The Bare-bones Truth About Osteoporosis

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The Bare-bones Truth About Osteoporosis

In yesterday’s issue of 10almonds, we asked you “at what age do you think it’s important to start worrying about osteoporosis?”, and here’s the spread of answers you gave us:

The Bare-bones Truth About Osteoporosis

In yesterday’s issue of 10almonds, we asked you “at what age do you think it’s important to start worrying about osteoporosis?”, and here’s the spread of answers you gave us:

At first glance it may seem shocking that a majority of respondents to a poll in a health-focused newsletter think it’ll never be an issue worth worrying about, but in fact this is partly a statistical quirk, because the vote of the strongest “early prevention” crowd was divided between “as a child” and “as a young adult”.

This poll also gave you the option to add a comment with your vote. Many subscribers chose to do so, explaining your choices… But, interestingly, not one single person who voted for “never” had any additional thoughts to add.

We loved reading your replies, by the way, and wish we had room to include them here, because they were very interesting and thought-provoking.

Let’s get to the myths and facts:

Top myth: “you will never need to worry about it; drink a glass of milk and you’ll be fine!”

The body is constantly repairing itself. Its ability to do that declines with age. Until about 35 on average, we can replace bone mineral as quickly as it is lost. After that, we lose it by up to 1% per year, and that rate climbs after 50, and climbs even more steeply for those who go through (untreated) menopause.

Losing 1% per year might not seem like a lot, but if you want to live to 100, there are some unfortunate implications!

About that menopause, by the way… Because declining estrogen levels late in life contribute significantly to osteoporosis, hormone replacement therapy (HRT) may be of value to many for the sake of bone health, never mind the more obvious and commonly-sought benefits.

Learn more: Management of osteoporosis in postmenopausal women: the 2021 position statement of The North American Menopause Society

On the topic of that glass of milk…

  • Milk is a great source of calcium, which is useless to the body if you don’t also have good levels of vitamin D and magnesium.
  • People’s vitamin D levels tend to directly correlate to the level of sun where they live, if supplementation isn’t undertaken.
  • Plant-based milks are usually fortified with vitamin D (and calcium), by the way.
  • Most people are deficient in magnesium, because green leafy things don’t form as big a part of most people’s diets as they should.

See also: An update on magnesium and bone health

Next most common myth: “bone health is all about calcium”

We spoke a little above about the importance of vitamin D and magnesium for being able to properly use that. But potassium is also critical:

Read more: The effects of potassium on bone health

While we’re on the topic…

People think of collagen as being for skin health. And it is important for that, but collagen’s benefits (and the negative effects of its absence) go much deeper, to include bone health. We’ve written about this before, so rather than take more space today, we’ll just drop the link:

We Are Such Stuff As Fish Are Made Of

Want to really maximize your bone health?

You might want to check out this well-sourced LiveStrong article:

Bone Health: Best and Worst Foods

(Teaser: leafy greens are in 2nd place, topped by sardines at #1—where do you think milk ranks?)

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  • Do Try This At Home: The 12-Week Brain Fitness Program

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    12 Weeks To Measurably Boost Your Brain

    This is Dr. Majid Fotuhi. From humble beginnings (being smuggled out of Iran in 1980 to avoid death in the war), he went on (after teaching himself English, French, and German, hedging his bets as he didn’t know for sure where life would lead him) to get his MD from Harvard Medical School and his PhD in neuroscience from Johns Hopkins University. Since then, he’s had a decades-long illustrious career in neurology and neurophysiology.

    What does he want us to know?

    The Brain Fitness Program

    This is not, by the way, something he’s selling. Rather, it was a landmark 12-week study in which 127 people aged 60–80, of which 63% female, all with a diagnosis of mild cognitive impairment, underwent an interventional trial—in other words, a 12-week brain fitness course.

    After it, 84% of the participants showed statistically significant improvements in cognitive function.

    Not only that, but of those who underwent MRI testing before and after (not possible for everyone due to practical limitations), 71% showed either no further deterioration of the hippocampus, or actual growth above the baseline volume of the hippocampus (that’s good, and it means functionally the memory center of the brain has been rejuvenated).

