Susan Brady - Nurtured Bones

Getting to the Core of your Body

by Susan Brady | Apr 19, 2021 | Exercise

The “core” receives a lot of attention in the fitness and physical therapy world. However, there is often confusion about what the term “core” really means. People often talk about the core as if it is one big muscle.

Predictably, when I ask my patients to show me where their core muscles are, they point to the large muscle in the front of the abdomen. This outermost muscle called the rectus abdominis is certainly the largest muscle in the abdomen.

However, the core actually consists of many different muscles in the trunk that extend from the base of your neck to your pelvis.

The five predominate muscles that make up the core are:

Rectus Abdominis – Informally known as the “ab muscle” runs down the front of your abdomen from your ribs to your pelvis. In people with low body fat, it is often visible beneath the skin forming the “six-pack.”
Transverse Abdominis – This is a large band-like muscle that wraps around the front and sides of your trunk. It is very important for providing stability to your pelvis and spine.
The Internal and External Obliques – These muscles run diagonally between the ribs and the pelvis. They help to rotate and bend your trunk as well as provide trunk stability.
The Erector Spinae – This is a large group of long muscles that lie on each side of the spine and extend from the pelvis all the way up to the base of the skull. It plays a key role in keeping good posture.
Multifidus – This consists of a group of small, deep back muscles that runs right along the side of the spine and are very important for stabilizing the spine during movement. Research shows that people with low back pain often have significant atrophy and weakness in the multifidus muscles.

Other muscles that play a part in the “core complex” are your pelvic floor muscles, the diaphragm, the quadratus lumborum, and the gluteal muscles.

Although these muscles all have independent actions that like bending, twisting, or extending the spine, or moving a limb, they also work harmoniously to stabilize the spine and provide a base of support for all movement.

Weakness in any of the core muscles can lead to compensation of other muscles for stability and mobility. This in turn can lead to back pain, pain in the hips, knees, ankles, and even pain in the neck and shoulders. Core muscle strength is also essential for balance and posture. If you find that you’re struggling with your balance or maintaining an upright posture, those are 2 clear signs of core muscle weakness.

There are plenty of great exercises that can help strengthen your core muscles. However, to properly train these muscles it is important to understand how to engage these muscles. As I mentioned above, the core muscles need to work in harmony producing a co-contraction of these muscles at one time.

There are 2 ways that I find most effective in teaching my patients how to engage their core muscles. Merely sucking your stomach in is not engaging your core!

First, locate 2 of the predominant core muscles: The transverse abdominis and the multifidus.

Transverse Abdominis

To find the transverse abdominis:

Locate the anterior iliac spine, the bony protrusion in the front of the pelvis bone
Slide your fingers in about 1 inch
Now draw a breath in through your nose and then exhale through pursed lips
You should feel this broad, flat muscle tighten under your fingers

Multifidus

To find the multifidus:

Place your fingers on your spine
slightly roll your fingers off to one side
Now with your opposite leg, take a step forward
You should feel this rope-like muscle pop into your fingers as you take a step

With your fingers on those two muscles, you are going to work on engaging your core muscles.

The first method is to take a deep breath in through your mouth and then forcefully breathe out through pursed lips as if you are blowing out candles. You are looking for a simultaneous contraction of the transverse abdominis and multifidus muscles.

Another method is to perform what is called abdominal bracing. With your fingers positioned as above, you are going to tighten up your trunk muscles to prepare as if someone is going to punch you in the stomach. Again, you want to feel a simultaneous contraction of both muscles. Additionally, you don’t want any movement to occur in the spine. If your spine rounds to the back, your abdominal muscles are overpowering your back muscles and if your belly pushes out to the front, your back muscles are overpowering your abdominal muscles. A good co-contraction of the core muscles does not result in any spinal movement.

Once you get the hang of activating your core muscles, start by engaging these muscles while doing everyday activities such as reaching overhead into a cabinet, lifting a laundry basket, pushing a shopping cart.

In the gym, think about engaging your core before you perform an exercise. I call this “setting” the core. For example, before lifting a weight, engage or “set” your core muscles first. This will ensure that your body is in correct alignment, will give you a stable base in which you can perform the exercise correctly, and reduce the risk of muscle compensation and injury.

Having a strong core will make you less prone to injuries, give you better balance, better posture, and more efficient movement whether performing your daily activities or even playing your sport. If you have osteoporosis, strong core muscles will protect your vertebrae from fractures and decrease your risk of falling and breaking your hip.

