Did you know that May is National Osteoporosis Month? It’s not a designation that requires a change of pace at the Save Institute, because we are dedicated to naturally reverse and prevent osteoporosis year-round!
But having a month dedicated to the topic of bone health and fracture risk is a good reminder that there is always more to learn, to do, and to share. Let the month of May usher in a wave of bone-healthy habits and new knowledge. And as you begin to improve your habits, remember that it’s just as important to let some unhealthy habits go.
The process of identifying and removing the unwanted is actually today’s topic, but on the molecular level! You see, the inflammatory marker called C-Reactive Protein (CRP) is a powerful tool that your body uses to identify cells and substances that need to be removed.
Read on to learn about the relationship between CRP levels and your bone health, plus much more.
What is C-Reactive Protein?
C-Reactive Protein is a ring-shaped protein found in blood plasma that is produced primarily by the liver in response to inflammation and tissue damage. The C in its name does not bear any relation to C-peptide (insulin) or vitamin C. It was discovered in 1930 as a substance in the blood of patients with acute inflammation because it reacted with the somatic ‘C’ carbohydrate antigen of Pneumococcus, hence: C-Reactive Protein.1
It functions in the body as an activator of the complement system, which is a part of the immune system that “complements” the ability of antibodies and phagocytic cells to remove microbes and damaged cells, promote inflammation, and attack pathogens’ plasma membrane. CRP does this by binding to a substance called phosphocholine that is found on the surface of dead or dying cells and some bacteria.
This binding activates the complement system by promoting phagocytosis of the binded cell by white blood cells called macrophages. Phagocytosis, a process of engulfing and digesting, is a means by which organisms clear dead, diseased or dying cells and bacteria. This makes CRP an important component of your body’s maintenance system.
What Does CRP Tell Me About My Bone Health?
Because it is formed in response to inflammation and damage in the body, CRP levels are an indicator of system-wide inflammation. It increases dramatically and quickly in response to tissue injury, like physical or thermal trauma, or infection by bacteria, viruses, and parasites. The goal is to help the body repair the damage or remove the intruder. When CRP levels are elevated, something is amiss, and if they remain that way for a long period of time, it can indicate chronic or systemic inflammation.
As Savers know, studies show that inflammation damages bones, so it shouldn’t be surprising that high CRP levels are an indicator of poor skeletal health and an increased risk of fracture.2 With inflammation comes a surge of immune activity, including an increase in cytokines. While this might help solve a problem in the short term, cytokines are deleterious to your bones. They kick off a series of reactions that increases bone resorption, which weakens your bones.
One group of researchers who cross-analyzed existing studies of older women found that participants with the greatest measure of inflammation were three times as likely to fracture a bone compared to those with the lowest levels.3 The evidence presented in these studies further confirms that CRP levels have a direct correlation with bone health.
There are many other health conditions in which CRP plays an important role, as you’ll read next.
Elevated Blood Pressure
CRP may lead to a vasoconstrictive state (narrowed blood vessels) with increased arterial stiffness, resulting in hypertension. One study showed that among a healthy elderly population, elevated CRP levels preceded the onset of hypertension. Subjects with the highest CRP measurements had double the risk of developing high blood pressure compared to those with the lowest measurements.4
Your dentist has surely warned you of the dangers of periodontal disease, in which the gums become chronically infected, leading to the detachment of tooth and bone, and bone loss. In patients suffering from this condition, CRP levels are notably elevated. Those levels increase with the destruction of gum and bone, and with the aggressiveness of the condition.5
Because CRP resides in blood plasma, it is heavily involved in cardiovascular issues. It can cause hardening of the arteries and trigger the onset of heart artery disease,6 or line the interior of blood vessels, causing dysfunction. It can also start a feedback loop of creating a problem, like atherosclerosis, that results in the local release of more CRP. A similar problem occurs with high levels of low-density lipoprotein (LDL) cholesterol, increasing CRP levels, which can in turn increase absorption of LDL.7
In otherwise healthy people, high CRP levels can predict myocardial infarction mortality, peripheral blood vessel disease, heart failure and arrhythmias.6
CRP levels have been associated not just with the occurrence of stroke, but with severity, and the likelihood of mortality or brain hemorrhage after a stroke. This indicates a relationship between inflammation and stroke that may relate to the presence of conditions causing inflammation, such as diabetes, hypertension, obesity, and Vitamin D deficiency.8
Metabolism and Obesity
Elevated CRP is correlated with obesity and abnormal fat metabolism in adults and children.9 It is tied to BMI, waist circumference, blood pressure, triglycerides, cholesterol, blood glucose and it is inversely correlated with HDL cholesterol and insulin sensitivity.
