Air Pollution May Contribute to Bone Loss

By now, we know that air pollution is responsible for millions of deaths and many more cases of chronic illness around the world. As if the more commonly known list of problems associated with it wasn't enough, we can now add to that an increased risk of bone fractures and loss of bone density.

An analysis of Medicare beneficiaries in the USA set out to determine if air pollution, specifically levels of particulate matter smaller than 2.5 microns (PM2.5), contributed to bone loss and fractures. In the areas they analysed, there were a total of 62 million people, 9.2 million of which were using Medicare. During the study period of 2003 to 2010, 763,630 of the Medicare beneficiaries were admitted to hospital with osteoporosis-related bone fractures. Each 4.18mcg/cubed metre increase in PM2.5 was associated with a 4.1% increased risk of osteoporotic fracture, when variables were controlled for. This may not seem like much, but 4.1% of a thousand people is 41. And for each of them, the risk of death rises by 10-20%, and most - 60% - will not fully regain their independence. They will need an unpaid family member, home carer or aged care centre. The same increase in PM2.5 was linked with a 0.08% drop in femoral neck bone density (the femur is the thigh bone) and a 0.06% drop in radius bone density per year.

A sunrise is much more beautiful when the air is clean.
Source: Sam311 (CC: 3.0).

This is not the first time that air pollution has been linked to bone fractures, at least in non-smokers. A previous study on almost six hundred men in their 70s found that long-term exposure to higher levels of both PM2.5 and PM10 (10 microns or less in size) was linked to lower total bone mineral density. In others, women living in urban areas had a 29% greater risk of forearm fracture compared to women in rural regions. Some cities in other countries are far more polluted than anywhere in the northeast mid-Atlantic region where the above study was conducted. What their levels of air pollution must be doing to bone health is most likely shocking. The reason why PM pollution has so many harmful effects is because it causes inflammation and oxidative stress, much like smoking.

There are of course more types of pollutants than particulate matter, which may also reduce bone mineral density. These include carbon monoxide and nitrogen dioxide. A study in Taiwan compared data from the country's Environmental Protection Agency and their health insurance research database, to see if there was a relationship between these pollutants and osteoporosis. They divided concentrations of air pollution into quarters for the analysis. Compared to the lowest quarter (Q1) for carbon monoxide, those living in Q2, Q3 and Q4 were at a 5%, 78% and 84% greater risk for osteoporosis respectively. As for nitrogen dioxide, those in Q2, Q3 and Q4 were at 35%, 24% and 60% higher risks compared to Q1.

It may sound terrible, but we have more than just hope. In 2015, half a million solar panels were installed around the world every day, and four wind turbines were installed each hour. With the growth of solar energy, it would be more than half a million now. Twenty-three percent of the world's electricity came from renewables that year, which would be a little higher now, particularly as clean renewables make up the majority of new capacity installed. Although it is only one factor contributing to healthy bones, it's all the more reason to help protect the environment in any way you can - when you reach your 80s, which would you prefer? Looking forward to more years of a great life, or sitting in an institution without much time?

Can We Enhance Growth Hormone Naturally?

Antiaging and longevity circles have known for many years that a decline in human growth hormone (HGH) levels play a key role in the aging process. Younger people have abundant levels of HGH, allowing for a youthful metabolism and body composition. However, reaching "middle age" results in a decline of HGH and other hormones, causing muscle loss, fat gain and many other problems. In men at least, every seven years after the age of 25 brings a 50% drop in the size of HGH's pulsed release. So it should be a simple matter of replacing lost HGH, right? Well, one study in men over 60 did find that 6 months of HGH injections had effects on lean body mass and fat tissue that were equivalent to reversing 10-20 years of aging, but growth hormone replacement is still controversial and not always available. Fortunately, there are relatively simple ways to naturally increase production of our own HGH, which are also much cheaper.

