Your Bone Density is Based on Much More Than Calcium and Vitamin D
/Genetics and science help us look in places beyond calcium and vitamin D that we may not think of when it comes to bone density and health—this includes places that your doctor and the team that looks after you, may also get some insights about.
Bone building is what we want to support so that your body has the ability to consistently clean out the old and replace with the new for a healthy bone density.
Many genes can impact our bones including those for your hormones (like estrogen’s bone-building ability) and for inflammatory compounds like IL-6 that can stimulate bone breakdown. I took a look at these topics in Part One of this Two Part bone series: The Surprising Genes That Influence Your Bone Density. I also talked about which foods and ingredients you can include in your diet to help tip the balance toward healthier bone density.
In this second article, let’s look at some other areas that can negatively impact your bone balance. These include stress, methylation, homocysteine, vitamin D and structural genes. If you prefer to listen to me discuss how these areas impact bone health, simply click on the video. Let’s get started.
How stress impacts your bone density
It’s no secret that persistent stress is detrimental to your health. When under stress, your body releases the stress hormone cortisol as part of your “fight or flight” response. Your fight or flight response raises your blood pressure and blood sugars to help you mount a defense. That’s fine when there is an enemy to fight, but too often, it’s the demands of everyday life that generates our stress. It turns out that our bones take also don’t deal well with stress.
High levels of cortisol are linked to a reduction in bone formation by altering some of the key hormones that are needed for bone development. Persistent exposure to cortisol can result in a gradual loss of bone density which occurs when the rate of bone loss exceeds the rate of bone repair and rebuilding. You can think of this as stress + cortisol chipping away at the walls of your bones.
Cortisol released with stress also reduces the availability of an enzyme (alkaline phosphatase) that’s essential for steering the mineral phosphorous in your bones. When alkaline phosphatase gets scarce, we often observe a concurrent reduction in bone density.
Another casualty of high cortisol levels is calcium uptake. Even if you eat all your leafy greens or get your dose of dairy, a high-stress environment reduces what I call your “Return On Ingestion.” In fact stress mounts one of the biggest assaults on your gut, so all nutrients are at risk, not just calcium. So in your mind, just equate stress to negatively changing the balance away from healthy bones.
How Methylation impacts your bones
Methylation is probably one of the most undertaught, misunderstood and overlooked processes in your body. Many clinicians have not learned enough about this important process.
In my opinion, methylation is one of the huge disconnects with bone health.
As you know, I live with osteopenia and osteoporosis. Fortunately I am turning this around - armed with good science, a good diet, a knowledgeable doctor, and the right physical therapist to supervise my weight bearing, balance and posture exercises. But beyond my team, what I have discovered in my research is there's definitely a connection between methylation and healthy bones. Dig deeper into my explanation of methylation here.
I look at hundreds of genomic reports every year and the process I see most frequently compromised is methylation. The key nutrients that support the methylation process are:
B vitamins (yep B2, B3, B6, B9 and B 12)
Magnesium
Zinc
Choline (in eggs, sunflower seeds, edamame/whole soy)
Betaine (in quinoa, beets and Swiss chard).
Biochemically speaking, methylation produces methyl groups that are used to activate hundreds of reactions with a myriad of health implications. You can think of methyl groups as switches that turn some genes on and other genes off. Since your genes produce proteins, when your body needs specific proteins, genes get turned on. When the protein quota has been met, genes get be turned off (assuming all is working well). Methylation is one of the ways your body can regulate protein production and stay balanced.
Methylation is important for bone health in several ways. Methylation is essential to the proper development and function of your bone-building cells. Methylation acts as a switch to turn on the process of bone building and turn off the process of bone breakdown. In other words, methylation helps to regulate what we call bone remodeling - the balance between bone building and bone breakdown.
So how do you know if your methylation process is working?
I’ll be honest with you, you need to work with a trained clinician who understands what methylation is to start with. I use genetic testing in my practice so I can see from your gene blueprint if methylation is potentially an issue for you. Beyond that I consider:
● Symptoms associated with poor methylation, such as fatigue, anxiety, inflammation or immune-related problems which can show up as skin issues, gut, respiratory to name but a few
● Lab tests that look at nutrient sufficiency to support the methylation process and also the ratios of specific molecules that occur in the methylation cycle
● A marker called homocysteine. High levels of homocysteine are frequently a reflection of a poorly functioning methylation cycle. This test is very easy to get from your doctor. More on homocysteine in the next section.
