Saturday
Aug132011

A fresh look at bone health

The quick answer:  The modern epidemic of osteoporosis, like coronary artery disease, is the natural result of an unnatural lifestyle—too much meat, sugar, and processed foods and too little use of the muscles. 

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American women worry about osteoporosis.  They should worry.  There’s nothing nice about stooped-over posture, the dowager’s hump, or a life-shortening broken hip.  Osteoporosis is a big problem and in the American way, treatment has become a big business.  Unfortunately the money spent on treatment—like calcium supplements and drugs—hasn’t solved the problem.  In this post we take a fresh look at bone health and talk about prevention.  Warning:  Most of what you've been told may be wrong. 

An Old Theory Revisited

The current calcium theory of osteoporosis calls for more calcium in the diet and this has carried over into government guidance.  Americans consume more calcium than any nation, yet we are advised to take more.  Problem is that while we consume more calcium, we still have one of the highest rates of osteoporosis.  This doesn’t make sense.  There’s another theory—call it the acid/alkaline theory—that’s been around since 1968 though largely ignored, perhaps because there’s no pill to sell. 

The Lancet, published in England, is a prestigious medical journal.  Over 40 years ago it carried a revolutionary article by two Harvard researchers, Amnon Wachman and Daniel Bernstein, titled “Diet and osteoporosis.”  The article offered evidence that osteoporosis was the natural result of the modern acid-producing diet, not of too little calcium. 

Another Harvard researcher, D. Mark Hedsted in a 2001 American Journal of Clinical Nutrition commentary “Fractures, calcium, and the modern diet” (you can read it here), made these points:

  1. Questioning the guidance to eat more calcium, Hedsted asked:  “Why do populations with low-calcium diets have fewer fractures than do those with high intake?”
  2. He further observed:  “the long-standing recommendations to increase calcium intakes [though this may increase bone density] appear to have had little or no effect on the prevalence of osteoporosis or fractures in the United States.”
  3. Hedsted also noted the link between heart disease and osteoporosis—when one increases, the other follows.  This pattern is seen in country after country—what’s good for the heart is also good for the bones, and vice-versa. 

Acid/alkaline Theory

To better understand the acid/alkaline theory of osteoporosis, here are a few bone facts:

  • Bones contain calcium, but it’s only about 3 lbs. in our 25 or so lbs. of bone. 
  • Bones have other vital minerals, including phosphorous, and magnesium.
  • Bones provide structure for the body, but they’re also a reservoir for minerals that the body taps as needed.
  • For survival, the pH (a measure of acidity/alkalinity) of our blood must be controlled.  (Blood pH should be 7.4; if your pH is lower you have acidosis.)
  • If our diet causes blood pH to be too acid, the body uses first sodium, then calcium from our bones to buffer and remove the excess acid.
  • The peak rate of calcium removal (resorption) is greater than the ability of the body to add calcium (absorbtion).  This makes sense because survival depends on controlling pH.
  • Because there are limits on the ability to restore calcium to the bones (we’ll discuss the factors later), it’s important to limit removal over the long term. 
  • Some foods are alkali-producing when metabolized; others are acid-producing, which can be a problem. 
  • Basically, plant foods are alkaline while animal products (and processed foods) are acidic. 
  • It takes time, decades, but the modern diet will cause osteoporosis by dissolving bone to use the calcium for buffering excess acid.

Building strong bones:

How does the body build strong bones?  Our knowledge is incomplete, but here are some key factors:

  • Mom: The quality of your mother’s diet during pregnancy is critical, then your diet, especially during puberty (when mom was doing the cooking).  In girls, bone formation at menarche can be five-fold greater than during adulthood.  As always, much depends on Mom.
  • Mineral balance is critical.  Minerals make bones hard (a matrix of collagen makes bones flexible) but they are needed in balance.  Too much phosphorous, for example, inhibits the ability to absorb calcium (a calcium to phosphorous ratio of 2.5 to 1 is best).  One problem is processed foods, which contain fewer minerals but more added phosphorous.
  • Vitamins, especially D and K2, are needed for bone building.  There is controversy about the best way to get vitamin D (whether by sunshine, the historic method, or pills) but many experts believe we’re getting too little.  Vitamin K is found in dark greens and other vegetables; the body converts this to the needed K2. 
  • Estrogen plays a role for both men and women (yes, men produce a small amount).  The decline of estrogen after menopause is problematic for women.  Some foods stimulate estrogen production but this is not well understood.  What to do?  Until we know more, eat well and take care of your health. 
  • Want stronger bones?  Build stronger muscles!  Exercise stimulates bone growth, especially if the normal load is slightly and repetitively exceeded.  Exercise also builds muscle, which partners to strengthen bones.
  • Americans love sugar but sugar disrupts the calcium to phosphorous ratio, inhibits calcium absorption, and increases calcium resorption from bone. 
  • Chronic stress can interfere with the building of strong bones.  We’ll address stress in a future post but pick your battles carefully and create islands in time where you have peace, order, and harmony.
  • Calcium absorption is reduced by smoking, alcohol, excess caffeine and meat, and improved by eating whole grains, herbs and fruits.  All things considered, the Word of Wisdom is a remarkable recipe for good bone health. 

