Posts Tagged "bone loss"

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.

Soy. Is it safe?

Posted by Liz on Jan 3, 2011 in diet, herbal medicine, osteoporosis | 0 comments

For years, researchers have been exploring the potential of soy isoflavones — naturally-occurring plant estrogens — for alleviating menopausal symptoms such as hot flashes, atrophy and bone loss. Thus far, certain components of soy, including genestein and S-equol have shown the most promise. However, are they safe?  And, as the adoption of soy as a viable alternative to risk-ridden hormone replacement therapy continues to grow, and women turn to supplements rather than food-based soy, is there anything that they need to worry about in terms of side effects?

Researchers recently evaluated this question in a study of 403 postmenopausal women who took  either 80 mg soy tablets, 120 mg soy tablets or placebo tablet daily for  two years. The particular type of soy isoflavones used were hypocotyl isoflavones, which are a byproduct of soy protein and (very rich in daidzein – the second most plentiful isoflavone in soy. The effects of the supplements were measured at the study’s start, at one year and at the end via blood tests and a well-woman examination (i.e. mammogram, pap smear, x-rays to measure bone density). A smaller group of women also had ultrasounds done to determine any possible effects on the lining of the uterus or development of fibroids.

Although the primary goal of the study was to determine the effects of this type of soy supplement on osteoporosis and bone loss, the researchers discovered that taking soy supplements during this time period did not present any major risk to health and did not affect thyroid function. Although one participant developed breast cancer during the study and one, endometrial cancer, 1) utrasounds in the subgroup of women who received them did not show any uterine thickening and 2) the rate of cancer development in this study, only two women over a two year time period, was considerably lower than statistically likely in a general population of women. Both of these factors support the contention that soy isoflavones are not likely to promote either cancers.

So, is soy safe over the long-term? It appears that it is. HOWEVER, bear in mind that the type of soy used in this study is are very different that the type that is commonly sold over the counter, which commonly contain higher percentages of genistein, the most plentiful isoflavone component in soy.

And what about osteoporosis? This particular paper did not address those specific results, although others have. Thus far, the results have been mixed. However, this particular study, better known as OPUS (Osteoporosis Prevention Using Soy)is one of the largest and most comprehensive to date and those findings are likely to come to light soon.

In the interim, if you are going to be taking soy in supplement form, be mindful that your exposure is likely to be as one to four times that a typical Asian diet and as much as 100 times that of a typical Western diet. While these level do not appear to be harmful, herbal and plant medicines are not without risk so as always, the rule of thumb is be vigilant and speak to a health practitioner first.

The B’s have it – bursting the belly and bones myth

Posted by Liz on Dec 3, 2010 in bone health | 2 comments

When it comes to aging and women, bone health is a big deal. As I’ve written time and again on Flashfree, women are at a particularly high risk for bone loss as they age because of declining estrogen levels, and in turn, a reduced ability to prevent an increase in net bone resorption (i.e. bone loss due to the activity of bone cells). And while we’ve been told that excess body fat actually protects against bone loss, novel research is putting that myth to rest. This news may affect the millions of women who are considered obese based on their body mass index (BMI > 30), who, although at greater risk for heart disease, diabetes and joint disease, were at least believed to have a weapon against osteoporosis.

In a small study that was presented at this week’s Radiological Society of North America meeting, an assessment of the abdominal and total fat and bone mineral density of 50 premenopausal women of varying BMI showed surprising results. According to the lead researcher, Dr. Miriam Bredella, “the general consensus has been that increased body fat protects against bone loss and obese women are at decreased risk for developing osteoporosis. However, we found that visceral fat — the deep belly fat — makes bone weaker.” In fact, the researchers found that women with more belly fat had significant declines in their bone mineral density and increases in the degree of fat within their bone marrow, but that total body fat or fat existing right below the skin had little impact on bones.

An important challenge for women is not only that metabolism slows and the risk for obesity increases as we age, but also, a natural increased risk for redistribution of fat to the abdominal area. And unfortunately, it’s one of the most challenging areas to address, requiring significant increases in physical activity and decreases in caloric intake. Some data suggest that isoflavones might help reduce waist circumference as well, although they are hardly definitive at this point. Still, a word to the wise: that belly fat is not going to protect your bones. Time to start moving and eating correctly; your bones will thank you.

Wednesday Bubble: protein, weight and bones – keep it in balance

Posted by Liz on Aug 4, 2010 in bone health, diet | 1 comment

Weight loss improves health, right? Well, yes, and no. Because it turns out that weight loss also increases the rate that the bone loses density, so in midlife and menopause, weight loss can be a double-edged sword.

In two recent studies published in the online edition of the Journal of Gerontology, researchers are reporting that women already at risk for osteoporosis due to their age and menopausal status may want to pay attention to what they eat when they try to lose weight. In fact, consuming large amounts of protein derived primarily from animal sources, e.g. lean meats like pork, beef and chicken, may negatively impact bone density and in turn, further increase osteoporosis risk.

Here’w what you need to know:

• In the first study, women between the ages of 43 and 80 reduced their daily caloric intake by 750 calories. Over three months, about half of the women ate meat-free diets that derived about 18% of their daily protein from vegetarian, dairy and egg sources and other half, ate diets comprised of about 30% protein derived from lean pork.

