Healthy Bones – Where Do We Go from Here?

May 29, 2012 in Exercise, Health, Nutrition by Joyce Bunderson

I received a beautiful new ring as an anniversary gift; and on Friday I went to have it sized down to fit my right hand ring finger. The jeweler asked if I knew my ring size, I answered, “Yes, size 4. It used to be 3½, when I was younger.” He said, “That would be unusual.” “So I’ve heard,” I responded. He measured my finger and said, “You really did know your ring size; those are some pretty small fingers.” For me it’s a tad bittersweet. My small fingers were once nice to have; but now they’re a reminder that there is only so much bone in this frame of mine to keep supporting my body. Because genetically, some of us are especially prone to osteoporosis, we need to stay on top of issues that are related to protecting the calcification of our bones. I know I’m not alone in this concern; about 44 million Americans are at risk for osteoporosis or already have it and about 20% are men.

Calcium supplements – heart attack risk

This past week I read some new research about calcium supplements. I realize that many persons are being directed by their doctors and health care professionals to take calcium supplements to fend off osteoporosis. Some people, like myself, are not able to take calcium supplements because they form kidney stones from too much concentrated calcium provided by supplements. That lesson, for me, was a hard, painful one (kidney stones – Ouch!). But now I guess the painful lesson may have some benefit.

The new research study is published in the journal Heart. In essence, the researchers found that taking a calcium supplement to help prevent bones from thinning puts people at a greater risk for heart attacks. They found that those who took regular calcium supplements along with other vitamins/minerals were 86% more likely to have a heart attack than those who didn’t take supplements. The persons who took only calcium supplements (not including vitamins) were 139% more likely to suffer a heart attack as those who didn’t take any vitamin supplements. The article didn’t say whether the calcium-only supplements were more concentrated, or why they were different. The researchers did not find any increased risk of heart attack from more calcium occurring naturally in the diet; in fact, the incidence was a bit lower. Increased risk is not from calcium eaten in foods and dairy products, only from calcium supplements.

One of the suggestions of the researchers is that we need to return to seeing calcium as an important component of a balanced diet. That is, we should try to get more calcium in our food. By getting our calcium naturally from food – that is, in small doses from real foods, it’s easier to absorb throughout the day, it is not likely to increase risks of heart attacks, and might even help a bit.

The study did not learn what it is about having a spike in blood calcium from taking supplements that caused the increase in heart attacks. My guess is that it has something to do with the calcification of the arteriosclerotic plaque building up in the arteries. But this is, as I said, just my wild guess. We know that calcium is in the plaque that causes atherosclerosis – the crystals of calcium may be involved in snagging the globs of cholesterol that are moving through the arteries. We’ll have to wait until more research is done before we have the answer to that question.

Bisphosphonates: Fosamax and its relatives

On May 9, 2012 the Food and Drug Administration warned the public about the risks for an atypical fracture of the femur (large upper leg – thigh bone) in the New England Journal of Medicine article called Bisphosphonates for Osteoporosis – Where Do We Go from Here? In short, the bad news is that the bisphosphonates (like Fosamax and Reclast) have been found to cause fractures in the femur, after being used for 3 to 5 years. So now, patients and their physicians have to consider the risk verses the benefits of this group of drugs. It appears that the bisphosphonate residues stay active in the bone long after the patient strops taking the drug.  It builds up as the bone keeps forming for some time after the patient is taken off the drug. Extra brittleness and the breaking of the femur, occurs just beyond the ball-joint. A friend and fellow-grandmother of some of our grandchildren had this happen to both femurs. It seemed very strange at the time. Now we know why. This is a concern for you and your physician to discuss – are these powerful drugs, a net benefit or the cause of nasty side effects?  How long should you take them?

Where can you go from here? – What can you do?

