This month's bulletin covers new studies about the impact of diet on bone health, new medical technologies for assessing fracture risk, and an honest look at how doctors treat their patients.
We'll start with a study from the UK about protein consumption and hip fracture risk. The researchers were surprised to find that both protein and coffee or tea significantly altered participants' risk levels.
Then you'll learn about a new technology that applies the principles of mechanical engineering to test bone strength. If the FDA approves this new device, bone mineral density could become less relevant.
Finally, we'll look at a study that listened in on conversations between doctors and their patients. The results were disheartening but useful to keep in mind as you choose your medical professionals.
Protein Plus Coffee And Tea Provides Fracture Protection
A study from the University of Leeds found that women who increased their protein consumption by 25 grams a day saw a 14% reduction in their risk of hip fracture. They also found that each cup of tea or coffee they drank reduced hip fracture risk by an additional 4%.
The study pulled data from the UK Women's Cohort Study and a total of 26,318 women between the ages of 35 and 69 years of age participated. Each participant filled out a questionnaire about their diet and lifestyle, which the researchers compared to hospital records over the next two decades, revealing the relationship between diet and hip fractures.
The increase in protein had an even larger benefit for underweight women.
“Writing in the journal Clinical Nutrition, the researchers noted that the protective benefits were greater for underweight women, with a 25g/day increase in protein reducing their risk by 45%.
The protein could come in any form: meat, dairy, or eggs; and for people on a plant-based diet, from beans, nuts, or legumes. Three to four eggs would provide around 25g of protein as would a steak or piece of salmon. 100g of tofu would provide about 17g of protein.”1
By providing your body with ample protein you support muscle formation. This study found larger benefits for underweight women, likely because they had less muscle mass to begin with so they had more room for growth. Stronger muscles help you to avoid falls and enable you to build stronger bones. That's because the force that muscles exert on bone stimulates the creation of new, stronger bone.
The secondary finding, that additional cups of tea or coffee further reduced hip fracture risk, is more complex than it appears. A deeper dive into the details of the study reveals that the association was stronger for tea in underweight participants. The study authors note that this cohort isn't useful for assessing high levels of coffee consumption, as they consumed a mean of two cups per day.
Studies focused on coffee consumption found that fracture risk increased in participants who drank four cups a day.2 Since this cohort didn't contain many people who drank that much coffee, the results don't reflect the potential for coffee to increase fracture risk.
However, the association between coffee and tea and reduced fracture risk isn't a surprise. Other studies have found similar associations– when the beverages are consumed in moderation. Scientists credit the polyphenols in each beverage, which can stimulate bone formation.
The varieties of these beverages you choose and the way you prepare them can make them more or less bone-healthy. For example, you can replace sugar with a plant-based substitute like stevia, or choose almond milk instead of dairy creamer.
A UK study found that women, especially underweight women, who increased their protein intake reduced their risk of hip fracture. They also found that tea and coffee additionally reduced hip fracture, although the cohort did not include heavy coffee drinkers. Tea and coffee should be consumed in moderation.
New Bone Strength Testing Machine Seeks FDA Approval
A company called OsteoDx is on the path to applying for FDA approval for a new medical device that measures bone strength. The non-invasive technology assesses the strength of the ulna, which is the longer of the two bones in the forearm.
They're calling this new method Cortical Bone Mechanics Technology (CBMT). OsteoDx asserts that this technology provides more useful and accurate information than DXA scans of bone mineral density (BMD). They developed CBMT in response to the ineffectiveness of BMD as a predictor of fracture or a gauge of bone health.
“OsteoDx’s approach, however, involves using vibration testing to directly estimate bone strength. This approach is similar to what engineers may use to determine the strength of, for example, a bridge. And no x-rays, other radiation, or incisions are involved. “Our approach is to measure what matters”, said Andrew Dick of New Marshfield who serves as OsteoDx’s director of engineering. “We leverage classical structural engineering principles to quantify bone stiffness, which yields a near perfect estimate of whole bone strength.”3
This technology is currently undergoing a series of studies that will compare its effectiveness to DXA scans for measuring bone mineral density. The company intends to seek FDA approval soon.
It remains to be seen if this technology will provide useful information about bone strength. If it does, it might further expose current osteoporosis drugs as ineffective at improving bone strength.
Medical technology company OsteoDX is conducting trials of a new device for measuring bone strength. This new technology uses the principles of mechanical engineering to test the strength of the ulna bone in the forearm. The test could prove more effective than DXA scans and provide information about bone health that is more useful than bone mineral density.
Doctors Interrupt Patients 11 Seconds Into Their Explanation For Visit
Researchers at the University of Florida analyzed videos of doctors and their patients to assess how long doctors let patients speak before interrupting them. They found that, on average, doctors cut off patients 11 seconds into their explanation for their visit.
“The team specifically analyzed the first few minutes of the 112 consultations, looking to find out how frequently doctors let the patients dictate the conversation. This was done through inquiries such as, “Tell me what brings you in today,” or “What can I do for you today?” If patients were given the opportunity to set the agenda, the researchers then timed the responses to see how long they could speak before the doctor interrupted them.
The results show that just 36% of doctors ask questions that allowed patients to set the agenda, but two-thirds (67%) of those patients were interrupted after responding.”4
Some doctors heard out their patients and allowed them to guide the consultation. Conversely, other doctors cut patients off right away, or never let them speak at all. The research found that primary care doctors were more likely to let patients speak, while specialists were more likely to cut them off.
The researchers suggested that a combination of burnout and insufficient training could be to blame for the lack of patient-centered care.
This poor treatment is evidently quite common, but you don't have to stand for it. If you feel that your doctor isn't listening to you, ask for them to hear you out. If they don't slow down and really listen, it's probably time to find a new doctor.
Researchers analyzed videos of doctor visits and found that, on average, doctors cut patients off 11 seconds into their explanation for their visit. Sixty-seven percent of patients were cut off this way, and only 36% of doctors gave patients the chance to offer an explanation at all. This indicates a lack of patient-centered care in our medical system. If your doctor doesn't listen to you, even after you ask them to, seek a new medical professional.
What This Means To You
The landscape of bone health continues to evolve, and the changes have only reinforced the value and efficacy of the Osteoporosis Reversal Program. Diet remains a powerful tool for supporting bone health, including consuming sufficient protein.
The Medical Establishment might finally be forced to reconsider bone mineral density as a useful measurement of bone health as new technologies emerge.
Through it all, your relationship with your doctor is crucial, since he or she should provide access to testing followed by guidance and advice based on the course of action you want to take. Building a positive relationship with the right doctor is so crucial that the Osteoporosis Reversal Program includes a report dedicated to this topic: Doctor Dialogues. You can use these tutorials to establish an open and honest dialogue with your healthcare professional.
Keep learning and keep acquiring the support and resources you need to make good choices and pursue an active, healthy, independent lifestyle.