Susan Brady - Nurtured Bones

Mighty Mitochondria and Your Bone Health

by Susan Brady | Jun 4, 2019 | Healthy aging

Mitochondria word cloud I’m sorry you haven’t heard from me for a while! I have been working hard on an exciting new project that I can’t wait to share with you in the next few months! So stay tuned!

In the meantime, I thought you would like to learn about some recently published research in the field of osteoporosis. A study led by researchers from the University of Pennsylvania school of Veterinary Medicine have found a link between mitochondrial damage and osteoporosis. This link lays out a possible mechanism by which lifestyle choices, toxins and medications can lead to weaker bones and fractures. But you may be wondering, what are mitochondria and how are they linked to bone loss?

What are mitochondria and why are they important?

Mitochondria are organelles in our cells that are best known for converting the food we eat and the oxygen we breathe into energy, biologically known as ATP. This energy is used to support every function your cell performs. They are also very important for detoxification and fighting free-radicals that can damage our cells. When your mitochondria are damaged it can lead to fatigue, memory loss, pain, and age-related conditions such as heart disease, diabetes, neurodegenerative diseases and, as this latest research suggests, osteoporosis.

According to the researchers at Penn Vet, damage to the mitochondria not only affects the production of ATP in the cell but also triggers a surge in the production of osteoclasts, the cells that are responsible for breaking down bone.

How do our mitochondria get damaged?

Your mitochondria are very sensitive and very easily damaged. The main way that mitochondria are damaged is through oxidative stress. You can think of oxidative stress as rusting. For instance, if you leave an iron gate out in the weather, it will rust, or if you cut into an apple and leave it exposed to air, it will turn brown. Oxidative stress occurs as a result of free radicals. Although the cell produces free radicals as part of our own metabolism, free radicals can also be generated by outside sources. When there are more free radicals than the cell can clean up, the result is oxidative stress and damage to the mitochondria. Chronic inflammation, exposure to toxins and infections, stress, sedentary lifestyle, and poor-quality, nutrient-deficient food can all lead to excess free radical production, oxidative stress and mitochondria damage.

Even though we have known for a while that excessive alcohol intake, smoking, stress, environmental toxins and certain medications can damage our bones, this study suggests that the reason may be directly linked to the damage these influences cause to the mitochondria.

It shouldn’t surprise you that the diet, exercise and lifestyle that is widely recommended for good health also nourishes, heals and protects your mitochondria as well.

How to Care for Your Mitochondria

Eat real, whole, organic foods that are free of chemical preservatives, additives, and pesticides that increase your toxic load.
Eat a rainbow of fruits and vegetables that supply antioxidants to help combat free radicals and oxidation.
Avoid toxins in your personal care products. Toxins can come in through food and water but also our beauty and personal care products like toothpaste, moisturizers, deodorants, shampoos, conditioners, perfumes and makeup.
Squelch inflammation by loading up on anti-inflammatory foods, controlling blood sugars, and maintaining a healthy body weight.
Exercise is one of the most powerful mitochondria boosters you can do! Strength training and high intensity interval training both increases the efficacy and function of mitochondria. However, overly strenuous or exhaustive exercise can actually contribute to free radical production and mitochondrial damage.
Stress reduction. Stress hormones can cause inflammation as well as create oxidative damage.

There are also several supplements that can aid in protecting our mitochondria, however, supplementation should be based on your nutritional status and should not be taken without seeking further advice.

Biggest takeaway: safeguarding your mitochondrial function could protect you against osteoporosis.

Need more guidance, give me a call and we can schedule a time to talk about all the ways you can protect your mitochondria and your bones!

Vitamin K2 and You

by Susan Brady | May 3, 2019 | Supplements

I was listening to a great webinar the other day hosted by Dr. Lani Simpson and featuring Dr. Kate Rheaume-Bleue, author of the book The Calcium Paradox. This is one of the first books to shed light on the importance of K2 supplementation for bone and cardiovascular health. This talk reminded me just how very important Vitamin K2 is for the health of our bones and our body, so I decided to remind you all as well!

Vitamin K2, a little known nutrient just until a few years ago, has emerged as having a critical role in how the body uses calcium. It is tasked in moving and keeping calcium in the bones and out of places where it shouldn’t be, such as arteries, joints, the kidney and bladder where it can contributed to calcification, heel spurs, bone spurs and kidney and bladder stones.

