Bone

Eating yogurt regularly improves bone health, lowers osteoporosis risk, study finds

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If you are a yogurt fan, there is good news. Eating more yogurt may improve your bone health.

Researchers at Trinity College announced in a news release that they observed a direct link between yogurt consumption and better bone health in older people who participated in the study.

“Yogurt is a rich source of different bone-promoting nutrients,” says Dr. Eamon Laird, lead study author and research fellow at the university, in a release. “Thus our findings in some ways are not surprising.”

Bone health in seniors is a big concern because of the risk of developing osteopenia (poor bone density), a prelude to osteoporosis — in which bones become porous and so fragile that a minor event can result in a fracture.

For this study, participants filled out a questionnaire about yogurt consumption. Frequency levels included never, two to three times per week, and more than one serving per day.

Researchers looked at many risk factors to determine whether a participant might have poor bone density. They considered diet — how much fish, meat and other dairy products were consumed. They factored in dietary supplements, such as Vitamin D. They also looked at overall health: body mass index (BMI), level of physical activity, kidney function, smoking and alcohol consumption.

A group of 1,057 women and 763 men were checked for bone mineral density (BMD), while 2,624 women and 1,290 men were assessed for physical function.

Women who consumed the most yogurt had about 3.1% to 3.9% higher hip and femoral neck BMD levels than those who ate the least amount of yogurt. Some of the physical function measures were 6.7% higher in the yogurt lovers.

For men, researchers measured a 9.5% lower indicator of bone breakdown for those with the highest yogurt consumption versus those on the other end of the scale. Researchers say this means there is “reduced bone turnover” in those who eat the most yogurt.

With all the differences in risk factors taken into consideration, researchers determined that for women, each additional serving of yogurt reduced the risk of osteopenia by 31% and reduced the risk of osteoporosis by 39%. In men, the risk of osteoporosis dropped by 52%. Researchers noted that vitamin D supplements also play a part in reducing risks for both men and women.

“The data suggest that improving yogurt intakes could be a strategy for maintaining bone health,” says Laird. “But it needs verification through future research as it is observational.”

Osteoporosis Is Scurvy of the Bone, Not Calcium Deficiency

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It saddens me to see older women diagnosed with “osteopenia” or “osteoporosis” listening to their doctors and taking supplemental calcium and even problematic drugs called bisphosphonates. These are irrational, dogmatic, harmful approaches to the problem of degrading bone as we age

“A joyful heart is good medicine, but a broken spirit dries up the bones.”~Proverbs 17:22

It saddens me to see older women diagnosed with “osteopenia” or “osteoporosis” listening to their doctors and taking supplemental calcium and even problematic drugs called bisphosphonates. These are irrational, dogmatic, harmful approaches to the problem of degrading bone as we age. In my time practicing nephrology and internal medicine, I saw numerous patients suffering from vascular disease while taking the recommended doses of calcium. X-rays revealed perfect outlines of calcified blood vessels and calcified heart valves. 

Osteoporisis Is Scurvy of the Bone, Not Calcium Deficiency

Pictured here is a calcified breast artery, often seen in women who are being treated for hypertension. The primary drug used in high blood pressure, a thiazide diuretic, causes the body to retain calcium and lose magnesium and potassium. We incidentally note these types of calcifications in the large arteries of the entire body, not just the breasts. I believe these problems are avoidable.

The matrix of bone will incorporate calcium and nutrients where they belong as long as the proper hormones and nutrients are present. Needless to say gravitational force in the form of weight bearing exercise is essential and should be the foundation to a healthy skeleton. Don’t be afraid to exercise with some weight in a backpack if you have no disk disease or low back pain.

You still have to look at what you can do nutritionally, and in interpersonal relationships to help your body heal itself. Supplements are no replacement for good nutrition. After all, scientists are constantly discovering new things about food and its interaction with the body that we don’t know.

The first thing to do is either google or look in your reference books to find foods right in Vitamin C, Vitamin K2, magnesium and minor minerals such as boron and silica. Silica is also important for bones. Remember too, that depression has many causes. Sometimes the cause can be nutritional deficiencies and sometimes depression can result from entrapment in unhealthy family dynamics. Controversially, I would also say that depression can also have spiritual origins.

