Macrobiotics Today, March/April 1992, Vol. 32, No. 2
"Osteoporosis: The Silent Threat" Gale Jack
When I was younger, I occasionally came across the word osteoporosis in my reading, but never paid much attention to it. I always associated it with older people. So I was totally unprepared when a dentist turned away from my x-rays and said, "You have the most advanced case of osteoporosis I've ever seen in a woman your age!"
Unfortunately, my experience may not be that uncommon. Many women may have osteoporosis and not know it until they've fractured a hip or wrist or have been told that they have to have dentures because of extensive bone loss. X-rays do not appear to be sensitive enough to detect bone deterioration until 30 percent of the bone mass is lost.
Osteoporosis is the thinning and loss of bone tissue which leaves the body subject to fractures from falls and loss of supporting structures of the teeth. In extreme cases, it can cause spinal collapse, recurrent back pain, and "dowager's hump" (a hump on the upper back most frequently seen in older women where the upper spine curves outward, the lower spine curves inward, and the stomach protrudes). And osteoporosis can precipitate hip fractures in elderly women which leads to death in 30 percent of those injured. An estimated 200,000 osteoporotic American women over the age of forty-five fracture one or more of their bones. Of these, over 40,000 die of complications following their injuries.
Loss of bone begins sooner and proceeds more rapidly in women than in men. It affects 25 percent of women after a natural menopause (with the most rapid bone loss occurring the five to six years following menopause) and up to 50 percent of those who have had a surgical menopause (brought about by the removal of ovaries or the uterus or both). Small body size, independent of body weight, is a critical risk factor. However, women of all sizes seem to have more bone loss than men and have it at an earlier age, but they are not the only ones affected. Michio Kushi estimates that between 60 and 70 percent of all people suffer from osteoporosis.
It's certainly much more widespread than is revealed by medical statistics because there are few outward signs of the disease in the early stages. One of the first outward signs is loss of height between your hips and neck. (If you don't know how tall you were in early adulthood, you can estimate that height by measuring the width of your arm span, since arm span and height are nearly equal at skeletal maturity.) Subtract your arm span from your head-to-heel height to give yourself a rough indication of your height loss. Any substantial difference may be a sign of osteoporosis.
Another sign is what's called transparent skin. If you can see the edges of both the large and small veins on the back of the hand then you may have osteoporosis as this reflects a lack of collagen in the skin's outer layers. One study of older women with osteoporosis showed that 83 percent had transparent skin while 13 percent did not.
But years before these outward signs appear, changes are showing up in the mouth, in the deterioration of tissues and bone surrounding and supporting the teeth. The earliest type of gum infection is known as gingivitis and is characterized by tenderness, swelling, and bleeding of gum tissue. In more advanced cases, the gums may appear reddish blue or even deep blue showing that the blood has condensed and stagnated in those areas.
Once pockets of infection occur between the teeth and gums where the gums have pulled away from the teeth, it's referred to as periodontal disease. At this stage, plaque accumulates on the teeth and keeps the gums from reattaching. The general view of dentists is that the infection leads to receding gums and the loss of bone that supports the teeth, causing the teeth to become loose. But I suspect the bone deterioration comes first, causing the receding gums and predisposing one to formation of the pockets as receding gum tissue parallels the loss of bone. After age 35, the most common cause of tooth loss is periodontal disease.
The symptomatic treatment of advanced periodontitis (where the gum tissues have receded beyond a certain level, plaque advances down the tooth roots and, in some cases, a lack of bone density is present on x-rays of the mouth and some teeth may be loose) is extraction of the tooth or a mouthful of teeth, depending on the dentist and how many teeth are perceived as hopeless. The teeth may be perfectly sound, but in the medical view, the supporting tissues cannot sustain them so they simply extract them.
Periodontists (dentists who specialize in periodontal disease) may recommend scaling (removal of tartar from below the gum line), curettage (removing the degenerated, diseased soft tissue lining of the periodontal pocket using a local anesthesia), root planing (removing irregular surfaces along the root of the tooth) and polishing the teeth as corrective measures in less advanced cases of gum disease. In more chronic or advanced cases, the diseased gum tissue may be surgically removed and the exposed root surfaces scaled, the bones reshaped, and gum tissues transplanted. None of these procedures addresses the cause and they can cause endless additional problems such as increased looseness and sensitivity in the teeth, further exposure of the tooth root, disturbance of the energy pathways in the meridians, not to mention, possible adverse reactions to anesthetics used as part of the procedures.
Physicians and macrobiotic teachers both understand that calcium and phosphorus are the major components of bone and when the amount of phosphorus is greater than the amount of calcium, bone loss occurs. But the medical profession would have us increase the intake of dairy products such as milk, cheese, and ice cream along with canned seafoods (especially tuna, salmon, shrimp, and sardines), meat, and poultry. In addition, calcium supplements are often recommended.
