Osteoporosis: a Post-Vegan Perspective by David Rainoshek, M.A

OSTEOPOROSIS: A POST-VEGAN PERSPECTIVE BY DAVID RAINOSHEK, M.A.

This file answers the question, “Does a diet with meat or other animal products necessarily contribute to Osteoporosis?” After 17 years of a plant-based diet, an M.A. in Vegan/Live Food Nutrition, and years of plant-based research and advocacy, the answer came as a surprise.

Table of Contents: Osteoporosis: A Post-Vegan Perspective by David Rainoshek, M.A.

See also: Vitamin K-2 Zinc Magnesium Silica Sodium Bicarbonate

Books: Nutrition and Physical Degeneration by Weston A. Price Conscious Eating by Dr. Gabriel Cousens, M.D.

Articles:

Websites:

Audio/Video:

Publications:

Organizations: The Weston A. Price Foundation The Tree of Life Rejuvenation Center

People: Dr. Weston A. Price Dr. Joseph Mercola Dr. Gabriel Cousens, M.D.

Integral Nutrition: An Integrated Diet and Lifestyle Prevents Osteoporosis

Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 1

Conventional: “Take calcium supplements, and take our osteoporosis drugs.”

Terms:

OSTEOPOROSIS: A POST-VEGAN PERSPECTIVE Source: David Rainoshek, M.A., www.JuiceFeasting.com

Main Contributing Factors to Osteoporosis

After reviewing all the research, I would suggest there are just a three main factors categories in determining whether you are actively encouraging, or discouraging Osteoporosis:

1. Nutrient Density of Your Balanced Diet. If your diet is highly processed, high in sugar, excessively high in protein (animal or plant), or low essential fats such as DHA and EPA, or low in Vitamin K2 (from animal sources or supplemented) you will predispose yourself to low Bone Mineral Density (BMD).

2. Acid-Alkaline Balance in Your Diet. Diets and lifestyles that do not provide alkalinizing minerals will cause the body to go to the bones for acid buffers, thus decreasing Bone Mineral Density because the bones have been robbed. A high-protein diet (plant or animal), a high sugar diet, smoking, alcholism, colas with phosphoric acid, excessive use of wheat or soy… all contribute to an acid condition in the body and can create osteoporosis if left unchecked. Your nutrient-dense diet should have plenty of alkalinizing foods (think organic vegetables) coming in.

3. Activity Level. Exercise is great for building and maintaining Bone Mineral Density, due to the pressure put on the bones, which tells them to build up. Astronauts have always had the challenge of losing bone mass in low gravity environments for this reason. You need to know when to be inactive, as well: get a good night’s sleep. Lack of regular and sufficient sleep upsets biorhythms, hormone balance, bodily repair and building work (including bones), and sends your acid-alkaline balance towards acid – not good for bone health.

The longer list of contributing factors to Osteoporosis is as follows:

+ Age / Aging + Sedentary Lifestyle + Smoking Tobacco + Alcohol (excessive) + High Blood Sugar + High-Sugar Diet + Colas (with phosphoric acid content) + Processed Food, Low Mineral Density Diet + High Stress + Lack of Sleep

Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 2 Notice I did not put on there the eating of animal products… I do not consider animal products necessarily a contributing factor to Osteoporosis… but I used to, based on data received through the lens of the Vegan Narrative.

The Vegetarian, Vegan, and Raw/Vegan Perspective

The plant-based perspective is that eating a diet with animal meat in it (the hyperbolic phrase is a “meat-centered diet”) contributes to osteoporosis because a diet that includes meat is acid-forming, and thus causes bone degeneration.

The data in many Vegetarian and Vegan books presents it just this way, and uses clinical research to back up their claims. However, the Vegan Narrative (that I used to espouse) misreads most of the data in favor of plant-based diets and against the eating of animal products. The Vegan Narrative does not differentiate between a Standard American Diet (SAD) with conventional animal products and a sedentary lifestyle with alcohol, caffeine, and/or tobacco in high amounts, and an Integrated diet of Whole Foods with organic/local animal products with an active lifestyle largely or completely devoid of tobacco, alcohol, and caffeine.

The difference is HUGE, but the Vegan Narrative promoters make no such distinction – and neither do researchers in clinical settings. Put another way, we are talking about three different places on the Spectrum of Diet, as I describe it: Junk Food – Standard American; Vegetarian – Raw/Live Vegan, and Integrated.

The meat-eating, diet, and lifestyle of the Standard American eater is leagues away from the meat- eating, diet, and lifestyle of someone at an Integrated level of eating. To confuse the two is folly at this point.

I used to parrot the data from such sources such as Diet for a New America by John Robbins, Conscious Eating by my mentor Dr. Gabriel Cousens, and others. But on re-examining the research from outside the Vegan dogma, I have come to learn that the results are not so straightforward as “the fewer animal products, the better for bone health.”

Again, ALL of these osteoporosis studies that investigate compare health-conscious vegans or vegetarians to your average Standard American Diet eater. This means that ALL the data is comparing the bone densities of health-conscious people who would make dietary and lifestyle choices that will be beyond – or far beyond – the average SAD diet eater. This skews the data already. Lifestyle and a diet beyond processed conventional foods is important. None of these studies are done with health-conscious eaters of Whole Foods and animal products vs. health-conscious eaters of all plants.

That being said, let’s now look at the osteoporosis data point by point, with reference to some important data.

Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 3 1. Calcium Intake is NOT IMPORTANT in Rates of Osteoporosis.

This has been borne out by research across the spectrum of dietary advocates and perspectives. Increased calcium intake – be it dietary or supplemental – does not appear to decrease osteoporosis rates.

2. Bone Mass Study: Raw Vegan vs. Omnivorous Eaters

In a study titled, “Low Bone Mass in Subjects on a Long-term Raw Vegetarian Diet,” Dr. Luigi Fontana and his team studied the bone density of Raw Vegans eating the diet for an average 3.5 years, and found that a Raw Vegan Diet LOWERS BONE MASS in Raw Vegans.1

On a seemingly positive note, the research also found that Vegans had lower levels of IGF-1 (which can increase tumor/cancer growth – but not necessarily), lower levels of C-Reactive Protein (CRP is an inflammatory marker), lower leptin (a sign of lower body fat), lower average bodyweight, and higher Vitamin D levels.

These results give credence to my (David Rainoshek, M.A.) contention (after 17 years of plant- based eating, including 6+ years as a Raw/Live Vegan) that a Vegan or Raw/Vegan diet is good in the short-term, but potentially damaging in the long haul. Why?

Deep Features: Bone mass is a deep feature or deep structure of the human body. The Raw Vegans experienced decreased bone mass in their average 3.5 years on the diet. Decreased bone mass is something that occurs over a long period of time, and is not suggestive of good health or proper nutrient assimilation long-term.

Surface Features: The positive results experienced by the Raw Vegans were all surface features of health: lower inflammatory markers, lower bodyweight, higher Vitamin D, etc. These can all be changed in a very short period of time, and given the positive results, suggests that a Raw Vegan diet does benefit some surface health features in the short-term.

The study also showed lower IGF-1 among R/V which has been proven to lower bone mass. Low IGF-1 is taken by Vegan advocates to be a desired outcome at all times, but this is not true. For a healthy individual, IGF-1 is an important growth factor for the whole human physiology, including the bone structure. If you have cancer, that same positive agent will also promote tumor growth. So the value of IGF-1 is situational.

For further research, see the conclusion of the research review, “Veganism and osteoporosis: A review of the current literature,” published in the International Journal of Nursing Practice:2

“Bone mineral density (BMD) of the hip was the most consistently reported statistic in this data set. All studies showed a statistically significant correlation between decreased animal protein ingestion and low BMD in the hip area (P≤0.05). Methodologies used by the

1 Fontana et al. Low Bone Mass in Subjects on a Long-term Raw Vegetarian Diet. Arch Intern Med. 2005; 165:684- 689 2 International Journal of Nursing Practice 2006;12: 302–306 Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 4 researchers for calculating both animal protein intake and BMD of the hip were similar (questionnaires and X-rays, respectively).

This consistency in the results and the methodologies is powerful when considered in light of the varied geographic locations of the studies (Finland, Taiwan and the USA).”

3. The Eskimos and Bone Density: Vegan Proof Against Meat-Eating?

Research shows that Eskimos – who eat a high animal protein diet – have very high rates of osteoporosis, data which is used by Vegan advocates to suggest that animal protein is bad for bone health. Here is an excerpt from Raw/Live Vegan M.D., Dr. Gabriel Cousens in Conscious Eating:

“Eskimos who have a calcium intake of 2000 mg per day, but a high protein intake of 250- 400 grams per day, have a high rate of osteoporosis. The Eskimo diet again points to the fact that a high-protein diet is a more powerful force in causing osteoporosis than a high- calcium diet is in preventing it.”

Here is the research article referenced above:

Mazess RB and Mather WM (1974) Bone mineral content of North Alaskan Eskimos. American Journal Clinical Nutrition 27: 916-925. Online: http://ajcn.nutrition.org/content/27/9/916

But correlation is not causation. A high-meat diet is only one of numerous factors in the lives of Eskimos. Some VERY important context is missing from the research quote above.

Alcoholism is at high rates in the Eskimo populations (see the research monograph, “Alcohol Use Among U.S. Ethnic Minorities”), and alcohol consumption has been proven as a highly causative factor in osteoporosis. Alcoholism is also correlated with other lifestyle choices that would also contribute to osteoporosis (such as lack of sleep, high blood sugar, high sugar diet, and tobacco use, and caffeine use). Eskimos have, prior to and at the time of this data collection, adopted more high-sugar, stimulating western processed foods, which Weston A. Price showed conclusively in his book Nutrition and Physical Degeneration to be bad for teeth and bone health among indigenous populations worldwide.

Therefore, the conclusion that because Eskimos eat a high protein diet, that this must cause osteoporosis is not at all conclusive or dependable. Consider the reported dental health and dental arch health (an indicator of overall bone health) of the Alaskan Eskimos, as reported by Dr. Weston Price in Nutrition and Physical Degeneration:

It might be expected that such wonderfully formed teeth would maintain so high an immunity to dental caries that their proud possessors would never be troubled with tooth decay. This, unfortunately, is not the case, a fact of great significance in evaluating our modern theories of the causes of dental caries. When these adult Eskimos exchange their foods for our modern foods, which we will discuss in Chapter 15, they often have very extensive tooth decay and suffer severely. This is clearly illustrated in Fig. 11, for these Eskimos' teeth had been seriously wrecked by tooth decay. They had been living on modern foods and were typical of a large number who are in contact with the Bering Sea ports. Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 5

One important phase of modern degeneration, namely, change in facial and dental arch form and other physical expressions, is of interest. It is a matter of great significance that the Eskimos who are living in isolated districts and on native foods have produced uniformly broad dental arches and typical Eskimo facial patterns. Even the first generation forsaking that diet and using the modern diet, presents large numbers of individuals with marked changes in facial and dental arch form. In Fig. 12 will be seen four Eskimo girls who are of the first generation following the adoption of modernized foods by their parents. All have deformed dental arches.

