Archive for Osteoporosis
Do you feel you are a slave to pumping in those large calcium pills morning and night? Perhaps you forget them then worry about your bone health. If you can identify with this, I have good news for you. Recent studies and articles are questioning the safety of high dose calcium supplementation.
Several months ago, a study published and talked about in the news shows, make the claim that vitamins can cause heart disease. Perhaps you remember your favorite evening anchor person warning you to be careful about taking those vitamins. At that time, this study from Germany showed a relationship between increased heart attacks and consumption of high dose calcium supplement. It did not show the same events for calcium intake through foods rich in calcium.
Many of us want to maintain strong bones as we age and are in a quandary on what to do regarding calcium. Your may be lactose intolerant and cannot take dairy. Or, like me, you may not like greens. So what to do?
A recent study out of Sweden gives a different picture to the health of calcium supplements. These researchers looked at data from more than 60,000 women that had been enrolled in a different study. They took anywhere from 500 mg to 21oo mg of calcium. It was found that the highest percentage of death from heart events occurred with consumption of more that 1400 mg daily and less than 600 mg daily. Women taking more than 1400 mg of calcium daily from both supplements and through diet were found to have a higher risk of death from cardiovascular causes.
Now the big question is why heart disease can occur with something as benign as a vitamin or supplement like calcium tablets. Calcium can collect in walls of arteries and in cholesterol plaque which is also within the walls. This calcium deposition can make artery walls stiff, leading to problems with blood flow through them.
Calcium supplements create a dose of calcium absorbed at one time, theoretically flooding the system with calcium. What is not taken up by bones will have to go somewhere, and that may be the artery wall. Calcium consumed through food is generally not as high a dose, is absorbed more slowly as other nutrients and fiber can be associated with its absorption. This may have a different dynamic to the management of calcium. Researchers in the Swedish study postulate that too little or too much calcium throws off calcium homeostasis and therefor is not metabolized as well.
What should you do with this information?
I would glean from these 2 studies that consuming calcium a few hundred mg at a time, say 200-300 mg is safe. Perhaps do this 3, maybe 4 times a day. Try to get at least half of this through food. Do not take large doses in one sitting to get taking it out of the way.
Whether or not you have any osteopenia or osteoporosis, staying active with weight bearing activity as much as you can is wise. Take the stairs several times a day. Park one place and walk from store to store when doing errands, if safe to do so! Take vitamin D or eat Vitamin D rich foods.
Its’ hard figuring out what to do as we age. There seems to be conflicting information daily on what to and not to do. Sticking with whole, natural foods; and using some common sense and restraint with other unhealthy foods is a lose rule that is generally reliable to stick to!
The search for new and better regimens for treatment of osteoporosis continues with studies looking at different combinations of standard osteoporosis drugs. There has been some recent promising advancement with bone health. Recent studies have shown a significant increase in bone density with combined use of Forteo with either Prolia or Fosomax.
The usual standard treatment for osteoporosis involves use of bisphosphonates such as Fosomax, but many women cannot tolerate this due to problems with their stomach or esophagus.
Prolia is a medication used for women with severe risk of osteoporosis and has been used for many years to prevent metastatic spread of cancer to the bones. It works at building bones by inhibiting breakdown of bone, much as Fosomax or alendronate do.
The quandary has always been how to build bone by activating bone making cells. This is where Forteo is used. Forteo is an injection medication containing a synthetic form of the hormone PTH, which stimulates the bone making cells.
Recent studies have shown that when these drugs are used in conjunction with one another, significant increases in bone density are seen. All of these medications have significant side effects, so it is still advisable to work at preventing osteoporosis by diet and exercise.
Weight bearing exercise is beneficial at stimulating bone formation. Consuming adequate calcium, about 1500 mg a day is recommended. This can be done through supplements and calcium rich foods such as dark greens, almonds, salmon and dairy products.
Recent studies had advised that calcium supplements can cause heart attacks but recent re-examination of this data is refuting that finding. So it is now felt most likely to be safe to take those supplements if you are treating or trying to prevent osteopenia and osteoporosis.
Preventing and treating osteoporosis begins with working on you bone health. If you are doing all you can do and still losing the fight for healthy bones, talk to your provider about these options if you are at risk for osteoporosis. You can click on this link to use a tool to calculate your risk for developing osteoporisis.
Osteoporosis is most often thought of as an illness for older, menopausal women; and this is certainly when it is most often discovered. It can, however, be an illness that comes to fruition after a life time of dieting and strict attempts at weight control.
