Browsing the Healthy bones Osteoporosis Rheumatic category...

An often overlooked component of good health and fitness is proper posture. Posture is the balance struck between the unrelenting force of gravity pulling down on you and the valiant effort of your body structure to hold you up. The path of least resistance between these forces is what we call posture. Good posture causes no pain or problems and helps you use your muscles, tendons, and bones optimally. “Bad” posture actually uses more energy, though it is often thought of as laziness. That’s a mistake, because poor posture may indicate an underlying structural problem that is not your fault at all. And if you try to correct a structural problem without knowing exactly what it is, you will probably exacerbate the situation.Say you have one leg that is significantly shorter than the other. To compensate, in an attempt to keep your eyes level (a real priority for your brain), you’ll probably hold your shoulders unevenly, creating a scoliosis in your spine. Your mother’s advice to “straighten up” will be useless—you literally can’t. A doctor without appropriate training might advise you to do some back-strengthening exercises to even out your shoulders, but getting stronger while you are still uneven will just exaggerate the tilt. If you made an appointment with me, your checkup would reveal the different lengths of your legs as the cause of your problem, and I’d prescribe a gradually adjusting series of heel lifts and several sessions of osteopathic manipulation to fix the cause of your problem. Now you have a physical support to help keep you level, and your muscles and bones will no longer have to contort themselves. Of course, this is a very simplistic explanation and an exaggerated example, but I think you get the idea: address the cause of the problem, not the result.Your posture is your posture, and you can’t will it to be different. If your shoulders are rounded, no amount of throwing them back or thrusting your chest out is going to “fix” them. You can make your posture work as well as possible for you, but you can’t make it into something it is not. So make sure your posture is maximally efficient, and get any permanent “bad” posture evaluated to discover if there is a correctable underlying problem. You’ll need an appropriate therapy program to make any changes necessary for optimal body positioning.Simply maintaining good posture no matter what you are doing in the course of your day is an excellent defense against kyphosis, the spinal curve commonly called “dowager’s hump” or “hunchback” that is a hallmark of osteoporosis. Keeping the head, shoulders, spine, and hips in alignment protects the spine, so you need to be conscious of how you walk, stand, sit, lie, climb stairs, sleep, drive, type, and everything in between. Stick with the natural curves of your back. If you stand against a wall, your heels, buttocks, upper back and shoulders, and back of your head should touch the wall. With a side view, you should be able to draw a straight line from your ear to your shoulder to the middle of the curve of your lower back to your hip, knee, and ankle. From the front, it should be clear that your eyes, shoulders, chest, and hips are all level and parallel to the floor.That is the alignment you should strive for at all times. If this is not your normal or comfortable posture, you may have a structural problem that should be evaluated by a professional. I recommend an osteopathic structural evaluation, as most nonspecialists tend to recommend strengthening exercises that may be good for posture in general but will actually exacerbate a structural problem. But for most people, conscious effort and increased strength will be able to help posture, barring a medical issue.A major pitfall to good posture is working at a desk. Proper alignment is crucial when typing or working at a computer in order to avoid carpal tunnel syndrome or other repetitive motion injuries to nerves and joints—and just to eliminate the achiness you feel at the end of a long day at your desk. When you’re at your desk, not using your computer, prop your work on a stand at an angle in front of you, so you don’t have to hang your head forward over flat papers to read them. Use a footrest, especially if you need one in order to keep your thighs parallel to the floor when your chair is otherwise adjusted to the proper height. Your chair should support the curve of your lower back, and if it doesn’t, use a pillow or rolled-up towel to do the job. When you are driving (which puts you in much the same position as sitting at your desk), use the headrest.Lifting anything without injury also requires proper posture: bend at the knees and hinge at the hips, not the waist, so your legs, not your back, are taking the heavy load.Sleep on your back or side, as sleeping on your stomach places a strain on your lower back.The first key is to be aware of your body position no matter what you are doing. It may require conscious attention at first, but eventually you’ll develop good habits and will align yourself properly automatically. The second key is to build your flexibility, balance, and strength (particularly of the front of the thighs, buttocks, and stomach), all of which are important to support good posture.*121\228\2*

A sixteenth-century herbal says ‘Give him a drinke of Cumphorie (comfrey) hearbe stamped with milk or ale, for that will helpe to knit the bones.’