A population-based study of the elderly found a direct correlation between CRP and BMI and CRP and total calorie intake, strengthening the relationship between obesity and calorie intake, and showing CRP as a marker.10
Your eyesight is one of your most valuable tools to prevent fractures. Falls and breaks are closely linked to the loss of eyesight that occurs with age-related macular degeneration (AMD). CRP is associated with eye blood vessel disorders and studies show a relationship between the protein andAMD. Women with the highest levels of CRP were found to be more than three times as likely to have developed AMD.11
In rheumatoid arthritis patients, CRP is found in joint cavity fluid, and can bind to white blood cells and other inflammatory compounds. The inflammation in rheumatoid arthritis (RA) is closely related to the production of CRP, making CRP levels a clear indicator of the severity of symptoms.12 This also makes CRP a strong predictive marker for joint destruction and disease progression in early RA and a strong risk predictor of non-traumatic fractures.
If you have experienced fatigue as a chronic problem, inflammation may be playing a role.13 Those reporting fatigue had higher than normal CRP concentrations in studies that looked at healthy adults and disease free survivors of breast cancer.14
Savers know that mood plays an important role in bone health. Multiple studies show that low-grade inflammation is also linked to depression, and those symptoms have been associated with increased CRP levels in several studies.15-16-17 The amount of CRP was even linked to the history of suicide attempts in depressed patients.18 The relation to mental health is also underscored by high levels of the protein in elderly subjects experiencing memory decline attendant to dementia.19
Lifestyle Habits That Elevate CRP Levels
As explained earlier, there are many reasons why CRP levels may spike, and that’s a normal part of our biology. But there are behaviors that can also cause it to climb, increasing the risk of the inflammation-related issues detailed above, including bone loss and greater risk of fractures.
You should avoid as much as possible the following CRP- producing situations:
Sleep is a crucial part of your body’s cycle of maintenance and growth. When your normal patterns of sleep are thrown off, it can lead to problems that are reflected by an increase in CRP. Excess sleep, insufficient sleep, and sleep disruptions can all be linked, depending on the impact on sleep patterns.20
Developing consistent sleeping habits that allow you get the right amount of sleep helps to keep CRP levels within the desirable ranges.
Stress and Substance Abuse
Savers are well aware of the relationship between stress and the hormone cortisol, which has a negative impact on bone. CRP levels are another indicator of the harmful effects of stress. Whether it is work-related, interpersonal stress, or chronic feelings of being overwhelmed, studies have demonstrated that they correlate with an increase in CRP.21
Another interrelated corollary is substance abuse. C-Reactive Protein is found more often when there is nicotine, alcohol, and cannabis use, and nicotine dependence.22 Alcohol use seems to be related to moderation, wherein CRP levels decrease with some use, but then increase with abuse or dependence.
Fatty Acids, Trans Fats & Vitamins
In men, high saturated/polyunsaturated fatty acid ratio along with lauric and myristic acids are associated with elevated concentrations of CRP.23 One study showed that those with the highest trans fat consumption had 73% higher CRP scores than those with the lowest consumption.24
Elevated CRP levels have been associated with vitamin D deficiency in elderly populations in urban settings,25 with Vitamin A deficiency in a sub-Saharan African study,26 and with low Vitamin K concentration in older men and women.27 It’s relevant to mention here that Vitamins D, A and K are all Foundation Supplements recommended in the Osteoporosis Reversal Program.
Cigarette smoking has been clearly established to increase CRP. This shouldn’t be surprising given the damage we know that smoking does to many systems of the body. Studies have shown that CRP levels are a result of the tissue injury that smoking causes.28
What Can I Do To Lower CRP Blood Levels?
Given that chronic health issues and stress result in high CRP levels, solutions to lowering levels are mostly aimed at ameliorating those problems. Following this advice will improve your health, both physical and mental, lower inflammation and keeping your bones and body in good shape.
