Heart Disease and Osteoporosis: Are cholesterol levels the true link?

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Written by Susan Brady

Osteoporosis and cardiovascular disease share many common risk factors such as diabetes, smoking, alcohol abuse, sedentary lifestyle, and in postmenopausal women, a decline in estrogen. However, over the last several years, emerging research has shown a growing link between the two conditions. In fact, a recent observational study reported in the Journal Heart found that a formal diagnosis of osteoporosis was independently associated with a 79% higher risk of cardiovascular disease. Last year in my blog articles titled The Curious Connection Between Osteoporosis and Heart Disease and Curious Connection, part 2 I highlighted two common links between osteoporosis and heart disease, high blood pressure, and atherosclerosis caused by calcium deposits building up in the arteries. Now another strong link has emerged. Dyslipidemia.

Dyslipidemia refers to having unhealthy levels of one or more kinds of lipids (fats) in your blood, such as low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides. Most of us have heard that LDLs are the so-called “bad” cholesterol and that HDLs are the so-called “good” cholesterol. It is well known that dyslipidemia resulting in high LDLs and triglycerides in combination with low HDLs can cause atherosclerosis and heart disease. It is now becoming evident that dyslipidemia can also lead to low bone mass and increased fracture risk.

Here’s how:

Bone is highly vascularized tissue that depends on a constant supply of blood for regeneration and remodeling. In fact, a typical long bong is nourished through 3 separate vascular systems to meet the metabolic needs of the bone. As in atherosclerosis of the heart, fats and cholesterol can accumulate in the blood vessels of the bone. When these fats become oxidized, especially the LDL cholesterol, it causes inflammation and damage, leading to arterial calcifications and plaques. In the heart, this can lead to blockages and heart attacks. In the bone, this can suppress osteoblast formation (cells that make new bone) and an increase in the production of osteoclasts (cells that break down bone) leading to bone loss. Having high lipid levels can also increase blood viscosity compromising blood flow to the bone.

Just like having higher levels of HDL cholesterol is associated with a lower risk of heart disease, it is also recently been reported to be associated with higher bone mineral density. HDL cholesterol is considered to be the ‘good” cholesterol because it helps to transport excess cholesterol from the body to the liver where it is then flushed from the system. HDL cholesterol also helps to modulate inflammation. Inflammation has a negative effect on bone and can disrupt bone metabolism leading to bone loss. In a recent study published in the journal Lipids in Health and Disease, the researchers report a positive association between HDL cholesterol and lumbar spine bone mineral density in people aged 20-59. Meaning the higher the HDL cholesterol, the higher the bone mineral density in the lumbar spine.

Below is a table that summarizes the effects that dyslipidemia can have on bone metabolism.

7 ways to protect your bones and your heart

Emphasize Exercise- Aerobic exercise, as well as strength training, can boost HDL cholesterol levels. Exercise has also been shown to enhance the antioxidant and anti-inflammatory effects of HDL cholesterol.
Opt-In for Olive oil. Research has also shown that one of olive oil’s heart-healthy effects is an increase in HDL cholesterol. This may be because it is a rich source of antioxidants called polyphenols.
Don’t forget Fatty Fish. The omega 3 fats in fatty fish may help raise HDL cholesterol and decrease triglycerides. Taking fish oils supplements can do the same.
Pile Up on Purple Foods. Anthocyanin, the plant flavonoid found in purple foods, has antioxidant effects which can increase HDL cholesterol, decrease LDL cholesterol and help fight inflammation. Examples of foods rich in anthocyanins include eggplant, red cabbage, blueberries, blackberries, cranberries, and cherries.
Splurge on Soluble Fibers. Soluble fibers bind to cholesterol in the intestine and remove it from the body. Legumes, vegetables, oatmeal, quinoa are good examples of foods with soluble fibers.
Go for the Garlic. Garlic has been shown to decrease total cholesterol levels and increase HDL cholesterol.
Add Anti-inflammatory Herbs. Anti-inflammatory herbs like ginger, turmeric, thyme, and cloves all have powerful anti-inflammatory effects that can help to prevent the oxidation of LDL cholesterol in the body.

As women go through menopause the decline in estrogen plays a strong role in developing heart disease and osteoporosis. But with a nutritious diet and healthy lifestyle, you can offset the effects. What the link between these 2 conditions truly shows is that any steps you take to support your heart health will also support bones and vice versa.