There are some things that you can do that will not make your femur brittle or increase your heart attack risk. Consider some of the following:

  • Vitamin D – vitamin D is very important part of building and maintaining bones. So let’s start with being sure that you’re vitamin D is sufficient. Your doctor can check your blood level of vitamin D. Vitamin D is not really a vitamin, but a hormone made when ultraviolet radiation from the sun hits your exposed skin. So if you’re sitting behind a window in your car, or are covered up when outside, or have sunscreen on, or have fairly dark skin, or are heavy, or older, you may not be making enough vitamin D. It’s really difficult to get enough vitamin D from your diet, even if you’re eating lots of fatty fish; fortified milk, juice and cereal; mushrooms and egg yolks. Of course, we all know that too much sun can cause deadly melanoma and crinkly, wrinkly prematurely aged skin; but some sun (maybe about 20 minutes on a sunny day) could be a benefit by producing enough vitamin D to give you a healthy amount of that important so-called vitamin. Unfortunately, some people can’t get outside, for one reason or another. And others of us live north of the 37-degree latitude line (draw a line from Norfolk Virginia to San Francisco, California). The amount of sunlight, north of that magical line, is insufficient to create vitamin D in your skin during the winter months, even if you’re skin is exposed. If you live in the north, decide with your MD, if you need supplements. Although you will not make too much vitamin D from sun exposure because your body regulates that, you can get a toxic amount of vitamin D from supplements – so don’t go off the deep end with vitamin D supplements. If you do take a vitamin D supplement, take the vitamin D3, not D2. D3 is the active form of vitamin D and is the more effective form that your body uses.
  • Weight bearing exercise – It seems pretty straightforward; it is exercise during which you bear weight – that is, let gravity pull extra weight against your supporting bones. So swimming, while being a wonder cardiovascular exercise would not be a good example of weight bearing exercise, because the buoyancy of water protects your bones from the effects of gravity. Cycling and elliptical trainers also are good for an aerobic workout, but not as good for improving bone health. Weight bearing exercise stimulates your body to make bone; so it’s an important part of the healthy bones equation.
  • Diet – There are some thing that the modern diet of meat, potatoes, and gravy leaves out ….. even with that token half cup of vegetables. O.K., there are really lots of things left out, but at this time, I’m referring to calcium. It used to be common to cook a big pot of greens. These greens gave people, not only protein, but, fiber, vitamins and a variety of minerals, and specifically – a big serving of calcium. It wasn’t even a hundred years ago, that humans commonly ate anchovies and sardines. You ask, “Why should we care?” Because the bones of those small fish were eaten. Walla! Calcium on a platter. When people were more commonly eating stewed chicken, fish and other stewed meats, quite a bit of calcium was leached into the water and was consumed. We Americans commonly eat a piece of broiled meat that is removed from the bone. While we generally think of drinking milk or eating cheese, when we are trying to increase calcium in our diet, maybe we should begin to include more dark green leafy vegetables. Try making salmon patties, from canned salmon with the bones left in the can. And include some greens in your soup recipes.

Dr. Grandpa, my sweet husband, came home the other day with a new pressure cooker. I gave it a whirl before writing this blog piece. The good news is that after making up a pot of chicken vegetable soup, the results were not only delicious but a nice contribution of much needed calcium. I put a chicken carcass with all the skeletal bones but the wings and one leg into the cooker with some tarragon and processed on high pressure for 10 minutes. Then I removed the chicken took the meat off the bones easily, and discarded the bones, now leached of much calcium.  Then I added a cup of watercress, and about 4 cups of radish greens; 1½ cups chopped carrots; a cup of chopped yellow onion, and 2 cups of sliced portabella mushrooms. This was cooked for about another 8 minutes. I added some already cooked wheat berries, a bit of salt and the deboned chicken meat, simmered it for a few minutes and served it. It really confirms our byline – Good Health Can Be Yummy. See the pictures of my first harvest of this 2012-year – French Breakfast Radishes. You’ll be surprised how delicious those calcium-rich fresh radish tops are in soup. Yum!

So getting out in the garden for a little exercise; soaking up a few rays, and then, making a nice homemade soup are only a few ways to safely contribute to strong bones without depending so much on risky supplements and drugs.

French Breakfast Radishes, the greens were wonderful in chicken soup.