Tag Archive for: osteopenia

I’m Back!

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It’s been an interesting five weeks since my knee replacement. I’ve never taken that much time off before, but I’m healing well—just not as quickly as I want. Researching the best way to gain back joint strength and muscle loss, I’ve come across a new term that combines two conditions: osteosarcopenia. It’s a combination of the loss of bone mass and the loss of muscle mass.

Osteopenia is the loss of bone mass. While associated with aging, other factors play a part such as genetics, lack of exercise, and poor absorption of nutrients.

Sarcopenia, loss of muscle mass, is definitely associated with the lack of exercise, but there are other factors as well. One that was surprising was the deterioration of mitochondrial function, both in number and effectiveness of function. When mitochondria can’t produce energy effectively and can’t repair and replace themselves, it can impact every cell and organ, not just muscle.

I’ve spent a considerable amount of time looking at the research to find out possible solutions to mitochondrial decline. I can tell you that one of the keys is exercise: strength training, stretching, and aerobic exercise. The rest merits significant explanation. That’s why it will be the topic of this year’s Super Bowl Webinar Aging with a Vengeance: Reclaiming Your Power! on Sunday, February 13 at 3 p.m. Eastern Time. More information to come.

What are you prepared to do today?

        Dr. Chet

Planning Your Infrastructure Upgrade

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In order to give you some ideas to help you focus on your body’s infrastructure, I’m going to share my list. I’ll give you my issues and why I feel they’re problems for me; I hope that will stimulate your thinking so you can determine your infrastructure upgrades for 2021. I don’t know that I can accomplish all of them in a single year, but I do know I can make a good start, and that’s what I’m hoping you will do as well.

Increase Muscle Mass

If there’s one getting-older issue that I completely underestimated, it’s the loss of muscle mass. It just sort of crept up on me and while I can’t quantify it in terms of pounds or percentage, I know I’ve lost strength in my upper body, and my legs seem to be a shadow of their former selves. Part of the reason that my legs lost so much mass, I believe, is directly tied to my inability to run consistently. I have no idea when I’ll be able to run freely again, if ever, so strength training is going to be critical to increase strength if not mass.

Improve Skin Quality

I have to confess that I never examine my skin. I don’t spend a lot of time looking at my face in the mirror, and I ignore my arms completely. But lately I’ve noticed that my skin is thinner and a slight scrape against the door frame that doesn’t even hurt can leave a huge purple spot. I’m not trying to recreate the quality of skin I had in my 20s, but I know it can be better than it is. (Has anyone in my household been nagging me about this for years? Um, maybe.)

Decrease Body Fat

The one that drives me crazy is the increase in body fat around my waist. I weigh 45 pounds less than my highest body weight ever, yet my waist circumference is greater now than it was then. The reasons are complicated, from the loss of muscle mass reducing metabolic rate to the gradual reduction in hormones as I get older. I know that there’s no such thing as spot reduction, and I don’t know if the general rule “you lose it first from where you put it on last” applies as you get older. But aside from increasing muscle mass, this one is just not acceptable and is a priority for me.

Increase Bone Mass

I’ve made no secret of the fact that I have osteopenia. In fact, I’m one-tenth of a Z-score from having osteoporosis. I have improved my vitamin D and calcium intake since my last bone-density test. I’ll find out in April whether that has resulted in any change. I’m not interested in continuing to be the amazing shrinking man, so this is an internal infrastructure change that must happen in 2021.

Improve Posture and Balance

This one seems a lot less obvious, but it’s still critical to overall health. Why? Because working on improving posture now, which means resetting the resting “tone” of the postural muscles will help with balance as we get older, and balance is critical if we hope to make it to an advanced age. The inner ear is part of it, but our ability to be able to move and do the things that we want to do can be dramatically impacted by poor balance. The modifications in muscle mass and fat mass, as well as bone mass, will have an impact, but it’s also critical to specifically work on posture and balance movements as well.

The Bottom Line

There you have it: my infrastructure plan for 2021. I’ve begun working on some, but there’s still research to read to find better solutions. That will include different approaches to exercise, whether weight training, stretching, or aerobic exercise. There could be specific dietary approaches that apply rather than just cutting calories. Supplementing with nutrient isolates and specific dietary supplements may also be part of the solution.

How about you? You may have cholesterol and HbA1c that needs to get lowered, cardiac output that needs to increase, and a microbiome overhaul; maybe you need to build strength in specific areas to compensate for arthritis and loss of cartilage.

