Recently I interviewed Kevin Ellis, known as “the Bone Coach”, as he discusses how to increase bone density, how osteoporosis and osteopenia are diagnosed, risk factors for bone loss, risks vs. benefits of osteoporosis medications, natural sources and supplements to consider adding to your diet, the most beneficial types of exercise for your bone health, and more.. If you would prefer to listen the interview you can access it by Clicking Here [1].
Dr. Eric Osansky:
With me, I have Kevin Ellis, who is also known as The Bone Coach. Kevin is a certified integrative nutrition health coach, podcaster, YouTuber, bone health advocate, and the founder of BoneCoach.com.
After an osteoporosis diagnosis in his early 30s, Kevin realized just how challenging it can be for the average person to make sense of what needs to be done to improve and how to move forward confidently with a stronger bones plan. Today, not only has he transformed his own health and made continued progress on his own journey, but he has now dedicated his life to helping women with osteopenia and osteoporosis gain clarity and confidence that improving is possible. Through a unique three-step process and world-class coaching programs, Kevin and his team of credentialed experts have helped people in over 1,500 cities around the world get confident in their stronger bones plan. His mission is not just to help one million people around the globe build stronger bones, but it’s also to help our children and grandchildren have the education, resources, and nourishment needed to prevent osteoporosis and other diseases in the future so they can lead a long, active life. That’s what we’re all here for.
Kevin, It’s a pleasure having you here.
Kevin Ellis:
Thanks so much for having me here. It’s great to be here.
Dr. Eric:
It’s great to chat with you. Why don’t we dive in with your background? If you could please let us know how you got started on this journey helping women with osteopenia and osteoporosis.
Kevin:
Absolutely. A lot of times, when you hear about osteopenia or osteoporosis, you’re not talking about a 30-year-old male. You’re talking about women, 50s-70s, or maybe the grandma who had fractures, hunched over, or was walking with a cane. You’re not thinking about the 30-year-old male.
For me, I was shocked when I was told I had osteoporosis. The great majority of my younger years, I was really active. I went into the Marine Corps and spent five years there. I got out of there and had these health issues that came to fruition and the surface. I had high stress, poor sleep, really poor energy. I could barely get out of bed some days. I had all these other health issues that started taking place.
Then I found out I had Celiac Disease, which is an autoimmune condition where the villi, these nutrient absorption centers in your small intestine, become damaged when you consume gluten. For me, my villi were becoming damaged and blunted to the point where they couldn’t do their job. They couldn’t absorb those nutrients that I needed that were so important. My body still needed those minerals and nutrients to execute its daily functions. It went to the bones, which are our greatest source of mineral reserves, and pulled from the bones. Then it only makes sense that I was subsequently diagnosed with osteoporosis right around 30 years old.
It was actually a physician’s assistant. It wasn’t even a doctor I was working with at the time. None of my doctors said, “Let’s do a bone density exam. You have Celiac.” It was actually a physician’s assistant who asked me, “Have you done this?” I said, “No.” They told me to do this. We both thought it was going to come back as normal.
When I got the results back, they sent me a letter in the mail. They didn’t call me or anything else. The letter said, “You have osteoporosis. Go on a gluten-free diet.” That was it. I remember reading that letter, and the blood drained from my face. I had tingles. What does this mean for my future, especially after I started Googling what osteoporosis was? All I saw was fractures and medication dependency for the rest of my life. It was scary.
At that point in time, I didn’t mention this before, but my father passed away at a really young age, when he was 35 years old. At the time he passed away, I was two months old. My entire life, I had this fear that I was going to follow in his footsteps to an early grave and not be there to be a father for my own kids. That was my biggest fear in life. I had a young daughter and a son on the way. I thought I was headed down that path. It was a living nightmare.
I realized at that point, I had to do something. I started doing a lot of reading and research and consulting with people. I spent a lot of money on food and supplements. I have an osteoporosis atlas. It was the most expensive book I ever bought on the topic. I have just about every book on the topic. I don’t recommend this to anybody. This is the level of research I was going to do to figure this out.
I started getting the right plan in place. I improved my health and my bones. I realized it’s not the average 30-year-old male who needs help. It’s the women in their 50s, 60s, 70s who is told they have osteoporosis and are presented with calcium, Vitamin D, go for a walk, take a bone medication, we’ll see you in one year for your next bone density exam. I’ll tell you that’s not enough.
That’s the reason why I became the Bone Coach, a certified health coach, built out a team of credentialed experts, now have launched a program called The Stronger Bones Solution that has helped people in 1,500 cities around the world, and launched BoneCoach.com. That is my journey of getting into and becoming the Bone Coach.