Price reports that the Eskimos had healthy teeth and dental arches, while living for generations on a diet of numerous meat sources, year-round. It was processed foods and western dietary options that destroyed their teeth, and created osteoporosis – not meat-eating.

Dietary Protein: Acidification and Bone Loss.

In a recent article on Mercola.com, Dr. Joseph Brasco writes:

“In studies demonstrating a negative effect [of protein intake on bone mass], it has been argued that dietary protein (especially in the form of animal based protein) is a primary source of acid ash, which results in the acidification of urine. In order to buffer the urine and maintain acid-base homeostasis, calcium salts are mobilized from the skeleton, resulting

Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 6 in a net calciuria. Over time, this buffering of endogenous acids may contribute to a progressive decline in skeletal mass and, ultimately, lead to osteoporosis.”

So what we have here is the possibility that eating meat can or may over-acidify the body, causing the bones to be leached of alkaline nutrients to balance the acid-forming effects of the meat. But whether this happens or not depends on the overall diet, and a diet with animal products in it is not necessarily acid-forming on the whole.

The measure of the acid load is called the Potential Renal Acid Load (PRAL). Consider again Dr. Brasco’s comments in the Mercola.com article:

However, grain products, legumes and dairy products (especially hard cheeses) also increased PRAL. In fact , according to Remer's data brown rice had a greater PRAL than any of the meat products examined (with the exception of canned corned beef - if you want to call that meat).

Total Dietary PRAL (and thus a diminished burden on bone density) can be reduced in numerous ways without removing healthy animal products from the diet. Try removing brown rice, excessive cheese, and increase the eating of alkaline-forming foods such as Green Vegetable Juice and plenty of fresh fruits and vegetables. One of the reasons we see the Eskimos having a hard time with osteoporosis is a lack of sufficient alkaline-forming foods… they have done well over the years according to Price’s research, but once the acid-forming nutrient-poor, high-sugar westernized foods came to their shores, the delicate balance was tipped in favor of acidification and bone loss.

Adequate hydration is also crucial to maintaining proper acid/alkaline balance and lowering the renal acid load. Drink your Quart of Morning Water with Lemon, and do Green Vegetable Juice with celery as a base for the juice.

If you suspect long-term over acidification, consider Sodium Bicarbonate (Arm and Hammer Baking Soda) in water. For instructions on that, see the work of Dr. Mark Sircus: http://sodiumbicarbonate.imva.info/

4. Vegan / Non-Vegan Children: Dental Health and Bone Structure.

Raw Vegan and Vegan children have been observed to have poorer dental health and lighter bone structure than their Vegetarian and omnivorous counterparts. This is corroborated by the Weston A. Price research in Nutrition and Physical Degeneration, and also discussed in detail in an article by long- term Raw Vegan, Shazzie in a must-read article, here:

Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 7 http://shazzie.com/life/articles/raw_vegan_children.shtml

Note the following take-home quotes from her article:

In fact, I've scoured the world and asked and asked. And this is the truth: no-one has yet come forward with a child who has been raised 100% raw vegan unsupplemented who is the correct weight and height for their age and is beyond breastfeeding years.

The truth is, though I'd love to see it, I have never once seen a 100% raw 100% vegan 100% unsupplemented child beyond breastfeeding age who has no tooth decay and is the correct weight and height for their age. Not one. Ever.

On the other hand, I have, since 2001 seen countless raw vegan unsupplemented children spanning several countries (including the USA) with growth, teeth and mental disorders. Now, don't ask, because I will not name names, ever.

My heart has wept when I've received letters from mothers who "just couldn't raise their children raw vegan", no matter how much they wanted to, even though they followed the advice of "experts" to the letter. And I've been puzzled as to why the raw food community covers these issues up time and time again. "Is it just me"? I've often wondered?

But it isn't just me, as the letters I've recently received tell me. It is a cover up, or at least it was.

I (David Rainoshek) have also known many Vegan or Raw Vegan children who were on the light side, and more concerning, had incredibly poor dental health. Vegetarian kids fared better, followed by children eating Whole Foods, Omnivorous Organic diets.

Part of this has to do with the presence (or not) of Vitamin K-2 in the diet.

5. Vitamin K-1 (Plants), Vitamin K-2 (Animals), and Bone Health.

Levels of dietary Vitamin K-2 intake are almost non-existent in Raw Vegan and Vegan diets. The only significant Vegan source is Natto, and few plant-based eaters know about Natto, can access it, or are willing to eat it. Raw/Vegan and Vegan eaters must convert plant-sourced K-1 into K-2, and humans are notoriously poor in this conversion process. Vitamin K-2 is critical for bone formation, bone density, and teeth density and integrity.

