Bone Health

Do ‘Forever Chemicals’ Affect Bone Health in Youth?

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Bone health begins in childhood, particularly during the rapid bone accrual phase of puberty, which is essential for attaining optimal peak bone mass. Peak bone mass is achieved in early adult life and affects both immediate and future fracture risk. Genetic, nutritional, exercise-related, and hormonal factors, and certain diseases and medications, have deleterious effects on bone health.

In addition, emerging data suggest that certain manmade chemicals known as per- and polyfluoroalkyl substances (PFAS) may affect bone accrual during this important period and potentially increase the risk for osteoporosis in adulthood. Osteoporosis refers to increased fracture risk because of low bone density and affects a large proportion of postmenopausal women and older men.

New evidence comes from a recent study conducted by investigators from the Keck School of Medicine , who examined the impact of exposure to PFAS on skeletal outcomes in youth. Of note, participants were primarily Hispanic; this population has a higher risk for osteoporosis in adulthood. PFAS are manmade chemicals with water- and grease-resistant properties. They are used in a variety of products, such as nonstick cookware, food packaging, water-repellent clothing, stain-resistant fabrics, carpets, and in certain industrial processes. They are pervasive in the environment, in wildlife, and in humans.

Use and production of certain PFAS, such as perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA),  have decreased over the past two decades, with a significant reduction in blood concentrations of these chemicals. However, they can be resistant to degradation and have very long half-lives. As a consequence, these “forever chemicals” continue to linger in the environment. Also, the risk for exposure to other PFAS persists, and almost every individual has detectable levels of PFAS in blood.

Scientists are still learning about the impact of environmental chemicals on bone health. In contrast, other factors that may jeopardize pubertal bone accrual and peak bone mass acquisition have been studied extensively, with guidelines for management of the consequent poor skeletal health.

For PFAS, studies have reported deleterious effects on various body systems, such as the liver, immune system, thyroid, and the developing brain. The limited data related to bone suggest negative associations between certain, but not all, PFAS and bone density — ie, the higher the exposure, the worse the impact on bone health.

PFAS may affect health through alterations in the endocrine system. They have been associated with lower levels of testosterone and downregulation of its receptor (and testosterone is known to modulate bone formation and bone loss). On the other hand, some PFAS are estrogenic, which should be beneficial to bone. A direct impact of PFAS on pathways regulating activity of osteoblasts (bone-forming cells) and osteoclasts (bone-resorbing cells) has also been postulated, with conflicting results.

Previous research on PFAS and human bone health has found mixed results. In adolescents, Xiong and colleagues  reported negative associations of PFOS, PFOA, and perfluorononanoic acid (PFNA), but not perfluorohexane sulfonic acid (PFHxS), levels with bone density at various sites, mostly in females. Carwile and associates  reported similar negative associations of blood concentrations of PFOA and PFOS and urinary concentrations of phthalates with bone density in adolescents, but only in males. Lin and coworkers also reported negative associations of PFOA and bone density in adult premenopausal women, but found no associations of PFOA and PFOS concentrations with self-reported fractures, suggesting questionable biological significance of these findings. These were all cross-sectional studies and did not report on the impact of these chemicals on longitudinal bone accrual.

In the recent study, Beglarian and colleagues examined the impact of PFAS on longitudinal changes in bone density in adolescents, drawn from the Study of Latino Adolescents at Risk of Type 2 Diabetes (SOLAR) cohort and young adults from the Southern California Children’s Health Study (CHS) cohort. They found that in adolescents, higher baseline concentrations of PFOS predicted lower bone accrual over time. In young adults, there was a similar negative association of PFOS concentrations and bone density at baseline, but not with longitudinal bone accrual. In this study, other PFAS were not associated with bone outcomes.

Overall, research appears to suggest that PFOA, PFOS, and PFNA may have deleterious effects on bone density and bone accrual over time. However, data are not consistent across studies and across sexes, and more research is necessary to conclusively define the impact of these chemicals on skeletal health, particularly during the critical pubertal years of maximal bone accrual. In the meantime, continued efforts are necessary to reduce to concentrations of these PFAS in the environment.

Vitamin C deficiency accelerates bone loss

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Vitamin C is well known as a powerful antioxidant and valuable weapon against cancer and other disease. But this versatile vitamin can also prevent bone loss by preventing oxidative stress that destroys bone structure.

Bone loss, known as osteoporosis, strikes older adults and can have devastating effects on mobility and quality of life. By supplementing with vitamin C, and following a healthy lifestyle to avoid toxins and other stress, you can minimize the risk of bone loss.

The stakes are high: Don’t become a victim of poor bone health

The National Osteoporosis Foundation estimates that about 54 million Americans are suffering with, or at-risk of, osteoporosis and low bone mass. Osteoporosis occurs when the body loses too much bone or makes too little bone. In some cases, both scenarios are occurring simultaneously.

The result is a weakening of the bones, causing an increase in incidence of bone breakage, even from a relatively minor fall. In the most severe cases, victims of osteoporosis can break a bone simply by bumping into something around the house – or even from just sneezing. Osteoporosis is more widespread than many realize. About one in two women and as many as one in four men aged 50 and older will break a bone in because of osteoporosis.

Patients are being misguided and mistreated

There is a mountain of information about bone health and how to avoid osteoporosis. Unfortunately, nearly all of it is wrong. The most common mistake is the idea that calcium can reverse bone loss. This misconception no doubt came about because osteoporotic bone is definitely deficient in calcium. But consuming large amounts of calcium have no effect on improving the conditions of the disease.

While additional calcium in the diet may show some improvement on a bone density test, those results are deceiving. Calcium is merely improving the test results from a superficial standpoint. It is doing nothing to strengthen the bone from within and safeguard against fracture.

Is your doctor telling you the truth about poor bone health?

Osteoporosis is actually scurvy of the bones, a symptom of vitamin C deficiency. Its reversal is dependent on restoring an optimal balance of antioxidants, particularly vitamin C – which helps promote the growth of new, healthy bone. Appropriate mineral intake is also necessary for optimal function of these antioxidants within the bone.

Deficiencies in antioxidants cause oxidative stress, which affects the bone, decomposing it over time. Resolving this oxidative stress is not as simple as taking a supplement, however, since the cause of the stress should also be addressed. But vitamin C plays a key role in an overall approach to minimizing bone loss because of its incredible efficiency in relieving oxidative stress.

Good news about the power of vitamin C for bone strength

Supplementing with vitamin C has been shown to improve bone density test results with strong, structurally sound bones, as well as reduce the risk of fracture. Research has shown vitamin C plays a pivotal role within the structural matrix of the bone itself, forming and cross-linking collagen, developing other non-collagen bone matrix proteins, regulating cells that are forming collagen and cartilage in the bone, as well as differentiating stem cells into bone cells.

