Posts Tagged ‘Diet’
Once again we have been treated to statisticians mushing together multiple disparate previous studies to “prove” that calcium alone, or vitamin D alone, or both together in one of many different combinations will not prevent fractures. All mushed together in a carefully selected meta-analysis, you can prove anything depending on which studies are included.
More important, asking if adding a specific dose of calcium, or vitamin D, or both, will prevent fractures, misses the entire point. Most studies did not properly account for the nutrients in each day’s diet in individual test subjects – or in individual control subjects, many of whom also consumed the nutrients being studied.
And how can you ethically ask a patient to limit their diet in a way you believe will put them at risk for fractures? You have to settle for encouraging patients who are inadvertently short on some nutrients to improve their diet. But then they do not fracture and you cannot prove that they would have if only you had withheld the information!
We help individuals improve their bone health. One size does not fit all. We do a Complete Bone Health Evaluation. Then we adjust nutrition and lifestyle as needed for that individual. In about half of women and three-quarters of men, this is enough.
Jay Ginther, MD
Treat to Target has been standard for chronic diseases like high blood pressure and diabetes for decades. These are chronic diseases, more common as we get older, that we can control with diet, exercise, and eventually medication. We cannot cure them.
Bone health joins the Treat to Target club in 2017. Increased Fracture Risk (Clinical Osteoporosis) is a chronic disease, more common as we get older, that we can control with diet, exercise, and eventually medication. We cannot cure Increased Fracture Risk, so treatment of some sort is necessary “forever”.
What is our target? Traditionally it has been maintaining the T-score found at the first assessment. This does not necessarily make sense, especially if there already are fractures. The target should be NO NEW FRACTURES. This is a game changer.
This means that we are aiming for a Bone Mineral Density T-score higher than -2.5 in someone who has not yet fractured. How we get there requires a new approach to medications, once we have reached the limits of Take Control Naturally detailed in previous posts.
This also means we need to check the VFA for previous Vertebral Compression Fractures, most of which go un-noticed, mistaken for pulled muscles. (I did that a few years back.)
THE TARGET IS NO NEW FRACTURES.
Jay Ginther, MD
Bones are over 80% protein. The organic part of bone is collagen, which is protein. Calcium is gradually deposited into the organic bone matrix to make bone stiffer. Ideal bone is mildly flexible, like a titanium airplane wing.
Healthy bones require adequate protein in your diet. Milk, cheese, and yogurt are good. Lean meats like chicken, turkey, and fish have less cholesterol than beef or pork. All sorts of beans, lentils, garbanzos (humus), nuts are vegetarian alternatives.
Protein needs are higher when you are growing, and again starting in your 60’s. The basic guideline during adulthood is 1 gram of protein for each kilo of lean weight. See our previously posted Protein Chart.
Muscle is mostly protein. Strong muscles keep bones strong by tugging on them and by compressing them. Strong muscles maintain balance and prevent falls.
Preparing protein foods from scratch can be time consuming. Some days I take the shortcut of Premier Protein Shakes. 30 grams of protein, only 1 gram sugar, low fat, only 160 calories, made from milk solids, and they have 500 mg Calcium.
Take Control Naturally by getting enough Protein in your diet.
Jay Ginther, MD
Calcium is responsible for the stiffness and strength in bones. Calcium is what we measure when we measure Bone Mineral Density. Without sufficient calcium intake you cannot have strong bones.
Most people can absorb 500-600 mg Calcium at a time, if taken with food containing Protein. This only works if your Vitamin D level is high enough.
You need to consume 400-500 mg in each of 3 meals to reliably get 1200-1500 mg every day. This is necessary because most people will pee and poop and sweat out at least 1000 mg of calcium daily.
Calcium is best absorbed when eaten in foods.
You can Take Control Naturally with diet alone.
Milk, Cheese, and Yogurt are all high in Calcium, but amounts can vary. Check the label to see how many ounces are needed to make at least 200 mg. (Check “serving size” and remember that “20%” is 200 mg when dealing with calcium.)
Some vegetables are high in Calcium. One cup of cooked Collards, Black-eyed Peas, or 1.25 cups cooked or finely chopped Kale or Okra each have 200 mg. 4 cups of chopped Broccoli is 200 mg. Of course you can eat these raw, if you prefer.
If you do not get enough calcium in your diet alone, Calcium Supplements are needed.
Jay Ginther, MD