Vitamin K2 is very different than vitamin K or K1. Vitamin K1, has been long recognized as being important for blood clotting. Because of this critical role, it is rare that we become deficient in vitamin K1. Not only do we get plenty of K1 through our diet, but the body continually recycles K1 to ensure it is ever present. However, it is quite common to become deficient in K2. It is more difficult to get K2 in our modern day diet and K2 is not recycled like K1. According to Dr. Rheaume-Bleue, people can develop a deficiency of K2 in as few as 7 days if not adequately supplied by the diet.

The reason why vitamin K2 is so important is that it activates two key proteins in the body:

Osteocalcin: once activated, it carries calcium and minerals into bones and teeth.
Matrix-GLA: activation of the matrix-GLA protein (MGP) inhibits tissue calcification. This protein is activated only in the presence of Vitamin K2.

Through activation of these 2 proteins, vitamin K2 can keep our bones strong and keep calcium from mineralizing in soft tissues of the body.

Role of Vitamin K2 for the Bones and the Body

Bone Health: Inhibits osteoclast (cells that break down bone) and activates osteocalcin, which helps take calcium from the blood circulation and bind it to the bone matrix.
Cardiovascular Health: Inhibits the deposit of calcium on the blood vessel walls which can lead to arterial calcification and arterial stiffening.
Prostate Cancer: A study published by the European Prospective Investigation into Cancer and Nutrition revealed that increased intake of vitamin K2 may reduce the risk of prostate cancer by 35%.
Improves Insulin Sensitivity: May help to ward off insulin resistance that can lead to diseases such as diabetes, heart disease and cancer.
Dental Health: Saliva is rich in vitamin K2 where is aids in reducing cavity-causing bacteria and mineralization of the teeth.
Kidney/bladder Stones: By activating the protein that inhibits mineralization, it may help to prevent stone formation.
Varicose Veins: Prevents accumulation of calcium deposits in veins which can contribute to varicose veins.
Wrinkles: Activates MPG in the skin, preventing calcification of elastin that can lead to wrinkles.

With all these fabulous benefits, you might be thinking “I should included more foods rich in vitamin K2 into my diet.” However, this is harder than you think. Vitamin K2 comes from fermented foods and grass fed, but not grain fed, animals. In animals, vitamin K1 obtained from munching on green grass, can be converted into K2. Animals fed a diet of grain will lack K1 and therefore K2. Humans can also convert K1 from leafy greens to K2, but at a very low rate. Our gut flora can make K2 as well, but not enough to make a significant contribution to our health.

The best sources of K2 are natto and goose liver, both which may be hard to stomach. Natto is a fermented soy food frequently eaten in Asian countries. You can also get K2 from grass fed animal products like cheese, eggs, and butter and most recently discovered from pork. Cheeses richest in K2 are Brie, Gouda, Jarlsberg and some Blue cheeses. However, you will have to eat a whole lot of cheese, eggs and butter to reach your daily requirement of K2.

So supplementing with K2 may be your best choice. However, there have been different thoughts about what type of K2 you should supplement with. There are 2 forms of vitamin K2 that are typically found in supplements: MK-4 and MK-7. The M in MK stands for menaquinone and the K stands for vitamin K. The numbers have to do with the length of the carbon tail on the chemical chain. The higher the number, the longer the chain and the longer it stays in the body. The initial studies on K2 and bone health used MK-4 and showed that when used in high doses (45 mg/day), MK-4 was positively associated with reduced risk of fractures. However, recently, more research suggests MK-7, which can be taken at lower doses, increases bone mineral density as well. The benefits of MK-7 is that it stays in the blood stream longer and you need a lower dose for efficacy.

According to Dr. Kate Rheaume-Bleue, either form is beneficial, but if your supplement contains MK-4 you will have to take a higher dose and more frequently. Much of the MK-7 used in supplements is soy-based, so if you have a soy allergy or otherwise want to avoid soy, so will need to find an alternative.

How much vitamin K2 do you need?

