Disease Proof : Disease Proof : Health & Nutrition News & Commentary : Dr. Joel Fuhrman

Bisphosphonates (Fosamax, Boniva, Actonel, Reclast), along with calcium and vitamin D supplementation, are a common conventional treatment for osteoporosis. These drugs are even used for prevention of osteoporosis in those with osteopenia.
Bone tissue continually goes through a cycle of formation of new bone and breakdown of old bone. Bisphosphonates increase bone mineral density in the short term by reducing bone breakdown, essentially reducing bone loss. However, it is not the same as building natural, healthy bone with exercise.  Exercise is essential, and, in particular, exercising the back and legs. Muscle strength is the most accurate way of predicting bone strength and of predicting risk of falls. Strengthening muscles has been shown to be the most effective way to strengthen bone and protect against osteoporosis-related fractures.¹ Compared to exercise, medications are relatively ineffective and may cause harm.

Since bisphosphonates accumulate in bone tissue and suppress bone turnover, there has been a concern about the strength and integrity of the medically treated bone. Apparently, the use of bisphosphonates actually causes the bones to become brittle despite the increase seen in bone mineral density. 

Several studies have reported the occurrence of specific and rare types of femur fractures in individuals (mostly women) who had been taking bisphosphonates, specifically alendronate (Fosamax), for approximately 4-8 years.^{2,3,4,5,6,7,8,9}Two new studies presented at the American Academy of Orthopaedic Surgeons national meeting this week have drawn more attention to this potential hazard.¹⁰ Long term users of alendronate (Fosamax) – were found to be at significantly higher incidence of fractures.¹¹ A frightening detail of these reports is that the fractures had occurred under minimal trauma – these fractures are not from falls. In fact, in most cases, these women were performing low-energy exercise, sometimes just walking down a flight of stairs.^12,13

These medications have other serious side effects as well, such as atrial fibrillation a heart rhythm disturbance. Prevention of osteoporosis and bone fractures does not need to involve potentially dangerous drugs. 

Primary causes of hip fractures

• Poor nutrition
• Sedentary lifestyle
• Muscle weakness
• Side effects of prescription drugs
• Declining vision
• Cigarette smoking
• Vitamin D deficiency

Exercise is a crucial component of my recommendations - most hip fractures result from falls. So, naturally, by increasing muscle strength and balance you can improve stability and prevent these falls.¹⁴ 

My recommendations for osteoporosis protection: 

1.      Eat a high nutrient diet. 

2.      Take the right supplements.

3.      Do the right osteoporosis fighting exercises. Swimming and biking will not do it. The best bone building exercises designed to strengthen muscles and bone and to improve balance, reducing the risk of falls are demonstrated in my DVD  Osteoporosis Protection For Life

Osteoporosis Protection for Life                                

Dr. Fuhrman's Osteoporosis Protection For Life DVD is an educational and invigorating program for combating osteopenia and osteoporosis that offers a significant improvement over drug-treatment. In this video, Dr. Fuhrman offers advice regarding diet, supplements, and exercise, and demonstrates the best exercises to effectively build strength and bone mass.

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1 Rubin C, Turner AS, Muller R, et al. Quantity and quality of trabecular bone in the femur are enhanced by a strongly anabolic, noninvasive mechanical intervention. J Bone Min Res 2002;17:349-357.

2 Cermak K, Shumelinsky F, Alexiou J, et al. Case Reports: Subtrochanteric Femoral Stress Fractures after Prolonged Alendronate Therapy. Clin Orthop Relat Res. 2009 Dec 18. [Epub ahead of print]

3 Capeci CM, Tejwani NC. Bilateral low-energy simultaneous or sequential femoral fractures in patients on long-term alendronate therapy. J Bone Joint Surg Am. 2009 Nov;91(11):2556-61.

4 Goddard MS, Reid KR, Johnston JC, Khanuja HS. Atraumatic bilateral femur fracture in long-term bisphosphonate use. Orthopedics. 2009 Aug;32(8). pii: orthosupersite.com/view.asp?rID=41933..

5 Ing-Lorenzini K, Desmeules J, Plachta O, et al. Low-energy femoral fractures associated with the long-term use of bisphosphonates: a case series from a Swiss university hospital. Drug Saf. 2009;32(9):775-85.

6 Lenart BA, Lorich DG, Lane JM. Atypical fractures of the femoral diaphysis in postmenopausal women taking alendronate. N Engl J Med. 2008 Mar 20;358(12):1304-6.

7 Sayed-Noor AS, Sjödén GO. Case reports: two femoral insufficiency fractures after long-term alendronate

therapy. Clin Orthop Relat Res. 2009 Jul;467(7):1921-6. Epub 2009 Feb 6.

