♪ Bob and Brad, ♪
♪ The two most famous physical therapists on the internet. ♪
- Hi folks, Brad Heineck, physical therapist.
- I'm Chris, the pharmacist.
- Bob's not here today,
but we've got Chris instead,
and we're very happy to have him here
to help us out with this video
and give us some real expert advice.
Osteoporosis or weak bones.
Can supplements and vegetables in your diet
reverse bone loss and keep things stronger?
This is science based.
Chris has got a lot of recent research on this,
but before we go any farther,
we need to do our typical introductory.
I'll do my best without Bob.
This is his part.
Bring it up right, Chris. - All right, here you go.
- All right, so go to our website, bobandbrad.com,
and, yes, we are doing a giveaway.
Oh, yes, sorry about that.
We don't know what the giveaway is,
because it's a future video,
but it will be something very exciting,
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We've got it all in digital media, social media.
Let's get on with the topic.
All right.
So, osteoporosis, Chris.
I think a lot of people hear the term
really don't know what it's about.
It can be a little scary.
So let's just talk about osteoporosis or weak bones,
who has it, and what is it?
- Yeah, well, it's brittle bones and it's something
that's gonna affect pretty much most of us,
I mean, 80% of women and about one in four men.
So as between the ages of 50 and 70,
50 for women, 70 for men.
- Why do the women have so much?
It's so prevalent in that?
- Couple of different reasons,
probably, at least what we think,
hormonal changes brought on by menopause
is probably one of the bigger ones.
Your genetics may have some driving force in that as well,
having a smaller frame.
- I mean, their hormones are clearly different than men
for this factor.
- Yep, there are female hormones, specifically estrogen,
and male hormones, specifically testosterone.
And each of those hormones seems to be the driving factor
in both cases.
So women, roughly around the age of 50,
that hormone level drops off,
and that's when you start to see the bigger bone loss.
So I mean up to even 2.5% per year
for like five to 10 years after menopause.
So you can lose up to 25% of your bone mass
right after menopause as a woman,
and as about 65 to 70 for men.
When that testosterone level starts to drop off,
you're gonna start to see that osteoporosis,
osteopenia step in.
- And the big issue with bone loss or osteoporosis,
there's really no symptoms.
I mean, it doesn't get you unhealthy.
It just creates weak bones, so that if you do fall,
you will get a fracture in possibly your hip, your wrist,
your back, or your spine.
- Exactly.
- And actually, once it gets so bad,
you can fracture one of your vertebra
simply by leaning forward to tie your shoe.
It compresses when you do that.
The bones compress.
And now I don't mean to scare people,
'cause this can happen.
It does happen, but not very often.
It's typically from a fall,
so you fall down, land on your bottom side,
you get a big impact.
You can break your pelvis or your pelvis, possibly your hip,
but even your spine when you get a compression fracture
in that vertebra.
That's very painful. - Oh yes.
- And it takes a number of weeks,
and I've had people with compression fractures,
couple months.
It's not comfortable.
It's hard to move around.
We wanna avoid these compression fractures,
these bone fractures
as a result of osteoporosis.
A lot of people do not want to deal with,
they think, "Oh, geez, I've got to get on medications.
"Isn't there something else I can take or things I can do."
And that's what we're gonna answer here.
Go ahead, Chris.
- All right, well, kind of the key is prevention.
So basically we'll wanna eat well
and wanna have some exercise in there,
want that weight bearing exercise.
- Now you're talking my language,
exercise. - You bet.
- Exercise, in regards to bone loss,
it's not just any exercise.
Like a good example, Chris and I are avid swimmers.
I promote swimming to all my patients
if they have a pool available, and they're interested.
But swimming is not gonna help bone loss.
We need weight bearing exercises or resistance,
like lifting weights or even resistance bands,
something that puts stress on the bones.
A little impact like walking is gonna help those bones,
the legs, the femurs, the hips, and the back.
The body reacts to the stimulus of that impact,
and it forms osteoclasts, bone formation, density.
Whether it reverses or improves
is that completely understood?
- I think you can, yeah.
I mean, I don't think it's fully understood,
but I think it's very realistic to say you can reverse it,
because let's say we'll just take a menopausal woman,
and they've lost 25% of their bone mass.
So we'll make them 55, 60 years old now.
They come in and see you, because they've fractured a wrist,
and they wanna get some motion back in their hand.
Let's say, what can I do in the future to prevent this?
Well, wanna make sure that we're eating well.
We wanna make sure that we're doing
some weight bearing exercises
to try and stimulate new bone formation,
but the things that we can do to prevent it
are to eat well, so you're gonna want to use...
So ideally, we're gonna want to get it through our food.
The best way to get calcium is through your diet.
Secondarily, that's gonna be using vitamin supplements.
And then, of course, so within those supplements,
we can certainly talk about those separate ingredients.
- So let's go on to that exercise.
If you Google Bob and Brad osteoporosis exercises,
we have two or three videos just on that.