We now have the benefit of modern medicine, advanced research and ‘high-tech’ diagnostic techniques. There is no cure, and once bone is lost it cannot be regained; but as more aspects of prevention and treatment of this disease become known, future generations may be spared this terrible suffering.

Meanwhile, much can be done with a lifelong course of preventive action against osteoporosis, beginning early in life with sufficient intake of calcium-rich foods such as milk and dairy products together with regular daily exercise. Good nutrition and healthy physical activity can go a long way to strengthen bones to last you a lifetime. Making your bones dense and stronger now will reduce your risk of osteoporosis in ten-twenty-thirty years’ time. True health insurance is what you do for yourself. You expect your bones to support you for the rest of your life – do as much as you can to support them.



Be not a twiggy nor a piggy!

Most medical experts agree that being extremely underweight or very overweight is unhealthy. Women who are underweight have osteoporosis more often than overweight women. Remember that weight goals should be individual and personal, determined with your doctor in relation to your existing state of health, your own weight history, and how your weight is proportioned between lean body tissues and fat. Weight charts are being revised upward after many studies have shown that people with average or slightly above average weight live the longest. And weight control is more a permanent way of eating, modifying food habits, rather than quickie diets. (For tables of desirable weights for adults, refer to the booklet Eating for Health, D.H.S.S., from Her Majesty’s Stationery Office.)

Dieting. Are you constantly going on the latest slimming diet or food fad? If you are always dieting – trying to lose those last 5 pounds – you may also be losing bone as well as body fat.

So many people are swayed by diet writers who like to link slimness with beauty, glamour, success and high fashion. The fashion industry has a lot to answer for, in encouraging women to be emaciated and, literally, bone-thin.

Food fads and regimens sweep the country from time to time, promising to take off weight rapidly, with no effort by the dieter; but most have serious drawbacks, limiting food selections, cutting out some essential nutrients, and reducing calcium and vitamins to dangerously low levels. Some diets emphasize individual foods or single food groups, like the banana diet and grapefruit diet, but no food is complete in its nutrition, and if eaten exclusively it can cause other deficiencies.

Low-calorie liquid diets have been popular, but should be undertaken under a doctor’s supervision for a short time only, since they are usually low in potassium and can cause heart abnormalities.

These diets allow large amounts of food to be eaten, but are excessively high in fibre or includes tablespoon of mineral oil or liquid paraffin at each meal; thus the nutrients in food are prevented from being absorbed while passing through the intestine, with the result that vitamins and minerals such as calcium also pass through without absorption into your body.

Diet pills (anorectics), either on prescription or over-the-counter products, that suppress the appetite have been popular as a quick way to lose weight. They generally deaden the sense of taste and the appetite, but at the same time they can increase blood pressure and metabolism. Prescription anorectics are mostly amphetamines or similar drugs, with the side effects of insomnia, nervousness, palpitations, increased pulse rate, higher blood pressure, dry mouth, diarrhoea and depression. Over a length of time you can become addicted to them.

Some women use diuretics as an aid to (temporary) weight-loss, but by increasing urine, these pills also increase loss of calcium.

Few low-calorie diets have the necessary amounts of calcium to maintain bone tissue – and it is especially dangerous for young girls who attempt fasting as they are consuming no calcium at all. Extensive fasting for religious beliefs or extremist political reasons can be equally hazardous.