Nutritional Approaches To Decreasing CRP
C-Reactive Protein is an endogenous compound that is synthesized in response to our physical state, so impacting that state through diet is an effective way to control CRP levels. Here are some foods and nutrients that can help keep your levels in check:
- Vitamin A, C, D, and K (All Foundation Supplements!)
- Vitamin E
- Niacin & Folate (both are B vitamins and Foundation Supplements)
- Carotenoids (like the beta-Carotene from carrots)
- Magnesium (An often overlooked Foundation Supplement)
- Polyunsaturated fatty acids (like omega-3 fatty acids)
- Fiber (get it from fruits and vegetables!)
- Probiotics (which are also essential for bone health)
- Coffee (which is acidifying, so drink in moderation)
- Green Tea (full of antioxidants, but also acidifying)
- Resveratrol (a polyphenol found in red wine)
- Cocoa & Dark Chocolate
Several studies have shown exercise to be a dependable way to reduce CRP levels.29 It doesn’t even require that much activity to have an impact.30 In the short term, stressful or difficult exercise can cause a spike in CRP. This is more true of aerobic exercise than anaerobic.31 Short and intense physical routines do not create much of a change in CRP, at least in the immediately following hours.
Whether it’s a yoga class, a bike ride, or the Densercise™ Epidensity Training System, exercise is a crucial part of a healthy lifestyle.
A Balanced Diet
This one is certainly no surprise given what we’ve already learned today. Just looking at the list of nutritional approaches to decreasing CRP should tell you that a balanced diet is essential to reducing inflammation levels and staying healthy. Studies have shown that diets high in fiber and rich in fruits and vegetables are linked to lower CRP levels, while high consumption of saturated fat, sugar, sodium and refined grains increase levels.32
Focused Breathing And Physical Activity
Studies have shown that practices like yoga, tai chi, and qigong, that combine deep breathing, meditation and moderate physical activity promote stress reduction and relaxation, which benefit your bones and overall health. Evidence from studies looking at a variety of cohorts showed the CRP reducing impacts of these activities.33 While the physical component is certainly a strong contributing factor, even a concerted practice of mindfulness was shown to have a small but significant reduction in CRP levels.34
The Power Of Staying Positive
Amazingly, studies have shown that pessimism actually increases inflammation, which in turn, affects CRP levels.35 Conversely, positivity actually has a beneficial impact on inflammation as well as other markers of well being.
Clearly, it’s important to stay positive and keep working toward your goals while reassuring yourself that they are achievable.
You’re already on the right path, gaining knowledge and tools to improve your bone health and better understand the processes that keep your body functioning at optimal levels. Almost every one of the recommendations that were covered today in relation to CRP levels can be found in greater detail in the Osteoporosis Reversal Program.
The integrative approach of the Program address not just how to increase your bone density, but how to improve your bone quality along with your quality of life.
Stop Worrying About Your Bone Loss
Join thousands of Savers from around the world who have reversed or prevented their bone loss naturally and scientifically with the Osteoporosis Reversal Program.
You deserve to be taken care of in your entirety, from combatting chronic inflammation to fueling the systems that generate young, healthy bones at every age. Stay positive, keep learning, and live your life to its fullest!
Till next time,
1 Ananthanarayan R, Paniker C). Ananthanarayan and Paniker's Textbook of Microbiology. Himayatnagar, Hyderabad: Orient Longman. (7th ed.). p. 218. 1978. ISBN 9788125028086.
