A Handful of Broccoli Sprouts A Day / Keeps Bone Imbalance (and Bisphosphonates) Away

Bone remodeling in an adult is the biological mechanism where old bone is removed by osteoclasts and new bone is formed by osteoblasts at an equal rate. In other words, these cells function "in sync" with each other. The result, when all is healthy, is a continual renewal of bone without any substantial overall loss in bone density as a person ages. But if the osteoblasts are unable to effectively produce new bone, and/or the osteoclasts are overly aggressive and resorb too much old bone, then they are "out of sync" and there becomes a deficit. When this deficit continues for years, bone density declines and will eventually lead to osteoporosis. A number of factors can increase or decrease the likelihood of imbalance in the bone remodeling process. In this blog I would like to review four important factors.

1) An "out of sync" situation occurs with Bisphosphonates*, the drugs commonly used to COMBAT osteoporosis. These medications are so powerful that they not only poison the osteoclast cells but they also dramatically interfere with the ability of osteoblasts to form bone. The result is that the skeleton becomes more brittle, "older", and more prone to breaking. Continued use of these drugs also puts a person at risk of serious adverse effects such as atypical femur fractures, non-union fractures, and osteonecrosis of the jaw.

2) An “in sync” situation occurs with the consumption of fruits and vegetables. Eating 5 to 8 helpings of fruits and vegetables each day not only helps reduce excessive bone resorption but it is important for boosting osteoblastic activity. Fruits and vegetables help alkalinize the body which promotes bone formation and they also provide polyphenols (most noted for their anti-cancer properties). These powerful phytochemicals are antioxidants that provide great protection against bone loss. The flavonoid kaempferol, found in high amounts in onions, and another flavonoid quercetin, found in dried plums, both have beneficial effects on bone and have been used in the treatment of osteoporosis.

3) Another ‘In sync’ situation involves epigenetics – external modifications to DNA that turn genes “on” or “off”.  The DNA sequence is not changed, but the modifications affect how cells “read” the genes and subsequently how they produce proteins. When bone cells interact to build and maintain bone, these processes are orchestrated by regulators of gene expression. A person may have genes for strong bones but the regulators of how those genes manifest are, for some reason or other, not turned on or off correctly and the bone strength is not realized. It is the epigenetics, or how genes are expressed, that becomes important with nutrition. Good nutrition allows a person's genetic make up to be expressed fully...to its full potential. But poor nutrition may lead to an under-expression of a person's genetic expression. And such is the case with bone health.

One particular phytochemical that can orchestrate gene expression and provide benefits for treating

Broccoli Sprouts

osteoporosis is sulforaphane – a naturally occurring isothiocyanate. In the Journal of Biological Chemistry, Thaler et al. reports that sulforaphane, found in high concentrations in cruciferous vegetables such as broccoli (especially broccoli sprouts), cabbage and kale, had substantial positive effects on the epigenetics of bone remodeling. In Thaler's study on mice, he found that sulforaphane helps to increase bone volume and reduce bone loss caused by a loss of estrogen. Sulforaphane acts as an epigenetic bone anabolic (building) agent and has a "two-pronged effect on bone formation and homeostasis by acting differently on osteoblasts and osteoclasts." Sulforaphane turns on genes involved in matrix mineralization and enhanced expression of osteoblastic activity. It also significantly decreases the expression of the osteoclast activator RANKL in osteocytes. The effect is that sulforaphane inhibits the production and activation of osteoclasts.

4) One final “in sync” factor is the promotion of a BALANCED bone remodeling system by promoting a RE-BALANCING of the remodeling process. Bone should be ENCOURAGED to GENTLY gain density, to enhance restructure and improved bone quality, and to gain strength. It should not be forced into an unnatural accrual of density without improvement in bone quality. OsteoNaturals’ OsteoStim contains ingredients that help reduce (not stop) EXCESSIVE osteoclastic activity and others to stimulate osteoblasts to build bone. The overall effect is that OsteoStim helps BALANCE bone remodeling. It helps encourage better bone QUALITY, not by destroying osteoclasts but by curtailing their activity and NUDGING osteoblasts to build new strong healthy bone. This is the key to OsteoStim's success. As a nutritional supplement for bone loss, OsteoStim isn't your source for minerals (those are found in OsteoSustain and OsteoMineralBoost); its job is to tackle remodeling. Without a balanced bone remodeling system, taking all the best minerals in the world won't do much good. A balanced bone remodeling process is key to supplemental minerals being effective and successfully combating bone loss.

Other strategies that MUST be included in one's quest to regain skeletal health include: a consistent regimen of physical activity, a diet that includes 60 to 90 grams of quality protein on a daily basis, supplementing with creatine and/or DHEA (when advised by a health care provider), reducing chronic systemic inflammation, and curtailing catabolic (cell destroying) lifestyle activities (such as smoking and heavy alcohol use).

The takeaway: there are lifestyle changes that you can make that actually alter the expression of your genes and your bone health; consider medications carefully; promote bone quality with OsteoNaturals' OsteoStim and eat your fruits and vegetables! For a double punch to overcoming osteoporosis, add broccoli spouts to your daily diet. It may help your genes, through epigenetic mechanisms, to boost bone building activity and reduce bone destruction.

