START BONE CARE EARLY
Building and maintaining healthy bone structure begins early in life. Bone building is complete in young women by the age of 17 and peak bone density occurs by the age of 25. Genetics accounts for only 30% of the risk of developing osteoporosis. So you see, keeping bones strong and healthy is a result of daily lifestyle choices we make along the way from the time we are in our early teens.
THREAT TO YOUR BONES
Maintaining healthy bones is an absolute prerequisite for enjoying every facet of life. Yet, according to the National Osteoporosis Foundation, 1 in 2 women older than 50 will suffer a broken bone due to osteoporosis. For men, that number is 1 in 4.
Osteoporosis is the disease of bone loss, and often there’s no sign of it at all until a bone snaps. Sometimes it presents as a severe backache, which people tend to treat with over-the-counter painkillers. Most often when someone “falls and breaks a bone,” it’s actually the other way around. They experience a fracture and fall as a result, then discover that they have osteoporosis.
THE HOLISTIC APPROACH IS BEST
As with most conditions, here at BeWell we apply the Holistic Approach to maintaining Bone Health. Here are just some of the factors to consider:
VITAMINS AND MINERALS FOR BONE HEALTH
There are many factors that influence bone health. The most important ones include optimizing:
- calcium
- magnesium
- boron
- vitamin D
- vitamin K
- ideal hormonal levels (especially as we age)
- daily exercise
- informed dietary choices
Although calcium is an important part of bone building, it’s not the only mineral that is at play. Magnesium can be as or even more important than calcium for some people. Magnesium helps build strong bone mineral crystals, which in studies have demonstrated that even with reduced bone mass, protect people from future fractures. Leafy green vegetables, nuts and seeds are excellent sources of most of these trace minerals.
Robust vitamin D levels are critical for maintaining healthy bone mass and are inversely proportional to bone fractures. Aim for a level that is between 55-75 ng/ml; don’t settle for barely more than 30. And have it checked annually. Those living in central Pennsylvania, or north of the Mason-Dixon line, can’t depend on the sun for vitamin D. And at least half the population has a genetic polymorphism (VDR) that makes it difficult to store this important vitamin-prohormone, so its important to pay attention to having a good amount.
THE ROLE OF CALCIUM
Vitamin K is important because it helps pull calcium into the bone matrix and prevents it from depositing in the arteries.
It prevents inappropriate calcium deposits by making sure the calcium goes where it’s supposed to, in bone, and not in the arterial walls.
There has been recent concern that excess calcium calcifies the arterial walls, so the recommendation for dietary calcium has been decreased over the years. Currently, no more than 400 mg per day should come from supplements and the rest of the total of 1200 mg each day should be from food sources.
PH IS KEY
Diets that are high in animal protein or other acid-forming foods like sugar and soda can also increase bone loss. Acid-forming foods can reduce systemic pH, causing the body to draw minerals from bone, if they aren’t available through the diet, in order to regulate the pH of the blood. Specifically, calcium and magnesium concentration is tightly controlled in the blood because they regulate the heartbeat. Therefore, the body will always prioritize having adequate levels of these minerals and will sacrifice bone density to do so. It is for this reason that evaluating calcium and magnesium through conventional blood testing is not necessarily accurate. The best way to assess your body’s storage of these minerals is through measuring magnesium in red blood cells and calcium as ionized calcium. Talk to your BeWell nutritionist about ordering these tests properly.
Managing pH through diet can go a long way toward preserving bone. You can use strips of inexpensive pH paper to check your urine and saliva and make dietary changes to keep your pH in an appropriate range. Most people feel much better overall when their pH is closer to neutral (ideal for urine is 6.4; for saliva it’s 7.2).
HORMONE BALANCE FOR BONES
In postmenopausal women, hormonal status also affects the ability to assimilate bone. At the very least, DHEA-S should be measured and possibly supplemented to maintain the ability to build bone, and its also protects the brain and improves skin tone. If there’s a long history of steroid use, then both calcium and DHEA should most definitely be part of an ongoing program to protect bone health.
At BeWell we use the DUTCH test to assess not only hormonal levels but their metabolites for more accurate balancing of your levels.
