Bone health

Making lifestyle changes for bone health — your way

by Dr. Susan E. Brown, PhD

Many of the people I see at the Center for Better Bones tend to focus on one single thing in their lives as the missing link to healthy bones. With a tone of guilt and sometimes embarrassment, they confess, I drink too much coffee, or I don’t like to exercise, or maybe they feel they don’t get enough calcium — that one thing could be any number of things. But for better or worse, there are loads of factors that affect our bones. I always like to frame this as a good thing, because it gives us tremendous choice when it comes to making helpful lifestyle changes.

Getting osteopenia or osteoporosis depends on your individual balance of bone-building forces and bone-depleting forces. These factors are constantly weighing against each other, and if we can tip the scales, even a small amount, toward bone-building, we can often prevent fragility and make a great difference in our bones. Our bones are amazingly resilient and can build themselves back up substantially at any age and any stage of life, if we help them.

There are countless approaches to making lifestyle choices for better bones, so you can decide which path makes the most sense for you. Let’s take a closer look at what your choices are, and how you might weight the scales, every day, in your bones’ favor.

Total body burden — how much are you carrying?

I like to explain the concept of total body burden with the camel image below. The camel is a good metaphor for your bones because, like your bones, it’s capable of carrying an awful lot before it collapses. You can see that each bone-depleting factor — whether a lifestyle habit or a product of the environment or simply a genetic predisposition — is another straw on the camel’s back. Adding one drain on bone integrity to the next, we pile straw upon straw, and eventually our bones become weak, fragile, and susceptible to fracture. These burdens break the camel’s back and quite literally our own backs as well!

In today’s modern world, we do a lot to burden our bones without even knowing it. Some things we have little to no control over. But women are always surprised to hear that stress, sugar, even lack of sleep, can affect their bone health. These are areas where we do get to have a say. I had one fracture patient, Martha, who was drinking cola every morning for breakfast. She wanted the caffeine, but didn’t care for coffee or tea. Many times we crave caffeine when we’re feeling exhausted, which can be the result of adrenal fatigue. Martha was surprised to hear that her seemingly harmless morning ritual was weighing heavily on her bones and could have contributed to her fracture. It probably wasn’t the only thing, but it may have been the straw that broke the camel’s back. Another woman may have the same morning habit but with fewer burdens in other areas, and never fracture in her life. So take a look at some of the factors that can compromise bone health, and figure out what your camel would look like.

Keep in mind that some of the straws on the camel’s back weigh more than others. Something like corticosteroid use, for example, could have much more impact on bone health than lack of exercise. So there are big changes and small changes to choose from. And the good news is, camels and bones are resilient! If you remove enough of the burden, the camel will regain its natural level of health, as will your bones. You certainly don’t have to change everything to make a big difference. Even removing or lessening one burden will help. I’ve seen women who remove just three and improve bone density and reduce their risk of fracture.

Start with the basic building blocks, and the rest is up to you

Our bodies require basic nutrients like calcium, magnesium, vitamin K, vitamin C, vitamin D, and many more. In fact, my research and clinical experience have shown me that there are 20 key nutrients for bone health. It may sound like a lot, but they are all needed to produce bone tissue and carry out our basic cellular functions. In an ideal world, our diet would naturally afford us these building blocks. But with our go-go lives and a super-industrialized food chain, we don’t always get the range of nutrients we need, no matter how carefully we try to eat. So I encourage the people I see at the clinic to cover their bases with a top-quality multivitamin containing all the key bone nutrients in adequate doses.

Using this nutritional foundation as your home base, the road ahead to healthy bones is determined by you. There is no one “right” direction in which to head. I usually suggest women choose for themselves how they want to begin, because we’re all in different places in our lives. Some of my patients are ready to make big lifestyle changes, like quitting smoking or committing to an alkaline diet. Others start small by making an effort to cut back on soda, processed foods, or sugar. The message here is that anything removed or limited on the camel’s back will help your bones. Anything.