    You can read a little more about the study here:

    A Personalized 12-week “Brain Fitness Program” for Improving Cognitive Function and Increasing the Volume of Hippocampus in Elderly with Mild Cognitive Impairment

    As for what the program consisted of, and what Dr. Fotuhi thus recommends for everyone…

    Cognitive stimulation

    This is critical, so we’re going to spend most time on this one—the others we can give just a quick note and a pointer.

    In the study this came in several forms and had the benefit of neurofeedback technology, but he says we can replicate most of the effects by simply doing something cognitively stimulating. Whatever challenges your brain is good, but for maximum effect, it should involve the language faculties of the brain, since these are what tend to get hit most by age-related cognitive decline, and are also what tends to have the biggest impact on life when lost.

    If you lose your keys, that’s an inconvenience, but if you can’t communicate what is distressing you, or understand what someone is explaining to you, that’s many times worse—and that kind of thing is a common reality for many people with dementia.

    To keep the lights brightly lit in that part of the brain: language-learning is good, at whatever level suits you personally. In other words: there’s a difference between entry-level Duolingo Spanish, and critically analysing Rumi’s poetry in the original Persian, so go with whatever is challenging and/but accessible for you—just like you wouldn’t go to the gym for the first time and try to deadlift 500lbs, but you also probably wouldn’t do curls with the same 1lb weights every day for 10 years.

    In other words: progressive overloading is key, for the brain as well as for muscles. Start easy, but if you’re breezing through everything, it’s time to step it up.

    If for some reason you’re really set against the idea of learning another language, though, check out:

    Reading As A Cognitive Exercise ← there are specific tips here for ensuring your reading is (and remains) cognitively beneficial

    Mediterranean diet

    Shocking nobody, this is once again recommended. You might like to check out the brain-healthy “MIND” tweak to it, here:

    Four Ways To Upgrade The Mediterranean Diet ← it’s the fourth one

    Omega-3 supplementation

    Nothing complicated here. The brain needs a healthy balance of these fatty acids to function properly, and most people have an incorrect balance (too little omega-3 for the omega-6 present):

    What Omega-3 Fatty Acids Really Do For Us ← scroll to “against cognitive decline”

    Increasing fitness

    There’s a good rule of thumb: what’s healthy for your heart, is healthy for your brain. This is because, like every other organ in your body, the brain does not function well without good circulation bringing plenty of oxygen and nutrients, which means good cardiovascular health is necessary. The brain is extra sensitive to this because it’s a demanding organ in terms of how much stuff it needs delivering via blood, and also because of the (necessary; we’d die quickly and horribly without it) impediment of the blood-brain barrier, and the possibility of beta-amyloid plaques and similar woes (they will build up if circulation isn’t good).

    How To Reduce Your Alzheimer’s Risk ← number two on the list here

    Practising mindfulness medication

    This is also straightforward, but not to be underestimated or skipped over:

    No-Frills, Evidence-Based Mindfulness

    Want to step it up? Check out:

    Meditation Games That You’ll Actually Enjoy

    Lastly…

    Dr. Fotuhi wants us to consider looking after our brain the same way we look after our teeth. No, he doesn’t want us to brush our brain, but he does want us to take small measurable actions multiple times per day, every day.

    You can’t just spend the day doing nothing but brushing your teeth for the entirety of January the 1st and then expect them to be healthy for the rest of the year; it doesn’t work like that—and it doesn’t work like that for the brain, either.

    So, make the habits, and keep them going

    Take care!

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  • Caffeine Blues – by Stephen Cherniske

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    Caffeine use is an interesting and often-underexamined factor in health. Beyond the most superficial of sleep hygiene advice (à la “if you aren’t sleeping well, consider skipping your triple espresso martini at bedtime”), it’s often considered a “everybody has this” drug.

