Hi, I'm Margaret, your MelioGuide, and I've been asked by readers to comment on a recent
article that came out on April 1, 2016 in the New York Times.
The author was Gina Kolata and the title of the article was "Exercise Is Not the Path
to Strong Bones."
Being April 1, I thought maybe this was a bit of an April Fools, but then I realized,
when there was a rebuttal five days later, and I didn't hear anything else on the New
York Times, that it wasn't a joke.
A couple of things that really bothered me with Gina's article.
So there's three key points here.
She talks about the low change in bone mass with studies that looked at bone through DEXA
scores.
And that is true in that over the years, many studies looked at bone change just looking
at DEXAs.
This is what you get done, a bone mineral density test is a DEXA test.
The more recent way of looking at bone is through a peripheral quantitative computed
tomography test, looking at the quality of bones.
Many of you have followed my blogs and know that I talk a lot about bone quality and not
just bone density, because strength of bone is a combination of both, and exercise impacts
the quality of bone more than just the density of bone.
That's really critical.
Alex Hutchinson in his article, his rebuttal, in Runners World titled "Is Weight-Bearing
Exercise Really Useless for Bone Strength?
Contrary to reports, exercise does matter for long-term bone health," and he actually
makes a really good point.
He looks at that 1% that Gina, you know, pushes off as being insignificant, we know is so
significant, that 1% loss or 1% gain.
So even in the short time span of a year, losing 1% is very significant when you think
of the lifetime of your bones.
We're looking at losing 1% a year, you know, after you reach peak bone mass.
That's somewhere, for some people, between the ages of 25 and 30.
We know for women who go through menopause, that bone loss even accelerates with menopause.
And so maintaining bone or gaining bone at rate of 1% is so significant.
With more recent studies, when we look at the quality of bone and they look at a meta-analysis
and they look at numerous studies, they can find bone changes happening in the order close
to 1% in just 13 weeks.
So that's super exciting.
That's looking at number one, that the difference between bone density and bone quality and
how it's measured.
Gina also talks about drugs in her article, the pharmaceuticals, and she talks about very
strong pharmaceuticals, the brand name being FORTEO, where it's... one, she doesn't mention,
but yes, it is a very strong bone builder.
But it is also very expensive, in the order of, in Canada, $4000 a month.
It's a daily injection.
It's something that's done for 18 months to 2 years.
And then followed up with a bisphosphonate, which is another pharmaceutical that she blows
off in her article.
For some people, these drugs are important, but for most people they're not necessary
and they come with numerous side effects, unlike exercise, that the only side effects
are positive.
Now, Alex brings up a good point in his article in regards to the differences of exercise.
Not all exercise is created equal.
Cyclists don't have as good bones as runners.
We know that distance runners don't have as good bones as short distance runners.
We know that people that lift heavier have better bones than people that do lighter endurance
type lifting.
And so we have to look beyond just exercise as one big term, but what type of exercise,
how intense that exercise is, how appropriate it is for you, the intelligence of the exercise
that's chosen.
That's why within the Exercise for Better Bones, I cover the flexibility in a safe and
effective way.
I cover balance exercises, strength exercises, and I cover all the different cardiovascular
choices you have based on your fracture risk.
We're not all created equal.
The challenge that the 60-year-old that walks into my clinic has hasn't exercised in a year,
her challenge level is going to be very different than the 45-year-old who's coming off of doing
10 Ks and looking to build her upper body strength and build bone through her spine.
When I see articles like what came up in the New York Times, it just really frustrates
me because I get people going, "Well, should I still exercise?
Is exercise still helpful?"
Absolutely, it is, because exercise is what's going to make the difference between growing
old with good quality of life.
It's going to make the difference of, "Oh, I can go on a holiday.
I can easily pick up my bags.
I'm pain-free.
I'm enjoying life.
I don't worry about how I interact with my grandchildren.
I'm not thinking, 'Oh my gosh, I'm going to break another bone.'"
Exercise is going to make a difference in your life beyond just that 1%.
And that 1% is so very important.
That's all I'm going to rant on today.
Thank you for tuning in.
Margaret from MelioGuide.