RHR: How one can Naturally Forestall and Deal with Osteopenia and Osteoporosis

On this episode, we talk about:

• The definition of and the distinction between osteopenia and osteoporosis
• Whether or not calcium dietary supplements really work
• The dangers related to calcium dietary supplements, together with coronary heart illness, most cancers, kidney stones, and extra
• Which vitamins affect and regulate calcium metabolism, together with nutritional vitamins D and K2, collagen, magnesium, and silica
• Different issues for bone well being, together with irritation, gluten intolerance, the intestine microbiota, weight-bearing train, stress, smoking, and extreme consuming
• How one can stop osteopenia and osteoporosis and enhance bone mineral density naturally

Present notes:

• “Why You Ought to Suppose Twice About Taking Calcium Dietary supplements” 
• “Calcium consumption and bone mineral density: systematic evaluate and meta-analysis”
• “Calcium consumption and hip fracture danger in women and men: a meta-analysis of potential cohort research and randomized managed trials”
• “Associations of dietary calcium consumption and calcium supplementation with myocardial infarction and stroke danger and general cardiovascular mortality within the Heidelberg cohort of the European Potential Investigation into Most cancers and Vitamin examine”
• “Impact of calcium dietary supplements on danger of myocardial infarction and cardiovascular occasions: meta-analysis”
• “Dietary and Supplemental Calcium Consumption and Cardiovascular Illness Mortality”
• “Long run calcium consumption and charges of all trigger and cardiovascular mortality: group primarily based potential longitudinal cohort examine”
• “B-Nutritional vitamins and Bone Well being–A Overview of the Present Proof”
• Articles by Chris on stress
• Articles by Chris on sleep
• Free eBook on intestine well being

Hey, everybody, Chris Kresser right here. Welcome to a different episode of Revolution Well being Radio. Current estimates counsel that just about 50 million Individuals now endure [from] osteopenia or gentle bone loss. In postmenopausal ladies, the numbers are even larger. About 54 % of ladies in that demographic have osteopenia, and a further 30 % have osteoporosis, which is extra vital bone loss. By age 80, that development predictably shifts in favor of osteoporosis, with 27 % of ladies with osteopenia and 70 % of ladies with osteoporosis.

Regardless of this, there are not any good therapies for osteopenia or osteoporosis in typical medication, and fractures are one of many main causes of untimely dying in seniors. There’s a saying in medication, “break your hip, die of pneumonia.” Which means, within the aged, a fracture can typically result in extended time in a hospital mattress, the place fluid can pool within the lungs, trigger pneumonia, after which trigger dying in people who find themselves inclined. Making issues worse, there are such a lot of myths and misconceptions about the right way to stop and deal with bone loss. For instance, you’ve most likely heard that taking calcium dietary supplements is vital for sustaining wholesome bones. It seems that supplemental calcium not solely doesn’t stop bone loss, [but] it could [also] improve the danger of coronary heart illness, kidney stones, and different issues. On this podcast, I’m going to set the report straight on what causes osteopenia and osteoporosis and inform you the right way to stop bone loss naturally with out medicine. Prepared? Let’s dive in.

What Are Osteopenia and Osteoporosis?

Let’s begin with a definition of phrases. Osteopenia refers to a lower in bone mineral density under regular reference values, but not low sufficient to fulfill the diagnostic standards for osteoporosis. Clinicians assess bone mineral density utilizing a T rating, which is a numerical worth decided by a bone scan. A T rating of unfavorable one to unfavorable 2.5 suggests osteopenia, whereas a rating under unfavorable 2.5 signifies osteoporosis. Bone mineral density will increase from beginning and normally peaks throughout early maturity. Girls sometimes attain 95 % of their most bone density by age 17, and males attain that degree by age 21. After age 30, there’s a gradual and pure bone mass discount that takes place over the following a long time in later life. In mainstream medication, scientists acknowledge that each genetics and way of life elements play a task in figuring out how briskly that bone mass discount happens. However the focus appears to overwhelmingly be on the affect of a single nutrient, calcium, fairly than acknowledging different essential elements like general weight-reduction plan high quality and nutrient standing, hormone steadiness, weight-bearing train, and physique mass.

I’m going to start out by debunking the parable that calcium supplementation is helpful for stopping age-associated bone loss. Then I’ll speak about different elements which might be vital for sustaining bone well being and even reversing osteopenia and osteoporosis as soon as these processes have begun. Calcium metabolism is undoubtedly essential. However there’s been an excessive amount of give attention to calcium itself, which has led to high-dose calcium supplementation that’s not solely ineffective however dangerous. You possibly can take a look at my article “Why You Ought to Suppose Twice About Taking Calcium Dietary supplements” for extra detailed data. You possibly can Google it, or I’ll hyperlink to it within the present notes. However I wish to summarize a number of the findings.