So I'll let you go onto there.
Let's take advantage of Chris's expertise here.
And let's talk about calcium now.
A lot of people think calcium is like the go to
diet supplement for bone loss.
- Yep.
- Or osteoporosis.
- Yeah, that's the one that's driving the bus.
So we'll use that phrase again.
So calcium is critical.
I mean, so a glass of milk, cup of yogurt,
but you can talk about things
that aren't necessarily animal based.
So you can look at spinach, Brussels sprouts.
- Vegetables? - Vegetables in general,
and specifically the green leafy vegetables.
_ Ah! - But you can also
get it in nuts, so almonds.
I mean, it's got a variety of different things
that you can extract calcium from.
So it comes out of the ground.
It's a mineral.
It's pulling it out of the ground.
You're gonna eat it.
You're gonna get calcium. - Ah.
- And there's a lot of things within those plants.
They call them phytonutrients.
So there are kind of other nutrients
that are in these plants--
- Not like Fido, the dog?
- No.
(Brad laughs) Totally different.
Totally different story altogether.
But what those nutrients do in balance,
and we'll talk about vitamin D and probably some vitamin K,
those help to make sure that the calcium that you eat
through your diet or through a supplement,
help to drive the way into your bones
to keep them strong and hard.
- What's the term I'm thinking of?
It just assists the body absorb the calcium?
- Yeah, exactly.
It's gonna help your cells.
And a bone is a living substance.
It's not a rock, like something really hard.
It's flexible.
It's pliable.
It's building up.
It's breaking down.
And the cells that make the bone require calcium,
and actually the things that help to make the calcium
get into those bones to drive the bus,
things like vitamin D and vitamin K specifically.
It's kind of both are interesting substances.
Vitamin D, interestingly enough,
just standing outside in the sunshine
gives you all the D you need, 10 to 15 minutes a day,
provided you don't have skin cancer risks,
and provided you don't have
any other skin issues
that dermatologists would be upset about,
but 15 minutes of controlled sun,
so it'd give you 49 days worth of vitamin D.
And it stores up in your fat cells,
believe it or not.
- Ah.
So if we eat a lot of green veggies, nuts,
is it still a good idea to take vitamin K or vitamin D
as a supplement to make sure that C is getting
into the bones, or?
- Yeah, D for sure.
And K is interesting.
Vitamin K, you have to be very careful.
And, again, we're gonna use the phrase
check with your doctor.
People that on the blood thinner, specifically Warfarin,
vitamin K is its antidote.
So if you take too much Coumadin or Warfarin,
which is that special blood thinner,
vitamin K is what reverses that process.
So vitamin K in plant sources, there's K1 and K2.
Your plant sources give you the K1,
and your meat and fermented sources, like cheeses,
give you your K2.
So they're both kind of,
even though they're fat soluble vitamins,
they're both a little bit different.
So we have to be super careful.
And doctors, if you're on the blood thinner,
will put you on maybe a low dose of K,
and maybe you'll use a supplement to get consistency,
or they're gonna tell you to eat the same amount of K
containing nutrients every day.
- So if you have a healthy person that is not on any meds,
then K or D,
then there's no issues. - Nope, at that point,
no, you're fine.
And you shouldn't be creating any issues
from that standpoint.
- So anytime you're taking some other medications,
you have to be careful with even these vitamins.
- Absolutely, you wanna check with your pharmacist,
your doctor, more importantly, your doctor,
'cause they're the ones that are taking care of you,
but you can always ask your friendly pharmacist,
(Brad laughs) and we'll certainly be able
to help you out as best we can.
- So vitamin K, there's red flag that are associated
with the blood thinners.
Any vitamin D issues?
- Just taking too much.
In the studies that I was looking at,
and I actually looked at a lot of them,
vitamin D is pretty fascinating,
but it seems like there's a sweet spot.
If you wanna break it down to a daily dose,
it seems to be anywhere from 600 to 1,000 IUs,
depending upon the study that you read.
- So wait, now that is something if--
- That's how they measure it.
- And if you take a supplement in a bottle of vitamin D,
it'll tell you, IUs on there? - Yeah.
And it's interesting, because they're kind of making
some changes with vitamin D supplement itself.
They're using IUs, which is kind of the older one,
but they're now kind of translating it to micrograms too.
So, for instance, a vitamin supplement that's 1,000 IUs
of vitamin D3
is 25 micrograms of vitamin D3.
So, just check your labels,
and if it's confusing, and it is for many,
just walk into your pharmacy,
they'll be able to help you out.
- So the average person, if you get vitamin D at 1,000 IUs,
that's probably a good sweet spot for most people?
- I think so, because the studies are showing that too much
actually may have a reversing effect
and actually contribute to more brittleness of bones.
- Ah! - So some interesting studies
that they showed.
- That's pretty recent?
- Very recent, actually.
