RHR: Tips on how to Naturally Forestall and Deal with Osteopenia and Osteoporosis

On this episode, we focus on:

• The definition of and the distinction between osteopenia and osteoporosis
• Whether or not calcium dietary supplements truly 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 concerns for bone well being, together with irritation, gluten intolerance, the intestine microbiota, weight-bearing train, stress, smoking, and extreme consuming
• Tips on how to forestall osteopenia and osteoporosis and enhance bone mineral density naturally

Present notes:

• “Why You Ought to Assume 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 research”
• “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 based mostly potential longitudinal cohort research”
• “B-Nutritional vitamins and Bone Well being–A Evaluate 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 People now endure [from] osteopenia or delicate bone loss. In postmenopausal girls, the numbers are even larger. About 54 p.c of girls in that demographic have osteopenia, and an extra 30 p.c have osteoporosis, which is extra important bone loss. By age 80, that development predictably shifts in favor of osteoporosis, with 27 p.c of girls with osteopenia and 70 p.c of girls with osteoporosis.

Regardless of this, there aren’t any good remedies 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.” Because of this, within the aged, a fracture can usually 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 vulnerable. Making issues worse, there are such a lot of myths and misconceptions about easy methods to forestall and deal with bone loss. For instance, you’ve in all probability heard that taking calcium dietary supplements is essential for sustaining wholesome bones. It seems that supplemental calcium not solely doesn’t forestall 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 document straight on what causes osteopenia and osteoporosis and let you know easy methods to forestall 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 beneath regular reference values, but not low sufficient to satisfy 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 unfavourable one to unfavourable 2.5 suggests osteopenia, whereas a rating beneath unfavourable 2.5 signifies osteoporosis. Bone mineral density will increase from delivery and often peaks throughout early maturity. Girls sometimes attain 95 p.c 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 influence of a single nutrient, calcium, reasonably than acknowledging different essential elements like general weight loss program high quality and nutrient standing, hormone stability, 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 discuss different elements which are essential for sustaining bone well being and even reversing osteopenia and osteoporosis as soon as these processes have begun. Calcium metabolism is undoubtedly vital. However there’s been an excessive amount of concentrate on calcium itself, which has led to high-dose calcium supplementation that’s not solely ineffective however dangerous. You may take a look at my article “Why You Ought to Assume Twice About Taking Calcium Dietary supplements” for extra detailed data. You may Google it, or I’ll hyperlink to it within the present notes. However I wish to summarize among the findings.

Do Calcium Dietary supplements Work?

A [2015] evaluation discovered that consuming a excessive quantity of calcium past advisable dietary tips, sometimes from supplementation, supplied no profit for hip or lumbar vertebral bone mineral density in older adults. A 2007 research revealed within the American Journal of Medical Vitamin discovered that calcium dietary supplements don’t scale back fracture charges in postmenopausal girls and will even improve the speed of hip fractures.

Are Calcium Dietary supplements Secure?

Past being ineffective for bone well being, normal calcium dietary supplements are related to some fairly critical well being dangers. A 2012 research 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 a virtually 140 p.c larger danger of coronary heart assault throughout the 11-year research 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 p.c, stroke by 20 p.c, and dying from all causes by 9 p.c. And at last, an evaluation involving 12,000 males revealed in JAMA Inner Drugs discovered that intakes of over 1000 milligrams of supplemental calcium per day from multivitamins or particular person dietary supplements [were] related to a 20 p.c improve within the danger of dying from heart problems.

However there are different dangers, too. Each 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 research reported a 40 p.c larger danger of dying amongst girls with excessive calcium intakes [of] 1400 milligrams and above, and a 157 p.c larger danger of dying in these girls [who] have been taking a 500 milligram calcium complement every day. These charges have been in comparison with girls with average every day calcium intakes between 600 and 1000 milligrams.