But if time feels of the essence, then supplementation is one route which could be taken. While the medical profession supplements with calcium and fosomax, in my opinion, a more constructive supplementation regimen could include Vitamin C, Vitamin K2, vitamin D3( in winter months, sun in summer) and boron, silica and magnesium. These are all far more important to preventing fracture and keeping bone healthy than calcium. 

Calcium will ultimately land in the muscles of the heart, the heart valves and the blood vessels, leading to cardiovascular disease. However if you are getting enough vit C, D3 and K2, your body will direct the calcium you ingest from your food, to where it belongs, not in your heart and blood vessels.

Vitamin C does several things to strengthen bones

  1. It mineralizes the bone and stimulates bone forming cells to grow.
  2. Prevents too much degradation of bone by inhibiting bone absorbing cells.
  3. Dampens oxidative stress, which is what aging is.
  4. Is vital in collagen synthesis.

When vitamin C is low, just the opposite happens. Bone cells that degrade bone called octeoclasts proliferate, and bone cells that lay down mineral and new bone called osteoblasts are not formed.

Studies have shown that elderly patients who fractured bones had significantly lower levels of vitamin C in their blood than those who haven’t fractured.[1] Bone mineral density- the thing that the tests measure, is higher in those who supplement with vitamin C, independent of estrogen level.[2],[3]

Vitamin K2 is well known among holistic practitioners to be important in cardiovascular and bone health. Supplementing this is also a good idea if bone or heart issues are a concern. Read more here.

And of course good old vitamin D3 with a level around 50-70 mg/ml will help keep the immune system functioning well and the bones strong.

This may seem like a lot of supplementing, yet to me is a worthwhile endeavor that will keep much more than the bones strong. These days getting enough vitamin C is not so easy with diet alone. With the toxic load we all have, even with the most pristine diets, we are requiring more vitamin C internally than our ancestors did. Adults would do well to take 2-5 grams per day of sodium ascorbate as a general supplement. If you have active kidney stones, or kidney disease please check with your doctor first.

Humans, monkeys and guinea pigs don’t make any vitamin C. This leaves us on our own to get our needs met. Cats weighing only about 10-15 pounds, synthesize more than 15 times the RDA of vit C recommended for humans. Goats are about the size of a human adults, and under no stress they synthesize 13G per day. Under stress it can rise to 100G. Do not fear taking vitamin C. It is the one of the most non-toxic and safe supplements known. Use liposomal vitamin C, sodium ascorbate or ascorbic acid, never Ester-C or calcium ascorbate.If you prefer a natural plant-based source, camu-camu is very high in C. However its harvest does threaten the rainforest.

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. 

Scientist Reveal What Cannabis Does to Your Bone

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A study from the Hebrew University and Tel Aviv University showed how a chemical in marijuana has strengthening effects on bone. The chemical is cannabinoid cannabidiol (CBD) and fastens bone healing without any psychotropic effects. This study was published in The Journal of Bone and Mineral Research.

 Researcher Yankel Gabet said that treatment of bones with CBD ensures strong, healed bones that will not break easily. It will help the maturation of collagenous matrix, which provides a new base for materialization of bone tissue.

The researchers used rats for this study by causing mild femoral fractures in them. They injected CBD to some of them, while the rest received CBD and tetrahydrocannabinol, which causes the marijuana high. They compared the two effects and found that rats injected with CBD showed the same results immaterial of THC addition.

The researchers also found that receptors in the body which react to cannabinoid compounds are not just located in the brain but are in the bones too. This helps the creation of bones and stops bone loss.

This study is a part of a project to find marijuana’s medical benefits and these new discoveries might motivate researchers to find the benefits of marijuana in treating osteoporosis and other bone diseases.

Gabet said that our body reacts to cannabis because we have receptors and compounds that are activated by compounds in marijuana.

These developments definitely show that cannabis has undeniable medicinal properties and that they can separate the clinical possibilities from the psycho-activity of cannabis.

Cannabis has several medicinal properties. AIDS patients use it to increase their appetite or to reduce side-effects of chemotherapy and chronic pain. Many studies show that it can regulate blood sugar and help in the treatment of multiple sclerosis and Parkinson’s disease.

The study also reveals that CBD controls seizures, prevents metastasis of aggressive cancers and destroys leukemia cells.