Dr. Eric:
That is some story. Obviously, cutting out gluten was important for someone with Celiac, so it was a piece of the puzzle. You did a lot more when it comes to, not just in the past, but currently, to maintain healthy bones now.
Kevin:
It is so much more than just going gluten-free. If you are Celiac, gluten-free is a must. It’s not a negotiable thing. It’s not like eating a little bit of gluten from time to time, and you’ll be okay. No, you have to remove it from your diet completely.
Dr. Eric:
When it comes to osteopenia versus osteoporosis, I’m sure some listening know the difference, but some people have heard of osteoporosis and may not be familiar with osteopenia. Can you differentiate between the two?
Kevin:
Let’s talk about what osteoporosis is. Osteoporosis means literally “porous bone.” It’s a condition characterized either by not enough bone formation, excessive bone loss, or a combination of those two things. In osteoporosis, both your bone density and your bone quality are reduced, which is going to increase the risk of fracture.
The way you find out you have osteoporosis is through a bone density scan, also called the DEXA scan. This is dual energy X-ray absorptiometry. It’s a painless test. Kind of like an X-ray, but low levels of radiation. You lay down on the machine, the machine does the scan, and it tells you your bone mineral density, the actual mineral content of your bone. Then it generates a score, which is called the T score.
The T score is telling you how much your bone mass differs from the bone mass of an average, healthy, approximately 30-year-old adult. If you have a score of +1 or -1, that is considered normal and healthy. If you have -1 to -2.5, that is considered osteopenia, also called low bone mass. That is a precursor to osteoporosis. If you have -2.5 or lower, that is considered osteoporosis. The greater that negative number becomes, the more severe the osteoporosis.
Most people are getting a DEXA scan, most women especially, in their 50s, 60s, 70s as a check in the box. Their doctor will order it, or they may not order them. You may be listening to this and thinking you haven’t had one yet. That is not uncommon either. If you have not had one, get one. You want to get this objective information, and you want to get a baseline from which you can monitor future changes.
If you had a parent or someone you know who had osteoporosis or a lot of fractures, and you are avoiding getting that information because you don’t want to know, that is not a good strategy. We don’t want to avoid doing something because we don’t want to know what the answer could be.
Dr. Eric:
What age do you recommend starting as far as getting a DEXA scan? 30s or earlier than that even?
Kevin:
Especially the women I am talking to in their 50s, 60s, and 70s who have daughters, I’m telling their daughters to go get a bone density scan. You’re reaching peak bone mass right around 30 years old. If you get a bone density scan in your 30s, that is a great baseline to have. You can monitor future changes in your 40s, 50s, and so on and so forth.
Especially when you get to a point where you hit menopause, you will have a reduction in hormones, which will impact your bones. You can lose up to 20% of your bone mass in a five-year period after you go through menopause. Really important to know that. A lot of people don’t understand that.
Dr. Eric:
Obviously, more common in women, which is why you focus on women. You’re a guy. You got diagnosed with osteoporosis. I will quickly ask: Should men also consider getting a bone density scan? I’m going on 52 this year, and I have never gotten a bone density scan. This chat makes me think, maybe I should get one.
Kevin:
Men should absolutely get their bone density scan, too. It’s not just women who are affected. We know primary osteoporosis is related to a decrease in estrogen in post-menopausal women. Estrogen has a reductive effect on bones. When estrogen levels decrease, as they do during menopause, that causes an increase in the activity level of cells that break down bone.
There is another cause of osteoporosis called secondary osteoporosis. This is where osteoporosis occurs as a result of behaviors, disorders, diseases, medications, and other factors. Men will fall into those other factors. Especially if you have overt digestive issues, Celiac, Crohn’s, ulcerative colitis, even thyroid conditions, or maybe you were taking specific medications for a long period of time. I can talk specifically about what some of these things are. Your bones could have been impacted.
For me, 30-year-old male, former Marine with a background in weightlifting, you would never think that I would be told I had osteoporosis, but I was. It was a total shock. It’s always good to get that information, know where you stand, and then the younger you are, the more things you have in your favor. It’s not saying the older you get, it becomes impossible. That’s absolutely not the case. You can build bone strength at any age. It just becomes more challenging the older you get and the more bone you lose. There are fewer cells involved in that process. That process becomes less efficient. We want people to be on the side of prevention, not reaction, and to get that objective information as early as possible.
The other thing I’ll mention about men, and this is just an observation that I have made, is that men are more likely to see this as a suck it up condition. I’m tough. I can handle it. Trust me, this is coming from a guy who thought he was pretty darn tough for quite some time. This is not a condition that is one of those you can just suck up. It’s really important to make sure you objectively figure those things out.
