Posts Tagged "bone loss"

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.

Wednesday Bubble: osteoporosis – all bets are off!

Posted by Liz on Mar 3, 2010 in bone health, estrogen | 3 comments

Which came first? The chicken or the egg?

When it comes to osteoporosis, all bets are off. Researchers are now saying that age and not estrogen decline is the primary culprit in development of osteoporosis in women. Estrogen simply acts to “accentuate” the negative results.

Aging increases what science refers to as “oxidative stress.” This means that as we age, an imbalance is created between certain molecules that freely circulate in the body (better known as free oxygen radicals) and cause major damage to cell and vessels walls and  the body’s natural ability to fight them off. Not surprisingly, oxidative stress has been linked to numerous chronic illnesses, including cancer, heart disease and diabetes.

In so far as osteoporosis goes, the loss of estrogen and androgens decrease our natural defenses against oxidative stress in bone in particular, leading to increased bone breakdown (resorption). The body also starts to overproduce certain hormones that directly affect the the vitality of the skeleton, causing bones to become brittle and more prone to fracture. However, studies also show that bone loss can begin in both women and men as early as age 30 or so, well before any major changes in sex hormone production.

The question is, what can we do about it?

Researchers have also found that there is a specific family of proteins in our bodies that act as a natural defense against oxidative stress. These proteins, better known as FOS (foxhead box transcription factors) are integral to a healthy lifespan and also, preserving bone mass. If researchers can identify what causes the decline in FOS, they may be able to devise strategies to preserve our reserves. Meanwhile, estrogen gets at least a partial reprieve this time.

Sources: Manolagas SC. Endocrine Reviews. 2010.  Ambrogini E. Cell Metabolism 2010;2:136-146.

Calcium conundrum: which supplement should I choose?

Posted by Liz on Sep 18, 2009 in bone health | 0 comments

Calcium supplements come in many forms including calcium citrate,  calcium carbonate and calcium gluconate.  Experts have long said that when it comes to selecting a calcium supplement, type is less important than the amount of calcium that is available for absorption by the body. This can be determined by looking at % of the recommended daily amount that is available in each dose. Currently, the National Osteoporosis Foundation recommends that women between the ages of 19 and 49 ingest 1,000 mg daily and over age 50, 1,200 mg daily.

Hence, I was intrigued when I ran across a newly published review in the September/October issue of Menopause that shows a significant advantage with a form of calcium I had not heard of before: ossein-hydroxyapatite complex (OHC), which is the mineral component of bones and teeth.

Conducting an extensive review of six clinical trials that compared OHC to calcium carbonate in 614 postmenopausal women, the researchers found that OHC was statistically superior to calcium carbonate in terms of preventing bone loss and increasing bone mineral density (BMD). Importantly, use of vitamin D did not affect the results nor did further statistical analyses.

OHC is available in microcrystalline form and often goes by the name MCHA or MCHC. This helps insure adequate absorption by the body. I’ve seen it available online and its price structure is similar to other standardized supplement formulations.

After menopause, women can experience as much as a 30% loss of bone, thereby increasing the risk for osteoporosis. I am heartened by this research and by the fact that we now have another tool in our kit to keep our bones strong and healthy. Prevention is key!

Sinking your teeth…into osteoporosis

Posted by Liz on Sep 7, 2009 in bone health | 1 comment

Time to beef up protection of your bones now….before osteoporosis leaves you with fewer teeth. Disturbing study findings from the March issue of the Journal of Clinical Periodontology suggest that osteoporosis won’t just leave you a few inches shorter and hunched over, but you may lose a few teeth while you’re at it.

Researchers examined 651 menopausal women between the ages of 45 and 70, measuring bone density in the hip, spine and the pelvis. Among the women examined, 140 had osteoporosis.

• Despite adjusting for factors that might increase osteoporosis risk, such as age and smoking, a significant association was found between osteoporosis and having fewer teeth.
• On average, women with osteoporosis had at one to three fewer teeth than those without.

Osteoporosis can affect the jaw, leading to bone loss and a decline in bone density needed to support teeth. Although the numbers of teeth lost are fairly low compared to healthy women, it’s important to keep in mind that studies show that tooth loss can have a significant impact on both quality of life and oral comfort.

I’ve written several posts about osteoporosis, bone loss and prevention so I’m not going to reinvent the wheel. But I do encourage you to peruse the archives and start taking steps to prevent, slow or halt bone loss before you lose a few bones, and a few teeth.

Just something to sink your teeth into….

Beer boosts bones

Posted by Liz on Aug 21, 2009 in bone health | 2 comments

Beer boosts bones. Say that three times fast.

Seriously, the weekend is fast approaching and it’s a beer sort of day; well sort of. A newly-published study is touting the news that bone density is better in beer drinkers than in non-beer drinkers. On the otherhand, drinking more than two alcohol drinks a day can be harmful to bone. Confused yet?

Researchers say that at appropriate doses, alcohol stimulates calcitonin, a hormone that inhibits the breakdown of bone cells and stimulate bone formation. As women age, they experience a deficit in calcitonin, which is one reason why osteoporosis is so prevalent after menopause. Key components in alcohol that promotes calcitonin and also inhibit postmenopausal bone loss are flavones, which are a type of flavanoid primarily found in certain cereals and herbs. Evidently, beer contains flavones.

In this particular study, which was published in the journal Nutrition, researchers measured bone density of the bones in their fingers, and evaluated weight, age and alcohol use in 1697 women. Women who participated in the study were on average, 48 years old; 710 were premenopausal, 176 were perimenopausal and 811 were postmenopausal. All participants were classified as moderate drinkers (1/2 cup to 10 ounces of alcohol per week), light drinkers (less than 1/2 cup alcohol per week) or non-drinkers, and were also classified according to whether they were beer or wine drinkers.

Study findings showed that women who were characterized as moderate beers drinkers had superior bone density compared to non-drinkers and wine drinkers, regardless of menopausal status and independent of age.

The researchers point out that it is likely that certain components of hops, namely the female flowers, have high estrogen-like properties. Moreover, they say that two isoflavones — daidzein and genistein — have been shown to have bone-protective properties and are present in beer. Beer is also a major dietary source of silicon, which studies show plays a major role in bone formation.

So, what to make of this study? Should you run out and buy a six-pack? Forgo that glass of wine for a cold one? The researchers say that they are not recommending that peri- and postmenopausal women start drinking beer to decrease their risk of osteoporosis. Still, one or two beers can’t hurt, right?