Do Calcium Dietary supplements Work?

A [2015] evaluation discovered that consuming a excessive quantity of calcium past beneficial dietary pointers, sometimes from supplementation, offered no profit for hip or lumbar vertebral bone mineral density in older adults. A 2007 examine revealed within the American Journal of Scientific Vitamin discovered that calcium dietary supplements don’t cut back fracture charges in postmenopausal ladies and will even improve the speed of hip fractures.

Are Calcium Dietary supplements Protected?

Past being ineffective for bone well being, commonplace calcium dietary supplements are related to some fairly critical well being dangers. A 2012 examine of 24,000 women and men aged 35 to 64 years, revealed within the [British Medical Journal](BMJ), discovered that those that used calcium dietary supplements had an almost 140 % larger danger of coronary heart assault throughout the 11-year examine interval, whereas consumption of calcium from meals didn’t improve the danger. A meta-analysis of research involving greater than 12,000 folks additionally revealed in BMJ discovered that calcium supplementation will increase the danger of coronary heart assault by 31 %, stroke by 20 %, and dying from all causes by 9 %. And at last, an evaluation involving 12,000 males revealed in JAMA Inner Medication discovered that intakes of over 1000 milligrams of supplemental calcium per day from multivitamins or particular person dietary supplements [were] related to a 20 % improve within the danger of dying from heart problems.

However there are different dangers, too. Day by day supplementation of calcium at 1000 milligrams, which is a typical dose, is related to elevated prostate most cancers danger and a rise in kidney stones. A current Swedish examine reported a 40 % larger danger of dying amongst ladies with excessive calcium intakes [of] 1400 milligrams and above, and a 157 % larger danger of dying in these ladies [who] have been taking a 500 milligram calcium complement day by day. These charges have been in comparison with ladies with reasonable day by day calcium intakes between 600 and 1000 milligrams.

Vitamins that Affect Bone Well being

To actually enhance our bone well being, now we have to look past calcium as an remoted nutrient. It’s vital to grasp that many vitamins affect and regulate calcium metabolism. An important are vitamin D, vitamin K2, magnesium, silica, and collagen. Vitamin D will increase calcium absorption and helps calcium metabolism. Vitamin K2 ensures the calcium will get into the bones and tooth and stays out of soppy tissue. Magnesium is required for calcium absorption and utilization, and magnesium deficiency causes calcium deficiency and hyperparathyroidism, which additionally impacts calcium ranges. Silica is the third most plentiful hint mineral within the physique after iron and zinc. It assists calcium and magnesium metabolism. Collagen is without doubt one of the most plentiful proteins naturally discovered within the physique and gives power and stability to connective tissues. Collagen manufacturing is integral for wholesome pores and skin, hair, nails, and bones.

Each collagen and silica help new bone formation by stimulating osteoblasts or bone-building cells. Collagen and silica additionally stop bone breakdown by inhibiting osteoclasts, our bone-resorbing cells, which attempt to break down bone tissue and launch minerals required for sturdy bones into the remainder of the physique. One examine indicated that day by day silica consumption improved bone mineral density of members, with a bunch who consumed 40 milligrams recording a bone mineral density that was 10 % larger than members who consumed 14 milligrams of silica day by day. Current analysis has additionally advised a task for a number of B nutritional vitamins, particularly B2, B6, folate, and B12, and nutritional vitamins C and E in bone well being. Tocotrienols, a lately found type of vitamin E, are particularly useful. They dampen irritation and forestall oxidative stress, each of that are main drivers of bone loss. Scientific trials have proven that tocotrienols lower bone resorption and improve bone turnover charge. Tocotrienols additionally enhance osteoblast numbers, bone formation, mineral deposition, and bone microarchitecture. It’s price noting that alpha-tocopherol, the commonest type of vitamin E that you just sometimes discover in dietary supplements and multivitamins, might have dangerous bone formation results. So, in the event you’re going to complement with vitamin E, it ought to be within the tocotrienol type.