So, what is HGH made of? Like many other things produced by the body, it is made of amino acids, the building blocks of protein. The most important amino acids for HGH are glutamine, arginine, ornithine and glycine. Glutamine is the most abundant amino acid in the body, and even consuming a relatively small amount of 2 grams (2,000mg) has been shown to increase blood levels of HGH. It has even been found to help protect muscle mass in patients vulnerable to losing it after inactivity following surgery. Therefore, protein supplementation could save a lot of time, money and inconvenience to people recovering from surgery. Arginine is also able to increase HGH release at rest, with its effects even greater when combined with exercise. Ornithine alpha-ketoglutarate is both tissue-building and may boost HGH secretion. Other research shows that combining arginine and ornithine aids the benefits of strength training by increasing lean body mass and strength. We should be consuming protein soon after exercise anyway. Glycine not only improves sleep, but a supplement mix of glutamine, glycine and niacin (vitamin B3) was found to significantly boost HGH levels in middle-aged and older men and women. Those who also responded with an increase in IGF-1 reported improved energy and memory.

The amino acids most important to HGH production are best when combined with exercise, because of their other tissue-building effects, but exercise alone is another way to increase HGH. One study compared the effects of exercise and passive standing on HGH, with both of these split into groups where volunteers were exposed to either 18 or 33 degree temperatures. All groups experienced a significant increase in HGH, but the strongest effects were seen in the exercise group exposed to higher temperatures.

How Much Exercise Reverses Aging By How Many Years?

In the latest round of "alternative facts" to come out of the current US government, Donald Trump has stated that exercise is harmful, because he believes that people are like batteries: born with a finite amount of energy. His belief that exercise kills you has come out just in time for a new study, which like many others, helps to confirm that exercise is one of the most practical antiaging treatments we have.

Source: Kyle Cassidy

You and other thinking people may have noticed by now that people just don't age as fast as they used to. Even centenarians, those who have lived past 100, are noted to be increasingly active and engaged, as well as increasing in number. At Tucson Medical Center's Salute to Centenarians event, some attendees exercised at least several times a week, do paid work and even live on their own. So much of this is caused by better knowledge of what makes up a healthy lifestyle, including exercise. But how much of an antiaging effect does exercise have, and what amount of exercise is needed to achieve this? Exercise science professor Larry Tucker's study on around 6000 adults, published in Preventative Medicine, found that "regular exercise at high intensity" could take nine years off your biological age! This level of exercise, by the way, is the equivalent of running 30 minutes for women, and 40 minutes for men, five days a week. However, people who only did low to moderate intensity exercise were no younger (in a biological sense) than those who did not exercise at all. My guess is that this level of exercise still has benefits, but not what was measured in this study.

“Just because you’re 40, doesn’t mean you’re 40 years old biologically,” said Larry Tucker. “We all know people that seem younger than their actual age. The more physically active we are, the less biological ageing takes place in our bodies.” The marker of biological aging that he and the other researchers measured was telomere length. These are protective caps of DNA which sit on the end of our chromosomes, and unfortunately usually shorten with each cell division. As lack of telomeres means cell death, longer telomeres are associated with longevity, and high-intensity exercise meant longer telomeres. This study echoes another which showed that HIIT (high-intensity interval training) has significant antiaging effects. It also echoes yet another on running; this one found that running one hour can add, on average, seven more hours to your life. These benefits stopped at about three extra years of life, and four hours of running a week. Overall, presidents are not always right, physical activity has been repeatedly shown to extend average lifespan.

Could This Be The Best Anti-Aging Exercise?

Too many of us would rather give up and resign ourselves to the eventually crippling aging process than do one of the most potent anti-aging therapies currently known: regular exercise. For those of us who have been won over by the rest of our lives becoming so much more enjoyable as a result of regular physical activity, the question is: what type of exercise has the most bang for our buck? Well recently, a team of scientists in the USA have found that high-intensity interval training (HIIT), a relatively new exercise technique, may be the most effective type of physical activity in the fight against aging.

HIIT involves alternating between short, vigorous bursts of exercise and going at a lighter, slower pace. This can be done with a variety of exercise types, such as cycling, running or swimming. For this study, healthy (without chronic illness) participants from both an older and younger age group were assigned to one of three types of exercise for twelve weeks. Some did HIIT with cycling and running, others did weight training, and others still did a moderate amount of both. In total, there were 29 adults aged 18-30 and 23 adults aged 65-80 who completed their assigned exercise program. The researchers measured a range of health and fitness parameters both before and 72 hours after these exercise programs.