2 Shinya Ishii, et al. “C-Reactive Protein, Bone Strength, and Nine-Year Fracture Risk: Data From the Study of Women’s Health Across the Nation (S” J Bone Miner Res. 2013 Jul; 28(7): 10.1002/jbmr.1915. WAN). Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880424/
3 Kamil E. Barbour, Jane A. Cauley. “Measuring inflammatory marker levels to determine risk of bone loss and fractures in older women.” April 20, 2013. Web: https://www.mlo-online.com/measuring-inflammatory-marker-levels-to-determine-risk-of-bone-loss-and-fractures-in-older-women.php
4 Sridevi Devara, David Siegel, Ishwarlal Jialal. “Statin Therapy in Metabolic Syndrome and Hypertension Post-JUPITER: What is the Value of CRP?” Curr Atheroscler Rep. 2011 Feb; 13(1): 31–42. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018293/
5 Tushika Bansal, et al. “C-Reactive Protein (CRP) and its Association with Periodontal Disease: A Brief Review” J Clin Diagn Res. 2014 Jul; 8(7): ZE21–ZE24. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4149169/
6 Fabrizio Montecucco and François Mach. “New evidences for C-reactive protein (CRP) deposits in the arterial intima as a cardiovascular risk factor” Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2546477/
7 Stancel N, Chen CC, Ke LY, Chu CS, Lu J, Sawamura T, Chen CH. “Interplay between CRP, Atherogenic LDL, and LOX-1 and Its Potential Role in the Pathogenesis of Atherosclerosis.” Clin Chem. 2016 Feb;62(2):320-7. Web: https://www.ncbi.nlm.nih.gov/pubmed/26607724
8 Alijan Ahmadi-Ahangar, MD. “”Predictive ability of C-reactive protein for stroke Caspian J Intern Med. 2016 Summer; 7(3): 151–152. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5062170/
9 Ritsuko Nishide,corresponding author Michiko Ando, Hidemitsu Funabashi, Yoshi. “Association of serum hs-CRP and lipids with obesity in school children in a 12-month follow-up study in Japan” Environ Health Prev Med. 2015 Mar; 20(2): 116–122.Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4597345/
10 Arch Gerontol Geriatr. “Relation between glucose levels, high-sensitivity C-reactive protein (hs-CRP), body mass index (BMI) and serum and dietary retinol in elderly in population-based study.” Luna RC. 2012 May-Jun;54(3):462-8. Web: https://www.ncbi.nlm.nih.gov/pubmed/21764149
11 Emina Colak, et al. “The role of CRP and inflammation in the pathogenesis of age-related macular degeneration” Biochem Med (Zagreb). 2012 Feb; 22(1): 39–48. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062327/
12 Maria I. Danila. “The Role of Genetic Variants in CRP in Radiographic Severity in African Americans with Early and Established Rheumatoid Arthritis” Genes Immun. 2015 Oct; 16(7): 446–451. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707038/
13 L. L. Carpenter, et al. “C-reactive protein, early life stress, and wellbeing in healthy adults “ Acta Psychiatr Scand. 2012 Dec; 126(6): 402–410. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580169/
14 Orre IJ1, et al. “Higher levels of fatigue are associated with higher CRP levels in disease-free breast cancer survivors.” J Psychosom Res. 2011 Sep;71(3):136-41. doi: 10.1016/j.jpsychores.2011.04.003. Epub 2011 May 18. Web: https://www.ncbi.nlm.nih.gov/pubmed/?term=CRP+%5Btitle%5D+insomnia
15 Daly M. “The relationship of C-reactive protein to obesity-related depressive symptoms: a longitudinal study.” Obesity (Silver Spring). 2013 Feb;21(2):248-50. doi: 10.1002/oby.20051. Web: https://www.ncbi.nlm.nih.gov/pubmed/23404927
16 Valkanova V, Ebmeier KP, Allan CL. “CRP, IL-6 and depression: a systematic review and meta-analysis of longitudinal studies” J Affect Disord. 2013 Sep 25;150(3):736-44. Web: https://www.ncbi.nlm.nih.gov/pubmed/2387042
17 Bo Mi Song,“Association between C reactive protein level and depressive symptoms in an elderly Korean population: Korean Social Life, Health and Aging Project” BMJ Open. 2015; 5(2): e006429. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342593/
18 Courtet P, et al. “Increased CRP levels may be a trait marker of suicidal attempt.” Eur Neuropsychopharmacol. 2015 Oct;25(10):1824-31. doi: 10.1016/j.euroneuro.2015.05.003. Epub 2015 May 21. Web: https://www.ncbi.nlm.nih.gov/pubmed/26032768