Different Elements that Have an effect on Bone Well being

Vitamins are essential for bone well being, and I’d argue most likely crucial issue that forestalls bone loss and might reverse it as soon as it’s began. However there are different issues past weight-reduction plan and vitamin. One is irritation. A number of totally different inflammatory cytokines have been implicated within the growth of osteoporosis. Sure pro-inflammatory cytokines play essential roles each within the regular bone reworking course of and within the pathogenesis of perimenopausal and late-life osteoporosis. Research have proven that osteoporosis is way more widespread in folks with power inflammatory situations like Crohn’s illness or ulcerative colitis, rheumatoid arthritis, and Hashimoto’s [disease]. Excessive ranges of C-reactive protein, an inflammatory marker, are related to low T scores and poor bone mineral density. Given all of this, some scientists have argued that osteoporosis ought to be categorised as an immunological dysfunction. In truth, they’ve even coined a time period for the affect of irritation on the growing old course of, “inflammaging.” And one of many largest impacts of irritation is on bone mineral density. So in the event you’re battling osteopenia or osteoporosis, you need to examine for irritation and sources of irritation and handle that to essentially make vital progress.

One other issue, talking of irritation, is gluten intolerance. For individuals who have an immune response to gluten, together with these with celiac illness, strictly avoiding gluten is important for stopping osteopenia and osteoporosis. One of many largest causes for that is that consuming gluten when you’ve got an intolerance to it triggers irritation. For folks with celiac illness and non-celiac gluten intolerance, each time they eat gluten, they’re triggering an immune response that results in systemic irritation. It ought to come as no shock {that a} lower in bone density is without doubt one of the first signs of celiac illness, even in in any other case asymptomatic sufferers. In different phrases, some sufferers who’ve celiac or non-celiac gluten intolerance will eat gluten and [not] get the telltale intestine signs that different sufferers do. For them, bone loss or a lower in bone density is without doubt one of the first predictable signs that may be objectively noticed. However the excellent news is that those that have lowered bone mineral density from beforehand undiagnosed and untreated celiac illness or gluten intolerance can considerably enhance their bone power just by following a gluten-free weight-reduction plan.

One other issue is the intestine–bone axis. Research have proven that there’s an affiliation between the intestine microbiota and bone well being. Bone problems are sometimes seen in folks with gastrointestinal problems, as I simply talked about. Intestine and systemic irritation are additionally related to elevated manufacturing of cytokines which might be key contributors to bone loss. Immune cells which might be activated by microbes within the intestine can migrate to the bone and immediately regulate bone reworking by way of osteoclast-inducing issue, RANKL, and different bone-active molecules. Elevated ranges of activated innate immune cells have been proven to extend expression of the signaling molecule [tumor necrosis factor alpha] (TNF alpha) within the bone marrow, and TNF alpha stimulates stem cells within the bone marrow to distinguish into osteoclasts. This ideas the traditional steadiness of bone resorption data, leading to larger ranges of bone breakdown and decrease bone density. Disruption of the intestine microbiota can considerably cut back absorption of the vitamins which might be essential for bone well being. This can be a double whammy impact, the place the mechanisms I simply described immediately cut back bone mineral density, however then these intestine points additionally result in decrease ranges of the vitamins that we all know contribute to bone well being. Along with decreasing absorption and metabolism of bone-friendly vitamins, microbes themselves additionally synthesize a few of these vitamins, which embody thiamine ([vitamin] B1), niacin (B3), pantothenic acid (B5), biotin (B7), folate (B9), pyridoxal phosphate (B6), and vitamin K2.

Osteoporosis is a significant public well being risk for an estimated 44 million Individuals, or for greater than half of these age 50 or older, making prevention and therapy an vital matter for folks of all ages. Be taught how one can take a pure strategy to stopping bone loss as you age on this episode of Revolution Well being Radio. #chriskresser #osteoporosis #osteopenia

One other essential issue for bone well being, which you’ve most likely heard of, is weight-bearing train. Doing the precise sort and quantity of bodily exercise regularly is simply as vital to sustaining wholesome bones as vitamin, decreasing irritation, [and] sustaining our intestine well being. And the very best sort of train for bone power, by far, is lifting heavy weights. The stress we placed on our bones throughout weightlifting stimulates the bone reworking course of, and doing weightlifting a number of instances per week has been proven to considerably improve bone mineral density, particularly in postmenopausal ladies.

Sleep is one other vital issue. It’s not solely vital for common well being and wellness, however it really immediately impacts bone density via the hormonal results of melatonin, the first hormone secreted throughout sleep. Melatonin impacts the actions of osteoblasts and osteoclasts, interacts with different hormones like estrogen to reinforce bone reworking, and features as a potent antioxidant, defending bone cells from oxidative stress and irritation.