Maintain General Health – 100-120 mcg, at least a portion of that should be MK-4, but it’s not clear how much!
Increase bone density – 180 mcg of MK-7 is best
Reduce arterial calcium – 400 mcg

So as you can see, we are in our infancy when it comes to understanding how much and what kind of K2 is needed. K2 is actually produced in several different lengths, MK-4 through MK-11, and only MK-4 and MK-7 have been researched….so future research on the other types could prove beneficial as well.

For now, If your not eating a daily helping of Natto or goose liver, be sure you are taking a supplement that provides K2, not just K1.

On a side note if you take Warfarin or any medication that has to do with blood clotting, talk to your doctor before supplementing with K2.

Need more guidance, give me a call and we can schedule a time to review your supplements to ensure you are getting all the nutrients you need to build and maintain strong, healthy bones!

Vitamin A: How much is too much?

by Susan Brady | Apr 10, 2019 | Supplements

This past week I had a new patient seeking advice on what supplements she should be taking to support her bone health, along with the health of her eyes and her immune system, and aid in preventing urinary tract infections. She came carrying a bag with over 20 different supplement bottles and explained why she took each one and the various websites or healthcare professionals who recommended each. As I read through the label of each supplement keeping a mental calculation of the amounts of vitamins and minerals, I became increasing concerned about the amount of Vitamin A she was consuming on a daily basis. Although Vitamin A is known to benefit eye health, and support the immune system and the bones, excessive amounts may actually contribute to osteoporosis.

Although the research is mixed, more studies than not suggest that consuming too much vitamin A may increase the risk of bone fractures. The latest animal study published in the Journal of Endocrinology, October 2018, concluded that consuming too much vitamin A may decrease bone thickness, leading to weak and fracture prone bones.

Our body cannot make vitamin A, so it is essential that we get it from our diet. Vitamin A is a fat-soluble vitamin, meaning that it needs dietary fat in order for it to be absorbed and then is stored in the body’s own adipose tissue. Therefore, if you take in more vitamin A than you need, it will slowly build up in your body’s tissues.

There are two dietary sources of vitamin A:

Preformed vitamin A, also known as retinoids/retinol, is the active form of the vitamin and is available for immediate use in the body upon intake. It comes from animal products such as liver, salmon, eggs, milk, fortified cereals and oils from fish, such as cod liver oil.
Provitamin A must be converted to the active form in the body. Beta carotene is the most well-known provitamin A and comes from colorful fruits and vegetables like sweet potatoes, carrots, spinach, cantaloupe. There is less likelihood of excessive buildup of vitamin A when it comes from the conversion of provitamins because, if the body has enough vitamin A, then the beta carotene will not be converted.

How much vitamin A do our bones need?

Evaluating the research, it appears that vitamin A intake (in the form of retinol) of greater than 5,000 IU a day can be detrimental to bones because it increases osteoclastic activity (the bone cells that break down bone). However, too little vitamin A can halt the development of osteoblasts, the bone-building cells that lay down new bone. In a 4-year study of 958 men and women found that an average daily consumption of 2,000 to 3,000 IU per day (600 to 900 mcg) was associated with the highest bone mineral densities.

The following tips will help you insure adequate,
but not excessive, intake of vitamin A:

Aim to eat 3-4 servings of colorful vegetables a day and 2 servings of colorful fruits for healthy carotenes.
Avoid large amounts or a daily diet that combines vitamin A-rich foods such as liver, fortified egg substitutes, margarine, dairy products.
Avoid supplementing with cod liver oil, since it has very concentrated amounts of vitamin A.
Be sure to read your supplement labels, to avoid taking in more than 100% of the vitamin A daily value from all your dietary supplements together.
Read labels on frequently eaten foods that may be vitamin A fortified, to determine how much pre-formed vitamin A (retinol) you are getting.
Check your skin creams. Some creams used to treat acne, psoriasis and other skin condition contain high doses of vitamin A which can be absorbed through the skin.

Vitamin A deficiency is very unusual in the United States and other developed countries. Yet a lack of the vitamin can lead to a higher risk of not only osteoporosis but also increased risk of infection, complications with pregnancy, skin problems and even blindness.

Reaching toxic levels of vitamin A are rare unless you are supplementing with it, but be aware of potential vitamin A toxicity symptoms such as vision problems, pain in the bones and joints, lack of appetite, vomiting, hair loss and sensitivity to sunlight.