19 B. Adar Kravitz, et al. “Elevated c-reactive protein levels are associated with prevalent dementia in the oldest-old” Alzheimers Dement. 2009 Jul; 5(4): 318–323. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740472/
20 . Janna Mantua and Rebecca M. C. “The interactive effects of nocturnal sleep and daytime naps in relation to serum C-Reactive protein” Spencer. Sleep Med. 2015 Oct; 16(10): 1213–1216. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592522/
21 Johnson TV1, Abbasi A, Master VA. “Systematic review of the evidence of a relationship between chronic psychosocial stress and C-reactive protein.” Mol Diagn Ther. 2013 Jun;17(3):147-64. doi: 10.1007/s40291-013-0026-7. Web: https://www.ncbi.nlm.nih.gov/pubmed/23615944
22 E. Jane Costello, et al. “C-Reactive Protein and substance use disorders in adolescence and early adulthood: A Prospective Analysis” Drug Alcohol Depend. 2013 Dec 1; 133(2): 712–717. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106409/
23 Santos S, Oliveira A, Casal S, Lopes C. “Saturated fatty acids intake in relation to C-reactive protein, adiponectin, and leptin: a population-based study.” Nutrition. 2013 Jun;29(6):892-7. Web: https://www.ncbi.nlm.nih.gov/pubmed/23594583
24 Lopez-Garcia E,, Schulze MB, Meigs JB, Manson JE, Rifai N, Stampfer MJ, Willett WC, Hu FB. “Consumption of trans fatty acids is related to plasma biomarkers of inflammation and endothelial dysfunction.” J Nutr. 2005 Mar;135(3):562-6. Web: https://www.ncbi.nlm.nih.gov/pubmed/15735094
25 Hyemi Lee, Kyoung-Nam Kim, Youn-Hee Lim, and Yun-Chul Hong. “Interaction of Vitamin D and Smoking on Inflammatory Markers in the Urban Elderly” J Prev Med Public Health. 2015 Sep; 48(5): 249–256. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592026/
26 “Zeba AN, Delisle HF, Rossier C, Renier G. “Association of high-sensitivity C-reactive protein with cardiometabolic risk factors and micronutrient deficiencies in adults of Ouagadougou, Burkina Faso.“ Br J Nutr. 2013 Apr 14;109(7):1266-75. Web: https://www.ncbi.nlm.nih.gov/pubmed/22914173
27 M Kyla Shea, et al. “Vitamin K, circulating cytokines, and bone mineral density in older men and women.“ Am J Clin Nutr. 2008 Aug; 88(2): 356–363. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2532855/
28 Sami Aldaham, Janet A. Foote, H.-H. Sherry Chow, and Iman A. Hakim. “Smoking Status Effect on Inflammatory Markers in a Randomized Trial of Current and Former Heavy Smokers.” Int J Inflam. 2015; 2015: 439396. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561108/
29 Jeffrey A. Woods,* Kenneth R. Wilund, Stephen A. Martin, and Brandon M. Kistler. “Exercise, Inflammation and Aging” Aging Dis. 2012 Feb; 3(1): 130–140. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3320801/
30 Hamid Alizadeh, Farhad Daryanoosh, Maryam Moatari, and Khadijeh Hoseinzadeh. “Effects of aerobic and anaerobic training programs together with omega-3 supplement on interleukin-17 and CRP plasma levels in male mice” Med J Islam Repub Iran. 2015; 29: 236. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4715379/
31 Cipryan L1, Svagera Z, Vala R. “IL-6 and CRP response to maximal exercise intervention” J Sports Med Phys Fitness. 2015 Jul-Aug;55(7-8):813-23. Epub 2015 Feb 13. Web: https://www.ncbi.nlm.nih.gov/pubmed/25678206
32 Marie Fanelli Kuczmarski, et al. “Diet quality inversely associated with C-reactive protein levels in urban, low-income African American and White adults” J Acad Nutr Diet. 2013 Dec; 113(12): 10.1016/j.jand.2013.07.004. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833870/
33 Nani Morgan,1 Michael R. Irwin,2 Mei Chung,3 and Chenchen Wang1. “The Effects of Mind-Body Therapies on the Immune System: Meta-Analysis” PLoS One. 2014; 9(7): e100903. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079606/
34 William B. Malarkey, MD, David Jarjoura, PhD, and Maryanna Klatt, PhD. “Workplace based mindfulness practice and inflammation: A randomized trial” Brain Behav Immun. 2013 Jan; 27(1): 145–154. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528077/
35 Brita Roy, et al. “The association of optimism and pessimism with inflammation and hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA)” Psychosom Med. 2010 Feb; 72(2): 134–140. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842951/