The Key to Healthy Bones: Results of A Hallelujah Diet Study

Weight Bearing Exercise is the Key

Background

I have a question for you:  Is there a special diet that builds stronger bones?  Do you need to eat more of certain foods or consume special supplements to have strong bones?

It is true that we as a country do not understand and practice a healthy diet and lifestyle when it comes to our bones.  Older women are especially susceptible to the disease of brittle, porous bones called osteoporosis.  The National Osteoporosis Foundation tells us that 1 of every 2 women will have a bone fracture in her lifetime due to osteoporosis, about 1 fracture every 20 seconds.  About 50 percent of non-Hispanic white and Asian women over the age of 50 have low bone density.  So, we can see that we do have a problem that causes enormous disability that is painful and costly.

So, is there a special diet for preventing osteoporosis?  Do we just need more calcium, calcium-rich foods, and more vitamin D, and a bit of exercise and we’ll be OK?  Oh, and medications if that doesn’t work?  Isn’t there something more that can be done?

Context of the Study

In 2006 the Hallelujah Acres Foundation embarked on a study to examine this question.  We wanted to know if the Hallelujah Diet supported strong bones and if women, especially petite women, had strong bones while following the Hallelujah Diet.  We wanted especially to know what factors made a difference between maintaining or losing bone strength.

We already knew quite a bit before we started the study about what was needed for healthy bones.  Excess animal protein is linked to poor bone health.  In a prospective study of 1,035 postmenopausal women aged >65 years with a mean follow-up of 7 years Sellmeyer and coworkers found that women with the highest ratios of animal to vegetable protein lost bone faster (0.78%/year vs. 0.21%/year), and they had a 3.7-fold higher risk of hip fracture.[1]  This study reinforced the previous findings that countries with high animal protein intake had higher rates of hip fractures compared to countries with low animal protein but high vegetable protein intake [2].

We also knew you needed adequate dietary calcium, but that calcium by itself wasn’t the key to bone health.  A meta-analysis of observational studies concluded that there was no link between dietary calcium and risk of hip fracture [3].  No link.  Not connected.  Dietary supplements of calcium have sometimes helped slow the loss of bone density, especially if more absorbable forms of calcium are used.  However, this hasn’t translated into fewer hip fractures in controlled studies [4].

We also knew that vitamin D was important for absorption of calcium and that adequate sunshine was very important.  We (falsely) assumed that getting more sunshine exposure would be sufficient for most women to have adequate levels of vitamin D.

We knew that leafy green plants provided vitamin K1 which activated the protein osteocalcin in the bone so that it could be cross-linked together and make bone more resilient and less likely to fracture on impact.

Finally, we knew that weight-bearing exercise was important to bones, so we encouraged the women in the study to do resistance exercise or weight-bearing exercise in addition to following the Hallelujah Diet.

Study Design

So, these are the instructions we gave to women with low bone density in our bone health study:  (1) : consume B-Flax-D daily, and spend more time in the sunshine in the summer (for higher levels of vitamin D), (2) eat at least one more serving of dark leafy vegetables per day than previously eaten, (3) get weight bearing exercise daily, (4) eat legumes at least three times a week, and (5) drink Willard Water (and later WaterMax) re-mineralized water instead of distilled water.

For three years we monitored bone strength of the women who were participating in the study at each Health Ministers Reunion from 2006 to 2009, using an ultrasound machine to measure bone strength.  Overall, 68 women joined the study and we had at least 3 measurements (of a possible 4 measurements) on 29 women.  This smaller group of 29 women made it possible to analyze trends of bone strength and dietary and lifestyle changes.

Results

The first thing we noticed is that just following the Hallelujah Diet did not automatically ensure that a woman would have strong bones.  Among all attendees in 2006, there were 11 women with normal T-scores, 26 women with osteopenic T-scores, and 20 women with osteoporotic T-scores.  This snapshot of scores did not indicate whether each woman was decreasing, maintaining, or increasing bone strength.  Among the 29 women with multiple measurements, 12 women decreased relative bone strength, 10 remained the same, and 7 women increased relative bone strength.  So, following the Hallelujah Diet did not automatically guarantee that over time you would build stronger bones either.

The next thing we noticed is that many women assumed they had adequate levels of vitamin D because they were outside and got a lot of sun exposure.  When we analyzed vitamin D levels in 2008 and again in 2009 we found that no women had optimal levels of vitamin D without using more than 4,000 IU of vitamin D3 per day.  Despite taking 4,000 to 5,000 IU/day of vitamin D3, a few women still did not get above 35 ng/ml.  This result points to the importance of individual testing to ensure that biological levels are optimized. 

After the Reunion in 2009 there were still no obvious clues indicating why some women lost bone strength and others were able to maintain or even improve their bone strength.  When analyzing the diet and lifestyle questionnaires no single factor correlations were found between change in bone strength and change in body mass index, in vitamin D level for 2008 or 2009, in blood pressure, in pulse rate, in the product of frequency and duration of exercise, nor in a measure of how much vegetable juice, BarleyMax, salads, fruits, nuts, seeds, fiber, and flax oil the women consumed. The changes in bone strength were not correlated with any changes in dietary patterns, either. Any reported changes in frequency of consuming vegetable juice, BarleyMax, salads, fruits, nuts, seeds, or legumes were not related to changes in bone strength measures.  So what was the factor that helped some women and not others?