First ask yourself if you really are overweight. Diet specialists realize that weight control is an interplay between our society’s culture and mass psychology, with personal psychology and physiology. Weight control is based on a simple formula: the number of calories taken in, minus the number of calories expended should equal zero or a minus figure. To lose weight, consume fewer calories with smaller portions (especially fats, sugar and starchy foods, and alcohol), and exercise more to speed metabolism, and actually decrease appetite. Decreasing calories to around 1200 or 1500 a day, choosing foods from the four basic food groups, with some fibre for bulk, plus increasing exercise, can help you lose poundage. Whole food in its naturally unprocessed state is generally lower calorie. But even though calorie-poor, make sure you are calcium-rich, with foods such as skimmed milk, lowfat cheese, yogurt and buttermilk. Discuss calcium supplements with your doctor or a dietician.

Children and teenagers should not go on diets until after their growth period has finished, unless under close medical supervision, as muscles and bone mass are still developing. Similarly, it is not advisable for pregnant women to undertake diets unless under the direction of their personal physician. Most doctors believe the proper weight gain during pregnancy should be between 22 and 35 pounds (10-16kg). It would be better for breast-feeding mothers who are anxious to lose their prenatal weight gain to do so slowly until they have finished breast feeding, otherwise their milk supply will suffer or their own skeletal calcium reserves will be depleted.



Now let’s turn to the big E that stands for EXERCISE, very necessary in maintaining a positive calcium balance.

During the past 100 years, machines have taken over most of the work previously done by human muscles. Labour-saving devices have taken on the manual labour in factory and home. Cars and buses have eliminated walking and bicycling. Lifts and escalators make stair climbing unnecessary. Fewer and fewer people have the hard labour of farm work; many sit to get to work, sit at an office all day, sit for meals, then sit in front of a TV or cinema screen.

But the body was designed to move, and physical activity is necessary to preserve bone mass.

A sedentary life can ruin your health, increasing the likelihood of muscle and bone deterioration, heart disease, obesity and premature ageing. Prolonged minimal physical activity can produce a calcium deficit, with losses of calcium mostly from weight-bearing bones. Excessive pounds can put an added burden on already weakened bones.

The good news is that it is almost never too late to do something about it. Regardless of age, studies show that exercise can help you, even if you are bed-ridden, confined to a wheelchair or somewhat handicapped. Tissues of all ages respond to resumed stimulus with vigour and renewal, as muscle is strengthened and bone density increases.

Young people should get plenty of exercise while their skeletal mass is still reaching maturity; adults need to continue exercise to maintain and strengthen their musculature and bone mass; and exercise is particularly important to older women who may be susceptible to osteoporosis and fracturing of bones. A common type of low back pain has been traced to weakened back muscles; exercise can bring relief and help prevent occurrences.

Exercise delays the loss of muscle tissue which in turn slows the demineralization of your bone mass, even to increasing the density of bones. It should come as no surprise that studies of athletes show they have greater musculature and denser bones than people leading a sedentary life. It has been suggested that the need for exercise actually increases with age, because as body processes and systems become less effective over the years, exercise should make up this reduction in efficiency by stimulating metabolism. But most people’s level of physical activity seems to decrease, and it is easy to find an excuse for sitting in an armchair. Many people have exercise deficiency and are unaware of it.

Exercise can:

•    accelerate the flow of blood to your bones, to transport

nutrients for bone building and increasing new bone growth,

will seem easier,

help reduce blood pressure,

act as a transquillizer releasing tension, reducing stress and

lowering the production of harmful adrenal hormones,

help you sleep better, without using pills,

help you ward off depression, and give a sense of well-being;

you’ll feel better because you’ll be healthier, and know you’re looking better, with glowing skin and more upright posture,

•    help decrease body fat and re-shape your body. More

significant than the numbers on your bathroom scales will be the change in the composition of your body tissue as you go from fat to fit.