I saw one woman named Claire, who lived in a college town in northern New York. She was intellectual by nature and didn’t spend very much time exercising. When she found out she had osteoporosis of the spine at age 52, Claire knew she needed to do something. But she was the sort of woman who made changes slowly and clearly told me that she did not want to be overwhelmed with a wide variety of dietary and lifestyle changes. In spending time with her, one factor stood out: Claire had no great love for the sun, and when she did go outdoors, she wore protective sunscreen. I recommended that she have her vitamin D level and her parathyroid level tested. As it turned out, Claire was vitamin D deficient, which in turn had led to overproduction of parathyroid hormone — and the excess parathyroid hormone was at the root of her bone loss. Correcting the vitamin D deficiency through a combination of high dose vitamin D supplementation and a few minutes of daily sun exposure during the spring and summer enabled Claire to make dramatic improvements. Not only did she halt her on-going bone loss, but in one year she gained 5.5% in hip bone density and 2.3% in the spine.

This kind of thing happens to many of us — we aren’t ready to change too much in our lives and then, once we master one goal on the list, the next goal seems easier to attain. But an important part of making any change in our lives is the desire to make it. I talked with another woman, Jill, who at 62 heard me lecture on the value of simple nutrient supplementation, pH balancing, and exercise for bone health. She took the message to heart and began a regular exercise program mixing both aerobic and strength-training exercises. She did these workouts twice a week and walked on the other days. At the same time, she made sure she improved her nutrient supplement program by increasing her vitamin D intake somewhat (although later we found out she was still low in vitamin D, even after raising her intake to 800 IU a day). After 18 months, she reported back to me that she had gained 5.5% in her spine and 4.2% in her hip — even though her vitamin D level was still low.

What these stories show us is that we can make small changes and see improvements because every “straw” counts. But especially with significant lifestyle changes, like Jill’s exercise program, you have to really want to make them if they’re going to work for you.

Several steps to change for good

Let’s talk a little bit about change. For some women, it might be easy to make the incremental changes I’ve listed above — all of which do add up. But for changes that prove more challenging, like quitting smoking, committing to an alkaline diet, or implementing a regular strength-training program, it helps to understand how we change. Psychologist and director of the Cancer Prevention Research Center at the University of Rhode Island, James Prochaska, PhD and his colleagues have studied this subject in depth. They have developed a highly effective model for change that’s based on the following six stages :

• Precontemplation. This is the stage in which we are not thinking about changing our behavior, and often even denying that we need to.
• Contemplation. At this point, you’ve most likely acknowledged that there is a problem or area of your life that needs changing, but you haven’t begun to think seriously about solving it.
• Preparation. This is the stage characterized by planning to make a change, with a timeline set, usually within a month.
• Action. Here is where you actively make the change you’ve been thinking about.
• Maintenance. This is where you work to protect the positive changes you’ve made so that there isn’t a relapse into old behavior.
• Termination. At this point, the problem or behavior is no longer an issue for you, and there are no temptations or incentives to return to your previous ways.

Just as we can weight the scales of bone health daily to one side or the other, these steps don’t always occur linearly, and you may hop back and forth between them before truly moving on. Some suggest the termination stage is impossible for some individuals to achieve, and that depending on how ingrained a behavior was in the first place, we are always resisting the temptation to return to previous habits. Much of this is rooted in how our personal stories and biochemistry interact, but no matter how entrenched, an obstacle can be reframed as a stepping stone.

In my experience of working with people to make positive changes for bone health, it seems that once they reach the action and maintenance stages, they feel so good with their new habits that they don’t want to go back to the old ways. This is the great thing about eating an alkaline diet, for example. So many of my patients are relieved to be eliminating more acid-forming foods, not just for their bones but because their digestion is better, their heartburn is relieved, and they have more energy overall.

You’ve already started on your road to better bones!

Just by reading this article and taking the time to fill in your camel’s burdens, you’ve begun to bring about consciousness to the everyday factors that can help your bones. This may lead you down a path that includes walking a mile every day, taking a high-quality multivitamin for your bones like the one we offer in our Program for Better Bones, or it may just leave you thinking twice about the foods you regularly eat. Remember that your bones are extraordinarily resilient, and that with each new day nature offers you the opportunity to start afresh. You can choose to naturally improve bone health and prevent osteopenia and osteoporosis on your own — on your own terms.

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References & further reading on lifestyle changes for bone health

 

Original Publication Date: 09/19/2005
Last Modified: 02/16/2010
Principal Author: Dr. Susan E. Brown, PhD