Stay tuned for some of my favorite core exercises…or if you can’t wait…reach out to me to schedule an appointment and I can get you started on some key exercises to strengthen your core today.

Lamb: A Healthy Protein Alternative?

by Susan Brady | Apr 1, 2021 | Nutrition

When I work with my clients, one of the first things I do is look at their daily diet. I observe to see if they are getting enough vegetables, proteins, fibers, and other nutrients, as well as a good variety in their diet. Quite often what I see is chicken, chicken, chicken! Day after day for lunch, and dinner, chicken. There is nothing wrong with eating chicken, especially if it is raised in healthy conditions. It is a great source of protein, vitamin B12, zinc, and iron. However, when you focus on one food, you run the risk of missing out on some other very important nutrients.

The healthiest diets include a wide variety of foods. It is important to incorporate an assortment of vegetables, fruits, and grains, as well as different sources of proteins. One of my favorites for adding protein variety to my diet is grass-fed lamb.

Grass-fed lamb is loaded with protein, is a great source of B vitamins, zinc, selenium, phosphorus, and even omega 3 fatty acids.

Lamb is often referred to as “Land Salmon” due to its healthy omega 3 fatty acid profile. A 3 oz serving of grass-fed lamb has approximately 1000 mg of omega-3 fatty acids. Comparatively, wild-caught salmon has approximately 1800 mg, and chicken and beef roughly 80 grams of this important anti-inflammatory fat. Although salmon is the food hailed for its omega-3 fatty acids, lamb doesn’t fall too far behind. Omega-3 fatty acids are thought to be valuable in helping to prevent a wide range of diseases, including cancer, asthma, depression, cardiovascular disease, auto-immune diseases, and osteoporosis. Omega-3 fatty acids can help reduce inflammation that stimulates the undesirable activity of our osteoclasts, the cells that break down bone, leading to osteoporosis. Most Americans don’t get enough of these valuable fats in their diet.

Including lamb in your diet also adds a nice variety of protein. As we age we need more protein in our diet. Protein is an essential building block for muscles, bones, skin, hair. It is also important for making the hemoglobin in our blood which transports oxygen around the body.

Most hormones, enzymes, and antibodies are also proteins. So getting enough protein to support these vital structures and substances is critical for the proper function of every cell and system in our body.

The exact protein requirement for older adults has yet to be established. However, per current research and expert opinion, it is recommended that most older adults need to consume 1-1.2 grams of protein per kilogram body weight every day to preserve muscle mass and health. To find your weight in kilograms, divide your weight by 2.2. A woman weighing 130 pounds or 59 kilograms needs between 59-70 grams of protein a day. A 180-pound man, at 82 kilograms, needs between 82-98 grams of protein a day.

3 oz of lamb packs about 23 grams of protein which is comparable to protein content in a serving of steak or salmon or chicken. In one serving of lamb, you get a healthy dose of protein, valuable omega 3 fatty acids, as well as B vitamins, iron, selenium, and zinc.

Although consuming animal proteins is one of the easiest ways to make sure you are getting your daily dose of protein, it shouldn’t be your sole source. Legumes, nuts, and seeds are also good sources of protein and provide other valuable nutrients as well. Remember, the healthiest diets include a multitude of foods.

It is easier than you think to add lamb to your diet

Many think that lamb is complicated to prepare and takes hours to cook so it is often seen as one of those meats reserved for special occasions, like Easter or Passover. Certainly, a leg of lamb or lamb stew can take a few hours to cook, but creating a meal around lamb burgers, lamb chops, lamb kabobs can be quick and simple.

You can grill up lamb patties as you would hamburger or turkey patties. I like spicing mine up with Penzey’s lamb seasoning. You can also use it in place of chicken for your kabobs. One of my favorites is to broil lamb chops with a garlic- rosemary rub. Combine any of these cooking methods with vegetables and a green salad and you have a nutritious meal in under 30 minutes. Quick and easy enough for even a busy weeknight.

It is really important that you buy grass-fed or pastured raised lamb. Like any animal protein, your meat is only going to be as healthy as the food and conditions that the animal was raised under. We are all familiar with the phrase “you are what you eat.” But it is more accurate to say “you are what your food ate.” So make sure you are getting your lamb from a healthy source. Lamb also falls into the red meat category, so it should be eaten in moderation.