Researchers at Mount Sinai School of Medicine were the first to demonstrate in an animal model that vitamin C actively protects against osteoporosis. Researchers there found that supplementing with vitamin C prevented bone loss in mice. Similar findings were documented in the International Journal of Experimental Pathology by researchers at Kyungpook National University in Daigu, Korea, who found that vitamin C deficiency caused failure of collagen synthesis, leading to symptoms of scurvy, including spontaneous bone fracture.

Take a comprehensive approach to avoid osteoporosis

There are a number of steps you can take for preventing and reversing osteoporosis. This comprehensive approach will address oxidative stress as well as get at the cause of that stress:

1. Eradicate old infections, detoxify your body and minimize new toxin exposure.
2. Address any critical hormone deficiencies.
3. Optimize antioxidant levels by supplementing with vitamin C, preferably a high-quality powder and liposome encapsulated forms.
4. Consider additional recommended dietary supplements, including lysine and proline, complete B complex, beta carotene, vitamin D3, vitamin K2, omega-3 fatty acids, magnesium glycinate, and mixed tocopherols.
5. And, of course, consider weight-bearing exercise like, walking, jogging or hiking.  Plus, strength training exercises like, dumbbell chest presses, push ups, lunges and squats. If you don’t know how to exercise properly, consider working with a health coach or fitness professional.  The rewards are worth the effort.

Abaloparatide Works in ‘Ignored Population’: Men With Osteoporosis

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The anabolic osteoporosis treatment abaloparatide (Tymlos, Radius Health) works in men as well as women, new data indicate.  

Findings from the Abaloparatide for the Treatment of Men With Osteoporosis (ATOM) randomized, double-blind, placebo-controlled, phase 3 study were presented last week at the American Association of Clinical Endocrinology (AACE) Annual Meeting 2022.

Abaloparatide, a subcutaneously administered parathyroid-hormone–related protein (PTHrP) analog, resulted in significant increases in bone mineral density by 12 months at the lumbar spine, total hip, and femoral neck compared with placebo in men with osteoporosis, with no significant adverse effects.

“Osteoporosis is underdiagnosed in men. Abaloparatide is another option for an ignored population,” presenter Neil Binkley, MD, of the University of Wisconsin School of Medicine and Public Health Madison, told Medscape Medical News.

Abaloparatide was approved by the US Food and Drug Administration (FDA) in 2017 for the treatment of postmenopausal women at high risk for fracture due to a history of osteoporotic fracture or multiple fracture risk factors, or who haven’t responded to or are intolerant of other osteoporosis therapies.

While postmenopausal women have mainly been the focus in osteoporosis, men account for approximately 30% of the societal burden of osteoporosis and have greater fracture-related morbidity and mortality than women.

About one in four men over the age of 50 years will have a fragility fracture in their lifetime. Yet, they’re far less likely to be diagnosed or to be included in osteoporosis treatment trials, Binkley noted.

Asked to comment, session moderator Thanh D. Hoang, DO, told Medscape Medical News, “I think it’s a great option to treat osteoporosis, and now we have evidence for treating osteoporosis in men. Mostly the data have come from postmenopausal women.”

Screen Men With Hypogonadism or Those Taking Steroids

“This new medication is an addition to the very limited number of treatments that we have when patients don’t respond to [initial] medications. To have another anabolic bone-forming medication is very very good,” said Hoang, who is professor and program director of the Endocrinology Fellowship Program at Walter Reed National Military Medical Center, Bethesda, Maryland.

Radius Health filed a Supplemental New Drug Application with the FDA for abaloparatide (Tymlos) subcutaneous injection in men with osteoporosis at high risk for fracture in February. There is a 10-month review period.

Binkley advises bone screening for men who have conditions such as hypogonadism or who are taking glucocorticoids or chemotherapeutics.

But, he added, “I think that if we did nothing else good in the osteoporosis field, if we treated people after they fractured that would be a huge step forward. Even with a normal T score, when those people fracture, they [often] don’t have normal bone mineral density…That’s a group of people we’re ignoring still. They’re not getting diagnosed and they’re not getting treated.”

ATOM Study: Significant BMD Increases at Key Sites

The approval of abaloparatide in women was based on the phase 3, 18-week ACTIVE trial of more than 2000 high-risk women, in whom abaloparatide was associated with an 86% reduction in vertebral fracture incidence compared with placebo, and also significantly greater reductions in nonvertebral fractures compared with both placebo and teriparatide (Forteo, Eli Lilly).

The ATOM study involved a total of 228 men aged 40-85 years with primary or hypogonadism-associated osteoporosis randomized 2:1 to receive subcutaneous 80 μg abaloparatide or injected placebo daily for 12 months. All had T-scores (based on male reference range) of ≤ −2.5 at the lumbar spine or hip, or ≤ −1.5 and with radiologic vertebral fracture or a history of low trauma nonvertebral fracture in the past 5 years, or T-score ≤ −2.0 if older than 65 years.

Increases in bone mineral density from baseline were significantly greater with abaloparatide compared with placebo at the lumbar spine, total hip, and femoral neck at 3, 6, and 12 months. Mean percentage changes at 12 months were 8.5%, 2.1%, and 3.0%, for the three locations, respectively, compared with 1.2%, 0.01%, and 0.2% for placebo (all P ≤ .0001).

Three fractures occurred in those receiving placebo and one with abaloparatide.

For markers of bone turnover, median serum procollagen type I N-terminal propeptide (s-PINP) was 111.2 ng/mL after 1 month of abaloparatide treatment and 85.7 ng/mL at month 12. Median serum carboxy-terminal cross-linking telopeptide of type I collagen (s-CTX) was 0.48 ng/mL at month 6 and 0.45 ng/mL at month 12 in the abaloparatide group. Geometric mean relative to baseline s-PINP and s-CTX increased significantly at months 3, 6, and 12 (all P < .001 for relative treatment effect of abaloparatide vs placebo).

The most commonly reported treatment-emergent adverse events were injection site erythema (12.8% vs 5.1%), nasopharyngitis (8.7% vs 7.6%), dizziness (8.7% vs 1.3%), and arthralgia (6.7% vs 1.3%), with abaloparatide vs placebo. Serious treatment-emergent adverse event rates were similar in both groups (5.4% vs 5.1%). There was one death in the abaloparatide group, which was deemed unrelated to the drug.

A prospective study of lifestyle factors and bone health in breast cancer patients who received aromatase inhibitors in an integrated healthcare setting

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Fracture and osteoporosis are known side effects of aromatase inhibitors (AIs) for postmenopausal hormone receptor positive (HR+) breast cancer (BC) patients. How modifiable lifestyle factors impact fracture risk in these patients is relatively unknown.

