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Understanding advice for dealing with osteoporosis and navigating info
I am looking at where I went wrong following the advice to exercise, eat well and take supplements. I did all of that - religiously for 9 months and I failed and in looking and how that could have happened I have been revising my actions and the advice I followed and what went wrong so I can correct it and hopefully help others. I am embarrassed to say that it was just not obvious to me.
I was told that walking is great for osteoporosis - so I did a lot of walking. Working up to 10k steps a day - But I am now learning that walking, just walking does not build bone density if it’s leisurely, even if for long duration. It has to be at a significant pace. And of course stair climbing and the elliptical but the heart rate has to rise to a particular level as well. Find out what that is for your body.
Weight bearing exercises - that is not enough. The exercises have to specially and safely address the spine and other bones and they have to be done properly or one loses the benefit of the exercise. I needed more of some exercises and fewer of the others and squats, for example, I was not doing them properly even though I had trainers watching me. My exercise physiologist helped me with proper form.
A wide variety of vegetables is recommended - but there are fruits, vegetables and nuts that are high in oxalates. If, like me, you have an issue with oxalates or are consistently eating a high oxalate diet - spinach, Swiss chard, rhubarb, almonds, prunes - like I was - day in and day out - oxalates bind to calcium and are excreted through urine.
I was eating copious amounts of rhubarb, Swiss chard, collards, sweet potatoes, almonds, almond flour in my crackers and foods. I thought I was eating calcium rich foods that were helping me but they were making me worse. Nobody told me this could be detrimental to my particular bone health.
I know look at not only calcium content but how high the oxalate content is. So I am actually absorbing the calcium intake in and it is going to my bones. It bears looking into this. My calcium oxalate level on the 24 hr urine test was 396. I brought it down to the normal level of 21 by changing my diet alone. No medication. However I had to be diligent and I am now navigating getting enough nutrients and calcium while regulating oxalates.
It’s not enough to “eat a lot of green leafy vegetables and have your plate look like a rainbow of colors”. Because many have high or moderately high oxalate content and either need to be boiled and the water drained in order to reduce the oxalate level, or avoided altogether depending on your situation. It’s important to read up on and understand how oxalates affect bone health and I had to figure this out the hard way because no one told me, not one doctor. Until it was a problem. With osteoporosis and bone health in general, I think this is a critical piece of information. I dont understand why this is not included in the general information.
The other part of the equation is our digestive system. I realized that if my digestive system was not absorbing nutrients properly, no matter how much or how nutrient dense my diet is, if my body is not absorbing and redirecting g these nutrients to the parts of my body that need it, the benefit is greatly reduced. The digestive system has to be healthy and able to absorb the nutrients you put into it. I thought just eating a pristine healthy diet would fix this but sometimes one needs a little more support in this area.
I wanted to mention this because for me, I realized that it was not enough to know what to do, and all I was told and all I read was what to do. I know now it has everything to do with how and to ask questions and when told I am making myself crazy (vs being given answers to my questions) to go elsewhere. I am learning to ask the how’s and the whys these things are happening and to research as much as I can instead of just following what I have been told to do, which is just not enough, at least for me and my body.
And I also believe that there is this assumption that everyone with osteoporosis is going to take medication so maybe it’s not important to know. And that the medication will just fix the bones. But it is important to know. So important, whether one takes meds or not, doctors and healthcare providers have to go a big step further to offer more than the status quo of walking, weight bearing exercise and eating leafy green vegetables, as do the sites that put out information on bone health.
This is what I am learning.
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Thank you! That’s good to know. At the moment I am using baby bok Choi, adult bok Choi (just kidding), kale and baby kale, broccoli, Brussel sprouts, and other veggies that are already significantly lower have good calcium content. I am nervous about how much oxalate remains in spinach given it’s already one of the highest in the list.
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1 ReactionYes! I am thrilled you are 80 and inspire me!! The research i do and the investment I make is for me. For the investment in cultivating a rich, vibrant and active life so I can continue to be an active participant in my life. If it helps the “research people” to offer us better quality of life so be it. I happily pay it forward.
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2 ReactionsI would love, if you feel comfortable sharing, the table or place where I can look at the vegetables and how to best access their nutrients with cooking. (Apologies, I didn’t see there was more to your email in my screen) I wholeheartedly believe in Chinese medicine as a a complementary method and in some cases alternative method. I practice qigong, my qigong healing practitioners and with it alone and diet and meditation (while still checking in with my doctor) avoided a third laparoscopic surgery as I saw the path I was on if I didn’t make lifestyle and energetic changes. I also healed a frozen shoulder in 4-5 weeks that two physicians (one specialist and one who had same condition) and a pt and other non doctor who had surgery, told me that it takes 18-24 months to heal. So from personal experience - healings like this are possible because I have personally experienced this and other changes in my body. But I work with my doctors, get all my tests and make the smart choices for me, like having an appendectomy instead of being offered the choice of waiting to see if it flares up again - given the randomness of it. I also Al’s myself - what if I could heal faster than what everyone is telling me? There is no guarantee but it doesn’t hurt to put positive messages and outcomes and hope in my brain (but not as a substitution for treatment).
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3 ReactionsThank you
For the suggestion. I want to take it and I was but I have issues with pancreas and so we are investigating if a supplement is the right choice for me vs taking it via bone broth. I am trying to see what I can get through food and supplement where I fall short or cannot consistently get what I need through food.
Does she also take meds in addition to drinking calcium citrate? I’m curious.