Summary:

Monitoring your bone health is like watching a glacier move, you need to take a long view.  There is much we don’t know and that likely won’t be known in our lifetime.  The best strategy then is to optimize bone formation and minimize the breakdown of bone to preserve blood pH.  Fortunately, the Word of Wisdom lifestyle works for both.


In the next post we'll discuss muscle-building exercises.  If you suffer from osteoporosis consult your doctor.  Be patient in adding exercises—try to avoid injury; see this as a marathon not a sprint. 

Budget Wisdom:  You don't need a fancy gym—gravity is free.  Jumping rope or climbing stairs is good for the legs.  Push-ups and pull-ups are good for the arms and shoulders.  A walker passed the house while I was working in the yard.  In conversation he said he does his age in push-ups.  I was impressed as he was in his 70s, though he looks younger.  Picking up small children counts too; as they get older you'll get stronger.  (They'll make you stop about the time they get to high school.)  The key is to incorporate into your daily life things that are harder than usual, and then do them for years and years. 

Comments:  Please share your experience with bone health.  What do your doctors recommend?  What works best for you?  What do you do to build and preserve muscle.

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    Thank you for providing great post regarding the subject. I'm an admirer of your blog. Keep up the great job.

Reader Comments (15)

Thank you for this wonderful, informative post. This is definitely something I think about often due to having a calcium deficiency. I worry about low bone density and developing osteoporosis. I am trying to up my intake of green leafy vegetables while eating less sugar. It isn't going well, but I am working on it! I commented about acid/alkaline on a sugar post, stating that green leafy vegetables are alkaline and would help reduce sugar (acid) cravings. I didn't realize that it could also affects osteoporosis. I see how it would though. Even more reason to stick to my dietary changes!

August 15, 2011 | Unregistered CommenterLaura

I think i am very lucky genetically with my bones - my 87 year old grandmother has been knocked down a few times, but never broken anything. And my parents always tried to give me a decent diet as I was growing up, and I've tried to keep that up. I don't tend to go overboard with the dairy products though, usually just a tub of fromage frais with lunch, or a slice of cheese in a sandwich.

In terms of building muscles, I attend Bikram yoga 2-3 times a week, go to Pilates once a week and have a weekly weight training session.

August 15, 2011 | Unregistered CommenterKate

I believe I'm pretty conscious of my diet and take moderate exercise, but I have to admit that calcium is not on my radar.

I'd be interested in some recipes or ingredients to spotlight oppose to the old dairy solution.

August 15, 2011 | Unregistered Commenterholly j

This post hits home. I have struggled with bone density as early as age 31. A dentist caught it and bone scan confirmed the issue. So, my doc has recommended I take magnesium in the morning and calcium and vit. D at night. I'm not entirely convinced about the calcium supplements as the various medical professionals in my life disagree about what kind to take. So, I'm trying (with increasing success) to limit sugar, salt, eat meat sparingly while increasing the amount of veggies of all kinds. Gratefully even almonds are a source of calcium. Also, as a stay at home mom of small kids, I rarely sit and am always lifting 20-40 lb 'objects'. So, gratefully my weight training is supplemented these days!

It's interesting that you bring up Mom's cooking. My goal is to make sure my daughter doesn't learn these lessons the hard way. We are trying to stay the course on nutrition always, but it is helpful to know that those pre-teen years are most critical. It's just so sad that the US diet turned so poor during an entire generation of kids being raised. Onward to do better for the next...

August 15, 2011 | Unregistered CommenterMeredith

I have really started worrying about osteoporosis in the past couple years because a knee specialist told me I have low bone density. I am 5'6", 130 lbs and 25 years old (No, this is not a dating ad) but being a light weight woman, I am a shoe-in for osteoporosis. To make matters much worse, I have had asthma since I can remember and have taken daily steroid medication my whole life. I have been warned that steroids keep your bones from absorbing as much calcium. I also really struggle with posture!

I have just started my "health journey" about a year ago and am trying to be more aware of what I eat. Less meat, more veggies, less sugar, no processed foods, etc. I live an active lifestyle and play soccer and softball but I wonder if I should be weight training. I heard it really helps strengthen bones, but I don't see myself as a "gym rat". Would yoga do the trick? Or some kind of aerobics? I have a road bike, but that is low-impact. Jogging hurts, but would it get better if I made myself do it? Advice is welcome!

August 16, 2011 | Unregistered CommenterCrystal

The last few months I've been doing the workout regiment in The New Rules of Lifting for Women by Lou Schuler. It's "real" weight lifting in a home workout (not toning or other half-attempts marketed for women). I'm not much of an athlete at all, but I have loved this program. I can tell I am stronger and the workouts are designed to begin at any level of basic fitness. I've never seen or felt such quick fitness improvement in any other exercise I've tried and highly recommend the program.