Methods

We conducted a prospective cohort study to examine the association of lifestyle factors, focusing on physical activity, with risk of incident major osteoporotic fracture and osteoporosis in 2152 HR+ BC patients diagnosed from 2006 to 2013 at Kaiser Permanente Northern California and who received AIs. Patients self-reported lifestyle factors at study entry and at 6-month follow-up. Fracture and osteoporosis outcomes were prospectively ascertained by physician-adjudication and bone mineral density (BMD) values, respectively. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated from multivariable proportional hazards regression. Models were adjusted for age, menopausal status, race/ethnicity, body mass index (BMI), AJCC stage, breast cancer treatment, prior osteoporosis, and prior major fracture.

Results

Over a median 6.1 years of follow-up after AI initiation, 165 women experienced an incident osteoporotic fracture and 243 women had osteoporosis. No associations were found between overall moderate-vigorous physical activity and fracture risk, although < 150 min/week of aerobic exercise in the 6 months after BC diagnosis was associated with increased fracture risk (HR=2.42; 95% CI: 1.34, 4.37) compared with ≥ 150 min/week (meeting physical activity guidelines). Risk was also higher for never or infrequently engaging in aerobic exercise (HR=1.90; 95% CI: 1.05, 3.44). None or infrequent overall moderate-vigorous physical activity in the 6 months before BC diagnosis was associated with increased risk of osteoporosis (HR=1.94; 95% CI: 1.11; 3.37).

Conclusions

Moderate-vigorous physical activity during the immediate period after BC diagnosis, particularly aerobic exercise, was associated with lower risk of major osteoporotic fractures in women on AI therapy.

Bone Health and Osteoporosis: An Orthomolecular Perspective

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Originally published on www.orthomolecular.org by Richard Z. Cheng, MD, PhD and Thomas E. Levy, MD, JD 

Osteoporosis, like most other disease, is caused by many factors including deficiencies of essential nutrients such as vitamin D. But the central dogma has been promoting just prescription drugs and calcium supplements. This strategy sounds simple and straightforward, but unfortunately not only does it not work, it may even be harmful. There is a rich body of data in the literature showing that lifestyle, nutrition, toxins, and hormonal balance have an impact on bone health and osteoporosis. A brief summary of this research is presented here. For optimal results, the practical management of osteoporosis and other chronic diseases should incorporate this knowledge.

A recent issue of New England Journal of Medicine published an article claiming that vitamin D supplementation does not improve osteoporosis. [1] Forbes magazine immediately jumped the gun: Stop Taking Vitamin D Already! [2]

Vitamin D is more than just a vitamin; it is more like a hormone with pleiotropic effects on the body, including immune-boosting effects that fight against Covid-19. Giving advice to stop taking vitamin D based on just one negative study is not only unscientific, it’s against common sense. (We will not discuss the study design issues, as Dr. William Grant will presently offer his critique of NEJM article’s poor study design).

Because vitamin D is involved in many aspects of health, maintaining an adequate level is critically important. Yet many individuals are deficient, which has likely increased the rates of infection and death from Covid-19. There have been many clinical studies on vitamin D3 and Covid-19 in the last two years, including a special collection of Micronutrients for Viral Infections – Reference Bibliography by International Society for Orthomolecular Medicine, [3] and several such papers on Orthomolecular Medicine News Service including a recent review by Dr. Grant. [4] Have the author and editor of the Forbes article not been updated on the vitamin D research — or is there something else?

Prescription drugs and calcium supplements have no significant benefits for treating osteoporosis.

Earlier this year, a meta-analysis published on JAMA found that bisphosphonates, a major class of prescription osteoporosis drugs offer very few benefits to osteoporotic patients. [5] Another meta-analysis on JAMA showed calcium supplements do not offer significant help to osteoporosis. [6]

Calcium supplements increase the risk of cardiovascular diseases and cancer.

To make matters worse, calcium supplements not only do not improve your health, but may actually increase your risks of cardiovascular diseases and cancer, as reported on a recent study. [7]

Many studies in the literature have demonstrated the risks of calcium supplements, as summarized by Thomas Levy. [8,9]

Prescription drugs and calcium supplements are not helpful and may even be harmful. So, are osteoporosis patients doomed?

Not at all. There is a rich body of evidence in the medical literature showing that osteoporosis is a multifactorial disease — and that a healthy lifestyle, reversing a toxin overload (by detoxification), optimal nutrition, and hormonal balance are effective in improving not only osteoporosis but overall health. [8]

Highlights of some of the relevant research:

  • Vitamin C and Osteoporosis:
    • Increased oxidative stress (= inflammatory response) in the bone is accompanied by an increase in C-reactive protein (CRP). The level of CRP can accurately predict fracture risk in older women with osteoporosis. [10]
    • Increases in other inflammatory markers are also closely associated with increased fracture risk. [11]
    • High-dose vitamin C can significantly reduce CRP and many other markers of inflammation. [12]
    • Vitamin C stimulates the development of osteoblasts. [13,14]
    • Vitamin C is necessary for the synthesis of progenin (class III), which is required for the growth of osteoblasts. [15]
    • Dietary vitamin C, which is negligible compared to the level provided by vitamin C supplementation, does not reduce fracture risk. [16]
    • Elderly osteoporosis patients with a history of fractures had significantly lower levels of vitamin C than those without a history of fractures. [17]
    • Supplementation with vitamin C, but not calcium, significantly increased bone mineral density in all bones. [18]
    • In ovariectomized mice, vitamin C prevents bone loss. [19]
    • Vitamin C significantly accelerates fracture healing. [20]
    • An adequate vitamin C level significantly improves the strength of healed fractures. [21]
  • Magnesium deficiency and osteoporosis:
    • Magnesium is a natural calcium antagonist. [22,23]
    • Magnesium dissolves calcium deposits in soft tissues. [24]
    • Magnesium deficiency leads to a detrimental increase in intracellular calcium. [25]
    • Magnesium increases bone density and reduces fractures. [26]
    • An adequate intake of magnesium reduces all-cause mortality. [27,28]
    • Usual supplemental doses have no toxic side effects.
  • Vitamin K deficiency and osteoporosis:
    • Vitamin K inhibits ectopic calcification by activating proteases such as osteocalcin and matrix Gla proteins. [29]
    • Vitamin K helps dissolve deposited calcium in organs and arteries. [30]
    • Neutralizes warfarin (warfarin can cause ectopic calcification). [31]
    • Reduced fracture risk. [32]
    • Improves bone quality. [33]
    • Adequate intake of vitamin K reduces cardiac and all-cause mortality. [34]
    • At any dose tried, there was no apparent toxicity. [35]
  • Vitamin D deficiency and osteoporosis:
    • An adequate level of vitamin D ensures that the body gets enough calcium from the diet.
    • The role of vitamin D goes far beyond the metabolism of bone and calcium.
    • Vitamin D regulates about 2000 genes. [36]
    • A deficiency of vitamin D leads to osteoporosis. [37]
    • Too much vitamin D exacerbates osteoporosis. [38]
    • During bone growth and development, vitamin D plays an important role in bone density. [39]
    • Therapeutic doses of vitamin D reduced all-cause mortality. [40,41]
  • Estrogens and Osteoporosis:
    • Estrogen reduces coronary calcium deposition. [42]
    • The higher the E2, the lower the CAC score. [43]
    • Estrogen inhibits a calcification-promoting protease. [44]
    • Estrogen deficiency leads to an increase in cytokines that promote inflammation. [45]
    • Reduction of fracture risk in patients with osteoporosis. [46]
    • Estrogen deficiency increases all-cause mortality. [47]
    • Estrogen deficiency promotes metabolic syndrome. [48]
  • Androgens and Osteoporosis:
    • Testosterone deficiency is a well-established fracture risk factor. [49]
    • Testosterone has a calcium channel blocking function. [50]
    • Prostate cancer patients often have low testosterone levels. [51]
    • Testosterone levels are often inversely proportional to coronary calcium index. [51]
    • Testosterone deficiency increases all-cause mortality. [52,53]
  • Thyroid hormones and Osteoporosis:
    • Thyroid hormones have a significant effect on the metabolism of cells throughout the body. [54]
    • The roles of early skeletal development and high bone mass (Peak Bone Mass) are essential. [55]
    • Both high and low thyroid function increase fracture risk. [56]
    • TSH has a direct (non-thyroid-related) bone-protecting function. [57,58]
    • Both too high and too low thyroxine independently increased all-cause mortality. This includes subclinical hypothyroidism and subclinical hyperthyroidism. [59,60]
    • Thyroid hormones status should be a part of routine medical examination, and should be checked regularly (at least annually), especially in the elderly population. Effective therapy is available.
  • Essential Fatty Acids (EFA) and Osteoporosis:
    • Some EFAs have calcium channel blocking capabilities. [61,62]
    • Numerous EFAs have been shown to protect bone mineral density. [63,64]
    • Blood EFA levels are inversely related to all-cause mortality. [65]
    • Not toxic, but may cause gastrointestinal discomfort in large quantities.
  • Calcium supplements are not only unhelpful, they are harmful: chronic hypercalcemia is common in adults, and calcium supplements promote coronary calcium.
    • A recent study showed that calcium supplementation has no effect on osteoporosis. [6]
    • One-third of Americans over the age of 45 have CT-detected arterial calcification. [66]
    • Coronary heart disease is associated with osteoporosis. [67]
    • Aortic calcification is associated with osteoporosis. [68]
    • Calcium supplements promote coronary calcium deposition.
    • A recent 10-year large study of 5448 subjects in the United States found that calcium supplementation was 22% more likely to be positive for CAC (coronary calcium index) than those who did not. CAC has been generally recognized as a reliable predictor of atherosclerotic plaque burden, coronary heart disease, and all-cause mortality. [69-71]
    • A recent meta-analysis again showed that calcium supplements increase the risk of cardiovascular disease. [7]
  • Significant calcifications outside the bones: indicating calcium excess
    • Ectopic calcifications are very common in cancer.
    • Using the latest MRI, 22 of 23 prostate patients were found to have prostate calcification. [72]
    • Excessive intracellular calcium is associated with cancer:
    • The relationship between intracellular calcium and cancer is well established. Higher intracellular calcium level increases cancer cell growth and metastasis. [73-75]
    • Conversely, a drop in intracellular calcium reduces cancer cell metastasis. [76]
    • Women with the highest scores on a bone density test had an increased risk of breast cancer. [77]
    • Calcifications are usually seen on mammography in patients with breast cancer. [78]
  • Calcium and calcium channel blockers (CCBs), also known as calcium ion antagonists, have the effect of reducing intracellular calcium ion level.
    • Evidence that increased intracellular calcium leads to increased intracellular oxidative stress (toxicity):
    • CCBs can prevent methylmercury-induced nerve damage in rats; [79]
    • The use of CCBs is inversely related to the occurrence of prostate cancer; [80]
    • CCBs reduce intracytoplasmic iron accumulation and further increase the increase in intracellular oxidative stress. The accumulation and increase of intracellular iron are also important factors in the carcinogenesis of cells. [81]

To put these altogether, we recommend an integrated management of osteoporosis that includes at least the following:

  1. Healthy lifestyle
    1. Sufficient exercise, outdoor activities, relaxation, and sleep.
    2. Nutrition rich anti-inflammatory healthy diets to include low carbohydrates, sufficient proteins and healthy fats; minimize processed foods and synthetic food additives, agricultural chemicals, antibiotics and hormones, and other environmental pollutants.
  2. Nutrition: In addition to adequate doses of vitamin C,D,E,K2, and magnesium supplements, macro- and micro-nutrients play a significant roles in the prevention and reversal of bone health and osteoporosis, as reviewed in [82]. Broad spectrum optimal vitamins and micronutrients, esp. vitamin C, D, K2, and magnesium, as these nutrients require each other for optimal effects, as described in [83].
  3. Toxins and detox. Environmental toxins are a major category of detrimental root causes to our health.
  4. Hormonal balance. Monitoring the status of the thyroid, adrenal and sex hormones and balance if indicated, is another under-recognized area in medicine today.

Concerned With Brittle Bones? Discover 4 Natural Ways to Support Bone Health

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Osteoporosis, characterized by porous, brittle bones, and low bone mass currently affects 54 million Americans – with potentially debilitating consequences.  Because this age-related condition often shows no symptoms, many people do not realize they have it until a sudden bone fracture occurs.

According to the Bone Health and Osteoporosis Foundation, a shocking one out of every two women aged 50 and older (and one in four men in that age group) will suffer an osteoporosis-related fracture at some point in their lives.  In fact, people with osteoporosis can experience broken bones from such seemingly innocuous activities as walking, standing, or sneezing.  To reduce your odds of a devastating fracture, experts advise consuming a diet rich in calcium and vitamin D.  In addition, four nutrients, in particular, are believed to help strengthen bones.  To discover these important nutrients – and what each “brings to the table” – read on.

