Myths Concerning Osteoporosis
Dairy products cause problems to many people such as allergies (IgE and IgG) to the main proteins of animal milk and/or due to lactose intolerance, but also because of their richness in saturated fatty acids and cholesterol. However we have long been told that the daily consumption of dairy products is essential to the development and maintenance of bone mass to avoid osteoporosis later on in life.
So is this a myth or a reality? Let’s start by examining the prevalence of osteoporosis in some countries where consumption of dairy products is no more than an anecdote, for example in Asia. When one examines Asia we in fact find very few signs of osteoporosis among the inhabitants. This finding of course raises several questions. Furthermore, now let us look at countries with a high consumption of dairy products, as in North-West Europe and North America, and compare the frequency of osteoporosis among their inhabitants. Well it is well known that there is a high level of osteoporosis in those countries! Troublesome isn’t?
Someone has to explain to me why these simple epidemiological findings go so totally against the long held “doctrine of osteoporosis”. Secondly, we should look at the following study from America which raises further issues about the dairy industry. When you read further you will quickly understand why!
I believe it is a remarkable study from a statistical point of view because it concerns 77,761 nurses followed over 12 years. That’s a million patient years; now that’s what I call a study. I think this should reassure us as to the validity of the statistical data from this particular study.
The authors of this article, published in 1997 in the American Journal of Public Health, identified two groups: the nurses who consumed animal milks (defined as those drinking at least two glasses of milk daily) on one side, versus the nurses who didn’t drink any milk (defined as those drinking a maximum of one glass daily) on the other. All we need to do next is compare the relative incidence of hip fractures together with forearm fractures in both groups.
Should we be surprised that we found 45% more hip fractures in the group of milk drinkers? These milk drinkers had less relative risk of forearm fracture but still 5% more than non-milk drinkers. In short the myth that “milk is essential to strong bones” is not supported for one second by the objective analysis of the facts and data, period!
The question remains why the abundant calcium in animal milks isn’t beneficial to many individuals. One possibility is that multiple problems of allergies and intolerance cause so much damage to the intestinal mucosa that the absorption of calcium is compromised. This would affect not only the calcium from dairy products, but also from other food sources: green vegetables, seeds, nuts, and mineral water. This remains a hypothesis but a seductive one. Have you ever seen a cow eating yoghourt? No, all its calcium comes from grass and only grass!
Far from me to forbid dairy products to everybody, but only to those who react negatively to them – with allergies or intolerances – who should no longer be subject to bitter criticism threatening to see their bones fall into dust as soon as they stop consuming them. The reign of this long held belief that dairy products are good for us is not acceptable any more. Patients judiciously refraining from dairy products don’t see their bone mass falling but on the contrary, as long as they are well advised as to the alternatives….and there are many.
Beside the already mentioned foods, one must consider the vegetable milks enriched with calcium, along with whole sardines that include soft bones. Let’s insist on the best of the best: sunflower seeds! For more information you can consult my internet site: www.gmouton.com: list of milks, list of waters, list of calcium; conference on the intestinal mucosa (5d - G.I. ECOLOGY 2 – MUCOSA, slides towards the end).
And finally, let’s now stop demanding that our school children obligatorily consume “three servings of dairy products per day”!
Discovered at the end of the 1960’s and initially called diphosphonates, the biphosphonates started to be seriously commercialized during the 1990’s. Their mode of action is to inhibit osteoclasts, the bone cells whose mission it is to clean up the bone rendered useless (a little bit like old wood on a tree that needs to be trimmed). Their aim is to reinforce the bones, and their usage is increasing significantly.
Their main goal, which is logical, is to target the weaknesses of bone mass, which might typically be seen in: post-menopausal osteoporosis, ageing men, or as a consequence of prolonged use of artificial corticosteroids. Bisphosphonates specifically inhibit the osteoclasts that destroy bone, leaving the osteoblasts, the ‘heroes’, to build new bone. In the short-term, this allows the bone mass to increase, but only temporarily.
However after a few months, or years, of continued use the bone architecture loses its dynamic nature. It is now no longer able to continually adapt to the structural changes of the skeleton. Just look at the silhouette of individuals aged 50, 60, 70, 80 or 90 years old and you can almost guess their age by the outline of their figure.
It is not rocket science to realize that this bone, which is thicker, doesn’t adapt well to the new axes of pressure resulting from the changing skeletal architecture. While it is true the bone is without doubt more abundant, in reality it is also more fragile, and…has even been known to break spontaneously!
I know that this sounds unbelievable but more and more scientific studies are raising numerous concerns about these drugs, including: inadequate bone mass of the femur, atypical sub-trochanteric fractures, osteonecrosis of the jaw, and failure of dental implants. All of these have been highlighted in recently published medical journals.
