bone health

Whole body vibration training: what’s the lowdown on bone health?

Posted by Liz on Aug 15, 2011 in bone health | 2 comments

Back in 2009, I wrote a post about the positive effect that whole body vibration training might have on body composition. Now, researchers are suggesting that it may actually affect bone health in a beneficial way.  Who would have thunk it?

If you don’t know what I’m referring to, whole body vibration training utilizes a vibration platform  for a number of theoretical benefits ranging from weight loss and rehabilitation for muscles to improved balance However, it is also promoted a low-impact alternative to drugs and other therapies to counteract bone loss associated with aging. The concept itself is a bit strange; a person stands, feet shoulder length apart , knees locked and hands to their sides on a vibrating platform producing between.3g’s and 1.1g’s (28Hz-60Hz) of vibration for up to 30 minutes a day (the maximum recommended vibration exposure without adverse effects). That’s it. No cardio, no weight training, no nothing. Just a whole lotta vibration.

So, does it or doesn’t it?

According to a study in the Journal of Osteoporosis, just 20 minutes of intermittent vibration (one minute on, one minuter rest) at low frequency, low magnitude strength (i.e. 12 Hz) resulted in significant and clinically meaningful declines in a primary marker for bone resorption (when bone cells break down bone). In this study, 46 postmenopausal women received vibration once or three times weekly over eight weeks compared to sham vibration (minimal, continuous vibration) once weekly. Of note, a third had already been diagnosed with osteoporosis, osteoporotic fractures or osteopenia, and 41%, with osteoarthritis. In other words, two thirds of these women already had issues with bone health.

The findings?

For the first time, whole body vibration training was shown to benefit bone health. In fact, the primary marker for bone resorption was reduced by 34.6% in women who had vibration therapy three times a week compared to women who had the sham vibration, which researchers say is clinically meaningful. The key was training at least three times week with high frequency, low magnitude vibration whereas training only one day a week only had minimal benefit.

Importantly, this decline is also significant when compared to a 25% reduction in markers of bone resorption in women with osteoporosis/oteopenia who take medication and regularly walk.

Information is still needed on factors like the duration of vibration training, if more or less would suffice and if benefits can actually be maintained over time. It’s also unclear if gender, nutritional or hormone status or use of medications affects the value of vibration training. Still, the results are pretty encouraging.

Positive vibrations? Yeah, you bet!

Wednesday Bubble: Soy takes another hit

Posted by Liz on Aug 10, 2011 in bone health, herbal medicine, hot flash | 4 comments

We’re live!

Welcome to the new home of Flashfree! Our URL has changed but the same content that you’ve grown to know and ‘love’ is the same.

Let’s kick off http://flashfree.me with the latest and ‘greatest’ report on soy: it does not help menopausal symptoms or prevent bone loss.

Isn’t this contrary to what’s been reported previously, at least with regards to women with the ability to produce  S-equol?

In this latest nail to the soy coffin, research appearing in the Archives of Internal Medicine suggests that part of the issue in proving or disproving the utility of soy for menopause is the lack of trials of long duration, consistent use of low doses of soy isoflavones, small number of participants and too much breadth and depth of age and menopausal status. However, the SPARE trial (Soy Phytoestrogens as Replacement Estrogen), aimed to change this paradigm by examining the effect of daily 200 mg soy isoflavones in tablet form in 248 women between the age of 45 and 60. All participants had been in menopause for one to five years or for six to 12 months. These women were studied for two years, were instructed to take the active pill or placebo tablet before breakfast, and stop taking any hormones for at least six months before the study started. Calcium was supplemented in women who were taking less than 500 to 1000 mg daily. Importantly, women taking the isoflavone tablets were actually receiving a dose equal to approximately twice that normally obtained through food in Asian diets.

At the study’s end, the researchers found that women taking soy or placebo were on equal footing and that soy did not appear to prevent bone loss or reduce bone turnover. Moreover, soy did not appear to have any significant effect on hot flashes, night sweats, libido or vaginal dryness. They also say that even though women who are able to produce S-equol in their guts were likely to benefit from soy compared to women who are not, they did not see any specific benefit when these women were studied separately. Although not considered a dangerous side effect, constipation was experienced by more than a third of women taking soy.

So, what are we to think? Some studies say soy is effective, particularly among S-equol producers while others, like this well designed trial, show that it is now. However, there has been some data suggesting that the ratio of specific isoflavones may play an important role, and there is no information in the published study about this ratio other than to say that the soy supplement used is similar to those obtained in health food stores.

When it comes to soy, the verdict isn’t quite out yet, although the studies that have been conducted to date can’t seem to tease out what’s what. As always, use caution and lower your expectations. There are other non-hormonal approaches that may provide greater benefit when it comes to bone loss and menopausal hot flashes and other symptoms.

Want to read more on soy isoflavones? Check out the Flashfree archives.