Meta-analysis actually from 2017,
so it was actually an NIH, so National Institutes of Health.
- So to be safe, if you're at that 1,000 IU dose,
you're doing good.
If you wanna get vitamin D, again,
you said if you're out in the sun,
you're probably getting all you need.
Is that accurate?
- Well, yeah.
And, again, yeah, our bodies are really fascinating.
They actually have almost like a turn off switch.
So after about 15 minutes, you can stay outside all day,
but hopefully you're putting on the sunscreen at that point,
but what happens is it actually just kind of turns it off.
And the excess D that you make is absorbed
into your fat cells.
So it's a fat soluble vitamin. - For a cloudy day.
- For a cloudy day. - Really?
- Exactly, yeah. - I like this.
- Yeah, so it's not so bad.
Like I said, if you're outside for 15 minutes,
you get about 49 days worth of vitamin D.
- Let me kind of put all this in.
I'm one of those people,
I don't wanna take the pills.
Although the vitamin K and the vitamin D, I'm thinking,
"Okay."
Calcium, we can take that in a pill form too?
- Yes.
- So if I drink my milk,
eat a lot of veggies, green, leafy vegetables, some nuts,
and exercise with some impact exercise,
I'm really putting myself in that direction
to maintain healthy bones? - Absolutely,
or even sometimes reverse it,
but everything that we do has limits.
And so with calcium, it's gonna be about when you're 18
to about 50 for females,
it's gonna be 1,000 milligrams,
and to men, it's gonna be about 18 to 70,
it's 1,000 milligrams.
If you're 70 on up,
then you're taking about 1,200 milligrams of calcium.
So when you look at the bottle,
you wanna look at the calcium rating.
It'll just tell you how many milligrams are in there.
'Cause even if you're getting it through your diet,
it can be too much.
And the other interesting thing about calcium
is you can only absorb so much at a time.
So 500 milligrams seems to be that number.
So when you're looking for it,
don't take any more than 500 milligrams,
'cause here's the weird thing,
You only absorb about 40% of it.
So you're not getting as much as it actually says.
- You mean in the pill form? - In the pill form.
And even to a degree in your diet,
but it's mostly pill form,
because most of the substances are calcium carbonate,
and they need your stomach acid to drive that
into your system to absorb properly.
- Now let's look at this on the flip side
in order to make your bone more healthy.
Let's say you're getting your vegetables, your nuts.
You're taking everything that we talked about.
You're getting your exercise.
Are there some other diet or habits
that can actually reverse it?
I'm thinking like maybe caffeine, alcohol,
those types of things.
- Well, (laughs) none of those are gonna help.
A lot of people think they're fun.
(both laugh)
The problem with specifically alcohol,
what's recommended basically
is no more than two drinks a day.
So I think that's pretty conservative,
especially being from Wisconsin.
- Well, they're pretty big drinks up there. (laughs)
- Yeah, that's true.
And we're talking four ounces of wine,
12 ounces of beer, one ounce shot.
That would be kind of the standard measure for everything.
- One per day maximum.
- Up to a max of two.
Smoking actually, interesting, is another one
that actually is a lifestyle habit.
It can be really rough.
- Well that's for your lungs,
but what does it gotta do with this?
- Believe it or not,
and they don't fully understand the mechanism,
but it seems to have a risk with causing osteoporosis,
or speeding up bone loss.
- Uh huh. - So it's something, again,
we all know smoking's bad.
We've known it for a number of years,
but it's just another reason why we should probably try
and kick the habit.
- Right.
Was there anything else in that?
I thought there was one other thing I was looking at.
The alcohol.
Caffeine? - caffeine,
- Coffee?
- Coffee, I mean, to a degree, some of it is okay,
but too much is bad.
So I mean, about a cup or two a day
is gonna be the max, though,
as, again, kind of tough on the absorption of calcium.
- Right.
I see some of those cups in the convenience stores.
You got the little ones, and you got the... (laughs)
- You got the bladder buster,
and that one's pretty tough too.
So yeah, again, we'd probably want to stick
to about eight ounces of caffeine of coffee.
- It's always
the reasonable size. - But it's different.
Well, that's the thing is you can go and buy a Frappaccino,
or you can buy the belly busters.
(Brad laughs) So it's always tough,
but it'll certainly be rocket fuel.
- Good.
Well, I think I had some excellent information here
for those people who wanna really stick to diet, vegetables,
all those things that you can just keep healthy with,
and not have to go
to the doctor. - Meats, cheeses.
- Yep, they're all on there. - Exactly.
- There's one thing that I think all these things
are maybe not gonna help, but Bob and I are working on this.
We can fix anything except for--
- A broken heart. - Broken heart,
but I don't think this is gonna hurt.
- No, it's definitely not gonna hurt.
I think it's gonna help.
- Yeah, it's one of those...
Well, anyway, (laughs)
we'll carry on this discussion after Liz turns it off.
(Brad laughs) - All right, bye.
(bright tone)