Please reach out if you need more guidance on building strong bones, a strong heart, or a strong body! 703-738-4230 susan@nurturedbones.com

References:

1. Anagnostis, Panagiotis, Matilda Florentin, Sarantis Livadas, Irene Lambrinoudaki, and Dimitrios G. Goulis. “Bone Health in Patients with Dyslipidemias: An Underestimated Aspect.” International Journal of Molecular Sciences 23, no. 3 (January 31, 2022): 1639. https://doi.org/10.3390/ijms23031639.

2.Tang, Yuchen, Shenghong Wang, Qiong Yi, Yayi Xia, and Bin Geng. “High-Density Lipoprotein Cholesterol Is Negatively Correlated with Bone Mineral Density and Has Potential Predictive Value for Bone Loss.” Lipids in Health and Disease 20, no. 1 (July 25, 2021): 75. https://doi.org/10.1186/s12944-021-01497-7.

4. Xie, Ruijie, Xiongjie Huang, Qianlong Liu, and Mingjiang Liu. “Positive Association between High-Density Lipoprotein Cholesterol and Bone Mineral Density in U.S. Adults: The NHANES 2011-2018.” Journal of Orthopaedic Surgery and Research 17, no. 1 (February 15, 2022): 92. https://doi.org/10.1186/s13018-022-02986-w.

3.ScienceDaily. “Thin and Brittle Bones Strongly Linked to Women’s Heart Disease Risk: Thinning Lower Spine, Top of Thigh Bone and Hip Predictive of Raised Heart Attack/Stroke Risk.” Accessed February 24, 2022. https://www.sciencedaily.com/releases/2021/05/210506183351.htm.

Goodbye Osteoporosis!

Guess who no longer has osteoporosis in her spine?? DEXA says now -2.4 osteopenia where was -3.2 before. HUGE improvement. No medication, just exercise and nutrition. I still have a ways to go with my hips and femoral neck, but this is really great news for me! ~D.S.

Osteoporosis Nutrition

After being diagnosed with osteoporosis, I began sifting through all the information available on nutrition and osteoporosis, but it was confusing and time consuming. Even though I thought my diet was good, Susan gave me advice on how to make it even better! I benefited very much from Susan’s nutritional advice and guidance for safe and effective exercises. My recent bone scan showed improvements in both my hip and my spine, so I am encouraged that all the changes that I have made are working! ~ M.R.

Proper Exercise and Nutrition

“Susan Brady is very knowledgeable about osteoporosis. In 2016, I was diagnosed with osteoporosis in my lower back. Through proper exercise and nutrition, Susan was able to guide me towards a regimen that would in turn almost reverse my symptoms. Because of her method, I have been able to curb my bone loss, gain strength, and improve my overall health. I feel that I am on the road to a happier, healthier lifestyle thanks to Susan.”~ B.L.

Alkaline Based Diet

While providing rehabilitation after my two hip surgeries, Susan also educated me in the importance of proper nutrition for strengthening my bones and improving my bone density. She encouraged me to eat an alkaline-based diet and to eliminate the junk food I was so fond of. Not only did I heal quickly, but also the doctors were amazed by the rapid bone growth as noted on my x-rays. I continue to include chia and pumpkin seeds in my diet, as well as other foods that are alkaline based. I honestly have Susan to thank for this complete transformation in my diet which has allowed me to go back to wearing heels which I thought I would never be able to do again. Nutrition matters — I am a perfect example of good bones from good food! ~R.G.

Prescription Holiday

Initially, I went to Susan Brady because my family doctor told me to take a holiday from the prescription bone density medicine that I had been taking it for many years. I avoid dairy since I am lactose intolerant and sensitive to dairy protein. I was confident that Susan could recommend a superior quality calcium, balanced with other supplements that would help provide the nutrients I needed for bone health. In addition to recommendations for supplements, she has evaluated my diet and my exercise regimen, making suggestions as needed. With guidance from Susan I have been able to maintain bone health without additional bone density medicine for several years now. ~K.N.

Surgery Rehabilitation

While providing rehabilitation after my two hip surgeries, Susan also educated me in the importance of proper nutrition for strengthening my bones and improving my bone density. She encouraged me to eat an alkaline-based diet and to eliminate the junk food I was so fond of. Not only did I heal quickly, but also the doctors were amazed by the rapid bone growth as noted on my x-rays. I continue to include chia and pumpkin seeds in my diet, as well as other foods that are alkaline based. I honestly have Susan to thank for this complete transformation in my diet which has allowed me to go back to wearing heels which I thought I would never be able to do again. Nutrition matters. I am a perfect example of good bones from good food!” ~R.G.

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