Three quarters of Hip Fracture Patients Deficient in vitamin D

The International Osteoporosis Foundation reported last week on an Indian study that could prove to be a useful index for the assessment of hip fracture risk in elderly people.

There has been much in the press recently about a recent report from the US Institute of Medicine which found that most people in the U.S. and Canada do not need vitamin D supplements as they are getting enough from their diets. Previous research has shown that low vitamin D levels increase the risk of cancer and heart disease and strokes, diabetes, breast and colon cancer, auto-immune diseases, infections and depression, and to play a role in muscle strength and multiple sclerosis. Studies have suggested many Americans don’t get enough vitamin D because they spend long periods indoors and wear sunscreen when outside which prevents vitamin D being absorbed.

This study from New Delhi India has revealed high rates of vitamin D deficiency among hip fracture patients, confirming the conclusions of similar international studies which point to vitamin D deficiency as a risk factor for hip fracture. It may be that Indians in general have low levels due to skin pigmentation, traditional clothing and the avoidance of sunlight.
Vitamin D deficiency has been linked to development.

The US study recommended amount is 600 international units of vitamin D daily and good food sources are oily fish and eggs but the main source is from sunlight on the skin.

Weak Bone Risk for Diabetic Children

Menopausal women are not the only ones at risk for bone loss according to the researchers at Georgia Medical College in the USA.

Osteoporosis is generally considered a condition that is primarily affects women during and after menopause but now it seems there is another group who could also be at risk. We know that one of the risk factors for diabetes in childhood is being overweight and a recent study of 140 overweight children age 7-11 and who got little regular exercise has found that the 30 percent with signs of poor blood sugar regulation had 4-5 percent less bone mass.

Now bone mass is a measure of bone strength and Dr. Norman Pollock, bone biologist at MCG’s Georgia Prevention Institute, has confirmed that this study is the first to suggest the association between weaker bones and type 2 diabetes risk in children.

Type 2 is the most common form of diabetes in adults and sadly is now becoming more common in children as it is often associated with being overweight and taking little exercise. The study has just been published in the Journal of Bone and Mineral Research and according to. Dr. Pollock “while overweight children may have more bone mass than normal-weight kids, it may not be big, or strong enough, to compensate for their larger size.”

Though of course it is not the case that everyone who is overweight has weak bones, Dr. Pollock feels it may have more to do with how fat is distributed throughout the body. For instance pre-diabetics tend to have more fat around their abdominal area, specifically visceral fat, a type of fat deep in the belly that is linked to diabetes and cardiovascular disease.

In this study, higher amounts of visceral fat were associated with lower bone mass while more body fat overall was associated with higher bone mass. “Taken together, it seems that excessive abdominal fat may play a key role linking pre-diabetes to lower bone mass,” Pollock said.

The good news is children — or more accurately their parents — have time to fix this problem which can have the potential for lifelong health consequences. Two of the simplest solutions are to engage children in regular exercise that can be maintained because they enjoy it and will continue it into adulthood and to pay real attention to their diet.

If parents truly want to enhance bone strength and ultimately reduce the risk of osteoporosis during childhood, then these two simple measures will not only improve their health but research has shown can also improve their ability to learn.

World Osteoporosis day

October 20th is the day to raise awareness of this potentially lethal condition and 2009 is the second year of a two year campaign which called on government health officials to recognize osteoporosis as a health priority

Osteoporotic fractures are a major cause of suffering, disability and death in the older population and their costs to our healthcare services exceed those of many other major chronic diseases. Between twelve to twenty percent of people die within one year following a hip fracture and it is estimated that 80% of those who are at high risk of osteoporosis, and have suffered at least one fracture, have neither been identified nor treated for the disease.

This means that you have to take responsibility here and if you feel you are at risk to have a bone scan done or take nutritional advice and support. For free comprehensive information on osteoporosis I recommend the booklet that Dame Dr Shirley Bond and I wrote and you can get a copy by clicking this link: progesterone

New bone implants on the way

Throughout our lives our bones continue to break down, and be replaced with new material as part of our body’s natural cycle of growth. However, when whole bones need to be replaced after tumours, or accidents, then there has so far been no way to successfully grow replacement bones. It happened in fiction with J K Rowling’s description of Skele-Gro which magically re-grows bones in around 8 to 12 hours and is a very painful process. Many women with osteoporosis find that using a natural bone growth promoter like natural progesterone may take longer but certainly isn’t painful!