Lamb is very popular this time of year with religious holidays such as Easter and Passover but if you enjoy lamb, consider adding it to your rotation of healthy meat options.

I am now seeing clients in person again as well as through virtual telemedicine conferencing. Please reach out if you need help reaching your health goals!

Time to Enjoy Bok Choy

by Susan Brady | Mar 27, 2021 | Nutrition

Move over spinach and kale and make room for bok choy. This Chinese cabbage has been popular in Asian dishes for centuries and is now becoming a rising star in the world of superfoods. It has a mild, sweet flavor and crispy texture that combines nicely with many dishes and can provide a refreshing variety to your daily intake of vegetables. Additionally, it has a powerful complement of nutrients that provide many wonderful health benefits.

Bok choy is part of the cruciferous vegetable group that includes broccoli, brussels sprouts, arugula, cauliflower, cabbage, and kale. Cruciferous vegetables are well known for their cancer-fighting properties, heart health benefits, and their ability to support detoxification. Additionally, cruciferous vegetables provide nutrients that help in the production of glutathione. Glutathione is the body’s most powerful antioxidant. Not only is it a master detoxifier but it is also responsible for recycling and recharging every antioxidant in our body.

Cancer Protection

Like all members of the cruciferous vegetable family, bok choy has unique sulfur-containing compounds called glucosinolates. Glucosinolates have been associated with reducing the risk of many different cancers including breast, prostate, lung, and colon cancers. These substances may help the body eliminate carcinogens, prevent cancer cells from proliferating, and may alter metabolism to stop the development of hormone-sensitive cancers, like breast cancers.

Anti-inflammatory and Antioxidant Benefits

Bok choy is a rich source of core antioxidants, like vitamins C and A, that are necessary in the fight against cellular damage caused by oxidative stress. Bok choy provides a full spectrum of over 70 antioxidants all of which work to prevent cell damage in different ways. for instance, bok choy contains lutein and zeaxanthin, which are antioxidants that protect the eyes and lower the risk of age-related macular degeneration.

Bok choy also provides anti-inflammatory phytonutrients that help to fight unwanted inflammation. Like other dark leafy greens, it is also an excellent source of the flavonoid quercetin which has both antioxidant and anti-inflammatory effects which can ward off many chronic health issues. Quercetin can also be a wonderful natural anti-histamine, so a perfect ally during allergy season.

Bone Health

One of my favorite things about bok choy is its benefits to the bone. It is an excellent source of so many of the vitamins and minerals needed to support bone health including vitamins K and C and minerals calcium, potassium, manganese, and phosphorus. All of which play a crucial role in maintaining bone structure and strength. Bok choy is also low in oxalates, a naturally occurring compound found in plants that can prevent the absorption of calcium and other minerals. Many high calcium vegetables such as spinach, collard greens, and swiss chard are also high in oxalates and therefore can reduce the absorption of these nutrients.

Cardiovascular Care

Bok choy also supplies many nutrients needed for heart health. In particular, bok choy provides folate as well as vitamins B12 and B6 which are necessary for removing the amino acid homocysteine from the blood. This is important because high levels of homocysteine increase the risk of cardiovascular disease. Calcium, magnesium, and potassium are all important for regulating blood pressure as well as heart rate.

How to Enjoy Bok Choy

Bok choy is a very versatile vegetable that has a mild, sweet flavor and crispy texture that you will enjoy eating raw or cooked. It can be shredded raw and tossed with other fresh vegetables to make a salad, it can be added to soups and stews, sauté it, or used in your favorite stir fry. You can consume all parts of the bok choy plant, including its white stems and green leaves.

However, it is important to chew raw bok choy well or chop prior to cooking.

Like all cruciferous vegetables, bok choy contains an enzyme called myrosinase which needs to be activated in order to convert the glucosinolates to its beneficial phytochemical sulforaphane. Chopping and chewing are needed to break down the plant cells to activate the myrosinase.

Cruciferous vegetables have so many wonderful health benefits that we should strive to get at least one serving a day. Bok choy’s ease of preparation, versatility in recipes, and nutrient density make it a superstar in this food category. Although often overlooked when meal planning, bok choy is a delicious and beneficial addition to anyone’s diet!

Check out 2 of my favorite bok choy recipes:

Salmon & Bok Choy Green Coconut Curry

Enjoy!