Vitamins that Affect Bone Well being

To actually enhance our bone well being, we now have to look past calcium as an remoted nutrient. It’s essential to grasp that many vitamins affect and regulate calcium metabolism. Crucial 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 likely one of the most plentiful proteins naturally discovered within the physique and offers energy 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 forestall 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 research indicated that every day silica consumption improved bone mineral density of members, with a bunch who consumed 40 milligrams recording a bone mineral density that was 10 p.c larger than members who consumed 14 milligrams of silica every 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 helpful. They dampen irritation and forestall oxidative stress, each of that are main drivers of bone loss. Medical trials have proven that tocotrienols lower bone resorption and improve bone turnover fee. Tocotrienols additionally enhance osteoblast numbers, bone formation, mineral deposition, and bone microarchitecture. It’s value noting that alpha-tocopherol, the commonest type of vitamin E that you just sometimes discover in dietary supplements and multivitamins, could have dangerous bone formation results. So, for those who’re going to complement with vitamin E, it ought to be within the tocotrienol kind.

Different Elements that Have an effect on Bone Well being

Vitamins are vital for bone well being, and I’d argue in all probability an important issue that forestalls bone loss and may reverse it as soon as it’s began. However there are different concerns past weight loss program and diet. One is irritation. A number of completely different inflammatory cytokines have been implicated within the growth of osteoporosis. Sure pro-inflammatory cytokines play vital roles each within the regular bone transforming course of and within the pathogenesis of perimenopausal and late-life osteoporosis. Research have proven that osteoporosis is far more frequent in folks with power inflammatory circumstances 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 categorized as an immunological dysfunction. The truth is, they’ve even coined a time period for the influence of irritation on the growing older course of, “inflammaging.” And one of many greatest impacts of irritation is on bone mineral density. So for those who’re scuffling with osteopenia or osteoporosis, you need to verify for irritation and sources of irritation and deal with that to actually make important 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 greatest causes for that is that consuming gluten when you might have 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 likely 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 likely one of the first predictable signs that may be objectively noticed. However the excellent news is that those that have diminished bone mineral density from beforehand undiagnosed and untreated celiac illness or gluten intolerance can considerably enhance their bone energy just by following a gluten-free weight loss program.

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 issues are sometimes seen in folks with gastrointestinal issues, as I simply talked about. Intestine and systemic irritation are additionally related to elevated manufacturing of cytokines which are key contributors to bone loss. Immune cells which are activated by microbes within the intestine can migrate to the bone and immediately regulate bone transforming through 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 suggestions the conventional stability of bone resorption data, leading to larger ranges of bone breakdown and decrease bone density. Disruption of the intestine microbiota can considerably scale back absorption of the vitamins which are vital for bone well being. It is a double whammy impact, the place the mechanisms I simply described immediately scale 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 serious public well being menace for an estimated 44 million People, or for greater than half of these age 50 or older, making prevention and therapy an essential subject 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 in all probability heard of, is weight-bearing train. Doing the correct sort and quantity of bodily exercise frequently is simply as essential to sustaining wholesome bones as diet, decreasing irritation, [and] sustaining our intestine well being. And the perfect sort of train for bone energy, by far, is lifting heavy weights. The stress we placed on our bones throughout weightlifting stimulates the bone transforming course of, and doing weightlifting just a few occasions per week has been proven to considerably improve bone mineral density, particularly in postmenopausal girls.

Sleep is one other essential issue. It’s not solely essential for basic well being and wellness, however it truly 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 transforming, and features as a potent antioxidant, defending bone cells from oxidative stress and irritation.

Talking of stress, stress ranges can immediately influence your bone well being. It’s well-known that the long-term use of corticosteroid medicines, which suppress cortisol ranges, trigger bone loss and may 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 could trigger a lower in bone mass. A number of research counsel that prime cortisol could result in decreased bone mineral density. Since cortisol is the first stress hormone, the easiest way to maintain cortisol ranges in an acceptable vary is to observe common stress administration.

And at last, I’m in all probability preaching to the choir right here, however it is very important do not forget that each cigarette smoking and extra alcohol consumption have been linked to diminished bone mineral density. If you’re smoking or are usually consuming in extra, stopping these habits as quickly as doable ought to be the primary precedence for protecting your bones wholesome.