8 Neviaser AS, Lane JM, Lenart BA, et al. Low-energy femoral shaft fractures associated with alendronate use. J Orthop Trauma. 2008 May-Jun;22(5):346-50.

9 Kwek EB, Goh SK, Koh JS, Png MA, Howe TS. An emerging pattern of subtrochanteric stress fractures: a long-term complication of alendronate therapy? Injury. 2008 Feb;39(2):224-31. Epub 2008 Jan 28.

10 LA Times: http://latimesblogs.latimes.com/booster_shots/2010/03/bisphosphonates-osteoporosis-medications.html

 

11 Somford MP, Draijer FW, Thomassen BJ, et al. Bilateral fractures of the femur diaphysis in a patient with rheumatoid arthritis on long-term treatment with alendronate: clues to the mechanism of increased bone fragility. J Bone Miner Res. 2009 Oct;24(10):1736-40.

12 Somford MP, Geurts GF, den Teuling JW, et al. Long-Term Alendronate Use Not without Consequences? Int J Rheumatol. 2009;2009:253432. Epub 2010 Jan 27.

13 ABC News: Fosamax: Is Long Term Use of Bone Strengthening Drug Linked to Fractures? http://abcnews.go.com/GMA/OnCall/fosamax-long-term-bone-strengthening-drug-linked-fractures/story?id=10045179

14 Ueki S, Kasai T, Takato J et al. Production of a fall prevention exercise program considering suggestions from community-dwelling elderly. Nippon Koshu Eisei Zasshi. 2006;53(2):112-121.

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We’ve known for years that excessive sodium intake contributes to hypertension, and a new meta-analysis of 13 studies has confirmed that high sodium intake is associated with increased risk of stroke and overall cardiovascular disease.¹ Salt consumption is also associated with kidney disease, and a new study suggests that reduced sodium intake could benefit bone health.

Women 45-75 years old with prehyptertension or stage 1 hypertension were assigned to one of two diets.  Both diets supplied the same amount (800 mg) of calcium.  One diet was a high-carbohydrate, low-fat diet.  The other diet was a low-sodium diet (1500 mg), which included red meat but was designed to have a low acid load.² 

Western diets, generally high in animal protein, produce acid in the body, forcing the body to buffer this acid in part by the release of alkalizing salts from bone (e.g. calcium citrate and calcium carbonate) – this is associated with urinary calcium loss and is thought to contribute to osteoporosis. Fruits, vegetables, and legumes have favorable effects on acid-base balance, since the acid-forming effect of their protein content, which is lower than that of animal products anyway, are balanced by their mineral content.^3-4

After 14 weeks, the women on both diets increased markers of bone formation and reduced their calcium excretion – those on the low sodium diet had a greater reduction in calcium loss. The authors concluded that this diet was protecting the mineral reserves in bone, and that this could have long-term implications for bone health. Future studies will likely measure bone mineral density and fracture incidence in response to these diets.²

The average daily consumption of sodium for Americans is around 4000mg, almost double the U.S. recommended maximum of 2300mg. The low sodium diet in this study provided a maximum of 1500mg of sodium per day, but included up to six servings of red meat per week, limited the consumption of nutrient-rich legumes to 4-5 per week, and was based on high-calorie, nutrient-poor grain products - 7-8 servings per day.⁵ The high-carbohydrate low-fat diet was likely based on grain products as well.

Although both of these diets had favorable effects when implemented in place of a standard western diet, they both have room for improvement. By minimizing the high-protein, high-saturated fat animal products, and replacing grain products with mineral- and phytochemical-rich vegetables, fruits, and legumes as the base of the diet, both acid load and sodium would be further reduced, presumably leading to further benefits on bone health.

References:

1. Strazzullo P et al. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ 2009;339:b4567

2. Nowson CA et al. The effects of a low-sodium base-producing diet including red meat compared with a high-carbohydrate, low-fat diet on bone turnover markers in women aged 45-75 years. Br J Nutr. 2009 Oct;102(8):1161-70. Epub 2009 May 18.

3. Welch AA et al. Urine pH is an indicator of dietary acid-base load, fruit and vegetables and meat intakes: results from the European Prospective Investigation into Cancer and

Nutrition (EPIC)-Norfolk population study. Br J Nutr. 2008 Jun;99(6):1335-43. Epub 2007 Nov 28.

4. Massey LK. J Nutr. Dietary animal and plant protein and human bone health: a whole foods approach. 2003 Mar;133(3):862S-865S.

5. http://dashdiet.org/

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Maybe I’m an idiot. I can’t imagine being overweight or obese is good for anything—except winning belly-flop competitions—but apparently there is a school of thought out there that high body mass index helps build strong bones. Luckily, a new study shoots that pieces. Turns out muscles keep bones strong, not fat.