Talking of stress, stress ranges can immediately affect your bone well being. It’s well-known that the long-term use of corticosteroid medicines, which suppress cortisol ranges, trigger bone loss and might result in osteoporosis. However excessive cortisol from stress may additionally result in comparable results on bone density. Cortisol not directly acts on bone by blocking calcium absorption, which decreases bone cell progress, and even a brief bout of elevated cortisol might trigger a lower in bone mass. A number of research counsel that top cortisol might result in decreased bone mineral density. Since cortisol is the first stress hormone, one of the best ways to maintain cortisol ranges in an acceptable vary is to apply common stress administration.

And at last, I’m most likely preaching to the choir right here, however you will need to do not forget that each cigarette smoking and extra alcohol consumption have been linked to lowered bone mineral density. In case you are smoking or are recurrently consuming in extra, stopping these habits as quickly as potential ought to be the primary precedence for holding your bones wholesome.

Stopping and Treating Osteopenia and Osteoporosis Naturally

Okay, so let’s put all of this collectively into an strategy that you need to use to naturally enhance your bone mineral density. The 1st step could be to get as a lot calcium as you may from [your] weight-reduction plan fairly than dietary supplements. You actually have to think about bioavailability right here, which is the quantity of a given nutrient that we are able to really take in and make the most of. When you take a look at the quantity of calcium in spinach on paper, it appears fairly good. However we solely take in about 5 % of the calcium that we eat in spinach due to the presence of a compound known as oxalic acid that inhibits calcium absorption. Conversely, with dairy merchandise, the bioavailability of calcium is a little bit above 30 %, so roughly six instances larger than it’s in spinach. To get the identical quantity of bioavailable calcium that you just get in an eight ounce glass of milk, you’d need to eat eight cups of spinach. That’s an enormous distinction, and it’s actually one thing you want to pay attention to in relation to getting calcium from meals.

Cruciferous greens are good supply[s] of calcium, and the calcium is pretty bioavailable in these meals as a result of they don’t have lots of oxalic acid. Canned, bone-in fish like sardines or salmon, the place the bones are delicate and also you’re capable of eat them, are a terrific supply of calcium, as nicely. That’s most likely one of many fundamental methods our ancestors acquired calcium along with consuming meat on the bones. Darkish, leafy greens like spinach, which I simply talked about, are comparatively excessive in calcium on paper, however they include oxalic acid and, for that motive, will not be nice sources of calcium. Seeds, like poppy and sesame, and almonds are respectable sources of calcium, however the bioavailability is decrease in these meals than it’s for dairy merchandise or bone-in fish or cruciferous greens. However there are different vitamins, as we mentioned, which might be vital for bone well being, like vitamin[s] C, D, E, K2, [and] B nutritional vitamins, magnesium, collagen, and silica. And one of the best ways to make sure that you’re getting sufficient of those is a nutrient-dense, entire meals weight-reduction plan with loads of animal merchandise, seafood, fruit and veggies, eggs, dairy merchandise in the event you tolerate them, nuts and seeds, and tubers. Consuming a broad number of these meals will likely be a superb beginning place for ensuring you’re getting all these different vitamins. Organ meats, inside the class of animal merchandise, are the very best supply of a lot of these vitamins that I simply talked about.

In fact, we additionally wish to give attention to our intestine well being due to the intestine–bone axis that we mentioned. Consuming loads of fermentable fibers that nourish and feed our intestine microbiota, [eating] fermented meals [that] include probiotics, consuming bone broth, and so on., are [all] actually vital steps you may take to enhance your intestine well being. When you want extra help right here, take a look at my web site, ChrisKresser.com, [where] we’ve acquired a free eBook on intestine well being that may level you in the precise route.

One other issue is train, which we mentioned. Lifting weights, specifically, is actually vital. I like to recommend this for all of my sufferers, males or ladies, particularly as they grow old. I feel sustaining muscle mass and doing weight-bearing train, whether or not that’s weightlifting or one thing else, are two of crucial issues we are able to do to make sure that we age nicely and cut back the danger of [age-related] ailments, together with osteopenia and osteoporosis. Managing stress is essential due to the connection between cortisol and bone well being that we talked about. The very fact is, we reside in a really traumatic world, and it is a problem for many of us. When you go to my web site or Google Chris Kresser and stress, you’ll discover a bunch of articles which have some actually sensible ideas for getting you began [with that].