• In the second study, women between the same ages consumed about 1,250 calories a day in five meals over nine weeks. While the bulk of these calories were from a vegetarian diet, women were asked to eat either 250 calories of carbs daily (shortbread cookies, sugar coated chocolates), chicken (plus 10 grams of butter) or the equivalent in fat/saturated fat but as beef.

• Although women in the first study lost about the same amount of weight (~19 lbs), those eating animal protein has a 1.4% greater loss of bone mass. Likewise, in the second study, all the women lost weight but those women eating animal protein sources lost significantly more bone mass compared to women eating carbs.

• Women in both of these studies were considered overweight or obese based on their body-mass indices (BMI).

Importantly, many of the today’s popular diets for weight loss (e.g. South Beach, Atkins) emphasize increased intake of protein over carbohydrates (although the former also emphasizes good versus bad (i.e. glycemic index) carbs. What this means is that while you are cutting back, you may also be losing more bone mass than you normally would with weight loss.

Consequently, one of best approaches for women who are going through menopause and trying to keep the weight off may be to increase the daily  amount of so-called “good fats,” which as my friend Mollie Katzen, suggests should include nuts, avocados and fatty fish like salmon. Many of these foods are also good sources of protein and while not necessarily working to build bone, may stave off bone mass loss while you are trying to lose a few pounds or maintain your current weight.

At the end of the day, it’s all about balancing the good, the bad and the ugly. Our skeleton is fragile and it’s critical that we do all we can to keep it in one piece.

Want to learn more? I’ve dedicated several posts to osteoporosis, bone loss and bone health.

Wednesday Bubble: Is S-equol the next big thing?

Posted by Liz on Jul 14, 2010 in new approaches | 5 comments

Last year I wrote a few posts about the potential of the isoflavone S-equol for addressing menopausal symptoms, including hot flashes and mood swings.

If you are unfamiliar with S-equol, it is actually a metabolite of a one of the three soy isoflavone compounds (i.e. daidzein), and is produced by bacteria that live in the intestines. One of the most interesting things about S-equol is that is one of the principal types of isoflavones that are found in soybeans and most soy foods. However, up to 80% of the U.S. population and about half of the Japanese population (who consume inordinate amounts of soy) cannot manufacture S-equol on their own and need to obtain it in supplement form.

This month’s Journal of Nutrition has devoted an entire supplement to S-equol research, and I’ve been fortunate to take a more detailed look at the evidence supporting the role of S-equol for menopausal symptoms. Notably, some of the  researchers actually say that “to conduct menopausal medical care appropriately [which, in their opinion, should be geared towards a better quality of life on an individual basis), it is necessary to provide evidence-based alternative medicines as much as possible.” It is wonderfully refreshing to find such esteemed colleagues backing my view of how menopause should be approached.

Hence, without further ado, following is what you need to know about the recap of study findings, and what still needs to be explored before we all start taking S-Equol.

In three randomized studies conducted in pre-, peri- and menopausal Japanese women who were or were not able to produce S-equol naturally, researchers found specific benefits in three areas:

• Mood improvement: 134 women who produced S-equol naturally and took a 10 mg daily S-equol supplement had significant reductions in anxiety; those who took 10 mg three times a day had significant declines in tension-anxiety and fatigue, and an increase in overall energy. Note that these women also limited their daily intake of soy products to no more than 20 mg/day.
• Hot flashes and other symptoms: In 320 women taking 10 mg S-equol daily or placebo for 12 weeks, S-equol supplements reduced the frequency of hot flashes by as much as 58%. Decreases in muscle and neck stiffness were also reported.
• Bone health: In 54 women who had undergone menopause within 5 years of the study, those who were able to produce S-equol naturally and took 75 mg  isoflavones daily supplement (mostly consisting of daidzein) lost a significantly lower percentage of bone in their hip area than women who were not able to produce S-equol naturally but also took the daily supplement. Researchers believe that S-equol actually mimics the action of estrogen in the body in terms of its ability to maintain bone mass and the balance between the build up of bone (bone formation) and the loss of bone (bone resorption). However, studies looking at how it acts in the body have only been conducted in mice and at relatively high doses. Information reported in the Journal supplement does show that at higher dosages, S-equol can negatively affect the tissues lining the uterus.

A few key take-away points to think about when we think about S-equol:

Researchers believe that the research in S-equol helps to show that soy isoflavones work best in individuals whose bodies are able to produce S-equol naturally. However, you’ve read the stats – the majority of people who live in the US do not produce S-equol naturally. Dosing and the exact type of S-equol may also influence outcomes. Likewise, They still aren’t sure how bacteria in the intestines influence S-equol’s effects and wonder if somehow, some other mechanism is at play. Further research is also needed to see if the beneficial effects of S-equol on menopausal symptoms can be extended to women who do not produce it naturally.

It’s too early to boost this bubble and I’m excited by this evidence-based alternative. Naysayers love to point out that alternative therapies are sham and snake oil. While this may be true of some preparations, it’s clear that researchers are taking natural substances to a higher level to see if they offer efficacy without the risks of hormone replacement.