The researchers looked at bone density and volume, as well as lean and fat mass, in 768 men aged 25 to 45, including 296 pairs of brothers.

After the researchers adjusted for weight, they found that men's bone mass and volume fell steadily as their percentage of fat mass increased, while bone size rose in tandem with lean mass. Fat in the trunk area had a stronger influence on bone size than fat on the arms and legs.

"Lean mass," the researchers conclude, "is the major determinant of bone size, providing further evidence that bone size is adapted to the dynamic load imposed by muscle force rather than passive loading" by fat.

Dr. Fuhrman agrees with the muscle-bone link, saying, “Strong muscles and bones are married together. Working out and strengthening the muscles, thickens the bones in the process.” And in his DVD Osteoporosis Protection for Life you’ll learn how certain exercises tone muscles and build bone density.

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Diets too high in animal protein and low in vegetable protein: Meat and other high protein foods leave an acid residue in the blood that leads to bone dissolution. To neutralize this acid load, the body calls on its stores of calcium to provide basic calcium salts. Studies show that people with a high animal protein intake can develop a negative calcium balance, regardless of how much calcium is consumed. An important study demonstrated an increased bone loss and risk of hip fracture in those with a higher ratio of animal protein to vegetable protein. The researchers concluded that an increase in vegetable protein and a decrease in animal protein may decrease the risk of hip fractures in the elderly.1 The recommendations are clear: green vegetables, beans, nuts, and seeds should be the major source of protein. It is important to note that later in life (after age 70), it is crucial to pay more attention to protein intake. At that point, both too much protein and too little protein are unfavorable to bone mass.2

High consumption of salt and/or caffeine: The consumption of large amounts of sodium and caffeine leads to unwanted excretion of calcium.3 Exactly how this works is not completely understood, but both salt and caffeine increase the rate at which blood is filtered through the kidney. The increased filtering pressure and flow compromise the kidney’s ability to return calcium supplies to the bloodstream.

Smoking: Nicotine can interfere with hormonal messages to the kidneys, inhibiting calcium re-absorption. The combination of smoking and drinking coffee or soft drinks, together with the dietary factors mentioned, makes the prevalence of osteoporosis in this country quite understandable. Dietary, health, and lifestyle components are working together to cause this drain of calcium.

Vitamin D Deficiency: Recent research studies have corroborated the fact that most Americans are Vitamin D deficient. This deficiency occurred even among a majority of study subjects who were already taking a multivitamin with the standard 400 IUs of Vitamin D. More and more health authorities are recommending that an additional 400 to 800 IUs of Vitamin D be taken over and above the 400 typically present in a multiple vitamin.

Vitamin supplements: In high doses, Vitamin A (retinol) is associated with birth defects, and recent research suggests the dose that causes risk is much lower than previously thought. If Vitamin A is toxic to a person who is pregnant and potentially harmful to the developing baby, it can’t be good for us the rest of the time. Research has shown it is linked to calcium loss in the urine and osteoporosis. For example, an important study found that subjects with a Vitamin A intake in the range of 1.5 mg had double the hip fracture rate of those with an intake in the range of .5 mg. For every 1 mg increase in Vitamin A consumption, hip fracture rates increased by 68 percent.4 Most multivitamins contain about 5000 IUs of Vitamin A, which is equal to 1.5 mg. This means if you conform to the current recommendations, which have become outdated, and get your Vitamin A from supplements, you could be weakening your bones. Instead, the body can naturally self-fabricate Vitamin A by consuming beta-carotene and other carotenoids in real food. Vegetables such as carrots contain beta carotene, not Vitamin A, and the beta-carotene from vegetables does not lead to excessive Vitamin A formation or cause calcium loss.

Poor physical fitness: Our bones are continually dissolving old bone tissue and rebuilding new bone. Interestingly, our bone strength is directly proportional to our muscle strength. Bones, like muscles, respond to stress by becoming bigger and stronger, and, like muscles, bones weaken and literally shrink if not used. It is essential to exercise, and, in particular, to exercise the back. Studies have found that a back-strengthening exercise program can provide significant, long lasting protection against spinal fractures in women at risk for osteoporosis.5

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No one wants creaky bones, but the number of hospitalizations for osteoporosis-related fractures has increased in the United States, jumping 55% since 1995. The Agency for Healthcare Research and Quality says more than 254,000 hospital stays are due to injuries stemming from osteoporosis.

That’s why Dr. Fuhrman made a DVD called Osteoporosis Protection for Life. In it he explains what you can do to keep your bones strong and healthy, with exercise, improved diet and supplements.