Identify your three to five areas and write them down. As the year progresses, I’ll share the solutions I’ve found with you because my goal hasn’t changed: to help you become the best version of yourself. Specify where you want to go and let’s get started.

What are you prepared to do today?

        Dr. Chet

Food Is Better Than Supplements, But …

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Getting your nutrients from food by eating a healthy diet is the most desirable way of getting vitamins, minerals, and phytonutrients. Period. If we could all do it, no question that’s the best way. But you and I don’t live in some fantasy world. We’re busy. We don’t always have enough time to shop and cook healthy meals. Dietary supplements have helped fill the nutrition gap.

What should we think about this latest research? Should we stop taking supplements, especially calcium? Before I give you my opinion, I want to tell you that I emailed the corresponding author of the paper, a brilliant woman and a talented researcher. I had two questions about the study. She answered me the same evening—Saturday night before Easter. That I got such quick reply was remarkable; I’m still waiting for answers from other researchers I contacted months ago.

The first question I asked was a basic one: what was the mortality rate of the subjects in the study compared with the national cancer mortality rate? The national mortality rate is 156 deaths per 100,000 people per year. That works out to 1.6 people per 1,000. The rate in the study was about 3 people per 1,000. She replied that the study results are not directly comparable for complicated reasons.

But here’s something that can be directly compared. A 62% increase in cancer mortality would be transferable to national statistics because that’s the idea: to generalize to the entire population. A 62% increase means that 2.5 people per 1,000 would die from cancer in a given year instead of 1.6. When applied to the entire population that could be a lot of people, but it applies only to those who took over 1,000 mg of calcium per day.

The other question I asked was whether they had data on how long the people were taking the supplements; NHANES asked about the 30 days prior and recorded the prior 24 hours. How long were they taking the supplements? Weeks? Months? Years? Decades? That might have made some difference. The data were collected in the questionnaires used for two of the cycles that I examined, but that data was not used in the analysis.


The Bottom Line

I think we should eat the best diet we can. I also think we should use quality dietary supplements to complement our diet. This study was an exercise in statistics more than nutrition. It can tell us the statistical outcomes of the people in the study, but it can’t really be used to tell us anything about what we should do as individuals.

Not every person who took a higher amount of calcium died from cancer. On top of that, if supplementation did have a significant negative impact on our health, it stands to reason there would have been more negative results than just for calcium. Because the research questions were fitted to the available data, there’s just too much we don’t know about factors that can influence the results.

Another good question the study didn’t ask is why people were taking calcium. For instance, a woman with osteoporosis may take calcium for better bone health. Did those women have fewer broken bones with supplementation? If so, that might be worth any higher risk that exists. As with any nutritional intervention, it’s important to weigh the pros and cons. If you’re concerned, talk to your healthcare professional about what you should do; they know you and your health status and can help you make the right choices.

Supplement confusion is a good reason to get a copy of my new CD Supplementing Your Diet. Check out why at drchet.com.

What are you prepared to do today?

        Dr. Chet

Reference: Ann Intern Med. doi:10.7326/M18-2478.

Food vs. Supplements

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Last week, the health headlines blared that nutrients from foods were better than nutrients from supplements—specifically that excess calcium from supplements was associated with an increased risk of dying from cancer. That will get your attention if you take supplemental calcium, especially if you’re taking calcium because your physician told you to take it because you have osteopenia or osteoporosis. Let’s take a closer look at this study published in the Annals of Internal Medicine.

Researchers examined data collected for the National Health and Nutrition Examination Survey (NHANES) on food intake and supplement use. NHANES data are now collected every two years, so they selected six consecutive cycles and tracked the all-cause mortality from subjects in those data. They found that in over 30,000 adults over 20 years of age tracked for six years, there were 3,613 deaths with 805 from cancer.

The researchers then examined the food intake and supplement use of the subjects from the prior 30 days of data collection with mortality data. That’s where they discovered that in the subjects who died from cancer, there was a 62% greater risk if they took more than 1,000 mg of supplemental calcium per day. The overall conclusion was that nutrients from foods are better than nutrients from supplements; in addition, some supplements may be hazardous.

Should you start chucking out your calcium supplements? We’ll take a closer look at this study the rest of this week.

What are you prepared to do today?

        Dr. Chet

Reference: Ann Intern Med. doi:10.7326/M18-2478.