    In this book, Cherniske explores a lot of the lesser-known effects of caffeine, and the book certainly is a litany against caffeine dependence, ultimately arguing strongly against caffeine use itself. The goal is certainly to persuade the reader to desist in caffeine use, and while the book’s selling point is “learn about caffeine” not “how to quit caffeine”, a program for quitting caffeine is nevertheless included.

    You may notice the title and cover design are strongly reminiscent of “Sugar Blues”, which came decades before it, and that’s clearly not accidental. The style is similar—very sensationalist, and with a lot of strong claims. In this case, however, there is actually a more robust bibliography, albeit somewhat dated now as science has continued to progress since this book was published.

    Bottom line: in this reviewer’s opinion, the book overstates its case a little, and is prone to undue sensationalism, but there is a lot of genuinely very good information in here too, making it definitely worth reading.

    Click here to check out Caffeine Blues, and remedy yours!

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  • The Glucose Goddess Method – by Jessie Inchausspé

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We’ve previously reviewed Inchausspé’s excellent book “Glucose Revolution”. So what does this book add?

    This book is for those who found that book a little dense. While this one still gives the same ten “hacks”, she focuses on the four that have the biggest effect, and walks the reader by the hand through a four-week programme of implementing them.

    The claim of 100+ recipes is a little bold, as some of the recipes are things like vinegar, vinegar+water, vinegar+water but now we’re it’s in a restaurant, lemon+water, lemon+water but now it’s in a bottle, etc. However, there are legitimately a lot of actual recipes too.

    Where this book’s greatest strength lies is in making everything super easy, and motivating. It’s a fine choice for being up-and-running quickly and easily without wading through the 300-odd pages of science in her previous book.

    Bottom line: if you’ve already happily and sustainably implemented everything from her previous book, you can probably skip this one. However, if you’d like an easier method to implement the changes that have the biggest effect, then this is the book for you.

    Click here to check out The Glucose Goddess Method, and build it into your life the easy way!

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  • Seed Saving Secrets – by Alice Mirren

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We all know that home-grown is best, and yet many of us are not exactly farmers (this reviewer tries with mixed results—hardy crops survive; others, not so much). While it’s easy to blame the acidic soil, the harsh climate, or not having enough time and money (this reviewer blames all of the above), the fact remains that a skilled gardener can produce a good crop in any conditions.

    That’s where this book helps; right from the beginning, from the seeds. Have you ever bought a pack of seeds, excitedly sown them, and then had a germination rate of zero or something close to that (this reviewer has)?

    Alice Mirren takes us on a tour of how to save seeds from plants you know are regionally viable (not the product of some vast globalized industry that doesn’t know you live in an ancient bog with a cold south-east wind blowing in from Siberia), and then how to care for and curate them, how to store them for future years, how to keep a self-perpetuating seed bank.

    She goes beyond that, though. Regular 10almonds readers might remember about the supercentenarian “Blue Zones”, and how big factors in healthy longevity include community and purpose; Mirren advocates for organizing community seed banks, which will also mean that everyone (including you) has access to much more diverse seeds, and when it comes to the perils of natural selection, diversity means survival. Otherwise, if you have just one seed type, a single blight can wipe out everything pretty much overnight.

    Bottom line: if you grow your own food or would like to, this is a “bible of…” level book that you absolutely should have to hand.

    Click here to check out Seed Saving Secrets, and see the results in your kitchen and on your plate!

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  • We looked at genetic clues to depression in more than 14,000 people. What we found may surprise you

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    The core experiences of depression – changes in energy, activity, thinking and mood – have been described for more than 10,000 years. The word “depression” has been used for about 350 years.

    Given this long history, it may surprise you that experts don’t agree about what depression is, how to define it or what causes it.

    But many experts do agree that depression is not one thing. It’s a large family of illnesses with different causes and mechanisms. This makes choosing the best treatment for each person challenging.

    Reactive vs endogenous depression

    One strategy is to search for sub-types of depression and see whether they might do better with different kinds of treatments. One example is contrasting “reactive” depression with “endogenous” depression.

    Reactive depression (also thought of as social or psychological depression) is presented as being triggered by exposure to stressful life events. These might be being assaulted or losing a loved one – an understandable reaction to an outside trigger.