If you are concerned about what supplements you should be taking to build up your bones, give me a call to discuss!

How much protein do your bones need?

by Susan Brady | Apr 3, 2019 | Nutrition

Over the years there has been a lot of controversy as to whether protein is detrimental or beneficial to bone health. Early research suggested that a high protein diet caused an increase of calcium excretion in the urine. It was assumed that the increase in urine calcium was due to calcium loss from the bones, suggesting that high protein diets were detrimental to bone health. However, it was then determined that increased dietary protein was accompanied by a significant rise in calcium absorption in the intestines, negating the excretion in the urine. And the latest research advocates that protein is critical to maintaining both bone mass and lean muscle mass as we age.

In fact, the most recent studies have concluded that a relatively high protein intake is associated with increase in bone mineral density (BMD) and reduces the incidence of osteoporotic fractures.

If you have been following me for a while, you know that I believe that osteoporosis is not just a weakness of our bones, but a weakness of our musculoskeletal system. Your muscles are essential to maintaining bone health and, study after study, confirms that a decrease in muscle mass has a detrimental effect on our bones. The loss of muscle mass as we age, known as sarcopenia, increases the risk of falls and fractures.

In fact, a 2015 report from the American Society for Bone and Mineral Research found that people with sarcopenia had 2.3 times greater risk of breaking a bone when they fell.

What are the benefits of protein?

- Supplies amino acids that are needed to make bone collagen and muscle
- Increases the production of a hormone called insulin-like growth factor 1 which supports bone formation and muscle mass
- Decreases serum parathyroid hormone (PTH) which can reduce the release of calcium from bones into the blood stream
- Needed for repair and rebuilding of muscle after exercise

How much protein do we need?

New evidence suggests that current dietary recommendations for protein intake may be insufficient to maintain muscle and bone mass as we age. It has long been recommended that adults should consume approximately 0.8 grams of protein per kg of body weight a day.

To find your weight in kg, divide your weight in pounds by 2.2. (130 lbs/2.2 = 59 kg)

However, we are now finding that this amount of protein is NOT adequate for maintaining healthy bones and muscles as we age. New recommendations advocate 1-1.2 grams of protein per kg of body weight a day, which is a 25-50% increase over previous recommendations.

In a 2015 study, adults over the age of 50 who roughly ate 1.5 grams of protein/kg of body weight were better able to rebuild and retain muscle compared with control groups eating the RDA recommendations of 0.8g/kg body weight.

A 2018 consensus paper indicates that higher protein intake (≥ 0.8-g/kg body weight/day) is associated with higher BMD, a slower rate of bone loss, and reduced risk of hip fracture, provided that dietary calcium intakes are adequate.

Are all protein sources created equal?

You can get protein from either animal sources or plant sources. Some believe that the source of protein doesn’t matter, where others believe strongly that one or the other is better. Animal proteins tend to have a good balance of all the amino acids that we need, whereas plant proteins may lack certain amino acids. It has been suggested that diets based on animal protein might have a negative effect on bone health. This is because animal proteins are thought to increase acid production in the body, leading to increased bone resorption and bone loss. Some studies have seen a positive correlation between consumption of animal protein and an increase in urinary calcium excretion contributing to bone loss. However, other studies have found no evidence that consumption of animal proteins is deleterious to bone health.

What I have found is that some people thrive on a plant based diet and others feel better when they include animal proteins. It is a very individual choice that often goes beyond health issues. My advice is that if you are going to include animal proteins in your diet, you offset any potential acidic effects by pairing the protein with 2-3 servings of vegetables or fruits. Fruits and vegetables are not only are rich in many bone building nutrients but also alkaline, which will balance out the acid in animal based proteins.