After which, getting sufficient sleep. That is the elephant within the room within the trendy world. I’ve come to consider that sleep deprivation might be the primary explanation for lots of trendy power ailments at this level, even in entrance of weight-reduction plan. You possibly can survive for fairly lengthy on a poor weight-reduction plan. You gained’t really feel nicely [and] you gained’t carry out optimally, however you may survive. When you’re sleeping fewer than 4 hours an evening for an prolonged interval, you’re going to disintegrate in a short time. I’m involved about how widespread sleep deprivation has develop into and the affect that’s having on our well being, not simply with bone loss, however just about each trendy power situation. So I actually can’t emphasize sufficient the significance of getting seven to eight hours of sleep [each] night time. I’ve written and spoken loads about this elsewhere. You possibly can Google Chris Kresser and sleep and get a lot of actually actionable and sensible tips about how to try this. However you need to make it a precedence. That’s one thing that you need to do by yourself. You must decide to [it] and you need to commit to creating time for it. When you do, there are lots of issues you are able to do from a weight-reduction plan, way of life, and conduct perspective to enhance your sleep.

Final however not least is wise supplementation. It’s now not potential to fulfill all of our nutrient [needs] from meals, sadly, however supplementation will help shut the hole. That is the principle motive that I created the Core Plus bundle from Adapt Naturals. It has quite a few advantages for bone well being. Bio-Avail Multi, which is our important multivitamin, multimineral, and phytonutrient mix, meets or exceeds the [Recommended Dietary Allowance] (RDA) in vitamins that help bone well being like vitamin C, [vitamin] D, magnesium, and silica. It has a full spectrum [vitamin] K2 mix with MK-4, MK-6, MK-7, [and] MK-9. It comprises a really low dose of calcium, solely 50 milligrams. So, nowhere close to these larger doses of 500 milligrams to 1000 milligrams that trigger the problems related to calcium supplementation. Bio-Avail Organ is a wealthy supply of B nutritional vitamins like B2, B6, folate, and B12, [which] we now know are vital to bone well being. It’s a mix of 5 organs—liver, coronary heart, kidney, pancreas, and spleen—that are 5 of the ten most nutrient-dense meals that we are able to eat. It’s additionally a superb supply of collagen. Bio-Avail E+ gives 300 milligrams of delta- and gamma-tocotrienols. I talked earlier within the present in regards to the thrilling advantages of tocotrienols for bone well being. Not like tocopherols, that are the extra widespread type of vitamin E that most individuals are supplementing with, tocotrienols will not be related to the next danger of most cancers or coronary heart illness over the long run. Bio-Avail Myco comprises mushrooms which have anti-inflammatory and antioxidant results. As we mentioned, irritation and oxidative stress are main drivers of bone well being. They’re additionally a wealthy supply of beta-glucan, which is a novel soluble fiber with quite a few advantages for intestine well being, and it improves the intestine–bone axis. Research have proven that mushroom extracts from reishi, turkey tail, maitake, and shiitake lower bone resorption and enhance bone formation. Mushrooms are additionally a superb supply of the important vitamins that help bone well being. Lastly, Bio-Avail Magazine has 300 milligrams of buffered magnesium chelate, which is a extremely bioavailable type of magnesium. That is vital as a result of a current examine advised that the majority Individuals are falling 200 to 300 milligrams per day in need of magnesium. So Bio-Avail Magazine will help shut this hole, and, as we all know, magnesium is essential for bone well being.

With the Core Plus bundle, you additionally get the Core Reset program. That is an app that can enable you dial in your weight-reduction plan, bodily exercise, stress administration, and different way of life elements. It has recipes, meal plans, buying lists, guided audio and video motion practices, and stress administration and meditation practices. It has a 28-day Kickstart Program that will help you get all these things dialed in and just remember to’re doing all of the weight-reduction plan and way of life issues proper so to create that strong basis for good bone well being. And the wonderful thing about the Core Reset app is that it’s offered at no further cost if you order the Core Plus bundle. You possibly can go to AdaptNaturals.com to be taught extra and get began.

I hope you loved this present. Osteopenia and osteoporosis are way more preventable than typical medication would have us consider. And it’s actually vital to try this as a result of, as I discussed [at] the start of the present, fractures are one of many main causes of age-associated early mortality or untimely dying. It simply makes a lot sense to do every part we are able to to stop this as a result of, talking personally, I wish to be energetic and proceed to do all of the issues that I take pleasure in nicely into my older years. And sustaining wholesome bones and satisfactory muscle mass are the 2 most vital issues to make that potential. So I hope this was useful, and I’ll discuss to you subsequent time.

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