Neuropsychopharmacology published a study that stated CBD is as beneficial as an antipsychotic drug. CBD is able to treat schizophrenia and paranoia, without any side-effects.

Although illegal under U.S Federal law, 17 states permit the use of CBD for research and medical purposes. Laws of 23 other countries also allow the use of marijuana for medicinal functions.

The federal government still doesn’t recognize marijuana as an “accepted medical use”. However, the recent FDA approval of CBD extracts in an experimental treatment for the Dravet syndrome.

Depression Hurts, Your Bones Included

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Growing evidence suggests that depression, one of the most common diseases of the brain, is so powerful it can actually erode bones in the body.

Depression Hurts, Your Bones Included

Our bones are constantly remodeling themselves – they build themselves up and break themselves down over and over again. Depression is like a severe and prolonged state of stress on bones that may weaken them, making osteoporosis more likely. Depression causes blood pressure and heart rate to increase and also causes the brain to produce dangerously high levels of hormones – it has also been suggested that specific hormonal changes associated with depression lead to bone loss.

Depression not only affects your brain and behavior—it affects your entire body, and that includes your bone health and risk of developing osteoporosis.

Someone suffering from depression might experience bouts ofinsomnia, loss of appetite, and overall lethargy, and these are all contributors to poor bone health. Studies show that older people with depression are more likely to have low bone mass than older people who aren’t depressed, and low bone mass is the biggest indicator of osteoporosis.

Younger women with depression may also be at risk for osteoporosis. One study found that among women who have not yet reached menopause, those with mild depression have less bone mass than those who aren’t depressed. Men who are depressed seem to lose bone even more rapidly and to a greater extent than women, however since bone density in men is greater to begin with, their risk of fracture may be slightly more forgiving than in women.

Medication

While currently available depression treatments are generally well tolerated and safe, some medications, including some antidepressants, anticonvulsants, and lithium, can increase your risk for osteoporosis. Certain medications can also increase your risk of falling, which is dangerous if you already have osteoporosis. The class of antidepressants known as SSRIs may be associated with higher rates of bone loss in older women.

A recent study funded by the NIH showed an association between SSRI use and hipbone loss in older women. In patients with depression and those on SSRIs, attention should be directed to the heightened risk of fragility fracture – a broken bone that’s caused by a fall from a standing height or less, indicating an underlying bone disorder like osteoporosis.

Lifestyle

If you have osteoporosis, you may need to make lifestyle changes, and these changes may actually increase your risk of depression. For example:

– To prevent falls that could cause already fragile bones to fracture or break, you may not be able to take part in some activities you once enjoyed.
– Weakened bones may make it harder to perform everyday tasks, and you could lose some of your independence.
– You may feel nervous about going to crowded places, such as malls or movie theaters, for fear of falling and breaking a bone.

But it can go the other way, too. Exercise is an important part of osteoporosis treatment, particularly activities in which you support your weight on your feet. These activities help to strengthen bones and muscles that can prevent falls and can also boost your mood and improve your depression.

People with depression and low bone mass need to try very hard to adopt bone health strategies, including use of supplements, quitting smoking, limiting alcohol consumption to fewer than two glasses a day, and participating in weight-bearing exercises and fall-prevention programs. Because earlyosteoporosis is primarily a silent disease, knowing that even mild depression can lead to bone loss years before fractures occur is of major clinical importance. Orthopedic surgeons should be aware of the association between depression and osteoporosis as well as the higher rate of bone loss in patients on SSRI medication for their depression. Treating depression can help you manage your osteoporosis and improve your overall health. Recovery from depression takes time but treatments are effective.

Metastatic Disease to Bone .

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Watch the video. URL: https://youtu.be/7czbkvd2ruk

 

7 metastatic disease of boneJ

Do You Really Need a Vitamin D Supplement?

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A new study says that taking vitamin D supplements for bone-strengthening and protection against osteoporosis is not necessary for healthy middle-aged adults.

But a bone health expert at Cleveland Clinic urges people at risk for vitamin D deficiency to consult their doctors before discontinuing use.

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Studies showed no significant increase in BMD

Recent concerns about the safety risks of taking calcium supplements has led some adults to take vitamin D (without calcium) for bone protection.

The University of Auckland study — a meta-analysis of past studies — found that vitamin D supplements alone had little effect on bone-mineral density (BMD). Investigators combined data from 23 past trials, studying 4082 adults, 92 percent of whom were women. Studies showed no significant increase in BMD in most areas of the body.