Dr. Eric:
Let’s go over some of the causes in greater detail, like the medications. As women, going into menopause. Can you dive deeper?
Kevin:
Absolutely. I know you talk a lot about thyroid. You and I did a podcast on thyroid, too, that we can refer people to also. Let’s talk about thyotoxicosis. That can be a contributor. That refers to having excess circulating thyroid hormones. That can be hyperthyroidism, overactive thyroid. That occurs when your thyroid gland produces too much thyroxine. You could have thyroiditis, inflammation of the thyroid gland. Iodine-induced and drug-induced thyroid dysfunction. Excessive intake of thyroid hormone in patients with hypothyroidism can also be a contributor, too. These can be some of the things that are contributing from a thyroid perspective to bone loss.
Let’s talk about some of the other more common ones as well. There are medications specifically that some people aren’t even aware of that can contribute to bone loss that they have been taking for quite some time. One is glucocorticoids. This would be prednisone, cortisone. Glucocorticoids are steroid medications designed to suppress inflammation. They mimic natural steroid hormones produced by your body and are used to treat conditions like asthma and autoimmune diseases like rheumatoid arthritis.
The reason they contribute to bone loss is they are reducing the gastrointestinal absorption of calcium, which is increasing the urinary excretion of calcium. That is also going to lead to a calcium deficit. You are not absorbing; you are excreting more; you have a calcium deficit, which is the primary mineral of your bones.
The biggest impact is that glucocorticoids act directly on the cells that break down bone, osteoclasts, to increase their life span. It ends up reducing bone density. That is a really big one to be aware of. If you are taking that medication or considering taking it, it will contribute to bone loss.
Another one is SSRIs, selective serotonin reuptake inhibitors. These are a class of drugs typically used as antidepressants. There was a review of 19 studies on the effect of SSRIs on bone that show they have a negative impact on bone density and increase the risk of fracture.
Also, antacids. These are drugs that reduce the production of or increase the suppression of stomach acid. A lot of times, when people are considering taking these medications or are taking them, they have heartburn or reflux. When you have those things, a lot of times, you have too little stomach acid. People take these medications to suppress what little stomach acid they do have. This would be your Omeprazole, Nexium, Prevacid, and H2 receptor antagonist drugs like Pepcid and Zantac.
The reason suppressing stomach acid is a problem is you need stomach acid to break down and extract nutrients from your food, like amino acids, the building blocks of protein. Your bones are 50% protein by volume. You need a constant supply of amino acids, calcium, magnesium, iron, B12. If you have low stomach acid, your body will be starved of these nutrients. You won’t be getting the nutrients you need.
Long-term, there are plenty of studies that show just using these medications will not be good for supporting your bone health and can have a negative impact. That is important to understand.
I already talked about GI conditions. Celiac is a big one. Ulcerative colitis, Crohn’s. Those are also big ones.
In terms of autoimmune conditions, when we are talking about these, Ankylosing spondylitis is one that primarily affects the spine and the vertebrae.
Rheumatoid arthritis is one where the body’s mistakenly attacking the joints. That is creating inflammation inside the tissues and joints that also can lead to bone loss.
Lupus is another big one that can contribute to bone loss as well. Anything that is contributing to inflammation in the body is going to be fueling those osteoclasts and extend their life span and continuing to break down bone, which will contribute to bone loss.
Dr. Eric:
When you interviewed me, I spoke about that, too. The research I did when I was looking at the impact of Graves’ and Hashimoto’s, thyroid autoimmunity, on the bone showed that the inflammatory process from those conditions has a great effect. It’s not just the thyroid hormone imbalance. That translates to other inflammatory conditions, so I’m glad you mentioned that as well.
Medications. Let’s talk about medication that they typically use as treatment for osteoporosis. You spoke before about some of the meds that could increase the risk of osteoporosis. You said if you go to a conventional medical doctor, they will recommend calcium, Vitamin D, walking, and some meds. Can you talk about the risks versus benefits of meds for osteoporosis?
Kevin:
This is a great topic because it will come up. If someone is diagnosed with osteopenia or osteoporosis, they are going to have a bone medication recommended to them most likely at some point. 90-95% of people I talk to, that is the situation they are in. They get diagnosed. In a 15-minute window, they get their bone density results back, are told they have osteoporosis, and are handed medication. There is very little education around the big picture of medication. Let me give you that education right now at a high level.
The first thing I want to point out is these bone medications are not like taking an aspirin. They have a dramatic effect on bone physiology. That is the first thing we have to understand.
There are two different categories of drugs: antiresorptive drugs, which are designed to slow down the resorption or breakdown part of the remodeling process. They are reducing the rate of bone breakdown and reducing bone formation. Then, we have another class called anabolics. I will talk about those in a minute.