Clearly I can’t do enough justice to the process of methylation in this short article. Suffice to say if you are interested in learning more, explain methylation in depth in my Genomic Kitchen Express Course. And if you want to connect methylation to what we do in the kitchen then enroll in the GENE-ius cooking course with myself and Chef Kate Waters for the deepest and yummiest dive!
Save 25% on our next GENE-ius course with coupon GENEFA22 by August 21:
Homocysteine is an important marker for bone health
High levels of homocysteine are associated with an increase in bone breakdown and a decrease in bone building. Homocysteine appears to “run interference” with bone stability and density by interfering with the collagen “crosslinks” that are integral to bone strength. Collagen crosslinks are where bone minerals are actually deposited within the bone matrix. You can now think of homocysteine as creating holes in the matrix and critical bone minerals slipping through, lost forever. Like a net full of holes.
Now, relating this back to methylation, recall that homocysteine is one of the measures we use to evaluate the efficiency of methylation. When it is elevated, methylation may be off track, but we now know that elevated homocysteine dose bone damage. We can keep homocysteine in check by eating foods rich in B vitamins, magnesium and zinc. We can also include foods rich in choline or betaine (mentioned above) as they offer a methylation “save” route when the cycle gets of track. Sort of like one of those run away truck ramps.
Bottom line: high homocysteine does bone damage. Pay attention and keep it in check
Vitamin D and YOUR bones
Your gene blueprint also provides insights into your vitamin D levels. It’s not news that vitamin D is very important for your bones and also your immune system. In fact scientists have identified over 200 genes that are influenced by vitamin D.
You may have learned that if you spend time in the sun, your body will make all the vitamin D it needs. Unfortunately, this is not the case for everyone. That’s because a whole host of genes, working in a harmonious cascade, are needed for your body to produce vitamin D. The sun simply acts like a kick starter to the process. If any of the genes in this vitamin D production cascade aren’t functioning properly, then you can get all the sun you want, but vitamin D production is thwarted
Think of this when you’re in your car, pull onto a local road and see that all the traffic lights ahead are green. Smooth coasting down that road! It’s stop and go however if those traffic lights are a mix of red and green. For vitamin D production, we want all of your vitamin D production genes (the traffic lights) to be signaling green. Very often we have a mix of red and green lights (genes) in our vitamin D production pathway. Depending on the mix of red or green or both, you’ll get a different vitamin D level in your blood. This is why we often see low levels of vitamin D levels despite sun exposure and eating eggs. In all honesty, some of the richest food sources of Vitamin D are no longer in our diet, but even if they were, genes can deliver a low vitamin D blow.
And here’s one more thing to know about vitamin D and your genes. Even if you have perfect vitamin D producing genes working together in unison, the vitamin D molecule has to bind to a receptor to do its work. And of course, a gene codes for that receptor. It’s called the Vitamin D Receptor or VDR gene. So you can make your vitamin D “cake” but you can’t eat it if the receptor is faulty. The body is complex isn’t it?
Suffice to say that if you have gene variants or “SNPs” that aren’t working efficiently, we often find that consumption of vitamin D-rich foods is not enough to support optimal levels for you body. In this case, you may need to take a supplement. But before you do, test and don’t guess. Supplements cost money. Take them only if you need to.
Structural genes and bone matrix
Matrix metalloproteins (MMP) are proteins that help create and support the structure of your bones as well as collagen and cartilage. MMPs appear to play an integral role in balancing bone building (osteoblasts) and bone breakdown/repair/replacement (osteoclasts).
Dysfunction in important proteins or the genes that code for them have been associated with rheumatoid arthritis, osteoarthritis and damage to the bone structure itself. MMPs need adequate levels of zinc and calcium to function correctly, so at least include adequate amounts of these nutrients so that these important proteins can do their bone work for you.
Telling your bone story through genomics
When I look at your genomic report, I'm looking for patterns in genes that tell the story of who you are. Specific to telling your bone story, you’re probably clear now that I am not just looking at one gene, I am looking at many.
I look for gene patterns that impact methylation, collagen production, hormone imbalance and inflammation. I consider genes that influence vitamin D production, or availability of zinc, antioxidants and other key nutrients. I evaluate your stress levels, type of exercise, whether you are over 40, peri-menopausal, what you’re eating. Whether you have had a Bone Mineral Density Scan. I ask a lot of questions.
