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In today’s video lesson, I cover several recent developments in the areas of nutrition and pharmaceuticals for osteoporosis.

Tomorrow we cover what you should be doing to prepare to meet the demands of the large number of clients with low bone density and osteoporosis.

Continuing Education Course

I encourage you to check out the Building Better Bones online course for Physical Therapists, Physiotherapists, Kinesiologists, Athletic Trainers, Occupational Therapists and Physical Therapy Assistants.

Over 12,000 health professionals have completed this course.

Building Better Bones Continuing Education for Physical Therapists

“I thoroughly enjoyed taking Working with Osteoporosis and Osteopenia. It offered a firm foundation in understanding osteoporosis, as well as a practical approach to dealing with patients. It included everything from testing seniors’ fitness levels through to exercises for posture, flexibility, balance and strength. If you are looking for a well rounded approach to treating your osteoporosis patients, you should be on this course! Lots of practical ideas that you can take to work on Monday morning.” — Colleen MacDonald, Physical Therapist, Misericordia Hospital, Edmonton, Alberta

Nutrition and Pharmaceuticals for Osteoporosis

When it comes to nutrition and bone health, there’s quite a bit written about alkaline diets, a diet that is high in fruits and vegetables and low in saturated fats, but what I’d like to talk about today, specifically, is some recent research that looked at an important mineral and an important vitamin when it comes to bone health.

The Role of Vitamin D

Let’s start with Vitamin D.

In the spring of 2010, the general of the American Medical Association published an article that had just over 2,000 women in the average age 76 years of age and they were given mega doses of vitamin D once a year over a three to five year period.

So, mega doses, 500,000 international units, once a year. What this study found, was that these woman actually had an increased fracture risk. The medical advisory committee from Osteoporosis Canada had a couple of theories in regards to the increased risk of fractures. One of them was that the enzymes that are needed to break down the active vitamin D were being produced at too great a level.

nutrition for bone health / nutrition and pharmaceuticals for osteoporosis

Another theory was that people were feeling so good about having all that vitamin D and their muscle function was working so much better, that they were all of a sudden just being that much more active and that might have increased their risk of fractures. The main outcome of this study was that although vitamin D is a fat-soluble vitamin, we shouldn’t be recommending to our clients that they take all their vitamin D in one day of the year, but rather, getting it the way nature intended, a little bit every day. So, the recommendations in Canada still stand between 800 and 2,000 international units a day.

The Role of Calcium

As far as calcium, there is a study that was published in the British Medical Journal in the summer of 2010. It was actually a meta analysis. And this meta analysis looks specifically at calcium supplementation alone in women and it was quite alarming because they found that women that were taking high calcium supplementation had a significant increased risk of heart attacks. And so the recommendation is that calcium should not be taken alone because vitamin D helps with the absorption of calcium. Another recommendation in Canada was that the recommended levels of 1,500 milligrams per day for the adult population over the age of 50 was reduced to 1,200 milligrams a day.

Osteoporosis Pharmaceuticals

And so far, as pharmaceuticals, as healthcare professionals, it’s very important for us to be aware of the different medications that our clients are on and the effect that it has, when we’re talking about osteoporosis, on their bone health. And so, there are a lot of bisphosphonates. If you listen to any of the commercials that ran the six o’ clock news, you’re going to be bombarded by commercials on different bisphosphonates and not all bisphosphonates are created equal. Some bisphosphonates protect against vertebral fractures, some against non-vertebral factors and some against both. Now, all these bisphosphonates are not created equal and so, it’s important that you be aware and that’s one thing we go into in more detail in the MelioGuide course, is the type of bisphosphates that are available on the market.

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December 15, 2015 at 1:10am

Brenda Mathee

I was diagnosed with osteoporosis of the neck, what supplements do i take to strengthen the bone and what excercise do u suggest to strengthen the neck area. Regards Brenda

December 15, 2015 at 8:03am

Richard Martin replies

Hi Brenda: Margaret covers these topics and more in her book, Exercise for Better Bones:

You can purchase the book on Amazon:

December 23, 2015 at 2:34am


I had an allergic reaction to Risedronate after 7 days on it, big chickenpox-like blisters on my skin, also had bad nausea. Docs are now trying me on an oestrogen-mimicking drug as I cannot Risedronate family of drugs. It has been very frustrating.

March 22, 2016 at 1:38pm


Hi Margaret,

I have a couple of questions regarding bisphosphonates:

1) Do you think drugs like alendronate actually help people grow stronger bones? I heard one person say that it stops you from losing bones, but it also inhibits you from growing bones. Is that true? Besides, there are many bad side effects for your body.

2) You said alendronate stays in the body. Does that mean you can stop taking alendronate after you are on it for 19 months?

March 23, 2016 at 2:46am


Hi Margaret,

You mentioned that almond is high in oxalates, and therefore inhibits calcium absorption, but what is your opinion on almond milk that's fortified with calcium? Should I be drinking water, instead of purchasing almond milk which might not be doing me any good?

August 22, 2017 at 11:02pm


My physican wants me to begin actonel due to bdm test. I am very healthy at 76 and dont take any other medicine except vitamins. I would like to hear your opinion. I am very impressed with your book.