One even finds a much higher complication rate in the orthopedic repairs of these “atypical” femur fractures. Of yet more concern, many fractures happen during surgical interventions or in its aftermath around the fixing plates; and that is not such a good thing! It is also not reassuring that many dentists, who specialize in dental implants, categorically refuse to operate on patients treated with bisphosphonates!
Finally, to close this first section on the side-effects of bisphosphonates, one must underline the fact that the longer these drugs are taken, the more frequent the occurrence of the atypical fractures. It is also useful to understand that the side-effects can even impact the eye socket and digestive tract.
It appears that there is a risk of developing an eye inflammation such as uveitis where the scleritis increases by 50%, even if the risk remains statistically low. The irritation of the esophagus frequently experienced after taking bisphosphonates (for which instructions for its use are well documented: fasting and standing) appears to increase the risk of cancer of the esophagus, albeit that this remains a controversy (as too the atrial fibrillation, a form of cardiac arrhythmia, which is apparently more frequent also).
All of the above are the subject of scientific publications that I invite you to discover on my website www.gmouton.com, in the heading “articles” under the title “7h- The Bisphosphonates Delusion”. This article, in English, deals with this subject and is rigorously referenced with 14 publications all dated 2010-2012.
So what conclusions should we draw regarding the utilization of bisphosphonates? The precise directions for their usage, and the length of time taking them, should be re-examined in view of the new data that is emerging. In the case of a recently menopausal woman that is suffering from osteopenia (a precursor stage of osteoporosis) is it really foolproof to take bisphosphonates that will increase her bone density during her fifties but will make them fragile for decades to come, precisely when the risk of fracture becomes more and more significant? I will let you answer that question….
The lack of recognition of food allergies
Let’s sum up the situation on the widespread lack of understanding and contempt towards food intolerances and allergies. We have heard just about anything and everything on the subject, and that's not only from the mouth of patients, but doctors too.
First let me set forth a few definitions. The word “intolerance” means the absence of a reaction by the immune system. In contrast, use of the term “allergy” implies an immune system reaction through the intermediaries of one of its two great actions: cellular immunity (via the white blood cells, that is to say the neutrophils or the lymphocytes) and humoral immunity (via the antibodies also called immunoglobulins).
Immunoglobulins are divided into several categories and the ones we are interested in here are IgE, IgG and IgA. IgE allergies are characterized by immediate reactions, which are potentially severe (the most extreme manifestation being anaphylactic shock). It represents 'classic' food allergy, with symptoms affecting the gastrointestinal tract (such as cramps, diarrhea, vomiting), the skin (such as hives, itching, eczema), and respiratory symptoms (such as asthma and laryngeal edema). In severe cases (anaphylactic shock), multiple organs are involved, wherein severe hypotension, along with respiratory and cardiovascular distress, can be life threatening. IgE antibodies can be detected in the blood or in sub-cutaneous tests called skin prick tests. Generally speaking, these reactions generate flagrant symptoms, most of the time.
IgA allergies correspond to a precise pathology, namely coeliac disease (severe allergy to gluten: multiple proteins from diverse cereals such as wheat, rye, barley and oat). This condition entails profound perturbations of the intestinal mucosa with hyper-permeability (leaky gut) and malabsorption. Anybody interested can learn a lot more via my website www.gmouton.com under the banners “articles” (references 7a, 7c & 7f) and “conferences” (see section Nutrition and Function).
IgG allergies reflect delayed immune reactions, seldom generating obvious clinical symptoms following immediate food intake. They therefore remain unknown to the patient except if we are looking for them through a blood test (important: request quantitative tests and not qualitative). In this case, detection is not possible via a skin test, as with the IgE antibodies.
IgG allergies are often called food “hyper-sensitivity” to distinguish them clearly from classic IgE allergies. This terminology doesn’t bother me at all, even if these are a form of true allergy, producing IgG antibodies. The more inspired specialists call them “non-IgE allergies” which reflects the complexity of immune reactions involved, furthermore involving, partially, cellular immunity.
On the other hand, calling IgG allergies “intolerances” is inappropriate because it is the source of severe confusion. By definition, intolerances represent adverse reactions to some foods without the involvement of the immune system. The best example is lactose intolerance, characterized by the absence of the enzyme capable of digesting this disaccharide, namely lactase. This doesn’t involve the immune system at all, as is the case also with (at least with our current comprehension) sulfites or monosodium glutamate (MSG), two other well-known causes of intolerance. When this intolerance involves lactose or fructose, the detection is only possible through a breath test and not through a blood test, nor a skin test. Confusion of this kind doesn’t help the patient to see clearly, making careful adherence to the definitions a must!
Plant Milk Issues
For anyone who experiences negative reactions towards animal milks (IgE allergy, IgG allergy, or lactose intolerance), it is logical to substitute one of a number of plant milks: see the detailed list on my website www.gmouton.com (click “lists” then listes in French; free download of the folder called “liste laits”).