Most people mistakenly are led to believe that drugs are the answer to treating osteopenia and osteoporosis. However, studies reveal that the bisphosphonates, like Actonel, Fosamax, Boniva, and Reclast, commonly prescribed for osteoporosis, are not as effective as we have been led to believe. As more and more research data comes out about the long-term risks of these medications, we are finding out that they are more dangerous than we had previously thought.

I want to give people the information they need to put an effective plan into action. In this video, I offer my advice regarding diet, supplements, and exercise. I am joined by my wife, Lisa, and staff to demonstrate the best exercises to effectively build your strength and bone mass. We've even added a fun 15 minute workout to start you on your way. Now is the time to take control of your health destiny!

For more, here’s a preview clip of Osteoporosis Protection for Life.

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I’m a guy. I forget things, little things, like birthdays, where I left my car keys, or to put on underwear. Luckily, some soy might fix that.

According to a new study, published in the British Journal of Nutrition, isoflavones in soy could help improve men’s mental function and memory.

Researchers recruited 34 healthy men and participants were given a daily dose of 116 milligrams of soy isoflavones. Then men were tested on memory, mental function and visual-spatial processing.

Data showed guys getting the soy isoflavones committed 23% fewer errors and needed 17% less time to complete tasks. So ladies, if your man is a big dummy. Go get him some soymilk.

Soy is a super food! Previous reports have found it lowers risk of breast cancer, improves heart health and helps build strong bones, but don’t go soy crazy. Dr. Fuhrman says no diet should be based on just one food, not even soy.

Via Nutra Ingredients.

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Most people mistakenly are led to believe that drugs are the answer to treating osteopenia and osteoporosis. However, studies reveal that the bisphosphonates, like Actonel, Fosamax, Boniva, and Reclast, commonly prescribed for osteoporosis, are not as effective as we have been led to believe. As more and more research data comes out about the long-term risks of these medications, we are finding out that they are more dangerous than we had previously thought.

I want to give people the information they need to put an effective plan into action. In this video, I offer my advice regarding diet, supplements, and exercise. I am joined by my wife, Lisa, and staff to demonstrate the best exercises to effectively build your strength and bone mass. We've even added a fun 15 minute workout to start you on your way. Now is the time to take control of your health destiny!

You’ll learn more in my DVD Osteoporosis Protection for Life:

• Get the best bone building exercises to do anywhere

• Build strong muscles

• Avoid high risk medications

• Learn common dietary causes of bone loss

Start building healthier, stronger bones now! Here’s a preview clip of Osteoporosis Protection for Life.

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According to new research in The Journal of Nutrition, experts claim low blood levels of vitamin D increase risk of a harmful bacteria infection called vaginosis. For the study, scientists tested 469 women in their first trimester of pregnancy and found 41% of women had vaginosis and 52% had low levels of vitamin D. The women with vaginosis had lower levels of vitamin D than those without the infection; Reuters explains.

Recently, low levels of vitamin D were tied to multiple sclerosis and higher risk of dementia and Alzheimer's disease. So make sure you get enough vitamin D! Vitamin D reduces risk of prostate cancer and helps build strong bones, which protects against osteoporosis.

If you need help keeping your vitamin D up, Dr. Fuhrman’s Osteo-Sun is specially formulated to provide sufficient vitamin D, both in its vegan and non-vegan forms.

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Presented at the American College of Sports Medicine's annual meeting researchers say women older than 30 who exercise more than 1 hour a week may have a lower risk of breast cancer. Scientists asked over 4,000 women to recall their physical activity levels when they were 10 to 15 years old, ages 30 to 50 and ages 50 and up. Women exercising in the over 30 group significantly reduced their chances of getting breast cancer; Reuters reports.

Exercise is great, but in January a report showed women under 70 are less active than men. Not good ladies, especially since regular physical activity helps strengthen bones and prevent osteoporosis and exercise like Tai Chi fights arthritis and diabetes.

In related news, America’s unhealthy habit of driving everywhere, even to the corner store, means we’re walking less, contributing to obesity and illness, like heart disease.

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More kudos for vitamin D! A new study in the journal Arthritis & Rheumatism claims insufficient vitamin D may cause cartilage loss in knee joints. For the study, involving 880 men and women, ages 51 to 79, scientists measured blood levels of vitamin D and knee cartilage volume. And 3 years later, retesting of 353 people revealed 58% had changes in knee cartilage and worsening osteoarthritis, both men and women with low vitamin D had less knee cartilage; Reuters reports.

Vitamin D is strong medicine and we get vitamin D from the sun’s ultraviolet rays. Vitamin D functions as a hormone, telling our intestines to absorb calcium and phosphorus, which builds strong bones and prevents things like rickets, depression and even difficulty thinking!

In his DVD Osteoporosis Protection for Life, Dr. Fuhrman explains why vitamin D is so critical, the importance of proper diet and he demonstrates a number of bone strengthening exercises.

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