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Antidepressants And Women’s Bones

Certain antidepressants used to relieve hot flashes, night sweats and other menopausal symptoms appear to increase the risk of bone fractures. The class of drugs, selective serotonin reuptake inhibitors (SSRIs), include Celexa, Lexapro, Prozac, Luvox, Paxil and Zoloft, and are now considered effective alternatives to hormone replacement therapy. Investigators from Boston’s Northeastern University used a pharmaceutical database to identify more than 137,000 women age 40 through 64 who began taking SSRIs for menopausal symptoms between 1998 and 2010 and compared them with some 236,000 women taking prescription drugs for indigestion. After one year, the fracture risk among the women on the SSRIs was 76 percent higher than it was in the women on the indigestion drugs, 73 percent higher after two years and 67 percent higher after three years. The database review didn’t prove that the SSRIs caused the increased risk, but earlier investigations have indicated that bone thinning is a possible side effect of SSRIs. The researchers suggested that, given these findings, women may want to consider taking the drugs for the shortest possible time and that research to determine whether the bone-thinning effect occurs at lower doses of SSRIs should be initiated. 

Milk May Increase Bone Fractures

If you've been drinking milk daily to help strengthen your bones, you might be on the wrong track, new research from Sweden suggests. The study found that drinking milk doesn't boost bone strength. Instead, the opposite can occur. The investigation suggested that drinking three or more glasses of milk daily increased the risk of bone thinning (often a precursor of osteoporosis), bone fractures - and death - in women. Milk consumption also slightly increased deaths from cardiovascular disease in men who drank three glasses a day compared to men who drank less than a glass of milk a day. Drinking milk didn't benefit men's bones either. To reach their conclusions, the researchers followed 61,433 women (aged 39-74 years in 1987-1990) for an average of 20 years and 45,339 men (aged 45-79 years in 1997) for an average of 11 years. The participants completed food frequency questionnaires for 96 common foods including milk, yogurt and cheese. This isn't the first investigation to conclude that drinking milk doesn't build bones in adults. In fact, this new analysis showed that instead of milk, you're better off eating cheese or fermented milk products (yogurt) - each serving reduced hip fractures and death rates by 10-15 percent.

My take? These findings don't surprise me. They're not the first - and I doubt they'll be the last - to suggest that drinking milk doesn't prevent the bone thinning that can lead to osteoporosis. I do not recommend consuming milk to prevent osteoporosis. The notion that milk is good for all of us throughout life has been fostered by the dairy industry. Although we all need calcium and vitamin D, you can obtain calcium from cooked greens (especially collards) as well as broccoli and tofu, molasses and sesame seeds. As for vitamin D, I recommend that all adults take a daily supplement of 2,000 IU since our need for this important nutrient is difficult to meet from diet alone (your body makes vitamin D with exposure to sunlight, but many people remain deficient). To build bone mass when you're young, eat plenty of green vegetables that provide calcium and vitamin D, get adequate physical activity and avoid smoking and consuming large amounts of soda, coffee, alcohol and sugar, all of which promote loss of bone density. To preserve bone mass in midlife and old age, you need regular strength training (sometimes called resistance exercise).

Omega-3s for Strong Bones

Omega-3 fatty acids may protect against bone lossPostmenopausal women who are increasing their consumption of omega-3 fatty acids for heart health may get a big bonus: protection against hip fractures. Researchers at Ohio State University analyzed blood samples from postmenopausal women and found that those with higher levels of omega-3s (from both fish and plant sources) were less likely to have broken a hip compared to women whose blood samples were low in omega-3s. The researchers also looked at levels of omega-6 fatty acids and found that hip fracture risk increased as the ratio of omega-6s to omega-3s went up. Omega-6s (from linoleic acid found in corn, soybean, safflower and sunflower oils) are more plentiful in our diets than omega-3s. The ratio of omega-6s to omega-3s should be no higher than four to one and ideally closer to two to one, but it is generally much higher, the investigators noted. Because this study was observational in nature – it showed only an association between omega-3s and lower risks of hip fracture - it did not prove cause and effect. But researcher Tonya Orchard, assistant professor of human nutrition, said the findings “add a little more strength to current recommendations to include more omega-3s in the diet."

Tonya Orchard and Rebecca Jackson et al, “The association of red blood cell n-3 and n-6 fatty acids with bone mineral density and hip fracture risk in the women's health initiative”, Journal of Bone Mineral Research, March 2013  doi: 10.1002/jbmr.1772.