Gwyneth Paltrow has told her Goop readers of her diagnosis of a brittle bone disorder.
The 37-year-old Iron Man 2 star shocked fans recently when she revealed she had been diagnosed with osteopenia, a risk factor for osteoporosis, which left many asking: was her macrobiotic diet to blame?
"I suffered a pretty severe tibial plateau fracture a few years ago (requiring surgery)," the mum-of-two wrote on her website, "which led the orthopaedic surgeon to give me a bone scan, at which point it was discovered I had the beginning stages of osteopenia."
Gwyneth wrote that extremely low vitamin D levels were to blame, but health experts immediately pointed the finger at her macrobiotic diet a high-fibre, low-fat diet that shuns meat, poultry and dairy.
"She's following a macrobiotic diet so she might not have enough calcium or protein, which all can contribute [to osteopenia]," says Milena Katz, accredited practicing dietitian and spokeswoman for the Dietitians Association of Australia.
"If she wasn't having any supplements then she would be deficient in many nutrients."
But Katz says without knowing Gwyneth's history, it's impossible to know the exact cause of her condition and it may just have been in her genes.
Risk factors of osteopenia
"Osteopenia is a Latin word for a lack of bone, says Professor Ebeling, medical director of Osteoporosis Australia. "It just means low bone density. It's not a disease but it's a risk factor for a disease, and that disease is osteoporosis."
There are many risk factors for low bone density, any of which, or a combination of many, may have lead to Gwyneth's bone loss.
According to Osteoporosis Australia, adequate bone health is maintained by getting adequate calcium, vitamin D and exercise.
Gwyneth wrote on Goop that her fracture "led my Western/Eastern doctors in New York to test my vitamin D levels, which turned out to be the lowest they had ever seen (not a good thing). I went on a prescription strength level of Vitamin D and was told to … spend a bit of time in the sun!"
Vitamin D helps your body absorb calcium through the small intestine and deficiency is certainly a risk factor for low bone density. As we get little from our diet, we require sun exposure to get the adequate amount something 9-5 office workers have difficulty doing.
"In Sydney or Melbourne you only need 10 minutes at about 10 o'clock in the morning or two in the afternoon, five times a week in the summer months to generate enough vitamin D, but it's more like about half an hour at midday during the winter months," Professor Ebeling says.
For more information on vitamin D, see Osteoporosis Australia's How much sun is enough.
Dietary factors are very important for maintain strong bones and a restrictive diet, such as the macrobiotic diet, would require supplementation to ensure adequate nutrient intake.
Calcium is essential for building and maintaining bone and as our body is unable to make calcium, it must come from the diet.
"It is very important to have adequate calcium in the diet and for young women we would recommend about 1000mg a day," Professor Ebeling says.
This equates to three servings of dairy a day. If you are unable to eat dairy, a doctor may prescribe a calcium supplement.
A high consumption of caffeinated drinks and alcohol can also lead to bone density loss, something that's not as commonly known as a lack of calcium.
Before starting any diet that limits whole food groups such as the macrobiotic diet, Katz recommends visiting your doctor for a blood test to check your levels of iron, calcium and zinc, to make sure you're not deficient. A bone density test is also advised, she adds.
Visiting a dietician is also advisable to make sure that you are getting the right amount of nutrients for optimum health.
"They also want to make sure that they get the vitamins they're missing out on in other ways, and also protein," Katz says. "It's like being a vegetarian if you're not eating meats then you've got to get your protein from alternatives like lentils and tofu."
Exercise maintains and increases bone strength by increasing bone mass and slowing age-related bone loss. It also increases muscle strength, which supports the joints and can prevent falls.
Osteoporosis Australia recommends 30 to 40 minutes of exercise, four to six times each week, including some weight-bearing (running, skipping) and resistance exercises (push-ups, squats).
According to Professor Ebeling, other risk factors for low bone density before the menopause include:
- a family history of osteoporosis;
- having an eating disorder such as anorexia or bulimia;
- having celiac disease;
- bone loss during pregnancy and;
- using Depo-Provera as a contraception.
While osteoporosis is often mistaken for a condition that only affects the elderly, Gwyneth's health scare has revealed that low bone density can affect women from a young age and many lifestyle factors increase the risk.
But the good news for Gwyneth is building stronger bones is always possible and "the best treatment is prevention," Professor Ebeling says. "Addressing the diet, calcium and Vitamin D issues and regular weight- bearing exercise."
For more information, visit the Osteoporosis Australia website.