There are many more young women who are athletic, as compared to past generations; which is a good thing. As athletic scholarships to colleges have become available to young women, the growth of women’s sports and numbers of female athletes have grown exponentially in the past 20 or so years. While this has led to more opportunities for young women, there is a potential medical problem developing called the Female Athlete Triad. This is a condition recognized by the sports medicine community that involves diet restriction, amenorrhea (lack of menses); potentially resulting in osteoporosis or osteopenia.
Currently, there is a push to do a better job by athletic departments, of screening and educating women athletes regarding diet and nutrition.
This lack of bone density is a problem not only because of potential fractures at a young age, but also the impact on the future older skeletal system. The bone density acquired by age 30, is often the bone density sustained through the remainder of adulthood until menopause. So if you arrive at menopause with osteoporosis, your chance of a hip or back fracture is much higher as your bones are surely to become more osteoporotic.
You may wonder why these young women have inadequate bone density at their age, especially since they are athletes. Many people cannot tolerate, or cannot adequately digest milk. Additionally, eating disorders among High School and College age women are very common; and body image can become overly important even for women athletes. Milk is often avoided due to the caloric content, which robs young women of a calcium dense source. The rigors of varsity sports are sometimes not adequately balanced by healthy nutrition, especially if not supported by coaching staff.
We women often don’t become concerned with these issues until we are post menopausal, and realizing a fall may be much more serious than the embarrassment alone.
It is important that we educate and become good role models to our daughters, granddaughters, nieces and others.
Talk to the young women in your life that calcium is important, and necessary for strong bones; and best obtained through dietary sources.
Support young women athletes you know and encourage them to be comfortable with their bodies. Encourage them to work to improve strength and stamina in their sport; and not to focus on being slender.
We all want to look and feel good, but there are too many mixed messages in today’s multimedia world. It can be difficult for young people to sort it all out, and keep a healthy reality in mind.
What is osteoporosis? Who is at risk? What can be done to prevent it? How is it treated? This is the first of a 3 part series. Parts 2 and 3 are in the membership area. Sign up on the home page to become a member and gain access to these additional videos.
Do any of you remember being told when you were young, and perhaps suffering from a sluggish bowel, to eat prunes? You may have thought ugh, that’s what grandma eats!
As it turns out, your grandmother knew what she was talking about. It appears that in addition to it’s laxative effect, prunes (or dried plums as we are now calling them) can also protect against osteoporosis.
A recent study at Florida State University, and published in the British Journal of Medicine; revealed that post menopausal women consuming 10 prunes per day had better bone density than their counterparts. This study was similar to one performed in 2002, but only carried out for 3 months, which revealed similar findings.
The most recent study included 89 post menopausal women, 55 of which consumed 100 gm of prunes daily along with 500 mg Calcium and 400 IU of Vitamin D. The control group of 34 women of same age consumed 100 gm of dried apples along with the same vitamins. They were followed for 12 months, and at the end; the study group was found to have higher bone density in wrists and spine as compared to control group.
You may be wondering, what is so special about prunes?
In addition to high fiber content (6.1 gm fiber/100 gm prune), they have a low glycemic index and are high in Phenolic compound as well as Boron. Phenolic compounds have been found to inhibit LDL cholesterol oxidation and may help in prevention of heart disease. Boron is felt to help prevent osteoporosis, perhaps by limiting bone re-absorption. Additionally, consumption of prunes appears to be associated with higher levels of insulin-like growth factor-1 (IGF-1) which plays a significant role in bone formation and remodeling. This particular compound has been studied extensively and has a positive affect on bone density in post menopausal women.
To sum up, it would appear prunes benefit bowel health, maybe heart health, bone health, are high in potassium; all the while not raising glucose and contributing to weight gain (you do need to count these calories though).
So is you are looking for a sweet treat, try some prunes….I mean dried plums!
Recently the USPTF (U.S Prevention Task Force) amended its’ recommendation for when post menopausal women should receive bone density studies. Prior to the current recommendation, only women 65 or older have been urged to have bone density studies to determine their degree of bone thinning. This is called osteoporosis and places a woman at risk for a hip fracture and vertebral fracture and collapse. The USPTF now recommends including women whose risk factor for osteoporosis may be equal to or greater than that of a 65 year old woman. This is an important issue that you can address with your provider at your yearly physical.
Hip fractures can be a significant adverse event for you or a loved one, as it can increase risk of serious infections and even death due to immobility. Additionally, vertebral fractures or collapse can significant pain and also carries increased risk of infections and death. It is estimated that by 2012, roughly 12 million Americans older than 50 years are expected to have osteoporosis. One half of all postmenopausal women will have an osteoporosis-related fracture during their lifetime. There are several tools you medical provider can use to determine if your risk for osteoporosis warrants a bone density study.
It is hard to imagine that this can happen to you when you feel so strong and mobile compared to elderly relatives or acquaintances you may see or interact with. It could be happening to you now, even in your relative youth.
