Saturday, March 23, 2013

Escape Fire

CNN recently aired "Escape Fire: The Fight to Rescue American Healthcare"-- a fantastic but utterly depressing documentary that focuses on the problems facing America's broken health care system and attempts to define solutions. The issue that most resonated with me, as Dr. Andrew Weil puts it in the film: health care today is really just a "disease management" system as opposed to one that is concerned about "preventing disease."

I'll never forget when I was first diagnosed with osteoporosis fourteen years ago at the age of 45. I wanted to know what caused my bones to become fragile in the first place and how to fix this situation. Five different endocrinologists simply wanted to put me on bisphosphonate medications--to artificially harden my skeleton and "manage" my condition. There was no discussion about nutrition, other than the advisory to drink milk. There was no discussion about my gastrointestinal health, other than the admonition that diarrhea (which I did not have) was a possible symptom that could be of concern. There was minimal investigation into possible food allergies/sensitivities that I may have had: one doctor tested me for anti-tissue transglutaminase (for gluten sensitivity). The result came back as 24 EU/ml and declared it as "normal." (25 EU/ml or greater is considered positive for celiac disease.) There is no doubt that these doctors were focused on"disease management;" there was no attempt to "fix" the things that were causing my bones to become fragile in the first place.

It is time to change how people think about and treat osteoporosis. I've made this my mission. Drugs are not the answer to osteoporosis. Quality nutritional supplements like OsteoNaturals are very helpful, but they too can't beat osteoporosis by themselves.

"Escape fire"* is a term used to describe an unconventional or counter-intuitive solution to a difficult problem. The escape fire for osteoporosis is to use a "whole-body" approach. A thorough diagnostic evaluation is needed to figure out where the destructive forces are of an individual's particular bone loss. With these results, you can take steps to eliminate or dampen destructive fires, improve gastrointestinal health, and promote normal bone remodeling. The focus for treatment can then turn to reducing fracture risk by taking a comprehensive approach that includes diet and lifestyle changes, exercise, nutritional supplements, and, when necessary, pharmaceutical intervention.

If you didn't catch the broadcast "Escape Fire: The Fight to Rescue American Healthcare", I urge you to visit Get educated, speak up, spread the word and be part of the solution to the health of our nation.

* To survive an approaching fire, fire fighters will burn the grass around them to create a fuel-free spot--thus allowing them to escape the fire.  

Thursday, March 21, 2013

Prebiotics Help Increase Calcium Absorption

Supplementing daily with prebiotics enhances calcium absorption according to a new study out of Purdue University. Just a 5-gram serving/day of galacto-oligosacccharides (GOS), a soluble, non-digestible fiber that can be fermented by gut microflora and used for food, increased calcium absorption in a group of 31 healthy adolescent girls according to research published in the British Journal of Nutrition.

Probiotics are live microorganisms found in cultured foods such as yogurt. You can also purchase probiotics in supplement form. Prebiotics, on the other hand, are a kind of "fertilizer" for probiotics and the microbes that live in your digestive tract. Prebiotics promote beneficial strains of gut microbes and are therefore great for improving digestive health. Both pro and prebiotics are in fact essential to a person's overall health and well-being. Onions and garlic are excellent food sources of prebiotics but it may be necessary (especially if you have digestive disturbances) to supplement your diet with higher doses of prebiotics along with high doses (10 to 50 billion) of probiotics.

There are several forms of prebiotics commonly sold in health food stores or on internet sites. The most common prebiotics are inulin and oligofructose (fructooligosaccharide) from chicory root, beta-glucan from brewers yeast (Saccharomyces cerevisiae), larch arabinogalactan, and galacto-oligosaccharides. Prebiotics help to balance gut microbial populations and promote beneficial strains of bacteria such as bifidobacteria.

If you have bone loss, there is a good chance you would benefit from improved gut health. Not only will taking a small scoop of prebiotics daily improve your calcium absorption but it will also promote healthy strains of gut microbes that help to reduce excess cortisol production, promote normal sex hormone levels, and keep your cholesterol normal. For more information on the benefits of pre and probiotics go to Ray Medina is the owner and writes a very informative blog. If you have a question regarding pre or probiotics, Ray is the man to ask...he is a walking encyclopedia.

Whisner, CM et al. 2012. Galacto-oligosaccharides increase calcium absorption and gut bifidobacteria in girls: a double-blind cross-over trial. British Journal of Nutrition, March, 14:1-12.

Wednesday, March 13, 2013

Omega-3 Fatty Acid Helps Reduce Fracture Risk

Systemic inflammation is the root cause of chronic disease. Heart disease, diabetes, Alzheimer’s, and yes, osteoporosis, have their underlying basis in inflammation. Chronic inflammation messes with the delicate balance of bone formation and resorption during the remodeling process and leads to bone loss.