They found that all three types of exercise increased muscle mass and strength for both groups, especially with weight training. This is important because unchecked biological aging causes a progressive loss in muscle mass and strength, which is not only unsightly, but also dangerous to our health and independence. All groups also showed an increase in insulin sensitivity, which is likely to mean a reduced risk of diabetes (and the very pro-aging process of glycation). In addition to this, both groups who did HIIT, whether alone or in combination, saw a boost in the amount of oxygen they consumed at peak intensity, which is an indicator of cardiovascular fitness. The younger volunteers who did HIIT alone increased it by 28%, while the older group saw an increase of 17%. For the mixed program, it was 17% and 21% respectively. This could mean that a combination of exercise types is best for people over the age of 65. Those in the HIIT groups also experienced improvements in the ability of their mitochondria to produce energy. These are small "organelles" (meaning "little organs") in our cells that produce all of our energy. In the HIIT-only groups, the younger volunteers had a 49% increase in mitochondria capacity, and the older volunteers saw a very impressive 69% improvement. In the mixed groups, only the younger volunteers saw their mitochondrial capacity improve, by 38%. Biological aging causes a decline in mitochondrial function too, which could at least partly explain why older people usually lose energy. HIIT also boosted the function of the protein-producing parts of our cells, known as the ribosomes.

It has been known for many years now that exercise can increase lifespan and reduce mortality rates, with one earlier study in the 1980s showing a 1-2 year benefit to longevity. This may have been an underestimation, as many of the volunteers may have decided to improve their health habits after signing up for the study. Exercise was also found to be more important than family history. Overall, HIIT has added benefits that other exercise types do not seem to possess, but if you want to start and have a medical condition, always consult your doctor first.

Prevent Bone Loss by Reducing Inflammation

Bone loss is both seen as a "normal part of aging" and recognised as a serious problem to the individual and society. Long-accepted ways to fight bone aging are weight-bearing exercise, calcium intake and in some cases, conventional or bioidentical HRT. But a new study from Ohio State University found that an anti-inflammatory diet could be another tool to reduce the risk of bone fractures in older women.

Source: Narek75

This study consisted of dietary data from 160,191 women aged 50-79 and the bone mineral density data of over ten thousand women. Fracture data was obtained from the entire group, and inflammation scores were assigned to 32 food components. Over the six year follow-up period, it was found that a high-inflammatory diet increased the risk of fracture by 50% in women under 63, compared to lower dietary inflammation scores. Women on less inflammatory diets also lost less bone density than those on more inflammatory diets, even if they had poorer bone density to start with. Unfortunately, there was no association between a more anti-inflammatory diet and fracture risk in non-white women and women over 63, which may be because of lower vitamin D synthesis (and there may be a place for BHRT after all). However, this is not the first study to find a link between inflammation and bone loss, or the first to uncover inflammation as a key driver of aging.

The food components given inflammatory scores were energy intake and the macronutrients, with different fats given separate scores; most vitamins; the minerals iron, magnesium, selenium and zinc; green tea; soy isoflavones; caffeine and alcohol. Anti-inflammatory herbs and spices such as ginger, turmeric and oregano were thought of as consumed in too low quantities by most people to have an effect (though we should be eating them daily). Vitamin K, particularly K2, has also demonstrated positive effects on bone density, but it was not included either. For example, a study of post-menopausal women taking 1,500mg of calcium alongside 45mg of vitamin K2 every day showed an increase in bone mineral density and a reduction of inactive osteocalcin by over half. Inactive osteocalcin is a risk for hip fractures which is elevated in patients with osteoporosis. Its purpose is to bind calcium to bones, and is activated by vitamin K2. Another showed an increase in activated osteocalcin, an increase in bone mineral density and an increase in bone strength. In other research, high K2 intake has been linked to an 81% reduction in non-vertebral (spinal) fracture risk! Why is the importance of vitamin K2 so overlooked? The answer may be in the rejection of K2-rich foods by the modern Western diet. Organ meats and a fermented soy food called natto are the biggest and best sources of K2, but taste (natto is strong!) and lack of social acceptance (organ meats) mean that too many people reject these. High K2 intake or supplementation has also been found to cut cardiovascular death risk by half or more. Overall, while this new study is useful in showing the effect of an anti-inflammatory diet in preventing bone aging, there is a lot that it leaves out.