In light of this researchers concluded that widespread use of vitamin D for osteoporosis prevention in adults without risk factors for vitamin D deficiency was unwarranted.

Importance of vitamin D shouldn’t be minimized

Chad Deal, MD, was not involved in the study but is Director of the Center of Osteoporosis and Metabolic Bone Disease at Cleveland Clinic.

Though not disagreeing with the study’s conclusions, he worries that the findings may cause some to minimize the positive impact of vitamin D on at-risk people.

“The study is on the effect of vitamin D on BMD, which is modest and not surprising,” says Dr. Deal. “Vitamin D would not be expected to have a large effect unless the patient had severe vitamin D deficiency, in which case the bone density effect could be significant.”

“Patients with vitamin D deficiency should not get the take-home message that vitamin D will not benefit them,” he says.

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Fracture protection and other safeguards

For older, at-risk patients, vitamin D deficiency can have a major impact on fracture, says Dr. Deal. Deficiency can cause osteomalacia, softening of the bone due to impaired mineralization, which makes fractures more likely.

“Bone mineral density is not a perfect surrogate for fracture, especially in older patients,” Dr. Deal says.

Vitamin D can also have “huge benefits” on muscle function, cognition and falling, he adds.

Healthy middle-aged adults should talk to their doctor about both their vitamin D and calcium levels to see if they need to be taking vitamin D supplements, either alone or with calcium.

A Bio-Patch Regrows Bone Inside the Body.

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Researchers from the University of Iowa have developed a remarkable new procedure for regenerating missing or damaged bone. It’s called a “bio patch” — and it works by sending bone-producing instructions directly into cells using microscopic particles embedded with DNA.

In experiments, the gene-encoding patch has already regrown bone fully enough to cover skull wounds in test animals. It has also stimulated new growth in human bone marrow stromal cells. Eventually, the patch could be used to repair birth defects involving missing bone around the head or face. It could also help dentists rebuild bone in areas which provides a concrete-like foundation for implants.

To create the bio patch, a research team led by Satheesh Elangovan delivered bone-producing instructions to existing bone cells inside a living body, which allowed those cell to produce the required proteins for more bone production. This was accomplished by using a piece of DNA that encodes for a platelet-derived growth factor called PDGF-B. Previous research relied on repeated applications from the outside, but they proved costly, intensive, and more difficult to replicate with any kind of consistency.

“We delivered the DNA to the cells, so that the cells produce the protein and that’s how the protein is generated to enhance bone regeneration,” explained Aliasger Salem in a statement. “If you deliver just the protein, you have keep delivering it with continuous injections to maintain the dose. With our method, you get local, sustained expression over a prolonged period of time without having to give continued doses of protein.” Salem is a professor in the College of Pharmacy and a co-corresponding author on the paper.

While performing the procedure, the researchers made a collagen scaffold in the actual shape and size of the bone defect. The patch, which was loaded with synthetically created plasmids and outfitted with the genetic instructions for building bone did the rest, achieving complete regeneration that matched the shape of what should have been there. This was followed by inserting the scaffold onto the missing area. Four weeks is usually all that it took — growing 44-times more bone and soft tissue in the affected areas compared to just the scaffold alone.

“The delivery mechanism is the scaffold loaded with the plasmid,” Salem says. “When cells migrate into the scaffold, they meet with the plasmid, they take up the plasmid, and they get the encoding to start producing PDGF-B, which enhances bone regeneration.”

Glucocorticoid-induced osteoporosis: mechanisms, management, and future perspectives.

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Glucocorticoids are widely used for their unsurpassed anti-inflammatory and immunomodulatory effects. However, the therapeutic use of glucocorticoids is almost always limited by substantial adverse outcomes such as osteoporosis, diabetes, and obesity. These unwanted outcomes are a major dilemma for clinicians because improvements in the primary disorder seem to be achievable only by accepting substantial adverse effects that are often difficult to prevent or treat. To understand the pathogenesis of glucocorticoid-induced osteoporosis, it is necessary to consider that the actions of glucocorticoids on bone and mineral metabolism are strongly dose and time dependent. At physiological concentrations, endogenous glucocorticoids are key regulators of mesenchymal cell differentiation and bone development, with additional regulatory roles in renal and intestinal calcium handling. However, at supraphysiological concentrations, glucocorticoids affect the same systems in different and often unfavourable ways. For many years, these anabolic and catabolic actions of glucocorticoids on bone were deemed paradoxical. In this Review, we highlight recent advances in our understanding of the mechanisms underlying the physiology and pathophysiology of glucocorticoid action on the skeleton and discuss present and future management strategies for glucocorticoid-induced osteoporosis.