Not sure if the scientists at Imperial College London had this in mind, but it seems that there is a worldwide interest in producing bone-like materials derived from stem cells with stem cell technology. The research results were recently published in the journal Nature Materials and it is hoped will be able to be implanted into patients who have damaged or fractured bones, or who have had parts of diseased bones removed. The idea is that, ultimately, these bone-like materials could be inserted into cavities so that real bone could meld with it and repair the bone.

It is currently possible to grow small ‘nodules’ of what appear to be bone-like material in the laboratory from different types of bone cells and stem cells. It is these different types of material that the scientists from Imperial College London have been comparing and they have discovered significant differences between the quality of the bone-like material that these can form.

For example, they found that materials grown from bone cells from mouse skull and mouse bone marrow stem cells successfully mimicked many of the hallmarks of real bone, which include stiffness. However, they found that the material grown from mouse embryonic stem cells was much less stiff and less complex in its mineral composition when compared to the other materials.

So what we have here is a good starting point as Professor Molly Stevens, from the Institute of Biomedical Engineering at Imperial College London, says: “Many patients who have had bone removed because of tumours or accidents live in real pain. By repairing bone defect sites in the body with bone-like material that best mimics the properties of their real bone we could improve their lives immeasurably. It brings us one step closer to developing materials that will have the highest chance of success when implanted into patients.”

Osteoporosis Prevention

According to government figures hip fractures cause more than 1150 premature deaths each month in the UK. By the age of 75 around half the population have osteoporosis, because as we get older our bones become more fragile and likely to break or fracture. Your risk is dependent on many factors including family history, race, gender, certain medical conditions and drugs, and your age. You can’t do anything about changing most of those, but you can do something to help prevent osteoporosis.

The first question is diet, and it increases your osteoporosis risk if you crash diet or have a very low body weight as you body takes the calcium it needs from your bones if you are not providing it in your diet. Some foods are very calcium-rich and so are beneficial in helping bones stay strong. These are: Low-fat or non-fat dairy products, tinned sardines and tinned salmon, dark green vegetables, tofu, almonds, figs, sesame seeds and calcium-fortified fruit juices and soy milk. If you can’t stomach any of those, then get a good calcium/magnesium supplement – not just calcium alone as you need the magnesium for maximum calcium absorption. .

Magnesium deficiency can be quite common in osteoporosis and although many fruit and vegetables have some magnesium in them, the best sources are whole grains, wheat bran, leafy green vegetables, nuts (almonds are a very rich source of magnesium and calcium), , bananas and apricots. You also need trace minerals: Boron from apples, almonds, pears and green, leafy vegetables and manganese from ginger, buckwheat and oats.

Collagen is a vital factor in having healthy ligaments, tendons and bones and for so are zinc, copper, beta carotene and vitamin C so if you are taking a multivitamin make sure those are all included.

Exercise is also important, and it’s never too late to start. The key factor is that it must be weight bearing such as walking, dancing, playing tennis. Tai Chi and Yoga are also very beneficial, but swimming although an excellent cardiovascular workout is not weight bearing and so won’t help prevent osteoporosis.

I am a great believer in using natural hormones to help with osteoporosis and this is work that was pioneered in the USA by the late Dr John Lee. He prescribed natural progesterone cream to his patients and kept a faithful record of their bones scans over the course of treatment. He saw a substantial improvement in bone density and soon became an outspoken proponent of its use, not something that endeared him to the medical profession! I myself set up the Natural Progesterone Information Service in the 1990’s as I believed very firmly in his work, and helped pass on his great results to many women, and some enlightened doctors.

Many women take HRT in the belief that it will help or prevent osteoporosis, and for a short time it will delay bone loss. Over time, however, that ability reduces and what is really needed is the hormone that actually builds bone. That is progesterone and unless that is introduced into any treatment regime then can be no improvement in bone density, which is the only real test of whether osteoporosis is being reversed or halted.