Antiresorptives are like bisphosphonates. Fosamax is a common one. Or RANKL inhibitors. Prolia is one you have probably heard of. With bisphosphonates, there are a lot of side effects: bone/joint/muscle pain. One of the biggest ones I hear from people is digestive issues. If you have digestive issues, you are probably going to have issues absorbing your nutrients, too. Some of the side effects that can happen but happen less, like osteoporosis in the jaw. That occurs when the jawbone begins to starve from lack of blood. You have cells in the jawbone that can start to die. That’s rare, but it’s something to be aware of, too.
The biggest concern with these bisphosphonate drugs is the safety and efficacy of the drugs are for patients who took them for less than five years. I have people who come to me who are on these drugs for eight or ten years. That’s a long, long time.
The reason that’s a problem is because, as all of us, we are going about our daily lives, doing our activities. We are starting to get these tiny, little, micro cracks in our bones; it’s normal. Then what happens is we have these cells in the bone that send out a signal; they say, “Hey, we have damage to the bone.” We have these bone-resorbing osteoclasts that come in and scoop out that damage. Right behind them, we have these osteoblasts, building cells, that form new, stronger, healthier bone.
When you are taking antiresorptive medication, if you slow down the activity level of that cell that is scooping out the damaged bone, over time, you start to accumulate that old, worn, damaged, weakened bone. That is one of the most important things that can ultimately lead to loss of structural integrity and strength in that bone. A lot of people don’t know that.
The other point is if you start something like Prolia, which is a RANKL inhibitor, you can’t just come off of it really quickly. It can actually increase your risk of vertebral fractures. You need to understand that if you are starting out on a medication, there are implications later on for you stopping that medication. It could require another medication after that.
Let’s talk about the other class of medication, anabolics. These are drugs that are designed to build bone and build it faster. They are stimulating the formation part of this bone remodeling process. What happens is more bone ends up being formed than is taken away.
Usually, the people who are recommended these drugs are those who have had low or no trauma fragility fractures. They have poor quality bone. They need a medication to help them build good quality bone. These drugs can help build that bone. They can help build better quality bone.
But what you have to understand about these medications is that you can only take them for a certain period of time, about 13 months-2 years. After you finish it, you have to follow it with an antiresorptive. Otherwise, you will lose all that bone that you just spent years of time taking medication for.
I have seen situations where people who had no business being prescribed an anabolic medication were being prescribed an anabolic medication. It’s really important for people to understand that you may be getting to a point where you are going on this endless cycle of medication, not even knowing it, just by starting out with that first doctor’s visit.
Dr. Eric:
It sounds like there might be a time and place for the anabolic medication. If they are on it, typically, they are on it for 13 months-2 years. Then they have to take the other medication to maintain what they built up. Is that correct?
Kevin:
Yes. I would say most of the people coming to us are trying to do everything they possibly can naturally before considering the medication option. There are situations where some people have had 5-10 or more fractures, which is an indicator of really poor quality bone. A lot of times, in those situations, there may have to be a quick intervention, which could be necessary and lifesaving.
I am not pro-medication; I am not saying you should take a medication. I’m saying you need to make an educated and informed decision. Most people don’t need a medication at all when they are prescribed one. That is my personal opinion that I have seen. It’s not necessary. But there are some situations where that may be necessary and lifesaving.
Dr. Eric:
Makes sense. Obviously, you want to try to do things to address the cause of the problem. These people aren’t deficient in any of these medications. There might be some situations where it’s really extreme. Maybe it’s a good idea for them to take it.
Let’s say if someone is listening to this, and they are already on one of those anabolic drugs, I assume they could switch gears if they want to and just take more of a natural approach. You won’t tell them to stop taking the medication, but if they make that decision on their own, they could stop taking it on their own or under the guidance of a prescribing doctor.
Kevin:
For sure. This is not me giving medical advice for any individuals because we are talking about the medications. If you are on an anabolic medication, if you have already started it and been on it for any length of time, you will need to follow it with an antiresorptive medication. Otherwise, the entire reason you’re taking it is going to be washed away. You’re going to lose everything you gained.
What happens is when you take an anabolic, yes, it speeds up the cells that build bone and build it faster. But it also speeds up the cells that break down bone. In order to build new quality bone, you have to speed up the osteoclasts, too. If you don’t slow down that train, that’s what’s going to happen after you come off of that. We have plenty of people who have been on an antiresorptive medication who are like, “You know what? I don’t think this is the right fit.” They decide to stop using it and are just fine. That’s not me telling anyone here specifically in your situation, but I would say most of the people that we encounter, they can do a lot of things naturally to build stronger bones and set themselves up for an active future.