Again, here is Shazzie from her article referenced above:

I researched Evie's Kitchen for about four years. It took me a long time to work out this small but hugely important missing link in vegan bone health. I've not seen it in any other vegan literature ever in my life. Vitamin K1 is abundant in leafy greens. As raw vegans who eat lots of greens and green juices, we get plenty. We then synthesise vitamin K2 in the gut from vitamin K1. This is the element that works with vitamins A and D to help bone minerals deposit themselves in the right place. If there's not enough vitamins A, D or K2, then bone and tooth problems will occur. It doesn't matter if you take in tonnes of minerals, if you don't have the fat soluble vitamins to help them find their homes, they won't work at all. Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 8 Animals are very good at converting vitamin K1 to K2. Humans are very bad at it, and it appears our daily upper limit of conversion is less than the amount we need for good bone health. It's abundant in the milk and organ meat of grass-fed animals. This is why goat's milk works, even though it's not natural to take the milk of another animal. Though vitamin K2 is a fat soluble vitamin, it's not stored for more than a few days in the body, so we need regular small amounts of vitamin K2 for perfect bone health. We can either choose to have it from animal products or as a supplement. If we don't have it, we will not remain in optimal health. If growing children don't have it, they won't grow correctly. A breastfed child will get it from the mother (from what she's eaten, taken as a supplement or converted). If the mother doesn't replace what the child takes, her teeth and bones may suffer. When the child stops breastfeeding s/he needs to get K2 from elsewhere. I've been giving Evie Ortho Bone Vegan (which contains K2) for a long time, long before I understood the importance of vitamin K2. I'm so thankful of that. Her health and size are perfect.

The variety of Vitamin K-2 that most (smart) Vegans are supplementing is called MK-7. Ortho Bone Vegan is great for kids, as Shazzie says above. We have been feeding our daughter, Sophia, Carlson’s Fish Oil, grass-fed butter and goat’s milk, and also this:

Many Vegan (or former Vegan) parents have reported Green Pasture’s Butter Oil with Fermented Cod Liver Oil to have turned the dental health of their children around completely. We did not wait for a turnaround, but began feeding this to Sophia at 6-12 months of age. (We eat it, too ☺)

6. Osteoporosis and MEN: Omnivorous vs. Vegan.

No Statistical Difference has been found in studies comparing meat-eating and Vegan men.

Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 9 A frequently cited study by Vegan advocates is “Bone mineral mass in adult lacto-ovo-vegetarian and omnivorous males” by Alice G. Marsh et. al.3 out of the American Journal of Clinical Nutrition in 1983, which compared the bone density profile of Seventh-Day Adventist Lacto-Ovo-Vegetarian men, and Omnivorous men.

Here is a direct quote from the study conclusions:

There it is. No significant differences. Actually, there were minute differences. The Omnivorous men lost 7% bone mass, the Seventh-Day Adventist Lacto-Ovo-Vegetarian men lost 3%. This is a 4% difference, and not a statistical difference.

But it gets more interesting… the Lacto-Ovo Vegetarian men were Seventh-Day Adventists. They did not smoke, drink alcohol, or drink caffeine. See the excerpt from the study for yourself:

These are ALL contributing factors to bone loss the Lacto-Ovo Seventh-Day Adventists did not have weighing against them. They also reported exercising, and the omnivorous men did not. Exercise builds and strengthens bones dramatically.

Given the non-meat related benefits going for the Seventh-Day Adventists Lacto-Ovo Vegetarian Men in the study, I think this erases the measly 4% difference in the results.

It is possible that had the omnivorous men exercised, and abstained from coffee, smoking, and alcohol, and EXERCISED, that they may in fact have scored BETTER than the Lacto-Ovo

3 Marsh AG, Sanchez TV, Chaffee Fl, Mayor GH, and Mickelsen O. (1983) Bone mineral mass in adult lacto-ovo- vegetarians and omnivorous males. American Journal of Clinical Nutrition 37:453-456. Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 10 Vegetarians. I can only imagine that these lifestyle improvements would have given the Omnivorous men in the study a greater than 4% benefit.

The Framingham Osteoporosis Study and Male Bone Mineral Density (BMD)

In 2002, Framingham research (see the study, “Bone mineral density and dietary patterns in older adults: the Framingham Osteoporosis Study). did show that eating more fruits and vegetables is good for bone mineral density in men (it did not matter for women in the study, sadly – we will get to that in the next section). 907 people, aged 69-93 were given food frequency questionnaires, and placed in six main dietary patterns: meat, dairy, and bread; meat and sweet baked products; sweet baked products; alcohol; candy; and fruit, vegetables, and cereal. Bone Mineral Densities were checked, and graphed. Here is what was found:

Men benefited from eating fruits and vegetables. Next in line was the “Meat, dairy, and bread” group. What I surmise from this is that the “fruit and vegetables” group not only has a more alkalinizing diet (it was not a diet devoid of animal products, candy, alcohol, etc.) that is probably also associated with persons who exercise more. The “Meat, dairy, and bread” group is eating a Standard American Diet, and are probably not any more health conscious than the average American.

Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 11 I do not read this data to suggest that if some fruits and vegetable are good, then a diet of ALL fruits and vegetables will be best. Nutrient-density is key, and animal products do provide important bone- building nutrients such as Vitamin K-2, and EPA and DHA, as suggested by the following study:

Protective effects of fish intake and interactive effects of long-chain polyunsaturated fatty acid intakes on hip bone mineral density in older adults: the Framingham Osteoporosis Study

You can read and download (for free) the study for yourself. It showed that for men and women, high fish intake (loaded with the omega-3 fats DHA and EPA) was associated with greater Bone Mineral Density, and may protect against bone loss.

