Are You Undermining Your Bones?
Simple measures to safeguard our bodies’ armature
Our neighbors, Jane and Moe, have lived across the street from us for thirty-plus years and are like family. We’ve witnessed their four kids grow up, and Moe quips that our son Alessio has become his surrogate son. Their youngest daughter recently married in a beach city near our home, and Andrea and I drove down for the wedding. It was a beautiful evening. We were especially happy for Moe in his role as the father of the bride. His kids are everything to him, and he beamed as the proud papa and host.
The day after the wedding, Moe came home early and was walking his two very large, very strong dogs together (not the wisest idea, all things considered) when his rambunctious boxer, Burt, spotted our cat, Thomas, innocently lounging on a neighbor's porch bench. The way Moe tells it, Burt leaped at taunting Thomas, knocking six-foot-one Moe off his feet and tumbling him onto the concrete walk. As an orthopedic surgeon, Moe was certain the fall had broken his hip.
He tried calling Andrea and Alessio, but neither of them had their phones nearby, so he called 911, which, in our town, summons both the fire department and paramedics in a matter of minutes. Alessio heard the rumbling of large vehicles out front and called to me, “Hey, Mom, why are there paramedics across the street?” I ran back to where Andrea was working just as he realized he had missed several frantic calls.
By the time Andrea crossed the street, the doctor was arguing with the paramedics on two fronts: the nature of his sustained injury and the hospital they were required to transport him to. Moe can be a tad prickly and very stubborn, but the first responders weren’t budging until they were told that the agitated individual before them was an eminent orthopedic surgeon and the hospital where he had privileges was not the closest. Understandably, Moe wasn’t about to go anywhere else. After skeptically asking Andrea, “Is this guy really a doctor?”—and then subsequently being presented with Moe’s hospital credentials and ID—the paramedics finally acquiesced, and Andrea sprang into action to drive him to his hospital.
I received blow-by-blow texts once they arrived at the hospital and as the afternoon progressed. X-rays confirmed that Moe had indeed broken his hip and, ironically, would need the surgery he had performed thousands of times: a complete hip replacement. Moe is a beloved member of the hospital’s surgical staff, and there was a steady stream of nurses and doctors in and out of the emergency room to assist. As his trusted colleagues filed in to review the x-rays, the most common comment was, “Good heavens, Moe, your bones are #%@&!” Yes, the bone surgeon has awful bones.
Soda bad, Moe bad
Falls are the leading cause of injury and death in older adults, and Moe’s accident only spotlighted these scary statistics. However, his problem was compounded by squishy bones. His doctors had many concerns that his bone would not receive the implant well and the surgery would be less than successful. They also expressed fears his recovery would be hampered by the overall weakness of his bones and the strength of the other hip once it tried to compensate. Undaunted, Moe was steadfast in his resolution for immediate surgery. Full steam ahead!
It appears as though Moe's decades-long habit of drinking soft drinks may have caught up with him. From his perspective, he will proudly tell you his current habit of drinking several Diet Cokes a day is a big improvement over the daily routine years ago of drinking more than a handful of regular Cokes, but the truth is: they are both horrible for bones.
All sodas, whether regular or diet, contain phosphoric acid, which can disrupt calcium absorption and increase calcium secretion—a double whammy coming and going! This can lead to a decrease in bone density and an increase in osteoporosis. Moreover, darker-colored sodas such as Coke, Pepsi, and—my childhood favorite—root beer, have higher levels of phosphoric acid.
Adding to the already perilous aspects of soda consumption is the significant presence of caffeine, which may affect bone density (especially in women), and added sugars, which have a negative impact on calcium balance. Lastly, excessive soda consumption can disrupt vitamin D production, which is essential for bone health as it aids in calcium absorption, which makes bones strong and hard.