Curcumin From Turmeric for Bone Health and Protect Against Fracture

For over 4,000 years, turmeric has been prized by natural healers for its ability to reduce inflammation and fight infections.  Botanically known as Curcuma longa, turmeric owes much of its antimicrobial, anti-inflammatory, and antioxidant properties to its active constituent, curcumin.  In addition to its other health benefits, curcumin is believed to help improve low bone density.

While clinical studies are lacking, promising early research conducted by investigators at the University of Arizona found that a turmeric extract helped to prevent the development of osteoclasts – specialized cells that facilitate the breakdown of bone – while protecting trabecular bone, the type of spine, and hip bone most susceptible to fracture in postmenopausal women.

Turmeric is available in powdered, tincture, liquid, and capsule forms.  Look for a turmeric formulation standardized to contain at least 94 percent curcuminoids, which was found to be more effective than lower concentrations.  Before supplementing with turmeric, however, consult your integrative doctor.

Thyme Helps to Manage Calcium Levels, Supporting Bone Health

While many know this piquant herb only as a seasoning, thyme has been used by natural healers for centuries to treat a variety of ills.  Botanically known as Thymus vulgaris, thyme contains micronutrients that promote bone health – including calcium, vitamin K, magnesium, zinc, and manganese.

In addition, thyme’s active constituent, thymol, is believed to inhibit the formation of osteoclasts.  One compelling study published in the International Journal of PharmTech Research suggested that 1,000 mg of thyme a day for six months improved bone mineral density in postmenopausal women more effectively than a calcium/vitamin D supplement.  The researchers noted that thyme helped to regulate calcium homeostasis, allowing it to have a protective effect on bone.

By the way, studies have shown that thyme is even more effective in supporting bone mineral density when it is used with its close “cousins” sage and rosemary.  In other words, the classic folk ballad “Scarborough Fair,” with its reference to “parsley, sage, rosemary, and thyme,” contains a recipe for better bone health … who knew?!

Thyme can be used fresh or dried – and is also available in liquid extract and capsule form.  While amounts found in food are generally recognized as safe, check with your integrative doctor before supplementing.

Don’t Despise the Dandelion! Greens Provide a Jackpot of Bone-Strengthening Nutrition

While homeowners and landscapers dread it for its ability to invade lawns, the humble dandelion – botanically known as Taraxacum officinale – is an overlooked and underrated source of both nutrition and health benefits.  Nutritionists at the famed Cleveland Clinic praise dandelion leaves as “probably the most nutritionally dense green you can eat, superior to even spinach and kale.” (And that’s saying a lot!)

While dandelion greens are rich in bone-building vitamin K, calcium, and potassium, their real “superpower” is their high content of silicon, which has been found to improve bone matrix quality and facilitate bone mineralization.

You can use tangy-tasting dandelion greens in mixed salads and sandwiches.  For a milder taste, soak them in cold, salted water for ten minutes, then boil until tender (about five minutes) and season with olive oil, garlic, and Parmesan cheese.  Dandelion supplements are also available, but get the “go-ahead” from your doctor before taking them.

Over Half of All Americans Fail to Get Enough Magnesium, Which Supports Bone Health

Multiple studies suggest that this essential mineral contributes to increased bone density and helps prevent the development of osteoporosis.  But unfortunately, most Americans don’t get enough of it in their diets.  According to the Office of Dietary Supplements, only 48 percent of Americans ingest enough magnesium from food to meet the estimated average requirement.

You can increase your dietary intake of magnesium with green leafy vegetables, nuts, seeds, and whole grains.  Pumpkin seeds are the “high-ringers” in the seed world, with one ounce of roasted seeds contributing 156 mg.  And chia seeds, beans, potatoes, and fresh (raw) yogurt are also good sources.  The recommended daily dietary amount for magnesium for adults is 420 mg for men and 320 mg for women.  Magnesium supplements are also available – but check first with your integrative doctor.

Other common-sense techniques for supporting bone health include: stopping smoking, getting a bone mineral density scan to assess osteoporosis risk, and performing weight-bearing exercises such as walking, stair climbing, calisthenics, or weight training.  Ask your integrative physician or health coach for help in designing an exercise routine that is right for you.

Remember: Osteoporosis strikes one out of every five women (and one out of every 20 men) over age 50.  Appropriate amounts of “bone-friendly” nutrients and herbs may help you improve your odds and “stand strong” as you age.

Simple Steps to Boost Bone Health

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Strong Bones For Life

Strong Bones For Life

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Weak and brittle bones don’t have to be part of aging. Your bones are a living tissue that rebuilds itself. Your bone mass reaches its peak between your mid 20s and mid 30s. You can “borrow” from that banked strength as you get older.  Here’s how to get, and keep, your bones dense at any age.

Calcium: Why You Need It

Calcium: Why You Need It

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If you’re like most Americans, you probably don’t get enough of this mineral to keep your bones healthy. Calcium makes your bones hard and dense. If your calcium levels are too low, your body takes it from your bones. Too much loss may lead to osteoporosis, or brittle bone disease. That raises your chances for falls and broken bones. 

Calcium: How to Get It

Calcium: How to Get It

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Starting around age 50, you need about 1,200 milligrams of calcium a day to stop bone loss. But you should get even more, 1,300 milligrams daily, between ages 9 to 18 to stock up for adulthood. Good food sources include:
•    1 cup plain low-fat yogurt (300 milligrams)
•    1/2 cup firm tofu with calcium (200 milligrams)
•    1 cup baked beans (140 milligrams)
•    3 ounces canned salmon with edible bones (180 milligrams)

Vitamin D: Why You Need It

Vitamin D: Why You Need It

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It works in tandem with calcium. Without vitamin D, you can’t absorb the calcium from foods. That forces your body to raid your skeleton for the nutrient. That weakens your bones. It also prevents your body from building strong new bone. A blood test can tell you your levels. Normal for adults is higher 20 ng/mL. Less than 12 ng/mL means you’re vitamin D deficient.  

Vitamin D: How to Get It

Vitamin D: How to Get It

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Your skin makes vitamin D from sunlight. Just a few minutes of sun each day should do it. The second way is from foods. Good sources include:
•    Fatty fish like salmon, tuna, or mackerel 
•    Fortified milk from cows, almonds, soy, and oats
•    Eggs
•    Pork
•    Fortified cereal

Supplements might help. But talk to your doctor first. Too much could be harmful.  
 

Get Physical Every Day

Get Physical Every Day

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When you exercise regularly, your body responds by adding more bone. Adults who work out can help prevent bone loss that usually starts in your 30s.  Bonus: Exercise builds muscles, which help improve your balance and coordination. So you may be less likely to fall in the first place. 