However, if that were effective in protecting the bones then I never could have developed osteoporosis because I ate plenty of all those foods for over thirty years. I had cheese, eggs, milk, meat, chicken, or tuna on a daily basis and later added calcium supplements. And most people today eat plenty of meat and dairy foods. More recent studies show that excess protein actually increases calcium excretion and leads to overall loss of calcium from the body.
A Michigan State study found that by age 65, the average woman who ate meat had lost one-third of her skeletal structure. Meanwhile, vegetarian women of comparable age had less than half the bone loss and were more active, less likely to break bones, maintained erect postures, and healed bones more quickly.
The Inuit (Eskimo) have the highest osteoporosis rates in the world. In a study of 217 children, 89 adults, and 107 elderly Inuit in Alaska, researchers found that they had lower bone mineral content, onset of bone loss at an earlier age, and development of bone thinning with a greater intensity than white Americans. The scientists attributed the greater degeneration to the acidic effects of the Inuit's high meat diet.
A diet of meat, poultry, eggs, milk, dairy, fish, simple sugar, fruit juice, and oily, greasy foods along with few good quality vegetables creates an acidic condition in the blood so the body has to use the minerals stored in the bones to maintain an alkaline blood. This borrowing of minerals causes the bones to become weak. And if this diet is eaten for a prolonged period, osteoporosis develops. On the other hand, appropriate proportions of whole grains, vegetables, sea salt, miso, soy sauce, beans, bean products, and sea vegetables along with fresh organically grown vegetables will create an alkaline blood condition. These foods will supply the minerals the body needs to maintain healthy bones and teeth.
Researchers from Creighton University in Omaha, Nebraska, and Purdue University in West Lafayette, Indiana, reported that the calcium in kale is readily and more efficiently absorbed by the body than the calcium contained in milk. In studies of eleven women, the absorption of calcium from 300 mg of kale averaged .409 mg, while from a similar amount of milk calcium absorption averaged .321 mg. "We interpret our findings as evidence of good bio-availability for kale calcium," the researchers concluded. Other greens they listed included broccoli, turnip, mustard, and collard greens.
The macrobiotic way of eating not only prevents osteoporosis but it can remineralize bones that have been thinned. I saw one medically documented case in which this occurred. A woman from Atlanta followed the standard macrobiotic diet set forth by Michio Kushi along with a few adjustments and way of life suggestions. She had medical tests before seeing him and after about two years of macrobiotic practice. The latter tests showed that her bones had remineralized. They were at about 90 percent of maximum density.
There is no need for someone to suffer fractures or have their teeth removed, even if they are told their condition is hopeless. But, it is important to take cooking classes and refine your personal practice of macrobiotics. If you are eating grains and vegetables, but consuming too many baked flour products such as cookies, cakes, crackers, and hard bread, or too much fruit, fruit juices, tofu cream pies, and amasake, you may not be successful. And even one donut or sugar-sweetened dessert per week can have a harmful effect on the teeth and bones. If you misuse salt by not cooking it into the foods or if you overuse salt, pickles, and condiments, you won't be able to stay away from sweets. But if you take care day-by-day then you can have a long, happy life - free from osteoporosis.
Six years ago a dentist looked at my x-rays and shook his head. He said I had to have full upper and lower dentures. None of my teeth could be saved. Fortunately, I didn't have the $3,000 he wanted for dentures and I wasn't persuaded by such extreme measures. By the time I could afford dentures, my understanding of my condition had improved somewhat. Then recently, in a busy period during a cold Becket winter, I became too yang and balanced that condition with lots of barley malt-kuzu drinks and amasake, which loosened one of my front teeth. I panicked and sought the opinion of several dentists. The third time I heard the same story - that my teeth couldn't be saved; I had no supporting bone - I gave in and had a number of upper teeth pulled. It was a traumatic experience which proved to me how very precious our natural teeth are. After deep self-reflection and a return to more balanced eating, I realized it was totally unnecessary to have had them pulled. Time, patience, and a few adjustments in my way of eating would have won out. I have stubbornly retained all of the teeth in my lower jaw and the remaining upper teeth even though the years following the initial diagnosis were the post-menopausal years during which I was at greatest risk for increased bone loss.
Osteoporosis is a silent threat only for those who don't understand the order of the universe or who refuse to live in harmony with it. For those who understand yin and yang, maintaining healthy bones and teeth may not be "a piece of cake," but it may be as simple as avoiding one.
End of Article
Author bio-statement: Gale Jack is a macrobiotic teacher, shiatsu practioner, and the author of Promenade Home: Macrobiotics and Women's Health and the forthcoming cookbook, Amber Waves of Grain. She lives in Hinsdale, Massachusetts with her husband, Alex and their daughter.
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