What is Chair Yoga?

Many people are eager to begin exercise in order to improve their fitness, but unfortunately some of us have a very difficult time finding something that will help us at our level of limitation. This includes many people suffering from osteoarthritis, one of the most common types of arthritis in older people. Osteoarthritis is the degradation of the cartilage in large joints, typically the hips and knees, and also leads to pain, swelling and stiffness. Unfortunately, the most common treatment for this disease is pharmaceutical drugs to relieve pain and inflammation, which do not always address the root cause and are frequently toxic. They also do not address the negative effects on strength, flexibility and balance which may contribute to falling in older people.

Yoga is one of the most accepted natural alternatives to these drugs, which may improve pain and joint functioning. But not everyone is able to, or feels comfortable with, regular forms of yoga which require standing. This is where chair yoga comes in. Chair yoga uses modified poses to accommodate the participant's need to either sit or stand while holding the chair, thus preventing falling or the fear of doing so.

What about the research? A recently published study aimed to test the effect of chair yoga on 131 older adults with lower-extremity osteoarthritis, comparing it to a health education program. Both of these interventions ran twice weekly for 8 weeks. Chair yoga significantly reduced pain, walking speed and fatigue compared to the health education program, but the effects wore off once people stopped practicing it. Scores on the WOMAC Physical Function test and balance also improved. For example, balance scores improved from just over 31 to almost 35 on the Berg balance score within 4 weeks, then rose by a tiny amount to 35 and stabilised. These results were almost seen as statistically significant (an over 95% chance of being caused by the treatment). Pain scores improved more rapidly at first and then stabilised, while changes to fatigue scores varied in speed over time. Teachers of chair yoga describe it as making the health benefits of yoga accessible to everyone, and some students can progress towards less dependence on using the chair for seating or balance support. Overall, if you suffer from a chronic illness that prevents you from doing traditional yoga, but you are able to perform it with the help of a chair, it's worth trying.

Fit Tai Chi Into Your New Year's Resolutions

Many of us have been making a list of New Year's resolutions, with "losing weight" and "exercising more" being two of the most common. But what if you can't keep up with the usual sports or gym classes because of aging or other health conditions? Fortunately - just in time for the new year - an Australian natural health magazine has put out an antiaging special issue which discusses how tai chi may be the right exercise for you.

Source: Pagodashophouse

Tai chi is based on some forms of Chinese martial arts, and may be over a thousand years old. Besides being an ancient tradition, research from multiple countries has suggested that tai chi can prevent falls, restore balance and increase bone density, all problems that come with aging. For example, a study found that older practitioners of tai chi, who had an average of seven years experience, had the same balance skills as younger volunteers. This wasn't during normal conditions, but instead volunteers were asked to rotate their whole heads and bodies for one minute, which is meant to impair balance. Other research has shown that tai chi fans have superior balance to age-matched controls, with less body sway, greater confidence and faster reaction times when asked to shift their body weight. Because of all of these findings in favour of tai chi for older adults, the editor of Age and Aging stated, "Perhaps the time has come to encourage tai chi more widely in the older population in general and in our patients at risk of falls in particular."

Perhaps, with the tragic death of Carrie Fisher on our minds, you are interested in improving your cardiovascular health in order to avoid the same fate. Recent research published in the European Journal of Preventive Cardiology suggested that tai chi can help those who practice it regularly improve muscle strength and cardiovascular health. Volunteers were found to have both stronger knee muscles and better elasticity of the arteries. The average large and small artery compliance both significantly increased, by 26.2% and 17.9% respectively. As the Natural Health Magazine special stated, tai chi holds a particularly high potential for the health of Australian women, as heart disease is currently the number one killer.

If you do decide to begin practising tai chi, it is important to not just settle for any program, as some have no evidence supporting them and there are a lot of sham products on the market. Among the styles most likely to be effective are the Sun, Yang and Wu forms. Slower, gentle styles are recommended for building bone density and strength, while faster varieties are better for cardiovascular health. The Sun style is characterised by higher stances and is best for improving strength, preventing falls and managing arthritis and osteoporosis. Yang has many lower stances, and a lot of upper body movement; it is considered to be beneficial for heart health. Wu is characterised by soft circular movements and was described in the NHM article as getting one woman out of a neck brace.