Osteoporosis and WOMEN: Omnivorous and Vegan.

Marsh AG, Sanchez TV, Mickelsen O, Keiser J, and Mayor G. (1980) Cortical bone density of adult lacto-ovo-vegetarian and omnivorous women. Journal of the American Dietetic Association 76: 148- 151.

Sellmeyer DE, Stone KL, Sebastian A, Cummings SR. A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women.

Frassetto JA, Todd KM, Morris C Jr, Sebastian A. Worldwide incidence of hip fracture in elderly women: Relation to consumption of animal and vegetable foods. Journal of Gerontology, Biological Sciences and Medical Sciences 2000; 55A : M585–M592.

Munger RG, Cerhan JR, Chiu BC-H. Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. American Journal of Clinical Nutrition 1999; 69 : 147–152.

Hannan MT, Tucker KL, Dawson-Hughes B, Cupples LA, Felson DT, Kiel DP. Effect of dietary protein on bone loss in elderly men and women: The Framingham Osteoporosis Study. Journal of Bone Mineral Research 2000; 15 : 2504– 2512.

Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 12

Insulin, Leptin, and Building Bone Mass

In Beyond Broccoli, Susan Schenck writes, “High insulin levels also contribute to osteoporosis. By keeping levels of insulin and leptin down, which happens on a low-carb diet that is also not too high in protein, you don’t just prevent bone loss, but you can actually build bone density. According to Dr. Rosedale, no drug, over the counter medication, supplement, or exercise will build new bone mass as dramatically as simply lowering your leptin levels.”4

RISK OF OSTEOPOROSIS Source: Dr. Joseph Brasco, MD http://www.mercola.com/article/carbohydrates/scientific_evidence_low_grains2.htm

Of all the potential negative side effects of dietary protein, the issue of osteoporosis is perhaps the most difficult to resolve. The literature is greatly divided on the topic, and clear recommendations are hard to find. In a recent study, Munger found that the intake of dietary protein, specifically from animal sources was associated with a reduced incidence of hip fractures in postmenopausal women.

In the articles' discussion, a brief review of protein's controversial role in osteoporosis was undertaken. In the studies showing a potential benefit (as in the author's paper), it has been theorized that dietary protein may strengthen bone by its effect on the structure and function of bone-related proteins.

In studies demonstrating a negative effect, it has been argued that dietary protein (especially in the form of animal based protein) is a primary source of acid ash, which results in the acidification of urine. In order to buffer the urine and maintain acid-base homeostasis, calcium salts are mobilized from the skeleton, resulting in a net calciuria. Over time, this buffering of endogenous acids may contribute to a progressive decline in skeletal mass and, ultimately, lead to osteoporosis.

However, Wachman and Bernstein, the two authors who originally postulated this mechanism for osteoporosis, theorized that by increasing the dietary alkaline ash this process could be halted.

In a study by Sebastian., he was able to reduce calicuria and improve overall calcium/phosphorous balance by the administration of potassium bicarbonate as a buffering agent to postmenopausal women consuming an acid promoting diet. The authors suggest that potassium bicarbonate could be administered long-term as a novel means of preventing and treating postmenopausal osteoporosis.

4 Schenck, Susan. Beyond Broccoli, page 92. Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 13 In a 4-year longitudinal study by Tucker, he was able to demonstrate that a greater bone mineral density was associated with increased dietary potassium and magnesium levels, as well as increased consumption of fruits and vegetables. The authors concluded that this positive association was due to the beneficial effects of potassium and magnesium on calcium balance and bone metabolism, as well as the buffering properties of increased alkaline ash in the form of fruits and vegetables.

Given the divergent nature of the theories, it is highly probable that both have merit. With respect to protein's beneficial effects, protein is certainly necessary for proper bone matrix formation and metabolism. It is likely a chronic suboptimal intake will jeopardize this function. One could conjecture that the studies finding a negative association between protein and osteoporosis have somehow highlighted this aspect of the equation. Those studies finding a positive association between protein and osteoporosis are probably looking at the endogenous acid production issue.

In an article by Remer, he calculated the potential renal acid load (PRAL) of frequently consumed foods in order to help dietitians design diets of varying urinary pH. On their list, animal protein sources (as expected) were calculated to increase PRAL.

Perhaps the most ironic of all, was Remer's finding that cheeses had the highest of the calculated PRALs. Parmesan, cheddar, and processed American cheese had PRALs almost 2 times any meat product. In light of Remer's data, the relationship of protein and osteoporosis cannot fully be determined without addressing the total dietary PRAL. The type of protein being consumed (lean meats vs. Processed meats vs. Cheese) and the other foods in the diet are likely to significantly affect the study's outcome.

The protein osteoporosis controversy was addressed in a review article by Spencer. According to the author, numerous studies have been published on the calcium-losing effect of protein. However, several aspects of the study conditions have to be considered in the interpretation of the results.

Some of these are the type of protein, such as purified proteins (which seem not to promote calciuria): the duration of the study (there may be a transient increase in calciuria followed by a normalization or reduction); whether the phosphorous (which has an independent calcium sparing effect) intake remained the same, was increased, or decreased; whether the diets were under strict control or with outpatient volunteers; whether the protein intake was changed from a low to a high protein intake or was changed from a normal to a high protein intake; and whether excessively high protein intakes were used.