BONE LOSS CULPRITS
Certain other drugs, besides steroids, also affect bone building. Especially the PPIs, used for managing acid reflux, heartburn and the like. These meds should only be used short term until the underlying cause of symptoms can be addressed. Used long term, they reduce stomach acid, thereby preventing the absorption of key bone-building minerals. Chronic low stomach acid (the underlying cause of many of the above-mentioned symptoms) has the same effect and must be corrected to improve digestion and therefore protect future bone mass.
There is another major block to absorption of bone building minerals that is unfortunately found in many healthy foods. This is a naturally occurring chemical called oxalate, found in greatest concentration in spinach, wheat, beets, nuts and soy. Talk to your BeWell nutritionist about evaluating whether oxalates are a problem for you. We use the NutrEval test for this.
Other dietary causes of reduced bone mass are not surprising. Sugar, especially in the form of soft drinks, is loaded with bone dissolving phosphates and depletes bone mass. Smoking and excess alcohol consumption (more than 7 ounces per day) are also associated with reduced bone mass.
MAKING SURE YOU ARE BUILDING BONE
DpD enzyme is released into the bloodstream when bone is being turned over and can be checked through urine. If the turnover rate is too high, we can deduce that bone loss is occurring and the program needs to be tweaked and then retested.
If the DpD enzyme is within normal range, we can assume that the bone building program is working and a Dexa scan would be the next test.
The advantage of this process is that it increases the chances of gaining bone mass without waiting 2 years between Dexa scans to determine whether a program is working or not. If bone is turning over too quickly, adjustments can be made immediately and then retested. Even after menopause women can gain up to 7% bone mass annually, so significant improvements can occur in two years.
THE IMPORTANCE OF WEIGHT BEARING EXERCISE
And finally, let’s circle back to exercise. Partaking in weight-bearing exercise every day is one of your best strategies to maintain healthy bones. This can range from strength training with barbells to using resistance bands at home to practicing Tai chi or yoga, all of which create resistance and stimulate bone repair. Immobility, which includes excess sitting and no exercise, doubles the rate of urinary and fecal calcium excretion causing a negative calcium balance.
There’s no magic to maintaining strong bones. Consistent exercise and a healthy diet remain the most effective practices for strengthening bones. When you feel strong and healthy, being outdoors is a joy, which then comes full circle to support a sense of health and well-being.
HEALTHY JOINTS
Maintaining healthy joints is all about supplying enough nutrients to repair the joint tissues and minimizing wear and tear. Our clinicians take a holistic approach to helping you preserve or improve your joint health. Here are some of the areas they will consider and may recommend testing to dig further into the causes of your joint pain.
#1: MAINTAIN YOUR IDEAL WEIGHT. The less weight your joints have to carry around, the healthier they will stay. Imagine carrying two 5 # bags of flour around with you all day. That’s 10#! Working with a BeWell nutritionist will help you achieve your ideal weight in a healthy manner, without feeling deprived.
#2: HYDRATE! Chronically dehydrated tissues deteriorate more easily. Hydration is not only about simply drinking water but also making sure your electrolytes are in balance. Consuming fruits and vegetables at every single meal and snack will go a long way towards supporting good electrolyte levels.
#3 KEEP MOVING, BE ACTIVE. Humans were meant to move. Movement creates lubrication, detoxification, and regeneration. It improves blood and lymph flow and enables nutrients to reach target tissue more effectively. But keep it moderate. A local orthopedic surgeon told me that as soon as he learned what running on pavement did to the knee joint, he quit. Enough said!
#4 EAT AN ANTI-INFLAMMATORY DIET. Maximize brightly colored fruits and vegetables. We recommend having a large bowl of veggies at the beginning of every lunch and dinner, before eating anything else.
#5 REDUCE OXIDATIVE STRESS. Many of our nutritional tests can tell you whether you are eating enough antioxidant rich foods to quench the additional oxidative stress that comes with exercise. This is super important to maintaining the integrity of your joints, and actually all your cells!
#6 AUTOIMMUNE CONDITIONS are a major cause of joint deterioration and can be caused by toxic metal/chemical load, intestinal infections, or dietary allergies. The most common joint related autoimmune conditions are rheumatoid arthritis and lupus.
#7 CONSIDER USING SUPPLEMENTS to keep cartilage healthy for longer. There are many formulas to pick from, depending on whether you are having pain or just want to prevent deterioration of the joints. Your clinician can help you choose the one that is right for you.
Monica Montag, MA, HHP, CN
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