    Endogenous depression (also thought of as biological or genetic depression) is proposed to be caused by something inside, such as genes or brain chemistry.

    Many people working clinically in mental health accept this sub-typing. You might have read about this online.

    But we think this approach is way too simple.

    While stressful life events and genes may, individually, contribute to causing depression, they also interact to increase the risk of someone developing depression. And evidence shows that there is a genetic component to being exposed to stressors. Some genes affect things such as personality. Some affect how we interact with our environments.

    What we did and what we found

    Our team set out to look at the role of genes and stressors to see if classifying depression as reactive or endogenous was valid.

    In the Australian Genetics of Depression Study, people with depression answered surveys about exposure to stressful life events. We analysed DNA from their saliva samples to calculate their genetic risk for mental disorders.

    Our question was simple. Does genetic risk for depression, bipolar disorder, schizophrenia, ADHD, anxiety and neuroticism (a personality trait) influence people’s reported exposure to stressful life events?

    Girl or teenager leaning against wall, hand across face, looking down
    We looked at the genetic risk of mental illness to see how that was linked to stressful life events, such as childhood abuse and neglect. Kamira/Shutterstock

    You may be wondering why we bothered calculating the genetic risk for mental disorders in people who already have depression. Every person has genetic variants linked to mental disorders. Some people have more, some less. Even people who already have depression might have a low genetic risk for it. These people may have developed their particular depression from some other constellation of causes.

    We looked at the genetic risk of conditions other than depression for a couple of reasons. First, genetic variants linked to depression overlap with those linked to other mental disorders. Second, two people with depression may have completely different genetic variants. So we wanted to cast a wide net to look at a wider spectrum of genetic variants linked to mental disorders.

    If reactive and endogenous depression sub-types are valid, we’d expect people with a lower genetic component to their depression (the reactive group) would report more stressful life events. And we’d expect those with a higher genetic component (the endogenous group) would report fewer stressful life events.

    But after studying more than 14,000 people with depression we found the opposite.

    We found people at higher genetic risk for depression, anxiety, ADHD or schizophrenia say they’ve been exposed to more stressors.

    Assault with a weapon, sexual assault, accidents, legal and financial troubles, and childhood abuse and neglect, were all more common in people with a higher genetic risk of depression, anxiety, ADHD or schizophrenia.

    These associations were not strongly influenced by people’s age, sex or relationships with family. We didn’t look at other factors that may influence these associations, such as socioeconomic status. We also relied on people’s memory of past events, which may not be accurate.

    How do genes play a role?

    Genetic risk for mental disorders changes people’s sensitivity to the environment.

    Imagine two people, one with a high genetic risk for depression, one with a low risk. They both lose their jobs. The genetically vulnerable person experiences the job loss as a threat to their self-worth and social status. There is a sense of shame and despair. They can’t bring themselves to look for another job for fear of losing it too. For the other, the job loss feels less about them and more about the company. These two people internalise the event differently and remember it differently.

    Genetic risk for mental disorders also might make it more likely people find themselves in environments where bad things happen. For example, a higher genetic risk for depression might affect self-worth, making people more likely to get into dysfunctional relationships which then go badly.

    Middle aged man looking sad, leaning on sofa, staring into distance
    If two people lose their jobs, one with a high genetic risk of depression the other at low risk, both will experience and remember the event differently. Inside Creative House/Shutterstock

    What does our study mean for depression?

    First, it confirms genes and environments are not independent. Genes influence the environments we end up in, and what then happens. Genes also influence how we react to those events.

    Second, our study doesn’t support a distinction between reactive and endogenous depression. Genes and environments have a complex interplay. Most cases of depression are a mix of genetics, biology and stressors.

    Third, people with depression who appear to have a stronger genetic component to their depression report their lives are punctuated by more serious stressors.

    So clinically, people with higher genetic vulnerability might benefit from learning specific techniques to manage their stress. This might help some people reduce their chance of developing depression in the first place. It might also help some people with depression reduce their ongoing exposure to stressors.