All these factors affect urinary calcium excretion during high protein consumption. After reviewing the available data, based on the aforementioned criteria, the authors concluded, "to our knowledge, no convincing data have been published showing that a high protein diet, using complex proteins for prolonged periods of time under strictly controlled dietary conditions, causes calcium loss."

It is quite obvious that the role of dietary protein in calcium homeostasis is complex and multifactorial in nature. However, given the work of Remer, it may actually be the net PRAL of the diet that is most important in influencing the development of osteoporosis, rather than the diet's absolute protein

Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 14 content. Since most of the current low carbohydrate diets encourage the ample consumption of vegetables, this is likely to offset any potential acidifying effects of increased dietary protein.

In fact, given most individuals do not consume enough vegetables and fruits, these diets are likely to promote better acid-base balance then the average American diet. Unlike the more modified low carbohydrate diets, modern ketogenic diets may pose a risk for calciuria since they rely heavily on animal protein, cheeses, and cured meats, and are usually not salt restricted (the Cl ion- not the Nat ion - can also cause a renal acid load and subsequently calciuria).

However, since most people are in ketosis for only a short period of time (after which they are theoretically supposed to transition into a modified low carbohydrate diet), it is unlikely that these diets will significantly contribute to an individual's overall risk for osteoporosis.

DEM BONES: DO HIGH PROTEIN DIETS CAUSE BONE LOSS? Source: Sally Fallon and Mary G. Enig, PhD Online: http://www.westonaprice.org/osteoporosis/dem-bones

Myths & Truths About Osteoporosis

An estimated 15 to 20 million Americans suffer from osteoporosis--thinning of the bones leading to back pain, increased fractures, and frailty, frequently with extensive suffering. One theory proposed to explain its prevalence in the US is a diet that is high in protein, from excessive consumption of meat.

The protein theory was first presented in 19681 and followed up in 1972 with a study comparing bone density of vegetarians and meat eaters.2 Twenty-five British lacto-ovo vegetarians were matched for age and sex with an equal number of omnivores. Bone density, determined by reading X-rays of the third finger metacarpal, was found to be significantly higher in the vegetarians. Two years later, a study on North Alaskan Eskimos reported that bone loss, determined by a technique called direct photon absorptiometry, was significantly greater in Eskimos than in whites, and began at an earlier age.3 Although growth patterns and bone densities in children were similar for both groups, by age 70, Eskimos were found to have bone densities 15% below comparable whites, with Eskimos females at 30% below comparable whites. The authors of the study attribute the decline in bone mass to the high protein diet of the Eskimos, especially its high meat content. Some studies with animals, as well as further studies with humans, given diets high in protein also indicate a greater loss of calcium and thinner bones than controls on low protein regimes.

But the pioneering research of Dr. Weston Price indicates that we should not accept the protein theory without further study. Dr. Price found many groups throughout the world subsisting on high meat diets. Although he did not directly study bone density in these peoples, he did study their teeth. He found that groups on high meat diets--including Alaskan Eskimos--had a high immunity to tooth decay, were sturdy and strong, and virtually free from degenerative disease.

Groups subsisting mainly on plant foods were less robust and had more tooth decay. Pre- Columbian skeletons of American Indians whose diets consisted largely of meat show no osteoporosis, while those of Indians on largely vegetarian diets indicate a high incidence of osteoporosis and other

Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 15 types of bone degeneration. The implication of Dr. Price's research and other anthropoligical studies is that high meat diets protect against osteoporosis. How do we explain this discrepancy?

The research of Dr. Herta Spencer, of the Veterans Administration Hospital in Hines Illinois, supplies us with clues. She notes that the animal and human studies that correlated calcium loss with high protein diets used isolated, fractionated amino acids from milk or eggs.4 Her studies show that when protein is given as meat, subjects do not show any increase in calcium excreted, or any significant change in serum calcium, even over a long period.5 Other investigators found that a high protein intake increased calcium absorption when dietary calcium was adequate or high, but not when calcium intake was a low 500 mg per day.6

The textbooks tell us that the body needs vitamin D for calcium utilization, and vitamin A for both calcium and protein assimilation. Protein given as a powder lacks these fat-soluble co-factorsthat the body can use to build and maintain healthy bones.

Synthetic vitamin D, on the other hand, can cause hypercalcemia, a disturbance of calcium equilibrium leading to excessive blood calcium and calcification of soft tissues.7 Synthetic vitamin D added to commercial milk does not have the same beneficial effect as vitamin D from cod liver oil in preventing rickets and strengthening the bones.

Fats, especially animal fats, also supply usable vitamin K. This nutrient is associated with blood clotting--individuals who lack the ability to use vitamin K suffer from hemophilia and risk uncontrolled bleeding when injured. But Vitamin K also plays an important role in bone metabolism. Vitamin K is more available in dairy fats than in the oils found in green vegetables. Studies indicate that vitamin K is more completely absorbed from vegetables consumed with butter than with vegetables eaten plain.8 Vitamin K is also manufactured by intestinal flora. Use of antibiotics can inhibit vitamin K production, leading to bone loss. Consumption of lacto-fermented foods such as yoghurt and old fashioned sauerkraut promotes the growth of beneficial flora in the intestines, and hence contributes to healthy bones.