Best Exercises to Build Bones

Best Exercises to Build Bones

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Weight-bearing activities. You work against gravity by:
•    Running
•    Walking
•    Dancing
•    Climbing stairs
These exercises are site specific. So jogging may strengthen the bones in your legs and feet, but not your arms.

Resistance exercise. This is also called strength training. It taxes your bones so they can grow  heavier and denser. Try:

•    Pushups
•    Free weights
•    Rowing
•    Resistance bands

Aim for at least 30 minutes of any type of exercise each day. 
 

Quit Smoking

Quit Smoking

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Nearly 1 in 7 American adults smoke. It’s a known risk factor for osteoporosis. Nicotine and other chemicals in tobacco slow the production of bone-forming cells. They also hinder blood flow to your bones. The result is frail bones that are more apt to break. That can be a concern especially in your spine, which already doesn’t get much blood.  

Cut Out Added Sugar

Cut Out Added Sugar

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Your body does not need any added sugar from soft drinks, cookies, and other processed foods. Too much added sugar may hurt your bone health because it:
●    Causes your body to flush out bone-strengthening calcium and magnesium in your pee
●    Prevents your intestines from taking in enough calcium 
●    Displaces important nutrients from your diet
 

Limit Alcohol

Limit Alcohol

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Heavy drinking can lead to more falls. It also makes your bones easier to break by interfering with with bone-growth cells called osteoblasts. Heavy drinking means 15 drinks or more per week for men and eight drinks or more for women. A drink is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of vodka, whiskey, and other hard liquor. It’s unclear if moderate drinking (one or fewer drinks daily for women and two or fewer for men) helps or hurts your bone health.

Bad to the Bones: What to Avoid for Bone Health

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1. Too Much Salt

1. Too Much Salt

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The more salt you eat, the more calcium your body gets rid of, which means it’s not there to help your bones. Foods like breads, cheeses, chips, and cold cuts have some of the highest counts.

You don’t have to cut salt out entirely, but aim for less than 2,300 milligrams of sodium a day.

2. Binge Watching

2. Binge Watching

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It’s fine to enjoy your favorite show. But it’s way too easy to spend endless hours in front a screen, nestled on your couch. When it becomes a habit to lounge, you don’t move enough and your bones miss out.

Exercise makes them stronger. It’s best for your skeleton when your feet and legs carry the weight of your body, which forces your bones and muscles to work against gravity. 

3. Miles of Bike Rides

3. Miles of Bike Rides

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When you pedal to work or ride for hours on the weekend, your heart and lungs get stronger. Your bones? Not so much. Because it’s not a weight-bearing activity, bike riding does not increase your bone density, unlike walks, runs, and hikes.

If you’re an avid cyclist, you’ll want to add some time in the weight room to your routine and mix it up with activities like tennis, hiking, dancing, and swimming (the water’s resistance helps your bones). 

4. Too Much Time in Your “Cave”

4. Too Much Time in Your “Cave”

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Maybe you need to get out more. The body makes vitamin D in sunlight. Just 10-15 minutes several times a week could do it. But don’t overdo it. Too much time in the sun can raise your risk of skin cancer. And there are some other catches, too.

Your age, skin color, the time of year, and where you live can make it harder to make vitamin D. So can sunscreen.

Add fortified cereals, juices, and milks (including almond, soy, rice, or other plant-based milks, as well as low-fat dairy) to your diet. And ask your doctor if you need a vitamin D supplement.

5. Another Pitcher of Margaritas

5. Another Pitcher of Margaritas

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When you’re out with friends, one more round might sound like fun. But to keep bone loss in check, you should limit the amount of alcohol you drink. No more than one drink a day for women and two for men is recommended. Alcohol can interfere with how your body absorbs calcium.

6. Overdoing Some Drinks

6. Overdoing Some Drinks

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Too many cola-flavored sodas could harm your bones. While more research is needed, some studies have linked bone loss with both the caffeine and the phosphorous in these beverages. Other experts have suggested that the damage comes when you choose to have a soda instead of milk or other drinks that contain calcium.  Too many cups of coffee or tea can also rob your bones of calcium. 

7. Bowls of Wheat Bran With Milk

7. Bowls of Wheat Bran With Milk

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What sounds healthier than 100% wheat bran? But when you eat it with milk, your body absorbs less calcium.

Don’t worry about other foods, like bread, that might contain wheat bran. But if you’re a fan of the concentrated stuff and you take a calcium supplement, allow at least 2 hours between the bran and your pill.

8. Smoke Breaks

8. Smoke Breaks

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When you regularly inhale cigarette smoke, your body can’t form new healthy bone tissue as easily. The longer you smoke, the worse it gets.

Smokers have a greater chance of breaks and take longer to heal. But if you quit, you can lower these risks and improve your bone health, though it might take several years.

9. Your Prescriptions

9. Your Prescriptions

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Some medications, especially if you have to take them for a long time, can have a negative impact on your bones. Some anti-seizure drugs and glucocorticoids, like prednisone and cortisone, can cause bone loss. You might take anti-inflammatory drugs like glucocorticoids if you have conditions such as rheumatoid arthritis, lupus, asthma, and Crohn’s disease.

10. Being Underweight

10. Being Underweight

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A low body weight, a BMI of 18.5 or less, means a greater chance of fracture and bone loss. If you’re small-boned, do weight-bearing exercises and ask your doctor if you need more calcium in your diet. If you’re not sure why you’re underweight, ask your doctor about that, too. They can check to see if an eating disorder or another medical condition is the reason.

11. If You Take a Tumble

11. If You Take a Tumble

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When you tripped as a child, you probably got right back up again. As you get older, though, falls get more dangerous, especially if you have weak bones.

A fracture or broken bone can take a long time to heal. In older adults, it can often be the start of a decline that’s hard to come back from. Walk easier at home with safety features like grab bars and non-slip mats. Clear the clutter from your path, indoors and out, to avoid a misstep. 

How to Safeguard Your Bone Health Naturally

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Story at-a-glance

  • Worldwide, 1 in 3 women and 1 in 5 men over the age of 50 will experience an osteoporosis-related bone fracture; 20 percent of those who break a hip die in the first 12 months following the fracture
  • Weight-bearing exercises are particularly important for the prevention of osteoporosis, which is characterized by porous and fragile bones. Eating a diet of real food, and getting sufficient amounts of specific nutrients is also important
  • For the obese, frail elderly and/or those struggling with poor mobility and low fitness, the nitric oxide dump, blood flow restriction training and whole body vibrational training can be particularly helpful

By Dr. Mercola

Osteoporosis is a common problem, affecting an estimated 1 in 10 women worldwide at the age of 60.1 By the time a woman reaches the age of 80, she has a 2-in-5 chance of developing osteoporosis. In most people, sometime during your 30s your bone mass will start to gradually decline. For women, that bone loss can significantly speed up during the first decade of menopause.