From all these patterns and questions, I start to put together a picture. I often advise we run a few lab tests to validate the impression from your gene signposts. We talk about how to optimize what you're eating, getting a handle on stress and sleep. Making sure you include resistance and strength work for your bones every day.
Genes tell me what questions to ask, what to look at, what to talk to you about and where to start so that you get to your best end game faster, efficiently and economically.
Listen in to me talking about what I see when I look at a DNA report
Ten things you can do for your bone density now
First and foremost, take your bones seriously! They are your infrastructure. They are what carry you around. Bones are a silent warehouse in your body. They store a lot of information, and unfortunately a lot of toxic stuff too. Don’t take them for granted. Jump into preventive action for your bone density now. Here are my suggestions
Use an App to evaluate your diet and see where your nutrient deficiencies and insufficiencies are. Be sure to get enough calcium, vitamin D, ALL YOUR B-vitamins, magnesium, and zinc. Work with a licensed nutrition expert if you need help meeting your nutritional needs.
DOWNLOAD: my free resource: Beyond Calcium—Nutrients for Bone Health
Make sure you are eating at least 1 gram/kg of your body weight in protein every day.
If you are over 40 years old, I recommend aiming for 1.2-1.4 grams/kg body weight.
You can calculate the amount you need by taking your body weight in pounds and dividing by 2.2. That will give you your weight in kg. Then take your weight in kg and multiply that by 1.2. That number gives you your target protein grams per day. Because of my history with osteopenia and osteoporosis, my personal protein target is 1.4 grams/kg body weight, so I multiply my weight in kg by 1.4.
If you need to track your protein intake, you can do that with an App. You may be amazed at how hard you have to work to get enough protein. If you focus on eating more plants versus animals, you will have to work even harder.
Download My Plant Proteins for Bone Health Recipe Book (above)
Build fermented foods into your diet because they contain nature’s source of vitamin K2. Vitamin K2 activates the protein called osteocalcin that adheres calcium to your bones. If you don't eat fermented foods, or you don't tolerate them well, that is your clue to talk with a licensed clinician and get some help. Bottom line: you won’t do well without the gut-supporting benefits of the probiotics in fermented foods.
Include weight bearing (or “resistance”) activity NOW. Weight bearing activity stimulates your bones, forcing them into active remodeling. If you're not doing weight bearing or resistance activity, replace your aerobic activity with this just to kickstart it. THIS IS IMPORTANT people!
Get a handle on your stress. You now know why
Ask your doctor for a bone mineral density test (DEXA scan) by age 40, particularly if you have a family history of osteopenia or osteoporosis. If you can detect osteopenia, you can turn it around with some of the tools and the information in this article, videos and downloads.
If you really want to learn more about some of these processes of inflammation, oxidative, stress, methylation, etc. I pointed out two courses you can take. Both inexpensive. Both life-changing
GENE-ius Cooking Course. Save 25% with this coupon by August 21: GENEFA22 - next course starts September 6, 2022
References
Azuma K, Adachi Y, Hayashi H, Kubo KY. Chronic Psychological Stress as a Risk Factor of Osteoporosis. J UOEH. 2015 Dec 1;37(4):245-53.
Follis SL, Bea J, Klimentidis Y, et al. Psychosocial stress and bone loss among postmenopausal women: results from the Women’s Health InitiativeJ Epidemiol Community Health 2019;73:888-892.
Homocysteine As A Pathological Marker For Bone Disease: J Cell Physiol. 2017 Oct; 232(10): 2704–2709.
Visconti VV, Cariati I, Fittipaldi S, Iundusi R, Gasbarra E, Tarantino U, Botta A. DNA Methylation Signatures of Bone Metabolism in Osteoporosis and Osteoarthritis Aging-Related Diseases: An Updated Review. Int J Mol Sci. 2021 Apr 19;22(8):4244.
Association of Vitamin D Receptor Gene Variation With Osteoporosis Risk in Belarusian and Lithuanian Postmenopausal Women. Frontiers in Endocrinology (9). 2018
Liao, J., Qin, Q., Zhou, Y. et al. Vitamin D receptor Bsm I polymorphism and osteoporosis risk in postmenopausal women: a meta-analysis from 42 studies. Genes Nutr 15, 20 (2020).