The atypical fractured worry me especially bc my femoral dexa is barely in osteopenia.
I applaud your efforts and agree that it can all be overwhelming and obsessive. But I think when dealing with osteoporosis we need to be diligent and even somewhat obsessive to make sure we are doing everything we can to maintain our body's function and integrity. It's really challenging to take all factors into consideration when you're trying to optimize your diet and lifestyle for bone and body health like you have. You didn't do anything wrong, in fact you did so much that is right! And now, you are refining your diet, etc, to optimize results and that's terrific!
I'd agree that boiling your oxalate rich veggies will eliminate some of the oxalic acid but it will also likely leach some of the minerals into the water that you discard so there is some trade off. I've also read that heat can break down the oxalate/calcium bind but of course, like in much of this information, there is conflicting information (though I think it is indisputable that boiling diminishes oxalates). All in all, it's probably best to avoid some of the highest oxalate-rich foods like rhubard, beet greens and spinach. Though they are high in calcium, the mineral content will not be as bio-available so they are not great sources in which to get our calcium. From what I have read from reputable sources, collards are not high in oxalates and they have one of the highest amounts of calcium in a green veggie. A cup of cooked collards has about as much calcium as a cup of milk. Oxalates are a particular problem if you are prone to kidney stones so flushing with lots of water diminishes the concentration of oxalic acid in our urine and is helpful to prevent stones if that is an issue. Oxalates themselves do not diminish bone density but they do inhibit the absorption of calcium so we have to take that into account when calculating our calcium for the day. Phytates and lectins in beans, nuts, seeds and grains also block calcium and mineral absorption but these are all healthy foods that our bodies benefit from (unless there is an allergy or sensitivity of course). When we eat a wide variety of foods and drink lots of water, I think some of this balances out.
As you mentioned, digestive integrity is also important so that we can extract and absorb the vitamin and mineral content from the rich sources we consume. Bone broth, gut soothing herbal teas and probiotic-rich and fermented foods can all be helpful. The fermentation process breaks down the oxalic acid so that might be one way to consume these nutrient-rich veggies and minimize the oxalate content.
On another note, in our country the daily recommendation of calcium for seniors is 1200 mg. I think this is on the high side to compensate for calcium that may be lost due to oxalates and other variables. The World Health Organization recommends 700 mg of daily calcium for seniors, far below what is recommended here. Who's right? (no pun intended). It's all crazy-making but as long as we are eating whole, nutrient-rich foods and exercising regularly, we're doing all we can with the current information available to us (and that information seems to be constantly changing!).
Here are a couple of great articles that address this, one from Harvard University and the other from the Royal Osteoporosis Society in the UK:
https://www.health.harvard.edu/staying-healthy/how-much-calcium-do-you-really-need
https://theros.org.uk/information-and-support/bone-health/nutrition-for-bones/are-there-any-foods-i-should-avoid/
A great tool for calculating your daily nutrition is Cronometer.com. Their basic service is free and there is even a tabulation that tells you the balance of calcium to oxalate consumption. There is a higher level of information available for a fee but I have found the basic site is really enough to help me keep on track every day.
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4 ReactionsThank you for the links!! My nutritionist just turned me on to chronometer and I am getting familiar with it! Yes - it all makes so much sense to me. I completely agree with you. Salad greens like romaine, arugula have virtually no oxalates so I will be having more of those as well as other lettuces like red oak, butter leaf etc to get other valuable nutrients. I have reintroduced dairy and I understand sheep’s milk yogurt and goat’s milk yogurt are easier on the digestive system than cow’s Milk yogurt and also contain 390 mg of calcium per serving - about a third (of 1200 mg). There is also lactose free organic milk and lactose free kefir and unhomogenozed Whole milk which is naturally high in k2. Then canned sardines in olive oil or canned wild caught salmon will be a good supplemental food.
I don’t know given the salt content of canned fish and other factors how often it’s okay to eat them per week as salt is not good for bone density.
The oxalates bind to calcium and direct it away from bone. I need to understand still how to better manage this. Learning curve.
Thanks everyone for your very valuable input.
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2 ReactionsI am convinced that taking collagen can highly probable contribute to positive change with respect to bone building. Extracellular organic matrix of bones is composed by 90% of collagen. Here is the link to the research:
https://www.frontiersin.org/articles/10.3389/fphar.2020.00757/full
Of course, we do not know how much of collagen supplement is assimilated by our bodies, however it is worth to take it. As I mentioned before, I take 2 times a day a spoon of collagen powder (hydrolyzed).
There are some research results that collagen indeed helps to improve bone strength:
https://www.mdpi.com/2072-6643/10/1/97
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2 ReactionsTotally agree with you - and - not all solutions and approaches work for all people - I for example have some issues that may be contraindicated. Much in the same way that dairy doesn’t agree with everyone. I mention this because we are not always aware of what works in general will work for the individual. So I am always cautious to agree - even though research backs it - we all still have to pay attention to our bodies and how we metabolize even what seems like the healthiest of options. H
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2 ReactionsHi Resort & Galactica, I too would be interested in the table or place where it outlines which high oxlate vegetables would better if cooked.
Resort, we're all struggling with the same issues you brought up. It's not clear to me why conventional doctors don't seem to understand the nuisances of osteoporosis. It's really an epidemic. Since I've started this journey 4 out of 5 women (some as young as 40s) have osteoporosis. This forum has been a wealth of information for me and so many other people.
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