Statistics suggest that, worldwide, 1 in 3 women and 1 in 5 men over the age of 50 will experience an osteoporosis-related bone fracture. In 2000, there were 9 million osteoporotic fractures, including 1.6 million hip fractures — a quarter of which occurred in men — which can lead to a significant decline in health and quality of life. Hip fractures can also be life-threatening. Twenty percent of those who break a hip die in the first 12 months following the fracture.

Statistics also reveal that osteoporosis is becoming more prevalent. In the decade between 1990 and 2000, the number of hip fractures increased by 25 percent worldwide.2 So, what can be done about this problem? It’s important to realize that osteoporosis is preventable by “proper living,” meaning eating right, getting nutritional movement and effective exercise.

Weight-bearing exercises are particularly important for the prevention of osteoporosis, which is characterized by porous and fragile bones. Unfortunately, drugs are typically the first-line remedy recommended by conventional doctors. This is tragic, considering these drugs do more harm than good.

The Case Against Osteoporosis Drugs

For example, oral bisphosphonate osteoporosis drugs such as Actonel, Boniva and Fosamax, are associated with a two-fold increased risk of esophageal cancer.3 Research also shows that, over time, these kinds of drugs will actually worsen your condition, because all you’re doing is fooling your body into producing denser but weaker bone.

This may sound like an oxymoron, but here’s how it works: Healthy bones maintain strength from a continual process of bone breakdown and bone rebuilding. Osteoclasts are cells that break down bone; osteoblasts are the cells that rebuild it. Healthy bone undergoes a dynamic process of cyclical removal of unhealthy bone and replacement with new bone. This is how they remain strong.

In osteoporosis, the net rate of bone resorption (breakdown) exceeds the rate of bone formation, which results in a decrease in bone mass. Bisphosphonates and similar drugs do not actually help your body build new bone. These drugs work by killing off your osteoclasts, which halts the normal bone repair process since you now lack the cells that break bone down.

The end result is increased bone density, but denser bone is not stronger! Eventually your bones become weaker and more prone to fracture. In women who have been taking a bisphosphonate-type drug for five or more years, their bones have literally lost the ability to regenerate and this is why many are still faced with more brittle bones and fractures.

Your Lifestyle Largely Determines Your Osteoporosis Risk

While diet certainly plays an important role, weight-bearing exercise is one of the most effective remedies against osteoporosis.4 For example, the walking lunge is a great exercise for building bone density in your hips, even without any additional weights. It is an absolutely extraordinary exercise and doesn’t cost anything to do. You can use YouTube to find demonstrations of how to do it properly.

Balance-building exercises like yoga and Tai Chi are also recommended. As long as you have strong muscles, bones and steady balance, your risk of falling is minimized. Should you fall, your chances of actually breaking a bone are also dramatically reduced.

Needless to say, the earlier you start exercising, the better — provided you keep it up. Exercise is really a lifelong lifestyle component, not a temporary fix for any particular problem. That said, even if you’re older, you can still improve your bone health. It’s never too late to start exercising. It just gets a bit more challenging, since you’re starting at a lower level of fitness with each passing year of inactivity. Below I’ll offer some effective exercise alternatives that can be particularly helpful if your fitness level is low. As noted by Fight Aging:5

“The research materials … argue that the majority of people are not aware of the degree to which they are harming themselves, and that efforts should be taken to correct this … In our technological society of cheap calories, easy transportation, and replacements for physical labor, most people eat too much and exercise too little.

That becomes ever more pronounced over the years … This has a cost when it comes to health … Avoidable damage done to health over the long term is often referred to as secondary aging. It includes … accelerated loss of muscle resulting from lack of exercise. Near everyone in later life fails to exercise sufficiently, as demonstrated by study after study showing improvement in the muscle and health of even very old people following modest resistance exercise programs.”

Exercise Naturally Builds Stronger Bones

Aside from walking lunges, high-impact exercises such as sprinting and jumping are also effective, as is weight training.6,7 In one 2014 study,8 women between the ages of 25 and 50 who performed a minimum of 10 “flea leaps” in a row, twice a day for four months, significantly increased the bone density in their hipbones.

An earlier study9 found hopping and weightlifting increased bone density in the spine by 2 percent. Weight training targeting both the upper body and legs was particularly effective. Keep in mind that you’re not restricted to any particular type of exercise though. For example, you don’t have to use weight gym equipment if you don’t want to. Other examples of high-impact weight-bearing exercises recommended by the U.S. National Osteoporosis Foundation include:10

  1. Dancing
  2. High-impact aerobics
  3. Hiking
  4. Jumping rope
  5. Climbing stairs
  6. Playing tennis

Lower impact weight-bearing exercises, which are a safer alternative if you’re frail include:

  1. Low-impact aerobics
  2. Stair-step machines
  3. Fast walking

Similarly, in lieu of weights, you can use just your body weight, elastic exercise bands or functional movements such as raising and lowering your body onto your tippy toes. Three other exercise alternatives worth mentioning that can be particularly helpful if you’re severely obese, old and frail, recovering from an injury or otherwise struggle with mobility, balance and low fitness are Whole Body Vibrational Training (WBVT), blood restriction training and the nitric oxide (NO) dump.

Whole Body Vibrational Training — An Excellent Choice for the Elderly

WBVT using a Power Plate is a safe, natural way to improve bone strength and density, thereby warding off osteoporosis. Best of all, it’s gentle enough even for the disabled and elderly, who may not be able to engage in exercises like leaping, hopping, sprinting or weightlifting.

In one six-month-long study,11 WBVT was found to produce a significant increase in hip area bone density in postmenopausal women, while conventional training was only able to slow the rate of deterioration. Another more recent study12 found that postmenopausal women who used a vibration platform for five minutes, three times a week for six months, increased their lumbar spine bone density by 2 percent. The control group lost about 0.5 percent of theirs in that same timeframe.

Blood Restriction Training Also Minimizes Injury Risk

Another technique you can try — which is also excellent for the elderly, or athletes recovering from an injury — is blood flow restriction or Kaatsu training. I’ll publish a full-length article on this in the near future but, in brief, it involves performing strength training exercises while restricting venous blood flow (but not arterial flow) to the extremity being worked.

A significant benefit of the method is that you can do strength exercises using just 30 to 50 percent of the weight you’d normally use while still reaping maximum benefits. It’s said blood flow restriction training can stimulate muscle growth and strength in about half the time, using about one-third of the weight, compared to standard weight training.