Fat soluble vitamin E also plays a role in promoting bone health, by protecting the calcium depositing mechanism from free radical disruption. In a recent study, investigators at Purdue University found that high levels of free radicals from omega-6 linoleic acid (found principally in corn, soy and safflower oils) interfered with bone formation, but that vitamin E gave needed protection in a diet high in polyunsaturates.9 In addition, they found that high levels of saturated fat also gave protection. That's right, the much-maligned saturated fats, found in tropical oils, butter and other animal fats, play an important role in bone modeling. This may be a major reason that population groups in tropical areas, where coconut and palm oils form a major component of the diet, have very little osteoporosis.

Bone loss in women coincides with diminution of estrogen and progesterone at the onset of menopause. But archeological evidence indicates that menopause does not necessarily initiate osteoporosis. Human skeletons of Huguenot women ages fifteen to eighty-nine recently exhumed in London showed little difference in bone density between premenopausal and post menopausal women.10 Once again, the role of animal fats in the diet can explain this contradiction. Vitamin A in animal fats is absolutely essential for the health of the entire glandular system, and hence the continued production of regulating hormones throughout life. Hormone replacement often recommended for the prevention of osteoporosis is not an ideal substitute for the natural hormones

Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 16 produced in properly nourished bodies. Estrogen is also synthesized in the adipose (fat) tissue.11 Perhaps this is why women naturally gain some weight at menopause. The extra body fat supplies them with additional estrogen and protects them from bone loss. Maintaining a svelte figure in middle age, either through weight loss or liposuction, does not necessarily confer health benefits. Very thin women are much more at risk for bone loss than those who allow themselves to enjoy good, wholesome food and become pleasingly plump.12 Many women smoke cigarettes to keep their weight down, a habit that lowers estrogen concentration in the blood stream and inhibits its effects.13

Only a rich, wholesome and varied diet can supply the many nutrients needed for the complex process that maintains the integrity of our bones. Dairy products, vegetables, nuts, meat and old fashioned bone broths supply calcium. Dr. Spencer's research indicates that post-menopausal women need about 1200 mg of calcium per day--400 more that the recommended daily allowance of 800 mg.14 One quart of whole milk, or six ounces of whole natural cheese supply the optimum 1200 mg of calcium. Individuals with a poor tolerance to milk products must take extra care to obtain sufficient dietary calcium. Fish, chicken or beef broth, prepared with a little vinegar to pull calcium from the bones, are excellent sources, and have supplied easily assimilated calcium to pre-industrialized peoples throughout the globe. Leafy green vegetables and grains, nuts and seeds are also good sources if properly prepared. Vegetables and grains should be consumed with animal fats like butter or eggs; and nuts, legumes and grains should be soaked, sprouted or sour leavened to neutralize phytic acid, a substance that can block calcium absorption.15

The "acid-ash" of meat is given as the reason high meat diets cause bone loss. But meats also supply phosphorus, which counteracts this acidity. Phosphorus is needed for the phosphate component of bone matter. Meats are also excellent sources of vitamin B12, which plays a recently discovered but little understood role in maintaining the integrity of the bones.16

Plant foods such as fruits, especially apples, nuts and grains supply boron, needed for the conversion of vitamin D to its active form, and for the formation of estrogen.

Iodine found in natural sea salt, sea foods and butter helps maintain healthy ovaries and thyroid gland, both of which play a role in maintaining bone integrity.

Magnesium, found in whole foods, also contributes to bone health as does natural fluoride, present in hard water as calcium fluoride.

Chromium may also contribute to bone health by normalizing insulin activity. Type I diabetics are prone to osteoporosis. Chromium picolinate has been found to reduce the amount of calcium excreted in the urine and therefore may protect against bone loss.17 Refined carbohydrates such as sugar and white flour can cause chromium deficiency.

But sodium fluoride added to drinking water is one of a number of substances that is harmful to our bones. It causes an apparent increase in bone mass, but the bone structure is abnormal and weak.18 Recent studies indicate that hip fractures are more common in areas where water is fluoridated.19

The late distinguished dentist, Dr. Melvin Page, demonstrated that sugar consumption upsets the natural homeostasis of calcium and phosphorus in the blood. Normally, these minerals exist in a precise ratio of ten to four. Sugar consumption causes serum phosphorus to decrease and calcium to rise.20 The excess serum calcium, which comes from the bones and teeth, cannot be fully utilized

Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 17 because phosphorus levels are too low. It is excreted in the urine or stored in abnormal deposits such as kidney stones and gallstones. Caffeine also upsets the natural balance of calcium and phosphorus, and causes increased calcium to be excreted in the urine. Phosphoric acid in soft drinks is a major cause of calcium deficiency in children and osteoporosis in adults.21 Aluminum from antacids, cans and pollution also contributes to bone loss.22

Osteoporosis is often associated with excess consumption of alcohol.23 This is the likely explanation of bone loss in Eskimos, who are highly prone to alcoholism. The fact that the Eskimo is an obligate carnivore may also explain his susceptibility to both alcoholism and bone loss. Isolated groups like Eskimos and Irish sea coast peoples, whose traditional diet has been rich in marine oils, lack the desaturating enzymes needed to produce very long, highly unsaturated fatty acids needed for prostaglandin production.24 People with arctic or sea coast ancestry would be wise to supplement their diet with cod liver oil, a rich source of very long chain fatty acids needed for virtually every metabolic process.