If you believe you are at risk of osteoporosis because of any of the risk factors I have mentioned, then speak to your GP about having a scan. Unfortunately osteoporosis has no outward signs to catch it in the early stages – it cannot be diagnosed from looking at you, or talking to you. The ‘symptom’ most easily seen is when a bone breaks under slight pressure or there are a number of breaks in a short period of time.

Prevention makes good sense, so plenty of exercise, calcium rich foods and investigate the role of natural hormones in building bone.

Eat colourfully for bone health

You know you ought to eat 5 helpings of fruit and vegetables a day for optimum health, and now it seems that if you choose carefully both men and women could be improving bone strength and lessening the risk of osteoporosis. It’s the antioxidant pigments (carotenoids) from plants that may play a protective role in taking care of bones and protect against bone loss in older men and women.

Osteoporosis used to be thought of as exclusively applying only to women, and men were rarely diagnosed with it, but that is now changing. The lifetime risk for a woman to have a bone break through osteoporosis is 30-40 per cent and in men the risk is about 13 per cent. Researchers at Tufts and Boston Universities used data from the ongoing Framingham Osteoporosis Study and their findings have revealed that an increased intake of carotenoids, and particularly of lycopene, gave some protection against bone mineral loss. It was different for the men and women in the study; men gained bone mineral density at the hip but women gained it in the lumbar spine.

Another reason to have a colourful salad with red tomatoes, and eat watermelon and pink and red grapefruit to ensure a good source of lycopene in your daily diet.

Important new finding on bone health

For the first time ever, a link has been made between the body’s production of serotonin in the gut and the production of osteoblasts, the cells that create new bone. Normally we associate serotonin with the brain and its role in our ‘feel good’ moods, but apparently a new study has found that 95% of the body’s supply of this molecule is produced in the gut and it is acting as a hormone to regulate bone mass,”

In an online paper published in the Journal Cell, a team led by Dr. Gerard Karsenty, chairman of the department of genetics and development at Columbia University in the USA have uncovered what could be a new way to control bone formation and treat could osteoporosis. Dr. Karsenty has found that gut serotonin is released into the blood, and the more serotonin that reaches bone, the more bone is lost. The reverse also applies; the less serotinin in the bloodstream then the denser and stronger bones become. As part of his study Dr. Karsenty was able to prevent menopause-induced osteoporosis in mice by slowing serotonin production. Osteoporosis is often dubbed ‘the silent killer’ because it is rarely diagnosed until the condition is established and bones start to break and fracture under little pressure. Conventional osteoporosis treatment has focused on preventing bone loss, such as with bisphosphonate drugs like Didronel, Fosamax and HRT, but unless action is taken to build bone then the situation eventually deteriorates. There are two more natural alternatives to such osteoporosis drugs, one of which is made known to us through this new study. Its findings have huge implications for osteoporosis treatment, as it could be a simple matter of regulating your diet. The basic building block for serotonin in the body is the amino acid tryptophan, which is found in red meat and turkey and in chocolate, oats, bananas, milk, yogurt, eggs, fish, poultry, sunflower and pumpkin seeds, and peanuts. So if you have a tendency to osteoporosis in your family, which is one of the biggest risk factors, then aim for a diet low in tryptophan foods to help minimise your bone loss.

The other approach, that has been tried and tested by many osteoporosis sufferers, is to use the hormone that is essential for bone-building and that is progesterone. Its levels decline with age and it is a simple matter to supplement with natural progesterone cream, patches or tablets. Though notionally available on the NHS in the UK, it is more likely to be offered as a private prescription and it cannot be bought over the counter in the UK, though it is perfectly legal to import it for your own use. If you want to know more about this hormone, the book Natural Progesterone by Dr Shirley Bond and myself will answer all your questions (you will find it on my website) and you can find plenty of suppliers of the cream that Dr John Lee recommended including Wellspring who operate out of Guernsey and have a helpful website at www.progesterone.co.uk

Osteoporosis and red grapefruit

I have mentioned the health benefits of red grapefruit in a previous issue, and now it seems that the pulp may increase bone strength and reduce the risk of osteoporosis. At present it is estimated there are three million people with osteoporosis in the UK and that half of all women and one in five men over 50 will break a bone from having this condition.