Fennel As Your New Favorite

by Susan Brady | Mar 9, 2021 | Nutrition

Eating should be pleasurable and enjoyable. However, you also have to remember that what you put into your mouths 3-4 times a day can have a significant impact on your health. First and foremost, food is intended to fuel and nourish your body. Your brain and body require daily nutrients including essential amino acids, over 30 different vitamins and minerals, a variety of plant phytonutrients, and fibers. In order to get these key nutrients every day, you need to eat a sufficient variety of foods.

Many of us get stuck in a food rut, eating the same foods day after day. It’s easy to see why! Meal planning and shopping become a breeze and you have confidence that the meal will be satisfying since you make it all the time. But eating the same foods every day can have its drawbacks. It can lead to nutrient deficiencies and possibly even food intolerances. By limiting yourself to a few different foods, you may be missing out on a lot of foods that are loaded with important nutrients that your body requires to stay healthy.

In fact, a 2015 study in the Journal of Nutrition demonstrated that greater food variety was associated with a lower risk of metabolic syndrome (defined as a cluster of symptoms including abdominal obesity, high blood sugars, abnormal cholesterol and triglyceride levels, and high blood pressure). Eating a wide variety of food also helps to promote a diversity of healthy bacteria in the gut. It may also be possible to develop intolerances to foods you eat too often. A diversity of real, whole foods will provide your body with the array of nutrients to keep it working optimally.

Over the next few weeks, I am going to highlight some exceptionally healthy foods that are often overlooked when meal planning and shopping, yet are easy to incorporate into your daily diet while also adding an array of nutrients and flavors.

Fennel

Fennel has long been used as a medicinal plant for a wide range of conditions. It is known to aid in digestion, promote cardiovascular health, protect against chronic degenerative diseases, support bone health, as well as exhibit cancer-fighting properties. These benefits stem from fennel’s numerous phytochemicals that provide valuable anti-oxidant, anti-inflammatory, antimicrobial compounds.

Fennel is an excellent source of vitamin C and a good source of calcium, magnesium, potassium, manganese, and phosphorus which are all nutrients important in supporting strong, healthy bones.
The essential oils in fennel can help to stimulate the secretion of digestive enzymes and gastric juices aiding digestion. These oils can also help to decrease inflammation in the intestines and improve the absorption of nutrients.
Anethole, the phytonutrient compound that gives fennel its unique smell and flavor, has been shown in several different studies to reduce inflammation as well as protect against cancer.
Fennel is also a very good source of fiber which may help to reduce cholesterol levels and support colon health.

How to use Fennel:

Fennel has a mild licorice-like taste. It is slightly sweet and adds a refreshing flavor to any dish. You can use the entire plant, including the fronds. If eating raw, you can thinly slice the bulb and use it for salads or coleslaw or spread the stalks with your favorite nut butter or dip in dressing. You can also slice up the fennel bulb and saute with extra virgin olive oil, solo, or with other vegetables. It pairs nicely with onions and garlic. You can also cut up the bulb into chunks and roast it alongside Brussel sprouts, sweet potatoes, or beets. The stalk can be used in place of celery in soups and stews and the fronds can be chopped up and used as you would other herbs like dill or parsley. It is a very versatile vegetable!

One of my go-to fennel dishes is a Fennel and Orange salad. It is quick and easy to make and is a light and refreshing side dish. It is particularly delicious alongside salmon or scallops.

Fennel is in season from autumn to early spring. So this is a great time to give this nutritional superfood a try. You never know, it might become a new favorite!

Susan Brady, MPT,

Doctor of Integrative Medicine

Nutrition Consultant

susan@nurturedbones.com

703-738-4203

Curious Connection, Part 2: Calcification & K2 to the Rescue

by Susan Brady | Feb 21, 2021 | Supplements

In my previous blog, I began the discussion around the curious connection between heart disease and osteoporosis. Oddly enough there are many incidences that show these conditions often occur together. There are certainly many shared risk factors like smoking, lack of exercise, poor diet, and hypertension, as I pointed out previously. There appears to be another connection as well, calcification, the accumulation of calcium in the body tissues.