    If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

    Jacob Crouse, Research Fellow in Youth Mental Health, Brain and Mind Centre, University of Sydney and Ian Hickie, Co-Director, Health and Policy, Brain and Mind Centre, University of Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • How to keep your teeth young

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    How to keep your teeth young

    The association between aging and teeth is so well-established that it’s entered popular idiom, “too long in the tooth”, and when it comes to visual representations, false teeth are well-associated with old age.

    And yet, avoiding such outcomes does not get anywhere near so much attention as, say, avoiding wrinkles or hair loss.

    At 10almonds, we’ve covered general dental health before, in a three-part series:

    1. Toothpastes & Mouthwashes: Which Help And Which Harm?
    2. Flossing, Better (And Easier!)
    3. Less Common Oral Hygiene Options

    Today, we’re going to be looking specifically at keeping our teeth young. What if you have lost your teeth already? Well, gum health remains important, and it’s foundational for everyone, so…

    Look after your gums first and last

    Hollywood’s most “perfect” whites would be nothing without the gums holding them in place. So, set aside the cosmetic whitening products that often harm gums (anything containing bleach / hydrogen peroxide, is generally a bad idea), andinstead focus on your gums.

    As for avoiding gum disease (periodontitis)?

    ❝In conclusion, periodontitis might enhance the association of biological aging with all-cause mortality in middle-aged and older adults.

    Hence, maintaining and enhancing periodontal health is expected to become an intervention to slow aging and extend life span.❞

    Source: Does Periodontitis Affect the Association of Biological Aging with Mortality?

    Ways to look after gum health include the obvious “floss” and “brush often” and “use fluoride toothpaste”, along with other options we covered in our “Less Common Oral Hygiene Options” article above.

    Also important: don’t smoke. It is bad for everything, and this is no exception.

    We expect we probably don’t have many subscribers who smoke, but if you do, please consider making quitting a priority.

    See also: Smoking, Gum Disease, and Tooth Loss

    Consider supplementing with collagen

    Everyone’s all about the calcium and vitamin D for bones (and teeth), but a large part of the mass of both is actually collagen. And unlike calcium, which most people not living in a food desert get plenty of, or vitamin D, which is one of the most popular supplements around, collagen is something that gets depleted as we get older. We’ve written about its importance for bones:

    We Are Such Stuff As Fish Are Made Of—Collagen’s benefits are more than skin deep

    And as for its role in combatting gum disease and tooth loss:

    Nanoscale Dynamics of Streptococcal Adhesion to AGE-Modified Collagen

    By the way, that “AGE” there isn’t about chronological age; it’s about advanced glycation end-products. Those are also something you can and should avoid:

    Are You Eating AGEs?

    A different kind of “spit and polish”

    We imagine you have the “polishing” part in hand; that’s tooth-brushing, of course. But spit?

    Saliva is hugely important for our oral health, but it’s not something most of us think about a lot. For example, you might not have known (or might have known but not thought much about) that many common medications affect our saliva, including many blood pressure medications and antidepressants:

    Impact of ageing and drug consumption on oral health

    Because there are so many possibilities, this is the kind of thing to check with your pharmacist or doctor about. But as a rule, if you take a medication whose side-effects include “dry mouth”, this might be you.

    Here’s a really useful (academic) article that covers what drugs cause this, how to diagnose it, and what can be done about it:

    Hyposalivation in Elderly Patients

    If something’s difficult, find a way to make it easier

    Sometimes, as we get older, some things that used to be easy, aren’t. We can lose strength, coordination, manual dexterity, memory, attention, and more. Obviously, we try not to, and do what we can to keep ourselves in good health.

    But, if you do have some disability that makes for example brushing and/or flossing difficult to do consistently and/or well, consider talking to your doctor to see if there are assistive devices that can help, or some other kind of support that could allow you to do what you need to.

    See also: Improving oral hygiene for better cognitive health: Interrelationships of oral hygiene habits, oral health status, and cognitive function in older adults

    There’s never any shame in getting help if we need it.

    Take care!

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