Stopping and Treating Osteopenia and Osteoporosis Naturally

Okay, so let’s put all of this collectively into an strategy that you should use to naturally enhance your bone mineral density. The first step can be to get as a lot calcium as you’ll be able to from [your] weight loss program reasonably than dietary supplements. You actually have to contemplate bioavailability right here, which is the quantity of a given nutrient that we are able to truly take up and make the most of. If you happen to have a look at the quantity of calcium in spinach on paper, it seems to be fairly good. However we solely take up about 5 p.c of the calcium that we devour 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 just a little above 30 p.c, so roughly six occasions 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 must devour eight cups of spinach. That’s an enormous distinction, and it’s actually one thing you want to pay attention to relating 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 tender and also you’re in a position to devour them, are an important supply of calcium, as properly. That’s in all probability one of many important methods our ancestors bought 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 purpose, usually are not nice sources of calcium. Seeds, like poppy and sesame, and almonds are first rate 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 are essential for bone well being, like vitamin[s] C, D, E, K2, [and] B nutritional vitamins, magnesium, collagen, and silica. And the easiest way to make sure that you’re getting sufficient of those is a nutrient-dense, entire meals weight loss program with loads of animal merchandise, seafood, vegetables and fruit, eggs, dairy merchandise for those who tolerate them, nuts and seeds, and tubers. Consuming a broad number of these meals shall be a great beginning place for ensuring you’re getting all these different vitamins. Organ meats, inside the class of animal merchandise, are the best supply of a lot of these vitamins that I simply talked about.

In fact, we additionally wish to concentrate on 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 forth., are [all] actually essential steps you’ll be able to take to enhance your intestine well being. If you happen to want extra assist right here, take a look at my web site, ChrisKresser.com, [where] we’ve bought a free eBook on intestine well being that may level you in the correct course.

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

After which, getting sufficient sleep. That is the elephant within the room within the fashionable world. I’ve come to consider that sleep deprivation might be the primary explanation for lots of fashionable power ailments at this level, even in entrance of weight loss program. You may survive for fairly lengthy on a poor weight loss program. You gained’t really feel properly [and] you gained’t carry out optimally, however you’ll be able to survive. If you happen to’re sleeping fewer than 4 hours an evening for an prolonged interval, you’re going to collapse in a short time. I’m involved about how frequent sleep deprivation has develop into and the influence that’s having on our well being, not simply with bone loss, however just about each fashionable 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 quite a bit about this elsewhere. You may Google Chris Kresser and sleep and get numerous actually actionable and sensible tips about how to do this. However you need to make it a precedence. That’s one thing that you need to do by yourself. It’s important to 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 loss program, way of life, and habits perspective to enhance your sleep.

Final however not least is sensible supplementation. It’s not doable to satisfy all of our nutrient [needs] from meals, sadly, however supplementation may also help shut the hole. That is the primary purpose 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 assist 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 accommodates 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 essential 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 great supply of collagen. Bio-Avail E+ offers 300 milligrams of delta- and gamma-tocotrienols. I talked earlier within the present concerning the thrilling advantages of tocotrienols for bone well being. Not like tocopherols, that are the extra frequent type of vitamin E that most individuals are supplementing with, tocotrienols usually are not related to the next danger of most cancers or coronary heart illness over the long run. Bio-Avail Myco accommodates 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 singular 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 great supply of the important vitamins that assist bone well being. Lastly, Bio-Avail Magazine has 300 milligrams of buffered magnesium chelate, which is a extremely bioavailable type of magnesium. That is essential as a result of a current research advised that almost all People are falling 200 to 300 milligrams per day in need of magnesium. So Bio-Avail Magazine may also help shut this hole, and, as we all know, magnesium is vital for bone well being.

With the Core Plus bundle, you additionally get the Core Reset program. That is an app that may allow you to dial in your weight loss program, bodily exercise, stress administration, and different way of life elements. It has recipes, meal plans, purchasing 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 items dialed in and just remember to’re doing all of the weight loss program and way of life issues proper as a way to create that strong basis for good bone well being. And the wonderful thing about the Core Reset app is that it’s supplied at no extra cost once you order the Core Plus bundle. You may go to AdaptNaturals.com to be taught extra and get began.

I hope you loved this present. Osteopenia and osteoporosis are far more preventable than typical medication would have us consider. And it’s actually essential to do 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 all the things 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 properly into my older years. And sustaining wholesome bones and satisfactory muscle mass are the 2 most essential issues to make that doable. So I hope this was useful, and I’ll speak to you subsequent time.

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