Source: Lancet

 

 

 

Bone is a plastic tissue .

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Decades ago, medical school final exams took the form of essays rather than the current multiple choice questions. For the histology finals, I selected the topic “Bone is a plastic tissue.” I knew absolutely nothing about the skeleton other than it was brittle and broken. It turns out that not only was I wrong but I knew as little about it as the professors: for the one and only time in medical school, I topped the class.

Bone is clearly a plastic tissue subject to modeling during growth and development and remodeling shortly after epiphyseal closure. The most common skeletal disease resulting from altered remodeling is osteoporosis in which resorption outstrips formation. Monitoring resorption and formation — measures of total skeletal metabolism — is overlooked in favor of monitoring bone mineral density — measures of regional, not total, skeletal status.

Why bring this up now?

A PubMed search for the last 10 years returned 35,121 citations (275 meta-analyses) for “bone density” and 13,162 citations (28 meta-analyses) for “bone turnover markers”. There is clearly no shortage of peer-reviewed literature regarding bone turnover markers, but there is so much variability in those 13,162 citations that meaningful consensus data is lacking.

You don’t need reminding that adherence to oral medications for osteoporosis is low, and not that great for injectable (subcutaneous or IV) therapies. Several studies have examined the use of markers to improve medication adherence but, to my knowledge, none of them have found markers to be useful in maintaining compliance with therapy.

Bone turnover markers have no role in determining which patient is a candidate for osteoporosis therapy and have not had much effect on patient adherence to therapy. My own practice is to measure markers as I recommend the patient start therapy and re-check markers after 6 months of therapy to both monitor that the therapy is effective and that the patient is adherent to therapy. My success rate in the latter is no better than reported in the literature.

I repeat measurement of markers when serial measurement of BMD indicates that BMD is no longer increasing. Ongoing use of osteoporosis therapies is safe for the vast majority of patients in whom BMD has plateaued, but there is increasing awareness of atypical femoral shaft fractures in a small minority of patients on long-term antiresorptive therapy. With that in mind, I interrupt therapy in patients with stable BMD, where bone turnover markers are in the bottom quartile of the reference interval. I re-check them at 6 monthly intervals until the values get to the top half of the reference interval, at which time therapy is re-started. That happens infrequently. When allowed by insurance coverage, I repeat BMD measurement after 1 year off therapy but have yet to see a patient in whom BMD has declined during that year. I cannot recall a patient in whom an uptick in remodeling has not occurred within 2 years without antiresorptive therapy and use that as an indication to re-start treatment.

Which markers to use? My preference is or serum CTX (resorption) and P1NP (formation) because patients are never in a hurry to provide a 24-hour urine collection or even a fasting urine sample.

Much has been written about the diurnal variation of biochemical markers of bone remodeling and the intra- and interassay variability. These are specious arguments against serial measurements of bone turnover markers. Firstly, when remodeling is suppressed as a result of therapy, even 50% variability in markers (it is not that variable) does not move many patients from one quartile to another. Secondly, there are many laboratory tests in which the variability is the same or even worse than for bone turnover markers. That has not stopped any clinician I know from continuing to order and rely on those results.

The bottom line — patient adherence to therapy tests our skills as clinicians every day. Asking a patient to wait 2 years to see if the therapy we prescribe is effective or not makes little sense to me.

Michael Kleerekoper, MD, MACE, has joined the faculty at the University of Toledo Medical School where he is Professor in the Department of Internal Medicine and section chief of the Endocrinology Division. The author of numerous journal studies, Dr. Kleerekoper serves on the editorial boards for Endocrine Today, Endocrine Practice, Journal of Clinical Densitometry, Journal of Women’s Health, Osteoporosis International and Calcified Tissue International. Dr. Kleerekoper is also a founding board member of the newly formed Academy of Women’s Health.

Source: Endocrine Today.