We obviously want calcification in the bones. That is what provides our bones with structure and strength. Where we don’t want calcification is in our soft tissues, like our blood vessels, heart valves, breasts, or kidneys in the form of stones. When calcium builds up within the walls of our arteries, it can damage the tissue and attract cholesterol leading to the narrowing and hardening of the arteries. Calcium accumulation in the heart’s valves, most commonly affecting the aortic valve, can lead to aortic stenosis. Recently there has been a growing concern that excessive calcium supplementation can contribute to the deposition of calcium in the blood vessel walls increasing the risk of heart disease.

So how can we ensure that the calcium we are consuming gets deposited in our bones and not our arteries?

Vitamin K2 to the Rescue

Vitamin K2, a rising star in the vitamin world, can be viewed as the calcium cop. It helps to direct calcium into the bone while stopping it from being deposited in our soft tissues. It does this by having the opposite effect on bones and blood vessels.

In our bones, vitamin K2 activates a protein called osteocalcin. Osteocalcin is secreted by the osteoblasts in your bone (the cells that make new bone). It takes the calcium circulating in the blood and binds it to the bone matrix. However, for osteocalcin to perform this action, it must first be activated by vitamin K2. Vitamin K2 activates the osteocalcin so it can bind to and move the calcium from the bloodstream into the bone. Adequate amounts of vitamin K2 are needed to usher calcium into the bone which in turn makes the skeleton stronger and less susceptible to fracture.

Interestingly, in the blood vessels, vitamin K2 also activates a protein that does the exact opposite. In the blood vessels, vitamin K2 activates a protein called MGP (matrix GLA protein). MCP is produced by the cells of vascular smooth muscle and prevents calcium from being deposited on the vessel walls.

In the bones, K2 activates the protein that ushers calcium into the bone, and in the arteries, it activates the protein that prevents calcification. This vitamin is key for keeping our bones strong and arteries clear.

Getting enough vitamin K2

Vitamin K2 is different from vitamin K. Vitamin K is most notable for its blood clotting effects and can be found in leafy vegetables. Dietary sources of vitamin K2 include chicken, beef, pork, egg yolks, liver, fermented dairy products (yogurt and some natural, ripened cheeses) from grass-fed animals. Fermented vegetables like sauerkraut and fermented soy foods, such as miso and natto are also a rich source of K2. Vitamin K2 is also produced by our gut bacteria, another important reason why we need to maintain a healthy gut microbiome!

The best way to ensure adequate intake of any nutrient is through food, however, if you have heart disease and/or osteoporosis you may want to consider supplementation. When looking at vitamin K2 supplements you may come across 2 different forms of vitamin K2: MK4 and MK7. Both have been shown to be beneficial, however, MK4 has a shorter life span, so you have to take it in larger doses and more frequently. MK7 stays in the bloodstream longer, so you need a lower dose. The most recent studies I have seen indicate that MK7 may have a higher efficacy due to its higher bioavailability and longer-acting time in the body. However, MK7 in supplements will often come from soy, so if you are sensitive to soy products you may want to look for supplements with MK4.

Vitamin K2 also needs to be taken in conjunction with vitamin D. There appears to be a synergistic interaction between these 2 vitamins. Current evidence suggests that supplementing vitamins D and K together might be more effective than the consumption of either alone for bone and cardiovascular health. Lastly, all fat-soluble vitamins, like vitamins A, D, E, K, should be taken with a high-fat meal to enhance optimal absorption.

One other note: Although I have seen many claims that vitamin K2 supplements do not have the same blood clotting effects as vitamin K, I have also read that vitamin K2 can interfere with blood-thinning medications like Warfarin and Coumadin. If you’ve been prescribed these drugs be sure to talk to your doctor before supplementing with vitamins K or K2.

If you are eating a healthy diet that includes grass-fed animal products and/or fermented foods, and have a healthy gut microbiome, you should already have adequate levels of vitamin K2. Unfortunately, testing for vitamin K2 status is not readily available through lab analysis, however, can be tested through SpectraCells’s Micronutrient test. If you are interested in learning more about this test, please reach out to me.

References:

1. Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566462/

2. The Synergistic Interplay between Vitamins D and K for Bone and Cardiovascular Health: A Narrative Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613455/

Susan Brady
is a Physical Therapist,
Nutrition Consultant and
Doctor of Integrative Medicine.
She is dedicated to helping people achieve
lasting good health and vitality.

Want to learn more about how you can improve your bone health? Contact me for a free 15 minute phone consult to learn more about the BONES Method™ and how it can help you achieve strong, healthy bones for life!

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