Dr. Eric:
Speaking of doing things naturally, let’s talk about food. Is there any diet or specific foods that can help to improve bone density?
Kevin:
Whenever I talk about food, I always like to start out by saying there is no one single dietary approach for every single person, or one specific set of foods that are only good for every single person. Now, there are some uniform things that I would suggest to most people.
You have probably beat this down, and I am going to put one more nail down in this coffin: sugar. Reduce your sugar intake. It’s key for bone health. Sugar will damage your bone by triggering an inflammatory response. It will lower your Vitamin D levels; deplete bone healthy minerals like magnesium, calcium, copper, and chromium; inhibit intestinal absorption of calcium; and block the absorption of Vitamin C. Vitamin C is key for maintaining a healthy skeleton. I will talk about that in a bit.
Your breads, cakes, cookies, crackers, pizzas, and pastas break down into sugar. That won’t be the best thing for your bones. Make better swaps. Get those things out of your life if you haven’t already. Find better alternatives for some of those things that are your favorites.
The other thing I would say is chemicals. If you can get food that’s organic or from your local farmers, go to your farmers’ market and ask them at the table, “Do you spray?” They will tell you if they do or not. Ask those questions.
You can always go to the Environmental Working Group. They have the Dirty Dozen and the Clean 15. If you are on a budget, they will tell you where you can get the most bang for your buck for organic. Don’t ever eat non-organic berries, especially strawberries. Those will be laced with lots of different chemicals. We want to make sure we look at that list. That’s a good starting point.
In terms of general dietary principles, if you are looking to handle an autoimmune condition, or you have Hashimoto’s or Graves’ or something like that, your dietary approach is probably going to work to put that autoimmune condition into remission. Your dietary approach may be different than somebody who is not working to put an autoimmune condition into remission. Those are just some important things I like to preface when I start talking about food.
Now, there are some foods that I’ve found that are pretty universal for most people that work really well for a lot of people. The first one is fish. Not just any fish. I would talk about fish with the bones in them. This would be canned fish. Non-BPA lining. We don’t want the BPA.
Dr. Eric:
Sardines.
Kevin:
Sardines, mackerel, wild salmon. You can find wild salmon with the bones in. The reason you want the bones in is because these bones are a natural source of not just calcium but all the other minerals that your bones need with the right co-factors and the other nutrients in nature’s perfect form. It is a great source of calcium and other minerals.
The other reason I like these is because they have protein. Protein breaks down to amino acids. Your bones are 50% protein by volume. You need these amino acids. Also, to support muscle building. Muscle and bone have a really important relationship together. You need to be able to support stronger muscles, and that’s why you need additional protein.
The other part of fish I like, especially canned fish, is they are easy to take to go if you are hiking or doing activities or on vacation. Throw them in a pack. Don’t open them up on an airplane. They smell horrible; people will hate you for it. Don’t get fish juice on yourself. I’m not making the case here for mackerel and sardines here, I know that.
But they have Omega-3s. These are fatty acids that can help dampen inflammation. Like Dr. Eric and I were talking about, anything that contributes to inflammation contributes to bone breakdown. That’s a big star for me. I really like that one.
Another one of my favorites is arugula. I have been talking about arugula for years. It’s a leafy green. Same cruciferous family of vegetables as broccoli and kale. It’s rich in potassium, folate, Vitamin C, Vitamin K, and calcium. All of those are important for bone health. You can get a great bioavailable source of calcium from arugula.
This is super interesting. There was a recent study that found a bioactive compound in arugula called erucin that helps turn off osteoclasts, those bone breakdown cells, which is awesome. It’s amazing. I didn’t even know this when I first started consuming arugula. Now, it’s just confirmed: Arugula is a great food for bone healthy diet.
There are two other reasons I really like arugula. One is it’s a bitter food. Our diets nowadays don’t have a lot of bitter foods in them for the most part. The reason we want bitter foods in our diet is they stimulate bile production and bile flow. Bile is produced by the liver and stored in the gallbladder. When you are consuming foods, it will help break down your foods, so it’s important to have.
The last reason is arugula, unlike spinach, a common green a lot of people use, is low in oxalates. I don’t ever like to vilify foods, other than candy, usually. Spinach has some great nutrients in it, but it’s high in oxalates. Oxalates are an antinutrient that bind up bone healthy minerals like calcium. They will prevent you from absorbing them. If you’ve got digestive issues or kidney stones, arthritis, or joint pain, those can be some indicators that you have a hard time breaking down and degrading that oxalate. You might not have the intestinal bacteria, oxalobacter formigenes, to break them down. You can swap spinach for arugula. If you need any other reasons to why arugula should be added in your diet, give it a shot.