Other compromising factors
As the calcium supplement market is a $400 million plus industry, many people are trying to do the right thing when they grab a pill, thinking it’s a one-and-done for bone health. Aside from the litany of products being confounding and—in some cases—somewhat dubious, there are too many factors that contribute to good overall bone health to think it could be as simple as taking a pill. Furthermore, any positive impacts of supplementing can be easily canceled out by poor lifestyle choices.
At the top of the list is a sedentary lifestyle, which is both very detrimental to bone health and something within our control. I only recently learned about Sedentary Death Syndrome, which encompasses 33 chronic diseases whereby inactivity is a contributing factor, including musculoskeletal disorders. Bones must be stressed to be strong, so weight-bearing movement and exercises such as walking, dancing, running, and weightlifting/strength training are critical as we age.
Additionally, evidence shows that jumping greatly benefits bone strength and could even help growing teens increase their height. (Think of the jumping Massai tribe with an average height of 6’3”.) At the beginning of my strength training routine, I’ve started incorporating a few minutes of hopping and jumping from side to side as one marble in the jar for bone strength (at 5’2”, I don’t have any misconceptions that I’ll grow!).
A diet low in nutrients and high in processed food is also a huge contributing factor to mushy bones. Bones need high-quality clean protein, such as lean meat, seafood, and eggs, and foods rich in calcium, such as yogurts, seeds and nuts, beans and lentils, and hard cheese (like my favorite Parmesan, which has a whopping 242 mg of calcium). Other calcium-rich foods include yogurt, milk, tofu, edamame, and dark green leafy vegetables. Above all: a wide variety of clean, whole food!
While smoking is on its very own naughty list, it is also terrible for bones, interfering with cell formation and calcium absorption.
And as if we didn’t need another reason to curb our wine, beer, and cocktail habits, excessive alcohol consumption impairs bone remineralization. What is considered excessive? It varies depending on the source, so it’s prudent to significantly reduce imbibing overall to be on the safe side, as well as for better health in general.
There are also certain medications, such as corticosteroids, that contribute to bone loss, as well as diseases like celiac disease and hyperthyroidism that affect bone health.
Rounding out the list are conditions that, at first blush, may seem out of our control but that we can nonetheless mitigate. Menopause leads to decreased estrogen production in women, but now, there are many modalities and treatments available to compensate. Although bone density naturally decreases with age, all of the above countermeasures implemented consistently can help to stem the inevitable loss.
The doctor-patient
Dr. Moe did have surgery that evening, as he insisted, and by the next day, he was getting out of bed on his own, much to the dismay of his nurses. By the end of that first-day post-surgery, he was home, and two days later, he was out walking down the block with a walker. By the first week’s end, he had returned to the office to see patients for half a day. Yesterday, I saw an Uber drop him off after his first full day back. Like I said, full steam ahead. However soft his bones, Moe is certainly hardheaded!
Andrea and I visited him on Sunday, and I took the opportunity to rib him about his soda consumption, as any good faux family member would. To our surprise, he has not only sworn off soda, but he is also seeing a fancy specialist and undergoing expensive treatment to strengthen his bones significantly. I congratulated him and offered up some additional unsolicited layman’s advice that he needs to work on his sugar habit (he maintains quite a stash of treats). He still isn’t convinced that it may be detrimental—despite his medical degree. But then again, he has had a soda habit for decades.
The silver lining
By the way, you may be wondering what happened to our cat Thomas, the innocent bystander at the heart of all the commotion. Burt’s barking, lunging, and the ensuing appearance of two giant rumbling vehicles scared Thomas so badly that he ran and hid for the rest of the day and into the night. I’m not sure where he tucked himself, but he was nowhere to be found. Thankfully, he came home the next morning not too worse for the wear—just hungry and very cranky. Much like our dear Dr. Moe.
Though I’ve attempted to retell it with humor and affection, this unfortunate episode was a needed reminder for the doctor to heed his own advice… and for all of us to nurture and safeguard our bodies’ inherently strong armature to live well, age great.