In the video above, Dr. Jim Stray-Gundersen, a leading proponent and teacher of Kaatsu in the U.S., discusses the method and its benefits. The American College of Sports Medicine claims you need to lift a weight that is at least 70 percent of your single rep max (1RM) to produce muscle growth,13 but studies assessing low-intensity exercise in combination with blood flow restriction have shown you can go as low as 20 percent of 1RM and still reap the benefits.

For most, 20 percent of 1RM is lighter than a warmup, virtually guaranteeing you will not sustain any kind of injury. Indeed, blood flow restriction training is used to rehabilitate the old and infirm in Japan, allowing them to rebuild muscle and regain some of their lost mobility.

Nitric Oxide Dump — A Great Exercise for Aging Muscles

Another exceptionally safe way to improve your muscle strength and general fitness is the nitric oxide dump — a revision and, I think, significant improvement of my Peak Fitness program. Instead of doing 20 minutes’ worth of high-intensity interval training (HIIT) on an exercise bike or elliptical machine, you can reap the same or better benefits doing four simple body movements that take just three minutes.

These exercises should ideally be done three times a day, and do not require weights of any kind. For a full demonstration, see the video above. Even though this exercise is only a few minutes, it will make you short of breath. Please be sure to breathe only through your nose, not your mouth. This is my new favorite high-intensity exercise and, unlike other high-intensity exercises, can be done every day unless you need to recover. Start with 10 repetitions of each movement and work your way up to 20 with the following:

  • 10 deep squats, raising your arms parallel to the floor as you squat deeply, getting your butt back as far and as low as possible while still making sure your knees stay behind your toes
  • 10 alternating perpendicular arm raises, stopping when your arms are the height of your shoulders
  • 10 stationary jumping jack motions. You’re not jumping; just moving your hands overhead, and touching hands on the upper and lower portions of the movement. Make sure your arms come up behind your head and not in front. This requires you to pinch your shoulder blades together
  • 10 overhead shoulder presses, making sure to keep your chest out and shoulder blades pinched together

How the Nitric Oxide Dump Can Benefit Your Health

Do each set in rapid succession, without resting in between. When you’re done, you’ll have completed a total of 120 to 240 movements. Done three times a day, with at least two hours in between each session, you’ll end up doing 360 to 920 movements a day. This exercise will:

  • Trigger the release of NO, a gas with antioxidant properties that protects your heart by relaxing your blood vessels and lowering your blood pressure, stimulates your brain, kills bacteria and even defends against tumor cells
  • Stimulate anabolic muscle building in addition to thinning your blood, making it less likely to clot and improving your immune function. NO is a potent bronchodilator and vasodilator, so it helps significantly increases your lungs’ oxygen-absorbing capacity
  • Give you more exercise benefits in a shorter time. You get more benefits from this exercise than you would get from most things you do in a gym in an hour. And, if you do it three times a day, that means you may be getting three to 10 times the metabolic benefit you’d get by going to the gym. Not that going to the gym is unwise; it’s just that your body needs exercise throughout the day
  • Stimulate mitochondrial function and health. Mitochondrial decline is closely linked to reduced cardiorespiratory fitness, and decreased resting mitochondrial ATP production may be involved in the development of insulin resistance with aging. By forcing your mitochondria to work harder, exercises such as this one will trigger your body to produce more mitochondria to keep up with the increased energy demand, and promote mitochondrial function and health

Older Adults Benefit From High-Intensity Exercise

While you must certainly start any exercise program at a level appropriate for your current condition, it would be a mistake to dismiss HIIT altogether. Recent animal research suggests HIIT can be safe and effective even in older populations, and may actually help reverse frailty. (As mentioned, the nitric oxide dump exercise is an excellent alternative to other HIIT programs.) As noted by study co-author Dr. Bruce Troen:14

“We know that being frail or being at risk for becoming frail puts people at increased risk of dying and comorbidity. These results show that it’s possible that high-intensity interval training can help enhance quality of life and capacity to be healthy … Increased mitochondrial biomass allows you to utilize oxygen more efficiency [sic]. With HIIT, we saw both mitochondrial increase and an improvement in muscle quality and fiber size in these mice …

Those four mice who had exhibited the kinds of deficits that correlate to frailty in humans improved to a completely robust level. The HIIT actually reversed frailty in them. Because the performance measures for the mice are directly relevant to clinical parameters, we think this program of exercise is quite applicable to humans. We’re laying a foundation so we can do this in people and so we can understand how to tailor it to individuals so they can successfully implement this.

Exercise stresses the system and the body can respond beneficially. We believe that the intensity of individualized HIIT provides a more significant but manageable stress so the body responds more robustly to these short, vigorous periods of exercise. In other words, you get more bang for your buck.”

Other Important Lifestyle Factors That Help Protect Your Bone Health

Getting older doesn’t automatically mean you’ll get weak and frail. Your lifestyle plays a decisive role here, and exercises such as those discussed above are effective means by which you can prevent osteoporosis. That said, you’ll also want to pay attention to your diet.

Processed foods produce biochemical and metabolic conditions in your body that decrease bone density over time, so avoiding processed foods is definitely an important part of the equation. Certain nutrient deficiencies can also contribute to weak and brittle bones. Among the most important are animal-based omega-3 fats, calcium, vitamins D and K2, along with magnesium. Following is a summary of some of the most important general guidelines for maintaining or increasing your bone strength:

• Avoid processed foods and soda, which can increase bone damage by depleting your bones of calcium. By ditching processed foods, you’re also automatically eliminating a major source of refined sugars and processed fructose, which drive insulin resistance. It will also provide you with a more appropriate potassium-to-sodium ratio, which is important for maintaining bone mass.

• Increase your consumption of raw, fresh vegetables, ideally organic. If you find it difficult to eat the recommended amount of vegetables you need daily, you can try vegetable juicing.

• Optimize your vitamin D levels, ideally from appropriate sun exposure. Vitamin D builds your bone density by helping your body absorb calcium. If you use an oral supplement, make sure you’re using vitamin D3 (not D2), and that you’re also increasing your vitamin K2 intake.

Consider making your own fermented vegetables using a special vitamin K2-producing starter culture, or supplementing with vitamin K2 if you’re not getting enough from food alone. Vitamin K2 serves as the biological “glue” that helps plug the calcium into your bone matrix. Also remember to balance your calcium and magnesium (1-to-1 ratio).

• Avoid sitting and incorporate as much nonexercise movement into each day as possible.

• Get regular exercise. Ideally, your fitness program should be comprehensive, providing the necessary weight-bearing activities for bone health while also improving your cardiovascular fitness and fat-burning capabilities with high-intensity exercises, along with gentle balance- and flexibility-boosting exercises such as yoga, Qigong and Tai Chi.