Guidelines to Dietary Protein:

1. Aim to get 1.0 to 1.2 g/kg body weight of protein daily
2. Divide protein up evenly between meals
3. Make sure you are getting at least 800 mg of calcium/day, calcium and protein interact to positively affect bone health
4. Unless you are a vegetarian or vegan, strive to get your protein from a combination of both animal and plant sources
5. When eating animal proteins, consume at least 3 servings of fruit or vegetables with every meal to offset potential acid production
6. Choose protein sources that provide other nutrient benefits, such as healthy fats
7. Choose protein sources that come from grass-fed animal that are raised without antibiotics or hormones
8. For protein to optimize bone and muscle health, resistance or weight training is necessary

It is also important to understand that the recommendation of 1.0-1.2 g/kg body weight of protein a day is just a rough estimate of how much protein you need. Protein needs will vary depending on weight, age, activity level and overall health. A sedentary person will need less protein than someone who exercises several times a week. For seniors or those with acute or chronic diseases, 1.2 to 1.5 g/kg may be necessary to over come the catabolic effects of aging and disease. One concern of a high protein diet is kidney disease. So those with kidney disease need to watch their total protein intake as instructed by their medical doctor.

Bottom line: Insufficient dietary protein intake may put us at an increased risk for developing osteoporosis.

Still confused as to how much protein you need?

Call me and schedule a consult to discuss all you bone health needs!

703-738-4230

Osteoporosis: East meets West

by Susan Brady | Mar 27, 2019 | Healthy aging

As the world grows smaller and my patient population more wonderfully diverse, I’ve been stretched to learn more about the traditional practices of Eastern Medicine. Although I take a holistic approach to treating osteoporosis, I have come to realize that I still continue to live in the realm of science and not the non-physical essence of the body. Western Medicine looks at the body as machine, each organ a gear that must turn correctly for the machine to work. Eastern medicine looks at the person as an extension of all life and effected by all entities on earth, and to be truly healthy, needs to be balanced within as well as with the surrounding environment. Is there as benefit to integrating Eastern Medicine into the treatment of osteoporosis?

Western medicine looks at the bones as cold, hard, rigid structures that simply need minerals and medications to stay strong. Eastern medicine views the bones as an integrative organ of the body that in order to stay strong, needs to remain balanced by the correct foods and energy. Western medicine views osteoporosis as a normal part of aging. In Eastern medicine, bone loss is seen as a larger pattern of diminishing overall health being created by imbalance in the body.

Let’s take a look at how various Traditional Medicine practices treat Osteoporosis:

Traditional Iranian Medicine:

In Traditional Iranian Medicine (TIM) it is believed that the human body is a combination of four elements known as “Anasoor-e-Char-Ganeh”. These elements are water, air, dust, and fire. All people are a combination of these four factors, giving us all unique characteristics called Mizajs.

Warm + Dry = Element of Fire
Warm + Moist = Element of Air
Cold + Dry = Element of Dust
Cold + Moist = Element of Water

According to Abu Ali Sina, who is regarded as one of the most significant Persian physicians of the Islamic Golden Age and the Father of early modern medicine, dust and water are considered the heavy elements that make up our physical body and air and fire are known as light elements that make our psyche.

Every organ and body tissue also has a Mizaj which dictates its Warmness or Coldness. Bones, teeth, fingernails, and hair all have cold and dry Mizaj. They are heavy, firm and rigid. In order to build strong bones and teeth as adolescents one must consume foods with a cold and dry Mizaj such as yogurts, wheat, rice bran, and barley. However, as we age, it is believed that we become excessively cold and dry leading to wrinkles, poor digestive system and porous bones. So adding warmer foods to our diet to balance the Mizaj would be more appropriate.

Warmer foods include the following:
Herbs: Dried Oregano, fennel seeds, bay leaves, spearmint, mint, mustard seeds, rose petals, dill weed, cilantro
Spices: cinnamon, saffron, ginger, green and black cumin seeds, black, white, red pepper, cacao, cardamom, cloves, vanilla, black seeds,
Vegetables: Onion, garlic, carrots
Fruits: figs, grapes, raisin, apples
Nuts: Almonds and walnuts

You can also temper colder foods by combining them with warmer foods. For instance rice should be made with cinnamon, saffron, cumin seeds to get rid of “cold” nature of rice; cheeses must be eaten with walnuts, oregano, mint, cumin.

Traditional Chinese Medicine:

Traditional Chinese medicine (TCM) focuses on 3 vital substances, known as “The Three Treasures.”

Vital Energy (Qi)
Essence (Jing)
Spirit (Shen)

Together, they form the foundation for understanding the human body and guide the healing practices of TCM.