Weight-Bearing Exercise is the Key

Only when examining the kind of exercise that women were engaging in did the factor show up.  Only 5 of 21 women who reported engaging in resistance training at any time during the study lost bone, while 6 of 8 women who reported only aerobic type exercise lost bone strength. The relative risk of bone loss (RR = 0.32, P=0.028, two-tailed Fisher exact test) for the resistance exercise group was statistically different from the aerobic group. Of the 13 women who reported resistance training more than one year, only 2 of them lost bone strength, while 9 of 16 women who did mostly aerobic exercise lost bone strength (RR = 0.27, P=0.052, two-tailed Fisher exact test.).

So, all the questions of whether the Hallelujah Diet has enough calcium or enough protein or enough greens, or enough whatever are all secondary for bone health.  There is no special diet for osteoporosis.  The same diet that protects you from other diseases and energizes your body with living nutrition is sufficient for supplying your bones with all of the nutrients they need.  What your bones need are exercise.  “Use it or lose it,” applies to muscular, mental, and skeletal strength.

Many other studies have shown that exercise (in particular weight bearing exercise or resistance training) builds bone structure.  Jogging, weight training, rowing, and aerobic exercises all were found to improve bone mass density [5].  In a 21-year study of 3,200 men aged 44 or older researchers found that those who engaged in vigorous physical activity were found to have a 62% reduced risk of hip fracture [6].

A meta-analysis of eight randomized clinical trials of post-menopausal women assigned to walking as exercise found evidence for benefit for the hip at the femoral neck, but no benefit for the lumbar spine [7].  They concluded, in agreement with our study, that “other forms of exercise that provide greater targeted skeletal loading may be required to preserve bone mineral density in this population.”  A review in 1999 concluded that resistance exercise rather than aerobic exercise more consistently has been shown to help bone density [8].  Resistance and strength exercises are still the recommended type of exercise for maximizing bone strength [9]. Lifting heavy weights, for example, is a safe and excellent exercise for bone health. An 8 month trial of heavy weight lifting and impact exercise by 60-70 year old women with low bone density found significant improvements in bone density and functional strength compared to a low-intensity exercise program [10].

Physiology experts recommend weight bearing, strengthening exercises along with exercise that increases balance. Maintaining balance helps prevent disastrous falls. If you are in good shape you can do high impact weight bearing exercises like jogging, running, jump rope, and high impact aerobics, as well as high intensity sports (or whatever intensity you can enjoy).  Bicycling, swimming, and walking help cardiovascular fitness, but they don’t help your bones very much.  More intense exercise is needed to put stress on the bones to send a signal to build a stronger structure.

So, weight bearing exercise is the key to healthy bones.  Just do it.

References

1. Sellmeyer DE, Stone KL, Sebastian A, Cummings SR. A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. Study of Osteoporotic Fractures Research Group. Am J Clin Nutr. 2001;73:118–22. Available from: https://pubmed.ncbi.nlm.nih.gov/11124760/

2. Frassetto LA, Todd KM, Morris RC, Sebastian A. Worldwide incidence of hip fracture in elderly women: relation to consumption of animal and vegetable foods. J Gerontol A Biol Sci Med Sci [Internet]. 2000;55:M585-92. Available from: http://biomed.gerontologyjournals.org/cgi/content/abstract/55/10/M585

3. Xu L, McElduff P, D’Este C, Attia J. Does dietary calcium have a protective effect on bone fractures in women? A meta-analysis of observational studies. Br J Nutr [Internet]. 2004;91:625–34. Available from: https://pubmed.ncbi.nlm.nih.gov/15035690/

4. Bischoff-Ferrari HA, Dawson-Hughes B, Baron JA, Burckhardt P, Li R, Spiegelman D, et al. Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr [Internet]. 2007 [cited 2010 Feb 23];86:1780–90. Available from: http://www.ajcn.org/cgi/content/abstract/86/6/1780

5. Todd JA, Robinson RJ. Osteoporosis and exercise. Postgrad Med J [Internet]. 2003;79:320–3. Available from: https://pubmed.ncbi.nlm.nih.gov/12840119/

6. Kujala UM, Kaprio J, Kannus P, Sarna S, Koskenvuo M. Physical activity and osteoporotic hip fracture risk in men. Arch Intern Med [Internet]. 2000;160:705–8. Available from: http://archinte.ama-assn.org/cgi/content/full/160/5/705

7. Martyn-St James M, Carroll S. Meta-analysis of walking for preservation of bone mineral density in postmenopausal women. Bone [Internet]. 2008 [cited 2009 Dec 22];43:521–31. Available from: https://pubmed.ncbi.nlm.nih.gov/18602880/

8. Layne JE, Nelson ME. The effects of progressive resistance training on bone density: a review. Med Sci Sports Exerc. 1999;31:25–30.

9. Schmitt N, Schmitt J, Dören M. The role of physical activity in the prevention of osteoporosis in postmenopausal women-An update. Maturitas [Internet]. 2009 [cited 2009 Dec 22];63:34–8. Available from: https://pubmed.ncbi.nlm.nih.gov/19356867/

10. Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. J Bone Miner Res. 2018;33:211–20. Available from: https://pubmed.ncbi.nlm.nih.gov/28975661/

Source for the image at beginning of article: https://www.takinglongwayhome.com/2018/01/i-have-found-fountain-of-youth-and-its.html