Exercise For Life Extension!

Want to not die? Or, in other words, live longer? Well, swimming, dance aerobics and racquet sports have recently been linked with the strongest life-extending effects in a recent British study. Researchers found that different sports were associated with different levels of benefit, and urged both doctors and government workers to incorporate their findings in public health interventions.

Doing a cute and staying healthy. Source: Tommy Wong (CC2.0)

So what exactly happened? The study was an analysis of 11 annual health surveys conducted in England and Scotland between 1994 and 2008. A total of 80,306 adults were included, with an average age of 52. The survival of each person was tracked for an average of nine years, and during this time, 8,790 of them died. They were asked about how much exercise, and what type, they had done in the last four weeks, and if it made them sweaty and breathless. This means whether or not the exercise was moderate to heavy. Compared to those who had not done any type of physical activity, those who did racquet sports had a 47% lower risk of death from any cause over the average 9-year period. Swimmers and dance aerobic fans had a 28% and 27% lower risk respectively, and cyclists had a 15% lower risk of dying. These effects are pretty impressive considering the age of participants and the long study period. It may also control for other healthy habits commonly seen in people who exercise regularly, as they would be common across exercise types. Running and playing football were not linked with a reduced risk of death, unlike other studies where running was shown to be protective. However, it may be because of the nature of these sports, and the climate of the UK, as football is seasonal and neither are all that compatible with colder seasons that would prevent one from going outside. Lower risk of injury and possibly greater mental stimulation may be other factors.

Another long-term study also showed a significant benefit of exercise on mortality rates. This was the second part of the Oslo study, that followed thousands of men born between 1923 and 1932. Over 5,700 of the surviving men chose to participate again in a second health check in the year 2000, and were monitored for another 12 years. In 2000, their ages were between 68 and 77, older than the participants of the above study. After 12 years, the results showed that exercise of any intensity for at least 30 minutes, 6 days a week, was linked with a 40% reduced risk of dying from any cause - even though they were now aged between 80 and 89. Regular moderate-vigorous physical activity was shown to add 5 years onto their lives! Less than one hour a week of light exercise did not reduce the risk of death, but the same amount of vigorous exercise reduced it by 23-37%. The death rate for people who did more than an hour of light exercise per week was 32-56% lower. The overall results were said to match the health benefits of quitting smoking. Actually, a 2002 study of over 877,000 Americans showed that quitting at age 35 extended life by 6.9-8.5 years in men, and 6.1-7.7 years in women. Quitting at age 65 extended life by 1.4-2 years for men and 2.7-3.7 years for women. Another found that quitting extended life in women by 10 years; this was a long-term study of over one million women. On top of this, quitting smoking can make exercise more enjoyable by allowing the lungs to repair themselves.

Paraplegics Learn to Walk With Technology

Even today, most people would tell you that once someone suffers a spinal cord injury, they won't walk again. Thankfully, the Walk Again Project has proven otherwise, with a new study published in Scientific Reports on the 11th of August. All eight patients, all with injuries over three years old, participating in the trial experienced neurological improvements.

How did they do it? Patients underwent a multi-phase rehabilitation program over 12 months, with total training time reaching 1,958 hours over all eight patients. The first stage took 178.5 hours on average, where they had to make a virtual reality set of legs walk and sleeves on their arms provided sensory feedback. This was repeated for another 30 hours while standing. Participants "passed" these stages when EEG readings could pick up that their brains remembered how to walk. Then the real walking began: first with a robotic exoskeleton and body weight support (BWS) on a treadmill (109 hours); then BWS on the ground (51 hours); then just the exoskeleton and a treadmill (143 hours); and finally just the exoskeleton (70 hours). A total of 581.5 hours.

