Estrogen does appear to lowering blood fats, which play a role in heart disease. If this is so, says Vandenbroucke, "a more direct attack on lipids would seem logical." Many naturopathic physicians agree. Rather than relying on hormonal therapy to decrease blood lipids, it would be far safer to use diet, botanicals and nutritional supplements to achieve this goal (15).

Healthy Bones
One-third to one-half of postmenopausal women suffer from osteoporosis (16). Age and sex, genetic predisposition, race and weight determine if you are at risk of developing this disease. A woman should think of strong bones as money in the bank. To help your bones, you should exercise, eat a balanced diet and not smoke. You should practice these good habits throughout your life in order to deposit a maximum amount of bone before withdrawal begins at age 35.

Calcium supplementation has been offered as the main solution to preventing osteoporosis. Once menopause begins, HRT is often used. Both treatments have their limits and problems. Calcium does not carry the same risks as synthetic hormones, but this mineral is not the final answer to a chronic, progressive disease.

Pre-adolescent children (17) and postmenopausal women (18) appear to gain the most from calcium supplementation. The calcium source also makes a difference. Dairy products are reported to be the most calcium-rich food. Lactose, or milk sugar, is said to make calcium more accessible to the body (19). Milk calcium is also less likely to inhibit manganese, a mineral necessary for bone formation, than supplemental calcium (20). On the other hand, some experts argue that the phosphorus and protein content of milk decreases the availability of dairy's calcium. If you are allergic or sensitive to milk, or are lactose intolerant, dairy foods can not be eaten.

The Bantu women of South Africa consume only 220 to 440 mg of calcium each day, yet osteoporosis is rare (21). It's not enough to eat a lot of calcium to ensure strong bones. You also need to control those substances and habits that rob the body of calcium such as caffeine, alcohol, smoking, sugar, sodium, phosphates and excessive animal protein (22,23,24,25).

We tend to forget that bone is a living tissue that, like other body systems, requires many nutrients besides calcium. In fact, when these extra nutrients are used together with calcium, bone loss is less dramatic (26). Vitamins B6, D and K, folic acid, magnesium, manganese, strontium, silicon, boron, zinc and copper are all instrumental in maintaining the skeleton (27).

1. Council on Ethical and Judicial Affairs, American Medical Association. Gender disparities in clinical decision making. Journal of the American Medical Association 1991; 266: 559-62.
2. Lock M. Contested meanings of the menopause. The Lancet 1991; 337: 1270-72.
3. Youngs DD. Some misconceptions concerning the menopause. Menopause, Sexuality, Depression 1990; 75: 881-3.
4. Gath D, Iles S. Depression and the menopause. British Medical Journal 1990; 300: 1287-8.
5. Harris RB, Laws A, Reddy VM, King A, Haskell WL. Are women using postmenopausal estrogens? A community survey. AJPH 1990; 80(10): 1266-1268.
6. Whitehead MI, Fraser D, Schenkel L, Crook D, Stevenson JC. Transdermal administration of oestrogen\progestagen hormone replacement therapy. The Lancet 1990; 335: 310-312.
7. Follingstad AH. Estriol, the forgotten estrogen? Journal of the American Medical Association 1978; 239(1): 29-30.
8. Bewley S, Bewley TH. Drug dependence with oestrogen replacement therapy. The Lancet 1992; 339: 290-1.
9. Nielsen FH. Nutritional requirements for boron, silicon, vanadium, nickel, and arsenic: current knowledge and speculation. FASEB 1991; 5: 2661-2667.
10. Nielsen FH, Hunt CD, Mullen LM, Hunt JR. Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. FASEB 1987; 1: 394-397.
11. Nielsen FH. Facts and fallacies about boron. Nutrition Today, May/June 1992: 6-12.
12. Cassidenti DL et al. Short-term effects of smoking on the pharmacokinetic profiles of micronized estradiol in postmenopausal women. Am J Obstet Gynecol 1990; 163(6). Pt 1: 1953-1960.
13. London S, Willett W, Longcope C, McKinlay S. Alcohol and other dietary factors in reation to serum hormone concentrations in women at climacteric. Am J Clin Nutr 1991; 53: 166-171.
14. Adlercreutz H et al. Dietary phyto-estrogens and the menopause in Japan. The Lancet 1992; 339: 1233.
15. Vandenbroucke JP. Postmenopausal oestrogen and cardioprotection. The Lancet 1991; 337: 833-4.
16. Licata, A. A., Therapies for Symptomatic Primary Osteoporosis. Geriatrics 1991;46: 62-67.
17. Johnston, Jr, C.C., Miller, J.Z., et al. Calcium Supplementation and Increases in Bone Mineral Density in Children. NEJM 1992;327: 82-87.
18. Andon, M.B., Smith, K.T., Bracker, M., Sartoris, D., Saltman, P., and Strause, L. Spinal Bone Density and Calcium Intake in Healthy Postmenopausal Women. Am J Clin Nutr 1991;54 : 927-9.
19. Shahkhalili, Y., and Mettraux, C., "Relative Importance of Carbohydrate and Protein Sources in the Differential Effects of Soy-based vs Casein-based Formulas on Bone Minerals in Rats," Am J Clin Nutr 53 (1991): 947-53.
20. Raloff, J., "Reasons for Boning up on Manganese," Science News 130 (1986): 199.
21. Mickelsen, O., and Marsh, A.G., "Calcium Requirement and Diet," Nutrition Today (Jan/Feb 1989): 28-32.
22. Hernandez-Avila, M., Colditz, G.A., Stampfer, M.J., Rosner, B., Speizer, F.E., and Willett, W.C. Caffeine, Moderate Alcohol Intake, and Risk of Fractures of the Hip and Forearm in Middle-aged Women. Am J Clin Nutr 54 (1991): 157-63.
23. Mazess, R.B., and Barden, H.S. Bone Density in Premenopausal Women: Effects of Age, Dietary Intake, Physical Activity, Smoking, and Birth-Control Pills. Am J Clin Nutr 1991; 53: 132-42.
24. Wisneski, L.A. Clinical Management of Postmenopausal Osteoporosis. S Med J1992; 85: 832-39.
25. Werbach, M.R., Nutritional Influences on Illness Tarzana: Third Line Press, 1988.
26. Anon. Lactose intolerance. The Lancet 1991;338 : 663-4.
27. Gaby, A.R., and Wright, J.V., Nutrients and Bone Health, Wright/Gaby Nutrition Institute (1988): PO Box 21535, Baltimore, MD 21208.