You have probably heard that supplementing with fish oil for their omega-3 fatty acids can help reduce the aches and pains of inflamed arthritic joints, but can omega-3s also help reduce the chronic systemic inflammation linked to bone loss? Can adding fish to your diet and supplementing with fish oil help prevent the progression of osteoporosis?

Dr. Tonya Orchard from the Department of Human Nutrition at The Ohio State University researched this question. Dr. Orchard and her colleagues analyzed the omega-6:3 fatty acid ratio of postmenopausal women through a completely unique approach and sought to determine whether this ratio could predict fracture risk.

The relationship of omega-6 and omega-3 fatty acids to bone density has been studied before but never through the assessment of red blood cell fatty acids. Earlier studies have looked at the impact of omega-3s on bone health but their results are conflicting. Some report that omega-3 oils can benefit bone health while others show no benefit at all. As it turns out, it is fairly difficult to accurately determine the amount of dietary fatty acids a person takes in and absorbs and then assess the impact of these fatty acids on fracture risk. But Dr. Orchard decided to use a unique approach. Instead of studying the fatty acid content of fat cells, or that found in the plasma or serum of blood, Dr. Orchard looked at the fatty acid content of red blood cells. Scientists have now determined that the amount of fatty acids found in red blood cells is a better reflection of long-term dietary intake of omega-3 fatty acids than any other component of blood or even of fatty tissue itself. By studying red blood cell fatty acids and their link to fracture risk, Dr. Orchard's novel approach seems to have laid to rest the long-standing question of whether omega-3s should be included in the armamentarium of individuals with bone loss.

The authors of this study which was published in the Journal of Bone and Mineral Research concluded that omega-3 fatty acids “were significantly inversely associated with risk of hip fracture in these WHI [Women’s Health Initiative] participants.” “Conversely, women with an n6/n-3 FA ratio in the highest tertile had nearly twice the risk of hip fracture compared to those in the lowest tertile.” “Women with highest RBC EPA [*] in this case-control study had a 54% lower risk of hip fracture.

While this study confirms that supplementing with omega-3s can benefit bone health, it is important to remember that reducing omega-6 intake is equally important if it is too high. That doesn't mean that you cut out all omega-6s from your diet. Omega-6s are important for health but too much of anything is not good. I remember when I used to eat loads of pasta while training for triathlons. I thought a plate full of spaghetti would be better than a plate of fish and vegetables any day! Argggg.... that's one of the reasons that I developed osteoporosis. Omega-6s--bread, pasta, cereal--cause inflammation when eaten in excess. It is the ratio between the omega-3s and 6s that is important and the typical American diet is higher in omega-6 fatty acids than in omega-3s. Not only are grains high in omega-6s but they are also acidic. Salmon, mackerel, herring, and tuna, on the other hand, are loaded with omega-3s to help reduce inflammation, plus they are a great source of protein. Krill oil, hemp seed oil and flaxseed are also excellent sources of omega-3s.

 * Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are the fatty acids found in fish oil.

Orchard TS et al. 2013. The association of red blood cell n-3 and n-6 fatty acids with bone mineral density and hip fracture risk in the Women’s Health Initiative. JBMR 28(3):505-515.

Sunday, March 3, 2013

Impaired Digestion, Microbial Overgrowth--Contributors to Osteoporosis

When most doctors talk to their patients about osteoporosis one of the first things they ask about is calcium intake. "Do you drink milk?" "Are you taking calcium supplements?" When I see patients with bone loss, one of the first things we talk about is their digestive system. The reason being that no matter how much calcium an individual consumes, if his or her digestive tract is unhealthy they won't have optimal, or even adequate, absorption. In addition, an unhealthy gut is a cauldron of inflammatory agents that can reek havoc, not only within the gut, but also by leaking into the body.

In my book, The Whole-Body Approach to Osteoporosis, I devote a whole chapter to the digestive system. I explain how impaired digestion and dysbiosis (microbial imbalance) can lead to intestinal hyperpermeability (leaky gut), a common contributor to many disease processes including osteoporosis. This is one of the most important subjects you can read about if you want to improve your health.

Recently, I came across a great website for a company called Syontix that looks to have great prebiotic and probiotic products for correcting gut dysbiosis and promoting digestive and overall health. Ray Medina is the founder of Syontix and he writes a great blog. If you have questions about dysbiosis and want to know why gut health is important, check out Ray's blog. He doesn't talk specifically about osteoporosis but his web site is loaded with important information that is VERY applicable to improving skeletal health.
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