Even small changes in the native diet of carnivorous populations render them vulnerable to degenerative disease like osteoporosis and alcoholism. A recent article on the Canadian Inuits indicates that commercial foods like jam, white bread and peanut butter have replaced some of the meat in their diet, even while they continue to maintain a traditional lifestyle.25

The 1972 study comparing British vegetarians and omnivores calls for additional comment. Bone density determinations through absorptiometry or X-ray are highly subject to error26, especially in unblinded studies where researchers may be biased towards obtaining pre-determined results. Subjects were matched merely for age, height and sex, but not for body composition and dietary habits such as smoking and sugar, coffee and alcohol consumption. A group of omnivores that smokes, drinks and indulges in a calcium-poor diet of refined carbohydrates will naturally have more of a tendency to bone loss than a group of health-conscious lacto-ovo vegetarians who consume plenty of dairy products. (British vegetarians do, in fact, tend to be very health conscious, avoiding not only meat but also alcohol, cigarettes, coffee and soft drinks. Unlike American vegetarians, they understand the importance of calcium-rich whole dairy products in the diet and eat plentifully of milk, cheese, butter and eggs.) When researchers compare the effects of high-meat diets to normal diets in the same person, no adverse effects are found, even over extended periods of time.27

Individuals who find they do better on high meat diets need not, therefore, worry about osteoporosis, as long as their diet includes complementary animal fats, plenty of calcium and a variety of other properly prepared whole foods.

References

1. A Wachman and D S Bernstein, "Diet and osteoporosis" Lancet 1968 1:958 2. Frey R Ellis, et al, "Incidence of osteoporosis in vegetarians and omnivores" American Journal of Clinical Nutrition, June 1972, 25:555-558 3. Richard B Mazess and Warren Mather, "Bone mineral content of North Alaskan Eskimos" American Journal of Clinical Nutrition, September 1974 2:916-925 4. Herta Spencer and Lois Kramer, "Factors contributing to osteoporosis", Journal of Nutrition, 1986 116:316-319 5. Herta Spencer and Lois Kramer, "Further studies of the effect of a high protein diet as meat on calcium metabolism", American Journal of Clinical Nutrition, June 1983 37 (6):924-929 Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 18 6. HM Linkswiler, et al, "Calcium retention of young adult males as affected by level or protein and of caclcium intake", Trans. N. Y. Acad. Sci, 1974 36:333 7. Judith A DeCava, The Real Truth About Vitamins and Antioxidants, Brentwood Academic Press, Columbus Georgia, pp 102-113. 8. C Vermeer et al, "Role of vitamin K in bone metabolism", Annual Review of Nutrition 1995 15:1- 22 9. BA Watkins et al, "Importance of Vitamin E in Bone Formation and in Chondrocyte Function" Purdue University, W. Lafayette, IN 47907 10. B Lees et al, "Differences in proximal femur bone density over two centuries", Lancet March 1993, 341:673-675 11. M E Nelson, "Hormone and bone mineral status in endurance-trained and sedentary postmenopausal women" Journal of Clinical Endocrinology and Metabolism May 1988, 66(5):927- 933 12. R N Baumgartner et al, "Associations of fat and muscle masses with bone mineral in elderly men and women", American Journal of Clinical Nutrition 1996 63:365 13. National Institute of Health Consensus Conference: "Osteoporosis" Journal of the American Medical Association August 1984 252(6):799-802 14. Herta Spencer and Lois Kramer, "Osteoporosis: Calcium, Fluoride and Aluminum Interactions", Journal of the American College of Nutrition 1985 4:121-128 15. Lindsey H Allen, "Calcium absorption and requirements during the life span", Nutrition News, February 1984 47(1):1-3 16. M E Melton and M L Kochman, "Reversal of severe osteoporosis with vitamin B12 and etidronate therapy in a pateint with pernicious anemia", Metabolism: Clinical & Experimental 1994 43 (4) 468-9 17. McCarthy, Med Hypotheses 1995 45:241-246 18. Yiamouyiannis, John, Fluoride, The Aging Factor, Health Action Press, 1986 19. C Cooper et al, "Water fluoridation and hip fracture", Journal of the American Medical Association, July 1991, 19(32):513-514 20. Melvin E Page, Degeneration, Regeneration 1949. Available from the Price Pottenger Nutrition Foundation, San Diego, CA 21. E Mazariegos-Ramos et al, "Consumption of soft drinks with phosphoric acid as a risk factor for the development of hypocalcemia in children: A case control study", Journal of Pediatrics 1995 126:940-942 22. Herta Spencer and Lois Kramer, "Osteoporosis: Calcium, Fluoride and Aluminum Interactions", Journal of the American College of Nutrition 1985 4:121-128 23. Herta Spencer, et al, "Chronic Alcoholism: Frequently Overlooked Cause of Osteoporosis in Men", The American Journal of Medicine, March 1986 80:393-397 24. D F Horrobin, Reviews in Pure and Applied Pharmacological Sciences Vol 4, 1983 Freund Publishing House 339-383 25. Yvette Cardozo and Bill Hirsch "Northern Exposure: An Inuit Adventure" Relax, January 1996 21- 27 26. Alternative Medicine, The Definitive Guide, Future Medicine Publishing, Inc., Puyallup, Washington, p 776 27. Herta Spencer, et al "Do Protein and Phosphorus Cause Calcium Loss?" American Institute of Nutrition, 1988:657-660

Copyright: © 2000 Sally Fallon and Mary G. Enig. All Rights Reserved. First published in Price-Pottenger Nutrition Foundation quarterly journal, (619) 574-7763. Printed: September 18, 2019 www.JuiceFeasting.com Osteoporosis: A Post-Vegan Perspective 19

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