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First, a Special Welcome all the readers to this newsletter - especially those who have signed up over the last few months.

There are so many things to talk about this month. There is some interesting new research that I want to share. But before I do that let me say a few things related to your weight bearing activity.

Remember that once you have dropped tobacco, caffeine and soda pop from your diet, one of the best things you can do for your Bones is to increase your weight bearing activities.

Researchers have found that people stick to weight bearing activities if the activities are part of their jobs and/or if they find things they ENJOY.

If your work does not involve manual labor or stair climbing, it is really important to find things that you will enjoy that put enough stress on your bones to stimulate your osteoblasts. Dancing, martial arts... You make your own list. Try something new this month.

Also you can add dozens of small weight bearing activities to your life by dropping some labor saving devices. Carry out the garbage instead of wheeling it. Squeeze your own orange juice. Use a broom instead of vacuum. Never use the arms of chairs when you stand up. Each bit helps increase the stress on your bones and each bit adds up.


FOOT, KNEE, HIP, BACK PAIN. If you finding walking painful do turn your shoes over and check the wear pattern on the bottom. If you find that wear is uneven eg. part of the heel or sole is more worn than the rest. Orthotics might make a difference.

About 2 years ago, I was not walking much. It was just too painful. A friend suggested that I try New Balance shoes and I really lucked out since the store where I went to buy them was owned by a man who fitted most of the runners in the well as people with special foot needs. He took one look at wear pattern on my old shoes and said, "I think orthotics could help."

He explained - even said that he guaranteed his work and would remake orthotics at no extra cost until we found the right ones. So, I got fitted and found relief in the next week. But I still had some knee pain so I went back. He rechecked everything and said that there were a few different things that might work. He made a new pair and said, "Try these for a week but if the pain is not gone, do come back and we will try something else." The second pair did the trick and I have been doing my 2 miles a day every since. Amazing.


OSTEOPENIA RESEARCH STUDIES. I have four studies - something for everyone.

1. African Americans with early rheumatoid arthritis at risk for Osteopenia and Osteoporosis.

2. Younger pre menopausal women (age 25 - 44) and bone density.

3. Is milk the problem? A study of younger males and BMD.

4. New study of the health needs of older women. (link to full text)


Title: "Prevalence of Osteoporosis and Osteopenia among African Americans with Early Rheumatoid Arthritis: The Impact of Ethnic-Specific Normative Data" concluded that African Americans with Rheumatoid Arthritis are at risk of Osteopenia and/or osteoporosis.

This study is just one more that is countering the widespread notion that Osteopenia is NOT a problem for African American women. The fact is that one out of every seven persons with Osteoporosis is an African American woman - even those without rehumatoid arthritis have problems. African American women need screening for Osteopenia and Osteoporosis too. Too many are not diagnosed until their bones reach the Osteoporosis stage or they have a major fracture. Pass the word: African American women need to discuss Osteopenia screening with their health care providers.

OSTEOPENIA RESEARCH #2, Pre menopausal women. More and more women under the age of 40 are being diagnosed with Osteopenia or Osteoporosis. This despite the fact that few women in this age group are routinely screened for Osteoporosis. A recent study concluded that it might be useful to do such routine BMD testing because knowledge of their condition led to changes in behavior in ways that has positive effects on their BMD.

"In the study they offered premenopusal women (age 25 - 44) with low bone mineral density either written material or small group education. After two years they reviewed dietary calcium intake, calcium supplement use, smoking behavior, physical activity, endurance fitness, lower limb strength and BMD. And found that after 2 years those who self managed increased BMD of femoral neck (hip)but not the spine.

They concluded: "Individualized BMD feedback combined with a minimal educational intervention is effective at increasing hip but not spine bone density in pre menopausal women. The changes in behavior through which this was mediated are potentially important in the prevention of other diseases, thus measuring BMD at a young age may have substantial public health benefits, particularly if these changes are sustained." Again, this is something to pass along to others.

OSTEOPENIA RESEARCH 3. Recently there have been claims that milk may be a cause of Osteopenia or Osteoporosis. (I am reviewing these claims and the relevant studies, both pro can con, and will be doing an article on this next month.)

Still concerns about milk have led to some new studies. Here is one published just last month:

Nutr Metab (Lond). Feb. 2006; "Determinants of bone mass and bone size in a large cohort of physically active young adult men". by JA Ruffing, F Cosman, M Zion, Susan Tendy , P Garrett, R Lindsay and JW Nieves corresponding author.

"The determinants of bone mineral density (BMD) at multiple sites were examined in a fit college population. Subjects were 755 males (mean age = 18.7 years) entering the United States Military Academy. A questionnaire assessed exercise frequency and milk, caffeine, and alcohol consumption and tobacco use. Academy staff measured height, weight, and fitness. Calcaneal BMD was measured by peripheral dual-energy x-ray absorptiometry (pDXA). Peripheral-quantitative computed tomography (pQCT) was used to measure tibial mineral content, circumference and cortical thickness. Spine and hip BMD were measured by DXA in a subset (n = 159).

Mean BMD at all sites was approximately one standard deviation above young normal (p < 0.05). African Americans had significantly higher hip, spine and heel BMD and greater tibial mineral content and cortical thickness than Caucasians and Asians. In Caucasians (n = 653), weight was a significant determinant of BMD at every skeletal site. Prior exercise levels and milk intake positively related to bone density and size, while caffeine had a negative impact. There was an apparent interaction between milk and exercise in BMD at the heel, spine, hip and tibial mineral content and cortical thickness. Our data confirm the importance of race, body size, milk intake and duration of weekly exercise as determinants of BMD and bone size.

OSTEOPENIA RESEARCH #4. And for the older women among our readers, you can read a complete short study: "New insights into the health priorities and needs of older women" by Elizabeth Phelan and James LoGerfo at:


WEB SITE CHANGES. In the last month I have added a short piece about OsteoNecrosis to the Fosamax page, added some new research about Actonel, Changed the information on the Advacal page case you want to recheck any of these.

Meantime, I trust that you will use April to review and renew the things that YOU ARE DOING to help your bones grow stronger.