Researchers at Texas A&M University have published the findings of their recent research in the journal Nutrition and it is good news for anyone at risk of osteoporosis or having a family history of it. Their trial was conducted on rats and found that when they divided the group into three and fed them a different diet. The rats given red grapefruit pulp in their diet showed significantly lower calcium loss from their bones and lower levels of urinary deoxypyridinoline.

Rats on the non grapefruit diet showed the exact opposite with higher levels of calcium loss and urinary deoxypyridinoline – both of which are indicators of bone bone breakdown and a greater risk of osteoporosis.

The more grapefruit the rats had, the greater the protection. So follow their example and eat red grapefruit every day to help ward off osteoporosis.

Stronger bones for men

Over the years of working with natural progesterone for osteoporosis, I was often asked about whether men also suffered from this painful bone condition – and the answer is a resounding yes. Because you don’t get any early warning symptoms with osteoporosis, it is vital for men to keep track of their health. I talked with a man in his 30′s who played rugby every Saturday and kept getting more frequent bone breaks than average. When he had a bone scan, he had advanced osteoporosis and all the fractures had been his ‘early warning’ signs.

Certainly men do benefit from taking natural progesterone for osteoporosis, but there now seems to be another factor, certainly in older men. Getting plenty of vitamin C from foods and supplements seems to boost bone strength in the over 70′s, according to research at Tufts University, Massachusetts, USA. They found that men whose had the highest intake of vitamin C intake also had the least bone loss in the hip. On an average dose of 314mg those didn’t lose bone density in the hip- even when their calcium intake was low – but men who got the least vitamin C of only 106 mg per day lost 5.6 percent of their bone over the four years.

Sadly the same effects were not seen in the women in the study, but it’s a good reason for getting at least 500mg of C a day to help protect bone health.

Why men need some weight at middle age

I am not advocating middle aged spread, but being too thin can be a real health risk for men. A study carried out at the University of Oslo on nearly 1,500 men over a 30-year period, has found that men who were relatively thin when young, or who lost weight as they aged, were at increased risk of osteoporosis, the brittle bone disease, when they were in their 70′s.

It’s often believed that it’s only women who are affected by osteoporosis, but this is just not the case. Because it is hard to identify without a bone scan, the first symptom is often an inexplicable bone break. I met one man who had only been diagnosed after his fourth fracture – as he played rugby it was put down to that, but his bones were breaking under very little pressure.

There are treatments available, usually your doctor will suggest drugs such as Fosamax, but excellent results have been seen in women using natural progesterone cream to rebuild bone. Not enough men have used it to say whether it is as effective for them, but it might be worth a try. Remember, your bones are constantly regenerating throughout your life. Old bone is drawn upon to supply instant demands for calcium (osteoclasts) and is replaced by new bone material (osteoblasts) to keep the skeleton strong. As we age, the process of rebuilding becomes less effective, and there is an overall loss of density, and the bones under examination can look almost lace-like when osteoporosis is well advanced.

If you want to avoid it, and there is a family predilection, then these are the factors that contribute most strongly to your losing bone density and strength – whether you are a man or a woman:

* Drinking too many colas as they are high in phosphorus which draws calcium from the bones.

* Not getting enough exercise – you need it to strengthen your bones.

* Eating too much fat from dairy and meat. Vegans and vegetarians have greater bone mass than meat eaters.

* Drinking too much alcohol as it interferes with calcium absorption.

* Excess coffee drinking as a study of nearly 83,000 patients showed a correlation between bone fractures and heavy coffee consumption.

* Smoking has been proven to increase bone loss.

* Some prescription drugs such as cortisone, blood thinners, antacids containing aluminum, chemotherapy, lithium, and certain antibiotics can increase bone loss.

* A junk food diet high in salt and sugar will leach calcium from the bones into the urine.

If you want to know more about the role of natural progesterone, a book I wrote with Dr Shirley Bond will give you more information. You will find details at the www.catalystonline.co.uk website. Plus, new research just presented to the American Society for Bone and Mineral Research is pointing towards compounds that could induce the body to treat itself for osteoporosis with the parathyroid hormone.

It is in the early stages of development, but it would probably involve a series of injections of a form of parathyroid hormone which triggers bone-building. Currently just using parathyroid drugs is extremely expensive – around £4000 a year – but it is hoped that the molecules reported here could be delivered much more cheaply and be more effective at promoting bone building.

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