One of my other favorite foods is Vitamin C-rich foods. You heard me talk earlier about why we shouldn’t consume sugar because it will block the absorption of Vitamin C. Vitamin C is super important for general health. We all know that. If you remember, our bones are made up of this collagen protein matrix upon which minerals are laid. Vitamin C stimulates pro-collagen, enhances collagen synthesis, and stimulates something called alkaline phosphatase activity, which is a marker for osteoblast, bone building cell, formation. That’s pretty cool.
Some of the best fruits, berries, citrus like lemons and limes, plums, cherries are all great ones. In terms of Vitamin C-rich vegetables, for those with autoimmune conditions who are putting those in remission, you don’t want to eat red and yellow bell peppers, but those are great sources of Vitamin C. They are also a nightshade, so if you are on an autoimmune protocol, you won’t be consuming those. You can get dino kale or lacinato kale, lightly steamed broccoli, Brussels sprouts. You can incorporate those. Those are some other good options to start incorporating into your plan.
Dr. Eric:
A number of years ago, I used to stuff my smoothie with spinach. Then I did a test from Great Plains Lab, their organic acids test, that looks at oxalates. Mine were definitely high. There were other high oxalate foods I was eating, but that definitely was the top oxalate food. That was the main change I made. I cut out the spinach and did add arugula. I can’t say I have eaten that as regularly as I should have because I didn’t realize how much calcium it has. I try to diversify when it comes to the greens and other vegetables. I did a retest of the Great Plains Lab. Sure enough, the oxalates decreased just with that change alone.
I was eating more nuts than I should have been eating, which are higher in oxalates. I can’t say I completely avoided the nuts. Berries, raspberries, higher. Anyway, you can’t completely avoid the oxalates, but the spinach is a big culprit. You’re right. It doesn’t mean that people can’t have spinach every now and then, but there are people who are doing what I was doing years ago, either stuffing their smoothies with spinach or having a lot of spinach in other ways. It has a lot of calcium, but not the bioavailable type of calcium that is found in other foods. I do need to incorporate more arugula into my diet.
Kevin:
I want to touch on one other thing here. You highlighted something that’s really important. I was also trying to talk about how I don’t like to vilify specific foods that could have healthy nutrients or could be in a dish you’re going to consume infrequently. What I don’t want people to do is develop a fear around some healthy paleo spinach casserole that somebody made for Thanksgiving, and they are completely avoiding something that they would possibly enjoy because it has this one food in it.
Same thing with beets. Beets are high oxalate. Cacao and dark chocolate, high oxalate. You can still enjoy those things from time to time. If you have issues with oxalate, you won’t be eating those every single day.
Dr. Eric:
Some are higher than others. I attended some of the Great Plains Lab workshops. They said spinach is by far the highest oxalate food. Even if you cook it, it might decrease the oxalates a little bit, but it won’t lower it from being a high oxalate food to a lower one. It’s still going to be a high oxalate food. I agree. Even with spinach, every now and then, or beets and sweet potatoes, you could drive yourself crazy trying to completely eliminate oxalates. A) You won’t be able to do it. B) You don’t need to do it.
You mentioned the importance of muscle when it comes to bone density. Can you talk about exercise and what types of exercise? I’m guessing resistance training based on what you just said.
Kevin:
Exercise is super important for your bone health. If you have younger kids, this is also important for them. By the time you turn 18, you have put on 90% of your bone mass. As you’re younger, you’re in these years that you’ve got a great chance to build a solid foundation for the rest of your life with your bone health. Get your kids in gymnastics. Get them playing sports. Soccer players do a lot of running in multi-directional ways. They have stronger bones in their legs.
The reason for this is that your bones need two different types of stimuli. They need muscle pulling on bone, and you need impact. The most effective interventions are using one or both of these in combination. You need muscle pulling on bone to become stronger, so you have this mechanical signal sending a chemical signal to tell those bones to become stronger.
Usually, what you’re going to be told to do, if you’re in the doctor’s office, and you have osteoporosis, they will tell you to do weight-bearing exercises and walking. You know what? Walking is great for your health. If you’re doing it now, keep doing it. But do not count on that as your only form of exercise. You need to do more than that. It could help you maintain your bone density in certain areas of your body, but it’s not going to help you build bone density. You need to incorporate other weight-bearing exercise.