One must realize that cow’s milk contains plenty of protein (more than human milk, in fact) and that its replacement by plant milk can imbalance a meal. The sacrosanct breakfast of cereal with rice milk is equal to consuming carbohydrates with…carbohydrates!
There is nothing more drastic to create a peak in blood sugar levels that will then generate a precipitous fall in less than two hours, hence a sugar craving for the whole day. Many cereals today are often coated with sugar (read the contents: up to a third of pure sugar is not unusual) and the rice milk itself contains loads of sugar as is indicated on the carton. Sugars are liberated during the milling of rice in the production of the milk, and this is true of all milks derived from cereals: oat milk, spelt milk, millet milk, corn milk…
Milk manufactured from oleaginous plants (nut families) will have a tendency to be less sweet: almond milk, hazelnut milk, walnut milk, chestnut milk… But in this case you need to be careful of the addition of sweeteners such as apple juice, corn syrup or the abominable agave elixir (this is pure crystallized fructose: 90% of these products are man-made) that distort the calculation! Once more, be vigilant about reading labels.
Legume milks are considered intermediaries because they contain proteins and carbohydrates at the same time: soya or pea milk. The contents of soya milk must be carefully examined. One can easily find some versions with no added sugar that contain only 2 grams of sugars per liter, while “standard” versions may contain 30 grams and the popular vanilla or chocolate flavored ones often provide as much as 100 grams of fast releasing sugars per liter!
Furthermore, non-fermented soya doesn’t constitute a food with a long history of consumption by the human race, unlike beneficial fermented products such as miso, natto (very rich in vitamin K) and soya sauce. Contrary to what you might be lead to believe, tofu (soya cheese) and yoghurt manufactured from soya milk do not ferment the soya beans. Therefore they don’t escape criticism, although the danger of soya should not be over-exaggerated, as some of the flagrant propaganda would like us to believe (perhaps coming from the dairy industry…?)
In short, we find ourselves rather depleted as far as plant milks are concerned…. The best solution is to find an almond milk or a coconut milk without added sugar; to make them ourselves if we have some spare time, to live in Spain and to enjoy the fabulous “horchata de chufa” (which is a milk made from tiger nuts, popular in the Valencia region). Even better, make your own kefir daily in your kitchen!
It is simple: buy some kefir grains that procure this wonderful harmonious community of bacteria and yeasts, which will balance your intestinal flora; add plant milk or coco water, plus a little brown sugar cane (that will disappear in the fermentation process: it will not taste sweet!) and wait 24 to 36 hours…
The Trickery of Artificial Sweeteners
If artificial sweeteners such as aspartame, sucralose, saccharine, cyclamate and acesulfame-K help people to lose weight we could have seen the results long before now. The United States would have given the world a shock with significant weight loss results. Given their near zero calorie content, everyone expected that their metabolic action would also be zero!
However, these assumptions gave little weight to the sweet taste receptors that overlay the tongue and the palate. In addition we have recently discovered that several of these receptors are also dispersed along the gut. You will find a lot of scientific literature on this subject in my conference “Gut Sweet Taste Receptors” (see my website email@example.com ).
If these above mentioned molecules have a sweetener action it is because their spatial configuration takes up the space of the sweet taste receptor. The sweeteners represent the “prongs” that then match themselves to the “sockets” which informs our brain that something sweet is coming… or something that pretends to be. This information is not harmless: it encourages intestinal absorption of nutrients by a powerful mechanism of genetic stimulation and it increases metabolism. The increase in metabolism is the result of a dual mechanism: increased combustion produced internally and more movements executed by the whole organism.
When it comes to real sugars with their traditional energy content, higher calorie intake is to some extent offset by increased caloric expenditure. But with 'fake' sugars, namely sweeteners without calories, they continue to activate the intestinal absorption of nutrients, but not the increase in energy output that goes with it. We do not yet know the molecular mechanisms that decouple the two phenomena that are otherwise well synchronized, but there is evidence (see the conference already mentioned above)!
I know that this may not be realistic given the widespread belief that "a calorie is a calorie". This is one of the well anchored tenets of the dieticians, when in fact it is a scientific deception. This is precisely why I've encouraged many of my patients to perform the following experiment. Acquire 40 rats, give them free access to a specific food for rodents. Then give a sweet drink to 20 rats while the 20 other will have the same drink but with an artificial sweetener.
The experiment, certainly not very seductive to start with, will become clear one month later when you weigh all your rats! Here's the good news: you don’t have to buy all those rats! Researchers from the Federale University of Rio Grande do Sul, at Porto Alegre in Brazil, have done it for you and they recently published their results in October 2012 in a renowned medical review (see details below).
These Brazilian scientists chose to give half the rats sweet yoghurt and the other half yoghurt with an artificial sweetener, but the principle remains identical: to compare the real sugar to its substitute. Guess which rats were the biggest after 12 weeks! There, you are starting to understand…..