Use it or lose it – more on osteoporosis

Posted by Liz on Jul 15, 2011 in bone health, osteoporosis | 0 comments

Bone health and osteoporosis. Yes, I know I keep writing about it. The reason is simple: you ARE at risk of losing your bone density and strength, especially if you are a woman over the age of 35. And if you are 50 or older? You have as much as a 40% risk of suffering a fracture due to osteoporosis during the rest of your lifetime. Moreover, during the first five years after menopause, women can experience as much as a 30% loss of bone density.

I can’t emphasize it enough. The risk is there. It is inevitable. However, you can reduce your risk a little bit by incorporating the following message into your life:

Use it. Or lose it.

In other words, you need to move.

The latest news out of the esteemed Cochrane Collaboration (an international organization that extensively reviews medical research) is that exercise specifically designed to promote bone growth and preserve existing bone mass, namely the type that places mechanical stress on the body, is necessary.  The newly-published review of 43, scientifically sound (i.e. randomized, controlled studies) is an update of a review that appeared in 2000. Of the 4,320 postmenopausal women included in the reviewed trials:

• Those who engaged in any form of exercise had slightly less (0.85%) bone loss than women who did not.
• Those who performed combinations of exercise types, i.e. walking, jogging, dancing, progressive resistance training, vibration platform had, on average, as much as 3.2% less bone loss than those who did not exercise.
• Non-weight bearing exercise, such as progressive resistance strength training targeting the lower limbs, was shown to slightly preserve bone mineral density at the hip, while the combination of exercise, per above, was most beneficial for slightly preserving bone mineral density at the spine. (Did you know that spine and hip fractures are the most common among women with osteoporosis?)

The conclusions are pretty clear: long periods of inactivity lead to reduced bone mass.However, here is a simple way to mitigate some of this loss, albeit slightly, and even help reduce the costly effects of osteoporosis: Exercise.

The best exercises? Those that stress or mechanically load the bones, meaning the type that make the bones support body weight or resist movement, such as aerobic or strength training, walking, or Tai Chi.

Ultimately, your goal is prevent osteoporosis from occurring in the first place. While some amount of bone loss is part and parcel with aging, resistance training is critical.

Move it or lose it.

Wednesday Bubble: wrinkles and bone density – what’s the connection?

Posted by Liz on Jun 8, 2011 in bone health, menopause, osteoporosis | 5 comments

There’s a connection between wrinkles and bones? When I caught wind of the research, I thought immediately of a Wednesday Bubble. But this one appears to be the real deal.

Researchers presenting at The Endocrine Society’s Annual Meeting this past weekend say that severity of facial wrinkles during the early years of menopause may indicate a low bone density (thereby leading to an increased risk for osteoporosis). Wow!

This information comes out of the ongoing Kronos Early Estrogen Prevention Study (KEEPS), which is looking at the effect of oral and transdermal estrogen therapy on measures of the carotid artery that might indicate thickening of the arteries (and eventual heart disease) as well as the build up of calcium in the blood. A subgroup of 114 women in their late 40s and early 50s and within three years of starting menopause were examined for this part of the trial.

The researchers looked at and scored severity and depth of skin wrinkling based on number of sites on the face and neck. They also measured skin rigidity (or firmness) on the forehead and cheek. Additionally, they evaluatd total body bone mineral density as well as at the lumbar spine and left hip.

The findings? Higher wrinkle scores (meaning more severe wrinkles) were associated with lower bone density measures at all sites, while firmer skin on the forehead and face were related to greater bone density, especially at the hip and spine.

The connection? Pun unintended but the researchers say that collagen, protein that naturally occurs in connective tissue in tendons, ligaments and even bones, is the common factor. They add that as women age, changes in collagen not only contribute to sagging skin and more facial lines but may also negatively affect both the quality and quantity of bone.

Although more research is needed, it might be worthwhile to obtain a dermatologic and bone density assessment at the start of menopause to see where you stand. And then speak to your health practitioner about the need for regular follow up and monitoring to insure that fragile bones don’t lead to fractures. Ultimately, if the link between wrinkling and bone quality is proven, it might eliminate or at least lessen the need for costly DEXA ( dual energy X-ray absorptiometry)  that are currently used to measure how tightly calcium and other minerals are packed into bone.

Who would thunk that wrinkles could actually be useful?!

Wednesday Bubble: is there a connection between dry mouth and osteoporosis?

Posted by Liz on Jun 1, 2011 in bone health, dry mouth, osteoporosis | 0 comments

This week’s bubble is neither burstable or good news. But it is important:

Dry mouth and bone mineral density appear to be related.

Say what?!!!

A bit of background is needed…

Osteoporosis is fast becoming a major health problem and as I’ve written time and again on this blog, is a significant characteristic of menopause, namely as the result of waning estrogen levels that lead to an imbalance between the build up and turnover of bone cells. Parathyroid hormone and cortisol have also been linked to bone turnover.