* alendronate (Fosamax), residronate (Actonel), ibandronate (Boniva) and zolodronic acid (Reclast)

Thaler, R., et al. Anabolic and anti-resorptive modulation of bone homeostasis by the epigenetic modulator sulforaphane, a naturally occurring isothiocyanate. J Biol Chem. Jan 12, 2016.

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Kefir: "Has the Potential to Prevent or Treat Osteoporosis"

Kefir, a fermented milk product, "has the potential to be utilized as an alternative treatment for postmenopausal osteoporosis". That is according to research published by Chen, et al. in the latest issue of Osteoporosis International. Kefir's amazing bone-health-promoting effects come not only from its high calcium content but also from its abundance of bio-active proteins. When milk is cultured with yeast and bacteria unique peptides are formed that enhance calcium absorption, boost the immune system, prevent blood clots, and ward off bacterial infections. Adding kefir to your daily diet can be a great boost to your over-all health.

By studying ovariectomized rats, Chen and colleagues determined that kefir, given daily over a 12 week period not only reduced CTX (a bone resorption marker indicative of osteoclast bone resorbing activity) but also actually prevented bone loss. The kefir improved bone mineral density as well as trabecular strength properties as measured through micro-CT scanning.

The authors concluded that kefir "may have the potential to prevent or treat osteoporosis in humans resulting from estrogen deficiency."

Chen, H.L., et al. 2014. Kefir improves bone mass and microarchitecture in an ovariectomized rat model of postmenopausal osteoporosis. Osteoporosis Int  DOI 10.1007/s00198-014-2908-x.

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Gluten Sensitivity and Osteoporosis

Gluten sensitivity is a reaction to the ingestion of gluten, a protein found in wheat, barley and rye grains. It is estimated that 6 to 10% of the U.S. population have adverse reactions to gluten. Symptoms may be gastrointestinal in nature (diarrhea, constipation, gas, bloating, abdominal pain) or manifest as other health related issues: anemia, weight loss, fatigue, general weakness, muscle cramps, achy legs, tingling sensations in the face or extremities, rash, mouth sores and tooth discoloration. But often, gluten sensitivity goes undiagnosed--silently lurking beneath the surface, causing system inflammation and the development of disease entities such as osteoporosis.

It is estimated that almost 1 out of every 100 people suffer from celiac disease--the more severe autoimmune form of gluten sensitivity, where the mucosa villi in the small intestines are flattened, limiting the body's ability to absorb nutrients--even if they are plentiful in the diet. But gluten sensitivity does not always manifest with gastrointestinal involvement. In fact, the disorders that have been linked to gluten sensitivity are extremely diverse. The following is just a sampling of those disorders: ADHD (attention deficit hyperactivity disorder), depression, migraines, cancer, heart disease, psoriasis, ulcerative colitis, rheumatoid arthritis, lupus, Hashimoto's thyroiditis, Sjogren's syndrome, recurrent pancreatitis, and osteoporosis. Because it has the potential to cause so many symptoms and has been linked to so many disorders, gluten sensitivity is frequently mistaken for other conditions or is overlooked entirely. However, awareness of gluten sensitivity is improving dramatically as more people speculate that gluten could be at the root of their health problems.

Doctors don't often look for gluten sensitivity in the assessment of their patients with osteoporosis. Unfortunately, this is a problem because gluten sensitivity can lead to bone loss not just from malabsorption but also through a systemic release of pro-inflammatory cytokines throughout the body. When mucosal cells become irritated (this can be from ANY food sensitivity, not just gluten) it causes gaps to appear at the junctions between the cells of the intestines. These gaping holes are large enough for undigested food molecules such as gluten to permeate the gut wall and set off an inflammatory response. Of all the food molecules that can potentially penetrate this "leaky gut," gluten seems particularly prone to producing a large inflammatory response.

If you have osteoporosis--even if you do not have the gastrointestinal signs and symptoms of celiac disease--you should still be tested for gluten sensitivity. It may be a contributing factor in your bone loss. The following tests can determine if you are sensitive to gluten: anti-tissue transglutaminase (tTG) IgA, total IgA, antigliadin antibodies (AGA) IgA and IgG.

The treatment for celiac disease and gluten sensitivity is to go on a gluten-free diet, to control signs and symptoms and prevent complications. Initially, following a gluten-free diet may be frustrating. But with time, patience and creativity, you'll find there are many foods that you already eat that are gluten-free and you will find substitutes for gluten-containing foods that you can enjoy.

If you are just starting a gluten-free diet, it's a good idea to consult a dietitian who can answer your questions and offer advice about how to avoid gluten while still eating a healthy, balanced diet. For gluten-free recipes and even hands-on classes in how to cook gluten-free, Leslie Cerier, "The Organic Gourmet" is a great resource. Leslie wrote Gluten-Free Recipes for the Conscious Cook which I highly recommend.

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