This is something I am seeing first hand with my mother. She has always been strong and active, playing tennis well into her late 70′s. Swimming laps into her 80′s. Always eating a healthy diet with milk and cottage cheese daily and taking her calcium tablets. Unfortunately for my mother and other women of that generation, the information on diet and osteoporosis was not generally disseminated when she was in her 40′s and 50′s. Despite her healthy life style, bone thinning most likely began decades ago.
That does not have to be the course of events for you! We know so much now and although some therapies come and go in almost fad-like fashion, bone strength seems like a “no-brainer”. Yes, there has been some recent controversy on the quality of bone that the bisfosphonates produce; and the USPTF does not seem to be jumping forward on recommendations for high doses of Vitamin D supplementation. But keeping bones strong through a healthy diet and exercise is something that everyone can do and benefit from. Maximizing food consumption to include vitamin packed vegetables, low fat dairy if you are not sensitive, as well as healthy nuts can provide you with natural occurring calcium readily absorbable. Weight bearing exercise and resistance work all contribute to bone health as well as cardiovascular fitness.
You can prevent some of the pain of osteoporosis by staying active, eating a healthy diet and ensuring you consume adequate calcium and vitamin D. We have talked a lot recently about the benefits of achieving a healthy weight through healthy diet and regular exercise. Prevention of osteoporosis is another reason!
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Is a thinning of bone in response to genetic, age, nutrition, inactivity and possibly other factors. Bone is not a static calcium filled mold. It is a dynamic, living tissue that is constantly being repaired by being reabsorbed and renewed.
Within our bodies are a series of clocks that determine the renewal of our bodies. They not only determine our sleep and waking patterns, but our patterns of cell life and death and perhaps patterns of metabolism. We know that there are special light sensors in the retina of the eye. These sensors need the light of the sun for 5 minutes a day to stay set and regulated. The sun also produces vitamin D3 in our skin, which along with vitamin K2, regulates mineral absorption and use.
Who is at risk for Osteoporosis?
Older women and men of northern European decent are at greatest risk. Asians too have an increased risk of osteoporosis. Those of African decent rarely have fractures or bone problems from osteoporosis. 45% of postmenopausal women have low bone density. Caucasian women have a 40% risk of a forearm or spinal or hip fracture (usually from a fall) in their lifetime. Caucasian men have a 13% risk.
Causes of Osteoporosis.
- Excess Alcohol intake
- Certain Medications like corticosteroids, anti-seizure, anti-organ-transplant-rejection drugs and chemotherapy
- Kidney Disease
- Liver Disease
- Spinal Cord injury
- Diseases of the Bone Marrow
- Hereditary Bone Development Diseases
- Endocrine and Metabolic diseases like Hyperthyroidism, Cushing syndrome, Hypogonadism
Although the main causes are 1) Estrogen deficiency and 2) changes of age
1/3 of all men and women with Osteoporosis have another coexisting cause of bone loss!
How to prevent and/or treat Osteoporosis.
Your bones are dynamic and constantly being remodeled. Providing your body with the raw materials in the form of fresh, organic food is very important.
Bone is composed of:
- living cells
The main minerals in bone are:
If there is not sufficient of these minerals in the blood, the body will remove them from bone to replace what is needed in the blood. There is a balance between minerals like calcium/phosphorus and zinc/copper. If one is too low the other is excreted. A diet high in carbohydrates increases insulin in the blood. High insulin levels on a daily basis causes loss of Magnesium and Calcium through the kidneys and retention of Sodium. This weakens bones and raises blood pressure. Low Vitamin D3 and K2 levels can adversely affect bone density also.
Just because a food has a lot of a mineral in it does not mean it is available to you. Spinach has lots of calcium but not much a Human can absorb. I have read about people leaving calcium supplements in their pocket, washing and drying the clothes and the supplement looking just like it did before the wash. Not much of that supplement is being absorbed. Check yours, drop a tablet in water, if it does not dissolve, drop it in 50% water and 50% vinegar. If it does not dissolve then, get a new supplement.
To prevent osteoporosis or even to help already weakened bones try this:
- keep protein to a minimum – .8grams per pound of IDEAL body weight (excess protein causes mineral loss through the kidney)
- eat lots of fresh fruits and vegetables
- do resistance exercises for 30 minutes 3 times a week – as good as estrogen in post-menopausal women
- practice balance exercises – falls are the main cause of fractures
- learn to fall – take a basic judo course or Akido orientation
- reduce stress – the stress hormone cortisol kills the bone forming cells called osteoblasts
- Talk to a very well informed, expert physician about taking some estrogen for a short while
- the bisphosphonate drugs can help for a little while but you have to move and eat right so you can stop them as soon as possible.