When I say weight-bearing exercise, that’s where your muscles and your bones are working against gravity to keep you upright. They are exercises you’re doing on your feet. Doing that on your feet, where you are working against gravity, you are placing stress on your bones. That’s a good kind of stress that we want. This would be your running, hiking, jogging, gardening, playing tennis, aerobics, jumping rope, climbing stairs, playing soccer with the kids or grandkids. All of those things are included in weight-bearing exercise. It also includes things like tai chi, yoga, Pilates, dancing. Those kinds of things can also be weight-bearing. If you’re doing those, keep doing them. That’s great.
Now, there are also some things called non-weight-bearing exercise. This is where your body is not working against gravity to keep you upright; you’re not placing that stress on your bones. This is the same situation that astronauts go up to space. Working against us to place that stress on our bones. They end up losing bone density over certain periods of time. We have to actively work against that. The exercise that we could be doing, non-weight-bearing, would be cycling, kayaking, seated stretching, seated exercises, or the biggest one is swimming. Swimming is a big one.
What I’m not saying is that if you’re doing these things now, if you’re riding your bike, you’re swimming, and you’re putting in some laps in the pool, or doing some kayaking, that’s great. If it makes you happy, if it reduces your stress, do it. But don’t overdo it. Don’t count it as your only form of exercise. It’s not going to be enough to stimulate what your muscles and bones need.
What is the other type of exercise we have to incorporate to give our bones what they need? Resistance training. This is where you’re using dumbbells, resistance bands. Could be even your own body weight if it gives you that level of intensity. You may be thinking, “Oh my gosh. Muscle strengthening. I have to be a body builder.” No, you don’t. You don’t have to be in that position. You just have to be able to do these exercises at an intensity that stimulates your muscle and your bone.
What intensity level is that at? The studies show the greatest effect on bone is in the 5-10 repetition range. There has been a lot of work done by Dr. Belinda Beck and some other research. They looked at things like overhead presses, deadlifts, squats, chin-ups with drop landings. Those were all effective.
If you are listening to this and are like, “I have never done a squat or a deadlift before. That’s so intimidating.” Don’t just YouTube it and knock out some sets. Understand it’s okay to expand what you may not be familiar with. Just do it safely. Find somebody who can help guide you through that. Get your proper body mechanics down. Make sure you’re doing the right things. Let’s slowly progress you to the point where you’re actually building muscle and bone strength.
This is not a quick fix. Bone health is not a quick fix. It’s not like you can get two good workouts in every other week, and your bones will be noticeably stronger. This is a long game. Play the long game with your bone health.
Dr. Eric:
You spoke about certain foods and just covered exercise. Do you have time to go over supplements a little bit? I’m sure people are wondering about calcium. I know you don’t recommend high dose calcium supplements. If you could talk about that, Vitamin D, and some other ones you might recommend.
Kevin:
Vitamin D is super important, not just for your overall health, but for your bone health. It’s not just a vitamin; it’s a hormone. It induces the transcription of more than 50 genes. It increases the intestinal absorption of calcium. It promotes higher bone mineral density. It will help lower fracture risks. It’s super important for our bone health.
Your best source of Vitamin D is going to be the sunlight. Midday sunlight, UV ray radiation. Bare skin, no sunscreen. 5-30 minutes a day in those warm months. Just enough not to burn. If you can go longer, that’s great. That’s the bare minimum for your best source of Vitamin D.
But most people aren’t even getting that in the warm months. We’re covered up. We cover up in our hats, our sleeves, our chemical-laden sunscreens. For sunscreens, when you get to the point where you have already gotten your sun, just enough to the point where you won’t burn, use a mineral-based sunscreen.
In terms of dietary sources, you can also get Vitamin D from salmon, herring, sardines, anchovies, oysters, and egg yolks.
With supplementation, you never want to supplement blindly with Vitamin D. You always want to test your levels. Test your 25 hydroxy Vitamin D levels. If you’re going into fall or winter wherever you are, there is a likelihood you will increase the level of supplementation you’d be using to maintain a healthy level of Vitamin D. It’s an important one to incorporate into your plan.
Vitamin K2. This is one that not everyone is too familiar with, but let’s talk about it because it’s super important for your bone health. You probably know about Vitamin K, and maybe K1. K2 is important because it aids in bone mineralization formation by activating something called osteocalcin. This is going to ensure that calcium is deposited in our bone and not our soft tissues like the arteries and kidneys.
There are different forms of K2. There is an MK4 form and an MK7 form. The MK4 form will be found in beef liver, grass-fed ghee and butter, dark meat chicken, pastured egg yolks, emu oil. MK7 is going to be found in things like hard cheeses, fermented foods, sauerkraut, kimchi, natto (which is the greatest source, but most people won’t be eating a lot of natto). This is a really interesting one. Bacterial fermentation in our guts can actually help produce Vitamin K2 as well. If you’re not getting enough K2, which most people aren’t, consider supplementation there as well.