When you eat food containing calcium, it passes along the gastrointestinal tract, with calcium absorption occurring throughout the length of the small intestine, diffused through the intestinal wall and transported by your bloodstream. The bloodstream carries calcium to body organs and tissues, for vital organ functions, and to storage in the bone cells as mineralization. Calcium is excreted in the urine and stools, and some in perspiration through the sweat glands. How much is actually absorbed by your body to aid mineralization? Absorption of dietary calcium in the intestines is incomplete, ranging from 10 to about 50 per cent of intake, depending on several factors varying with:

your age, with the differing interplay of hormones,

your general health and lifestyle, such as habits of smoking

and alcohol use,

your intake of other nutrients such as vitamins,

your level of emotional stress,

your level of physical stress and amount of exercise, and

certain medication you may take for chronic conditions

or diseases.

A breast-fed baby receives about 60mg of calcium per kilogram of body weight, and retains 66 per cent of this amount. In contrast, a baby fed formula with standard cow’s milk receives about 170mg of calcium per kilogram of body weight, but retains only 25 to 30 per cent. Because of the greater absorption of calcium from human milk, it better fulfils calcium needs.

Between eleven and eighteen years of age there is usually much accelerated growth of skeleton and muscles, although the retention of calcium can be variable. During these formative years, good nutrition is especially important, with attention paid to daily calcium intake, if the strongest potential skeletal mass is to be attained.

With bone tissue being constantly remodelled, and adult bone not being static, 600 to 700mg of calcium may enter and leave the bones each day.

During pregnancy, in spite of the increased efficiency in absorption, calcium needs are increased above the non-pregnant state. Nutrients, including calcium, are passed to the foetus through the blood circulation of the mother, so it is crucial that a woman has an immediate concern for her extra daily calcium needs as soon as she knows she is pregnant. In fact, it’s a good idea to build up calcium levels before becoming pregnant. A full-term baby contains about 25 g of calcium: skeletal tissue starts to form during the third month of pregnancy, with most calcium deposited during the last trimester at a rate of200 to 300mg daily. Towards the end of pregnancy, when a mother stores additional calcium in preparation for lactation, it is important to continue adequate intake of the mineral.

During breast-feeding, the amount of calcium secreted in breast milk may amount to 250 to 500 mg each day. If a mother has an extremely heavy flow of milk, considerable losses of calcium may occur, making it vital for her calcium to be replenished to safeguard her bones and those of her child.

if you have children in quick succession, with or without breast-feeding, your skeletal mass may be depleted of calcium, especially if you are still adolescent.

Calcium absorption can be influenced by your general level of health, with decreased absorption during an illness and in later years, starting at the age of forty-five for women and sixty in men. Exercise improves calcium absorption, making workouts work better, while prolonged inactivity (such as a long illness) can decrease absorption.

Some medications such as antacids, tetracyclines, laxatives, diuretics, and heparin obstruct calcium absorption.

If you smoke, drink alcohol or many beverages containing caffeine, consume a high-protein diet, use excessive amounts of salt, or have a sedentary lifestyle, you want more calcium, and need extra servings of calcium-rich foods.

During and after menopause, with the changing balance of hormones controlling calcium utilization, coupled with reduced intestinal absorption, and possibly a less active life, calcium requirement is even greater.



Whether the stress is physical or emotional, it stimulates the adrenal hormones that cause bone depletion and much calcium can be lost in the urine. Stress may also reduce the amount of calcium absorbed by the intestines and maintained in your skeleton. It can also increase cholesterol in the bloodstream, acid in the stomach, and depress your immune system so your body’s resistance to viruses and infections is lowered. But studies have not yet revealed why, in similar situations, some people seem almost stress-proof and others are highly vulnerable.

Nobody lives in a stress-free world. We all have stress -anxiety, grief, boredom. But to rid our lives of all problems would be the biggest problem of all. Normal stress is good, helping us to cope with life, with sudden emergencies, and to adapt to change. But excess stress can be distress.

Don’t rush to take a pill: try different ways to manage your emotions:

Try to relax – listen to music – read a good book. Try recreation with friends – take regular holidays. Try expressing your emotions – talk to someone to share

Try some form of relaxing exercise – go for a walk.

Or accept the situation that is creating the stress. If you realize

you’ve been pushing yourself too hard, ease off the pressure.