VR headsets have improved too. Source: Minecraftpsyco

After months of training, sensory and motor improvements were found in all patients. On average, the Zone of Partial Preservation (ZPP), which is the spinal levels retaining some sensory function, improved by 5 levels. Some improvements, such as the ability to sense where their legs were and what they were doing, only began to appear after several months. Clinical improvement of motor function also took months to appear. All patients also improved in the Walking Index (WISCI). One went from a score of 0 to 6; another went from 1 to 5; another three improved from 1 to 6; two went from 6 to 9 and the last patient went from a score of 6 to 12. What does this mean? A score of 0 means no ability to walk; 1 means able to walk with parallel bars, braces and two people for under 10 metres; a score of 6 means the patient can walk a walker, braces and the help of one person for 10 metres; 9 means walking with a walker and braces for 10 metres and a score of 12 means the ability to walk with two crutches and braces. The reductions in improvements that most patients saw after taking a break for 30 days were quickly reversed.

Taking long breaks reversed some of the improvements, but could they ever be permanent? Other research on people learning to read Braille on weekdays showed that their brains' "maps" for the Braille-reading fingers initially grew during the week, but shrunk back to "normal" by Mondays. The "map" sizes on Monday didn't start to keep growth until six months, and then slowly improved over the next four months. In terms of hours of practice, it was 600 hours - two to three hours a day, five days a week for 10 months. This is similar to the paraplegic patients' training time, but walking may take longer to be permanently re-learned. Maybe home-based programs, so people with spinal injuries could train every day, would be best to prevent the setbacks caused by breaks. There are already exoskeletons available for purchase, with variety of products going up and costs going down; however suitability comes down to the individual's needs. In conclusion, there is hope, practical hope, for people suffering from spinal cord injuries, and it's happening now.

Building Muscle Without Exercise

While many people struggle with losing weight, some of us need to gain weight in order to improve our health. You may be dealing with, or recovering from, a chronic condition, such as those from years of gluten-induced damage like myself, or may want to avoid or reverse frailty caused by aging. Particularly for those who are severely damaged and cannot exercise too much, or if you are like me and are very insecure about being underweight (and are just beginning to put something together to do at home), you might be interested in whether or not building muscle without much exercise is possible.

Typical protein sources.

Fortunately, a study published in JAMA in 2012 suggests that building muscle without much additional exercise is possible. The purpose of this study was to evaluate the effects of different high-energy diets: one with low protein (5% of energy), one with normal protein content (15%) and one with high protein (25%). It involved 25 male and female participants, all with a BMI in the normal or overweight range. For 13-25 days, all participants were put on a weight-stabilising diet, and then for the next eight weeks were then put on one of the three excessive-energy diets as described above. These provided about a 40% increased energy intake compared to the stabilising diets. After the eight weeks, those on the low-protein diet gained just over 3kg, while those on the normal or high-protein diets gained just over 6kg. However, while resting energy expenditure and body protein/lean mass did not increase for the low-protein group, those on the normal protein diet gained 2.87kg of muscle, and those on the high-protein diet gained 3.18kg, and both increased their energy expenditure. With the low-protein diet, 90% of weight gain was fat, while in the other groups fat accounted for 50% of weight gain. Neither sex nor race significantly affected weight gain.

As the participants of this study still gained fat, I would still recommend exercising in order to build muscle; this just shows that you don't have to solely rely on exercise. The type of protein also matters too, i.e. the amino acids, which are the building blocks of proteins. There are around 20 amino acids, but the three branched-chain amino acids are most important for muscle growth, especially leucine. Leucine works with insulin and insulin-like growth factor 1 (IGF-1) to regulate muscle growth, partly by increasing the activity of mTOR, which often carries a negative image. However, mTOR has its place, in the context of building muscle, especially if you need to do this in order to avoid frailty. Additionally, even though I have written in support of lowering IGF-1 through the Paleo Diet, I have also said that increasing it is necessary to speed fracture healing. Context is key, just as you need some cortisol to live. I would also like to add the importance of glutamine, if you have considerably aged biologically or have/had another condition that results in gastrointestinal damage, as we often recommend this to rebuild the gut lining. The contribution of inflammation to age-related muscle loss is another topic for another post; that would be chronic inflammation, not the acute inflammation we often need to fight infection or initiate healing. Antiaging and longevity require control of various factors, not an all-or-nothing approach.