place.

The myths she thus uncovered were as follows:

1) The myth of risk. Every woman over the age of 50 is at risk of osteoporosis.

Healthy women without symptoms are measured to have low bone density, though in fact a specific level of bone density may in fact be normal for them. The test says nothing about the strength of the women’s bones. Persons who do not smoke, drink, take medications, but have an excellent diet, and have had no previous low-trauma fractures should not be labeled “at risk”.

Osteoporosis is a condition characterized by low bone density and no mention is made of bone quality - its strength or brittleness, i.e. its tendency to fracture.

Most people never fracture as a result of low bone density, and the disease osteoporosis is rare in women under 80.

BMD testing does not accurately identify women who will go on to fracture.

There is substantial evidence that a good diet, healthy lifestyle and regular exercise are sufficient protection against fracture.

2) The myth of diagnosis, Diagnosis of osteoporosis is accurate, reliable, and meaningful.

Different brands of DXA machines (which measure bone density) give widely varying diagnoses. Sally, a healthy 50-year-old woman, was only fractionally below normal on one DXA machine, but on the other had bone density so low that it was “close to the threshold for a diagnosis of osteoporosis”. In one clinic she was declared totally healthy, and in another it was recommended that she undergo treatment.

Falling is the big problem with the elderly, not bone density, and any bone will fracture under certain conditions.

3) The myth of causality. Age-related bone loss is the cause of deadly fractures in the elderly.
Elderly women who have no risk factors for osteoporosis other than their age and low bone density results are prescribed harmful drugs. These might increase bone density but do not reduce the risk of hip fracture.

Most hip fractures – the severest of fractures – occur after a fall. A fall to the side – as opposed to forward or backward. increases the risk of hip fractures by about six times and is considered a much greater risk than low bone density.

Susan Ott is quoted as saying “Other factors include how tall a patient is, how far she falls, how she lands and maybe the shape of her hip.”

Also, other factors such as low body weight are more accurate than low BMD in predicting hip fracture in the elderly.

A family history of fragility fracture, inadequate diet, eating disorders, lack of exercise, etc may result in fragile bones.

Among predictive factors for hip fracture are a maternal history of hip fracture, having the same body weight as at age 25, self-rated health being fair or poor, intake of medications, less than four hours a day on feet.

Consumption of dairy products is associated with an increased risk of hip fracture.

There is no evidence that osteoporosis drug therapies prevent hip fracture in the elderly. To prevent fractures we should:

1) Maintain body weight
2) Walk for exercise
3) Exercise to increase balance and flexibility
4) Avoid long-acting benzodiazepines, corticosteroids, sleeping pills, etc.
5) Treat impaired vision
6) Remove tripping hazards in the home
7) Consume a balanced nutrient-rich diet
8) Receive sunlight exposure or take supplemental vitamin D

The wearing of hip pads can provide substantial protection against hip fractures. A frail at-risk group wearing hip pads experienced five times as many falls as the healthier control group, but sustained no fractures.

4). The myth that osteoporosis can be safely treated and prevented with drugs.

The author explains the considerable risks of HRT and the various drug treatments including biphosphonates, alendronate, selective estrogen receptor modulators (SERMS), fluoride etc.

5) The myth that high calcium intake alone prevents osteoporosis, whether from dairy or supplements.

Most women with osteoporosis get plenty of calcium. Calcium supplementation has not been proven to build bone. Countries with the highest rates of osteoporosis are the highest consumers of dairy products. (In this connection I would recommend that your read “Building bone vitality” by Amy J. Lanou, which book I have also reviewed.)

In Gambia the average bone mineral density and calcium intake are very low, yet so is the incidence of osteoporosis (fracture).

Inuit peoples have a normal to very high intake of dietary calcium between 500 and 2,500 mgs per day and one of the highest rates of osteoporosis in the world (as defined by bone mineral density).

Bantu women, on the other hand, get only 350 mgs of calcium a day. Bantu women never have calcium deficiency, seldom break a bone and rarely lose a tooth. They consume much less calcium and much less protein than Western populations , yet are essentially free of osteoporosis (fractures).

The Inuit eat a meat-based diet while the Bantu consume a vegetarian-based diet. Meat-based diets increase the acidity in the blood and urine and people eating these have an average urine pH of 4.5-6.5, whereas those who do not eat meat have a pH of 5.5.-6.5. To buffer the higher acidity and regain equilibrium, the body leaches calcium from the bones.

Frail health more than any other single factor leads to bone fractures, so we must focus on building up our health by making sure we get adequate nutrition, maintaining normal weight, exercising, avoiding smoking and alcohol, obtaining job satisfaction and personal happiness, managing stress and avoiding exposure to chemical pollution.

Exercise benefits the skeleton, and is the single most effective strategy to prevent fragility fracture. “The force of muscles pulling against bones promotes new bone growth, and the more you use your muscles, the more this stimulates bone remodeling and bone formation.”

Perhaps the most useful chapter in the book is the one entitled “Creating strong bones”. I found this to be extremely informative.

Even if you have read other books on the subject, I would strongly advise you to read this one too. I feel it is a sort of basic book that will help you to discern true facts from misinformation. It provides a healthily skeptical and factual source of information. ( )

Every woman should read this book! What an eye-opener. Women are being duped into think their normal bone loss is a scary condition that needs treatment with drugs that are even more dangerous. This is a well-researched book that gives a balanced picture of the "disease" and the treatments. Just say no to bone density scans, as you will learn that they are almost meaningless at predicting fractures. ( )