Jing is regarded the essence of life because it nourishes, fuels, and cools the body. It is believed to reside in the kidneys and in TCM, the kidneys are in charge of the bones. As jing diminishes with age, there is a loss of kidney qi (energy) and blood stagnation, resulting in lower bone density. Strengthening kidney function through food and herbs is considered to be a main principle in TMC to addressing bone loss.

Foods to nourish the kidneys:
Fruits: berries and other dark colored fruits
Vegetables: sweet potatoes and asparagus. Also
Nuts and seeds: Black sesame seeds, walnuts
Spices: ginger, licorice,

Herbs are also used to strengthen the kidneys, build qi, and work towards regeneration of new bone:
Foxglove (Rehmannia glutinosa)
Horny goat weed (Epimedium saggitatum)
Goji berry (Lycium barbarum)
Red Sage (Salvia miltiorrhiza)

Recently, in an animal study, a compound found in red sage has been shown to block an enzyme that is responsible for the breakdown of collagen in bones during osteoporosis.

There’s no single, most effective Chinese herbal therapy for bones because the herbs need to be tailored to individual needs. If interested, do contact a knowledgeable practitioner that can formulate a herbal remedy specifically for you. I am not an TCM practitioner, so I am not advising you to go out and purchase these herbs.Other TCM practices that aim to improve Jing and Qi include acupuncture and massage.

Traditional Indian Medicine:

Ayurveda, is the traditional Indian Medicine. The term “ayurveda” can be defined as knowledge (veda) of the lifespan (ayu). In Ayurveda, the elements are coded into three forces, which govern all life processes. These three forces, kapha, pitta and vata, are known as the three doshas. These three doshas regulate every physiological and psychological process in the body. Every person has a dominant dosha, and an imbalance manifests as a sign or symptom of disease.

The three doshas are made up of five elements:

Vata has qualities reflecting the elements of space and air
Pitta has qualities reflecting elements of fire and water
Kahpha has qualities reflecting elements of water and earth

Each of these doshas have very different characteristics and although every person carries all 3 doshas within them, one dosah usually dominates. Each dosah also influences different body organs, so for instance, the main locations of the Vata in the body are the colon, thighs, bones, joints, ears, skin, brain and nerve tissues.

From an Ayurvedic point of view, menopause marks a natural transition from a pitta predominant phase of a woman’s life to a vata predominant phase. Vata, when it is in excess, has a catabolic effect on the body tissues, leading to bone loss.

Vata can be brought back into balance by eating the right foods:
Some of the key foods include:
Fruits: berries, avocado, peach, dates
Vegetables: sweet potatoes, beets, watercress
Legumes: red lentils
Grains: wild rice
Nuts: pistachios

Also choose warm and cooked foods, like nourishing soups and stews, over cold, raw foods. If you are to eat a raw vegetable salad be sure to add a spicy olive oil dressing to it.

According to Ayurveda, foods that specifically nourish bone tissue include: spelt, black grapes, radish, beetroot, sugar cane, garlic and ginger.

How can we integrate Traditional Eastern Medicine philosophies to enhance bone health?

Understand that your body can heal itself, if balanced correctly, which means nourishing your mind, body and soul.
Realize that your body isn’t just a machine, but a living energetic entity that is affected by all life and elements around us, and there is a balance that each of us must find to be truly healthy.
If you have a strong genetic makeup of one particular culture, follow the diet and rituals of your ancestors. What did you grandmother or great grandmother cook? Those are the foods that will best nourish your body and bones.
Incorporate the foods, herbs, spices suggested by these ancient practices to help balance your Mizajs, Doshas and support the your Kidney Qi.
- Common to all philosophies: cinnamon, cardamom, ginger, garlic, root vegetables, nuts and seeds, olive oil, figs, and grapes

Many traditional practices continue to exist today, despite the advances in conventional medicines. Why? Because despite lacking in scientific research to support them, they work! As our community expands to all corners of the earth, this the prime time to embrace traditional medicine practices that have been the foundation of healing and health for hundred’s of centuries. If you are interested in better understanding any of these practices, I encourage to seek out a practitioner that specializes in these traditional medicines. For your bones and your body to truly heal, they need to be nourished by nutrition and exercise, but also through vibrant energy and spirt.

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