Vitamin C. I talked about how important that was. Obviously, we want to try to get as much Vitamin C from our diet and nutrition. Sometimes that’s not possible. Incorporating that into your plan could be helpful.
When it comes to calcium, I am a big fan of get as much as you can through your diet first. Get it in those forms where it has all the other nutrients that you need. I do find a lot of times though that people are still falling short, or they’re having a hard time making sure they are getting calcium into their diets.
In those situations, usually the maximum I would want to see somebody incorporate is 500mg a day. Not all at one time. Maybe spread out in two different meals. Use an absorbable form of calcium. Any of the ones bound to an organic acid or amino acid can be helpful. Malates. Citrate is a highly absorbable form. MCHC calcium, which is like bone meal basically. That can be helpful, too.
If we are talking about a controversial topic, dairy. Let’s talk about that one. If we have an autoimmune condition, dairy is most likely not going to be a part of your plan, especially initially. If you or someone in your family has that as part of their plan, for bone health specifically, cultured dairy, fermented dairy would be the way to go. If you’re going to incorporate it, make sure you are getting some additional benefits from it.
The benefits of fermented and cultured dairy is you have probiotics, beneficial bacteria and yeast that come in large quantities, which can help your gut health. They could also lead to better nutrient absorption. Those are my thoughts on calcium.
Another big one I will touch on is magnesium. You have to have magnesium. It has 300 functions in the body. You need it to build proteins back inside your body. I talked about how important proteins were. In order to rebuild anything inside our bodies, you need magnesium to do that. If you want to rebuild stronger bones, magnesium has to be part of your plan. As you’re increasing your calcium and Vitamin D, your need for magnesium increases as well.
And Omega-3s. I touched on that before. If you’re not eating healthy, fatty fish, get some Omega-3s in your diet. Get them in their bioavailable form. Those are all good things to incorporate.
Dr. Eric:
You mentioned healthier forms of dairy like fermented dairy. If someone is going to eat dairy, it’s optional, you would say. If someone is eating plenty of arugula and other vegetables higher in calcium, and maybe the fish with the bones, there is no need for dairy. Would that be correct?
Kevin:
Especially if you’re adding in some supplementation, that can help you. If you’re eating a can of mackerel, for example, you may be getting 250mg of calcium from those bones, maybe a little bit more, like 300mg. How many cans of mackerel are you going to eat in a day? I can tell you: I eat quite a bit of mackerel and sardines. I’m at my limit at about two a day. That is 600mg.
Let’s say I add in three ounces or 85g of arugula. That is one of those big plastic clam shells full of arugula. That is 200mg of calcium. That is a pretty significant volume if you are eating a raw salad. If you sauté that down in some good quality olive oil, that can make it a little bit smaller to consume. You have 200mg of bioavailable calcium there. Now we’re at 800mg.
Now we’re starting to try to figure out some of the other sources for we can bring in calcium to our diet. Cruciferous vegetables. Those have a pretty good absorption rate for the calcium. There has to be some supplementation that takes place usually for most people because they have a hard time from a practicality standpoint and from a convenience standpoint, figuring out how they are going to get enough into their diets.
Dr. Eric:
You shared so much great information. I’m sure there are people who want to know more. Can you let us know where can people find out more about you, Kevin?
Kevin:
You can always find me at BoneCoach.com. That’s where we have Stronger Bone Solution coaching programs. We help a lot of people; the program was featured in Forbes and other places. Even medical doctors, physicians, registered nurses, nurse practitioners, and orthopedic surgeons come through our programs and refer their patients to us after. We have physiciansspending their own money to learn about bone health outside of the pharmaceutical treatments and then referring their patients to us. I am proud of that and happy to see that because I think we have a long way to go in our conventional system. If you want to learn how to build stronger bones naturally, and you want to do it the right way, head to BoneCoach.com.
For your audience, Eric, I have a free Stronger Bones master class. This is where I would encourage every single person who is listening to this right now, if you are worried about your bones, fractures, or if you have someone you know who has osteoporosis, forward this onto them. Help them out. Make them listen to this podcast. Get them to sign up for that free master class.
If you sign up for that master class, not only will you get the awesome information that comes with it, but I will send you the replay, so you can watch at your own convenience, and I will send you a bone healthy recipes guide, too. Those are the best ways to get a hold of me.
Dr. Eric:
I need that free bone recipes guide.
Kevin:
I’ll send it to you.
Dr. Eric:
It was great chatting with you, Kevin. Thank you so much for sharing your expertise related to bone health. Really do appreciate it.
Kevin:
Happy to help.