Dry mouth (i.e. a feeling of dryness in the mouth and need to use liquids while eating) and burning mouth syndrome (i.e. burning in the tongue or oral mucus membranes and taste alterations) are also common during menopause, affecting up to 40% of women. Until now, experts have not been able to adequately determine why these symptoms occur and more importantly, effective management strategies.

The link? Recent data have shown that estrogen levels may be significantly lower and both parathyroid and cortisol levels significantly higher in menopausal women who complain of dry mouth. Moreover, as the results of a new study in Menopause show, there may be a true relationship between these two conditions and that bone loss may be the actual cause of oral dryness and related symptoms. In this study, researchers evaluated 60 women in menopause (mean age 56) for the presence and severity of dry mouth and then based on their results, divided them into two groups. Dry mouth was confirmed by responses to a scientific questionnaire and collections of saliva. The researchers also measured bone mineral density at the spine.

Importantly, the participants were not particularly active and none engaged in any sports activity, except walking. The women were also matched by body mass index, age, or years of menopause. And yet, women with low bone mineral density, including relationship to other women in the same age group and 30 years younger, were significantly more likely to experience dry mouth and had significantly less saliva when their appetites were not stimulated.

Clearly, more research is needed. However, there are some things you can do now. The first strategy to combat osteoporosis and bone loss is to get measured for bone loss and disease markers. Steps like calcium supplementation, a healthy diet and regular exercise are critical. And if you suffer from dry mouth? You may want to speak to your dentist about a referral for a bone mineral density scan or better yet, have him or her contact your gynecologist or regular health practitioner for a pow wow. Not only may you help your bones, but you may actually change that dry feeling.

Calcium, vitamin D and heart disease. What’s the 4-11?

Posted by Liz on May 2, 2011 in bone health, heart disease | 5 comments

“Calcium supplements cause heart attacks in postmenopausal women.”

Whoa! What?!

If you saw the headlines last week, you may be wondering what’s up with calcium supplementation. Afterall, don’t medical professionals advise the use of supplements to stave off bone loss associated with osteoporosis? And as a result, the Centers for Disease Control reports that over 50% of adults currently use calcium supplements and more than 60% of women over age 60.

It’s important to get away from the sensational headline and take a closer look at what the research shows and what you need to know.

Previous studies have suggested that there may be a link between use of calcium supplements (without vitamin D) and heart attack; in fact, as Reuters‘ reported last year, calcium supplements were shown to increase the risk of heart attack by as much as 31%, possibly as a result of plaque formation in blood vessels. However, is the risk the same if calcium is used alone versus if it is used in conjunction with vitamin D?  In the Women’s Health Initiative study, the use of calcium and vitamin D did not appear to influence heart disease risk at all.

However, researchers decided to take another look at the data because they say that in this trial, more than half of participants were taking ‘personal calcium’ (i.e. not regulated or standardized to all trial participants) and almost half were also adding Vitamin D.

In this reanalysis, published just last week in the British Medical Journal, the researchers discounted the women who were characterized as personal users of calcium supplements and instead, limited their evaluation to a group of women who were not using personal calcium supplements at the study’s start and previously unpublished data from the trial. The findings? The use of calcium with or without vitamin D appeared to cause a 25% to 30% increase in the risk for heart attack and a 15% to 20% increased risk for stroke. However, the researchers say that even small increases in the incidence in heart disease may manifest substantially, especially in the elderly. They add that if you take a look at the risk-benefit ratio, it is unfavourable, meaning that taking calcium with or without vitamin D for five years would cause twice as many heart attacks or strokes than then numbers of fractures that would be prevented.  Additionally, the data analysis suggests that dosing is not a factor, and that the total amount of calcium taken daily is less important than the abrupt changes in blood calcium levels immediately following supplementation.

Although this research answers a few questions about potential risks about calcium supplementation, it also leaves a key question unanswered:  how does the addition of magnesium and vitamin K, which are often included in commercially-available calcium supplements, affect these findings? Data suggest that these minerals and vitamins are added to keep calcium in the bones where it belongs and out the arteries where it does not.

The best guideline, as always, is to visit a physician to assess your bone health and come up with a plan that works specifically for you. Although calcium supplementation appears to be risky, more data are needed before leading organizations start to change their tune about calcium and bone health. Meanwhile, stay ahead of the headlines and try to focus on increasing the amount of calcium-rich foods in your diet:

* DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration to help consumers compare the nutrient contents among products within the context of a total daily diet. The DV for calcium is 1,000 mg for adults and children aged 4 years and older. Foods providing 20% of more of the DV are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthful diet. The U.S. Department of Agriculture’s Nutrient Database Web site lists the nutrient content of many foods. It also provides a comprehensive list of foods containing calcium.
** Calcium content varies slightly by fat content; the more fat, the less calcium the food contains.
*** Calcium content is for tofu processed with a calcium salt. Tofu processed with other salts does not provide significant amounts of calcium.