August 16, 2011 | Unregistered CommenterDenae

Crystal, from what I have heard it is weight bearing exercise that helps the most with increasing bone density. This includes yoga, tai chi, brisk walking, dancing, and even golf. So yoga would be good!

August 16, 2011 | Unregistered CommenterLaura

I've just been catching up on a few posts, so my question is actually regarding the sugar topic. I don't remember you addressing this- maybe I'm wrong- but what do you say about honey? Is this a healthy replacement for sugar? Of course, I'm sure it should also be used in moderation, but is it better?

August 16, 2011 | Unregistered CommenterJodi

Jodi, honey has just slightly more nutrients than sugar, but there are other benefits: 1) There is a limited supply, 2) It doesn't seem as addictive as sugar, and 3) Though sweet, it is more satisfying, you don't eat as much honey as sugar. Still, I count it under the AHA 6 tsp. daily of sugar maximum (9 tsp for men, based on body size). Best to you.

August 16, 2011 | Registered CommenterSkip Hellewell

I have a question that is off-topic, but in my journey to less meat, has become important. I am currently using white rice with those legume recipes (I know) and need to switch - any recommendations about how to choose a better rice? I realize it's not enough to just to grab some brown colored rice off the shelves, but I don't really know what I should be looking for or avoiding. Any help would be greatly appreciated!

Skip: Elizabeth, this is a good question and deserves some research and response. We bought some whole "brown" rice as well as some unpolished long-grain rice but found it turned rancid before we ate it all. White rice doesn't do this in my experience. Like freshly-ground whole wheat, refrigeration is required and shelf life is shorter than the refined version (with few nutrients left to oxidize). And the whole grains take longer to cook also. So rice-cooking time doubles from 20 to 40 minutes. Readers, please add your experience with whole rice.

August 17, 2011 | Unregistered CommenterElizabeth

In response to the rice issue - we cook and freeze extra. It makes it even more convenient than white rice because it just needs to be pulled out of the freezer. However, I do have a chest freezer and that definitely helps with the space issue. Finally, I bought a bunch in bulk last year and ended up putting it in mason jars with oxygen absorbers. The jars have been stored in our pantry (of sorts) since and are still fine.

August 17, 2011 | Unregistered CommenterMeredith

I cannot begin to tell you how much I appreciate this post and your blog. For over a year I have been experiencing unexplained joint pain. I've seen several doctors, physical therapists, and athletic trainers, and none of them can explain what's going on -- or they aren't trying very hard! The last doctor I went to simply came to the conclusion that I am "slightly" Vitamin D deficient, and then put me on 5,000 IU. I think my problem is probably a combination of poor nutrition (vitamin D deficient) and hypermobile joints, and I've been striving to improve my diet and maintain an exercise routine with cardio and strength training. I've been pondering and pondering what are the right things to do, and I spent hours reading the scriptures. I was amazed at how much simple truth, guidance and advice I found there. Basically, after hearing doctors just want to push expensive useless medications on me (without diagnoses), and then feeling there must be a more natural way, then SEEING that others are on the same page...it reassures that there is a natural, wholesome way for me to be healthy. Thank you. :)

August 19, 2011 | Unregistered CommenterHannah

This is a great post! I was told to take calcium supplements (I'm only 26) but never felt right about it. My mom is 50 and has always eaten very little dairy; she had a bone density test and her bones looked great. She also eats lots of veggies, little meat and little processed food. I take that as proof of what you said in the post.

As far as brown rice, that's really all we eat. There are many varieties. Usually I use the regular long grain and keep it in the basement. I find it helps to soak it in warm water overnight. I absolutely love brown basmati or brown jasmine rice to serve with stir fries and curries. They cost a little more, but it's worth it. I also bought a big bag of short grain brown rice from Costco, but didn't care for it as much, it was more sticky and less fluffy.

August 20, 2011 | Unregistered CommenterLindsey

When I know I will want brown rice in the evening, I have used an old trick passed down generations of women in my family: Put rice and water in a pan an d bring it to boil, then take it off the heat, wrap it in some old newspapers and "put it to bed" (i.e. wrap it in your warmest blanket). When you get home in the evening, the rice is ready, though I usually heat it up again since I like my food steaming hot. Saves both time and energy!

September 25, 2011 | Unregistered CommenterMims

When I know I will want brown rice in the evening, I have used an old trick passed down generations of women in my family: Put rice and water in a pan an d bring it to boil, then take it off the heat, wrap it in some old newspapers and "put it to bed" (i.e. wrap it in your warmest blanket). When you get home in the evening, the rice is ready, though I usually heat it up again since I like my food steaming hot. Saves both time and energy!

September 25, 2011 | Unregistered CommenterMims

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