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There is a lot of information about health topics on the web. Some of it is good. The problem is in trying to distinguish What is good now from what was good 1 month to 1 year ago. There is also the problem of who sponsored the information and what they have to gain.
Osteoporosis is one of the subjects that has information all over the map. In western society the common wisdom says a woman should:
- take vitamin D3 but how much, how often
- take calcium but how much, how often and from what sources
- exercise, but what kind and how much, how often
- take estrogen – this is a big risk, should you or not?
- take a bisphosphonate – Fosamax and others – but what about side-effects, poor absorption, and maybe more fractures with it than without
All this is quite confusing.
Let me introduce you to 3 women experts and authors on this subject.
She is a gynecologist, an expert on women’s health especially during menopause. She is a best selling author and has had her books made into PBS specials (see PBS.org). Her book Women’s Bodies, Women’s Wisdom has been updated. In it she addresses the issue of mineral supplements, topical progesterone, diet and the work of two other authors I will introduce in the next two paragraphs.
Second, you need to know the name of Amy Lanou, Ph.D. from the Univ of NC Asheville.
She is a researcher in health and wellness. She reviewed 1300 studies done on osteoporosis and identified 135 that addressed the issue of diet and fractures in menopausal women. She found that calcium, while important, was not a panacea. That unless you also consumed enough of 16 other nutrients, calcium wasn’t going to make a difference. She reports her findings in her book.
Last let me introduce you to Miriam E Nelson Ph.D, director of the Center for Physical Activity and Nutrition at Tufts University.
Her research has found that resistance exercise – we call it lifting weights – for as little as two 40 minute sessions a week, can prevent osteoporosis.
Learn more about these authors and their books on our Squidoo lens of the same name
If you want the books and click through on the lens, you get the Amazon price and service, you support the Squidoo charities and you financially support this blog because we will see a few cents of that sale.
Who do you read? What is your experience with osteoporosis? Did you like what you read here? Leave us a comment! Recommend us on Twitter, Facebook and StumbleUpon by using the links at the end of this post. Tell us what you want. Send us a contact form!
So what does heartburn have to do with the strength of your bones? Bruce Bair and I write and talk a lot about healthy habits in this blog. Why? After a life time of bad habits (either some or a lot) the effects of these bad habits often strike in mid-life.
Researchers are not sure, but they have culled statistics from the Women’s Health Initiative that suggest that perhaps the class of medication called PPI’s (proton pump inhibitors) may place post menopausal women at risk for bone fractures of the wrist, forearm and spine. PPI’s include Prilosec and Prevacid, which are both over the counter and prescription Protonix, Aciphex, and Nexium. They do not include Zantac, Pepcid or Tagamet.
The “stomach acid reducers” do exactly what that categorizing name implies, they reduce acid in the stomach. This helps inflamed or damaged stomach lining to heal and reduces or eliminates the pain associated with these stomach injuries (inflammation, ulcers …). The PPI’s are very good because of the effectiveness with which they block acid secretion, which is almost total. The H2 blockers ( Zantac, Axid, Pepcid and Tagamet) are anti-histamines that block acid secretion by perhaps 70% at best.
You may think the almost complete acid suppression of the PPI’s is great, but consider this for a minute. We were made to produce stomach acid for a reason, so if you block this acid, there may be an unwanted or unanticipated reaction. Our stomachs need that acid to absorb certain nutrients, without which there can be deleterious effects. Researchers have not yet determined what causes these increased fractures. However one could surmise that the absorption of calcium or Vitamin D and other nutrients necessary to make strong bones is inhibited without enough stomach acid.
So what is a person to do? This leads me to the reason for this post.
DIET AND HEALTH HABITS. The majority of people have indigestion because of what they eat and drink. We have a lot of information on this blog about healthy habits and reasons to incorporate healthy habits as you age. Frequent heartburn would be another reason to get a lifestyle tune up. Many people have heartburn because of
- eating a big load of carbohydrates regularly,
- acidic and fatty foods (pizza!) a
- too much caffeine and/or alcohol,
- eating too much food late at night.
Oh no, you say; these guys want to take away all of our fun! Not so.
I merely encourage women to look at
- what they are eating and drinking,
- look at your level of exercise
- ask yourself if you can make any changes that will help you feel better.(We have 30 tips in our free booklet you can sign up to receive in the upper right corner.)
Usually, changes that help you feel better, also help you look better. And remember, every pill you take has a benefit and a potential risk. These stomach medications are generally very safe if used for a specified period of time. But why take a medication when you can make life style changes which negate your need for this medication? It is all about choices and how much energy you are willing to put into feeling and looking better. If you need some help with this send us an email via the contact page.
Do You think I am crazy? Let me know! Leave a comment for me to read. Lets talk about this.