BRAIN-BUILDING, PREVENTING OSTEOPOROSIS, WHAT CARDIOLOGISTS DO FOR HEART HEALTH… AND THE NEW CANADIAN EATING GUIDELINES

I was at a boxing day party of cardiologists this year, many of whom had come straight from the local hospital where they’d been treating Christmas day heart attacks as well as looking after the usual heart-diseased in-patients. I noticed (glumly) that none of the cardiologists were drinking or snatching at the canapes, so I did some sleuthing. After briskly working the room asking for a new year’s resolution that could improve the health of all of us, this is it:

1. Eat less
2. Drink less alcohol
3. Exercise more

Simple stuff. And all of the cardiologists I chatted to exercised regularly – and to a breathless degree. If you watched Michael Mosley (Trust Me I’m a Doctor) on Wednesday night, you’ll have seen how walking, and particularly fast walking, reduces fat, lowers blood pressure and raises mood.

We already know that exercise can improve how the blood vessels in our brains work, keeping our brains in tip-top shape. But a study last week found that any exercise that makes you a bit breathless increases the amount of grey matter (the dense clumps of cells) in our brains. The volume of our grey matter mirrors our ability to do certain types of brainwork, including focussing and recalling. Studies have found that musicians who’ve been accumulating knowledge for years typically have more grey matter. A decline in grey matter is also associated with dementia and general ageing.

This study involved more than 2000 Germans (over a fifteen year period) and found that ‘peak oxygen uptake’ correlated with ‘increased grey matter volume’. The neurologist author noted that enlarging grey matter using vigorous exercise was as effective for older people as it was for mid-lifers. Whatever your age, keep exercising and pushing yourself just that little bit further. Take it slowly and check with your GP if you’re not used to exercising.

So this year I’ll be continuing my practice of walking everywhere, as fast as I can. I’ll be avoiding urban walking on pollution-heavy days: a study led by the Barcelona Institute for Global Health and published last week showed a clear link between air pollution and poor bone health. It follows a 2017 study that found exposure to air pollution led to a loss of bone mineral density and a greater risk of fractures. Even very small increases in PM 2.5 (the tiniest particles of pollution) resulted in a greater number of bone fractures in older adults. Researchers aren’t sure why this happens but think that ‘inhaling polluted air could lead to bone mass loss through oxidative stress and inflammation.’ Others speculate that pollution affects our production of Vitamin D. The 2017 study, however, found people living in polluted areas had lower levels of parathyroid hormone, a hormone that regulates calcium levels in our blood, raising it when it becomes too low.

I was diagnosed with osteopenia last year, rather to my surprise. Osteopenia is the precursor to osteoporosis but – with the right sort of exercise and diet – it can be halted in its tracks. Having osteopenia (early bone thinning) doesn’t mean you’ll develop osteoporosis. But it does mean you need to avoid those things that contribute to bone thinning and embrace those things that prevent it. For me the diagnosis was a wake-up call – I need to do more for my bones. The prospect of breaking a bone whenever I hug a grandchild or trip on a kerb isn’t hugely appealing.

Professor Baccarelli, who led the 2017 study, found that Vitamin B can diminish the effects of pollution-induced heart disease as well as pollution-induced epigenetic damage to DNA. He doesn’t know if the benefits of Vitamin B extend to osteoporosis, but I’m eating a diet rich in B vitamins just to be sure. And I’m making sure I get plenty of calcium. I’m not a fan of supplements (studies suggest food is a much better source of vitamins) but we’ll be digging into the latest data on B and calcium supplements, just to be sure. Watch this space. In the meantime Vitamin D helps our bodies absorb calcium, so I’ll continue taking a daily D supplement.

I’ve also ordered a pollution mask. Just for those days when I have to walk or sit in slow-moving traffic. I’m not sure if I’ll wear it (I find them rather terrifying, but perhaps in the future we’ll all wear them, as they do in Chinese mega cities) but I’ll keep it in my bag. Just in case. The latest masks filter almost 100% of PM2.5. More to follow once I’ve trialled it.

Because of my osteopenia diagnosis I’ve added running and jumping to my exercise programme. If you’ve read our book or come to one of our masterclasses, you’ll know that jumping is a favourite activity of Susan. You’ll also need to do a little strength or resistance training. 10 minutes a day of weight lifting or working with your own body weight (squats, planks, lunges) is all that’s needed.

Yes, it’s a bit of effort and sacrifice, but osteoporosis is the most common reason for broken bones in the elderly, and the risk of death after a fracture rises by 20%. Only 40% of those who’ve had fractures regain their independence. Many of those live with a much greater level of fear in their lives. Fear of falling leads to a fear of moving. And once you stop moving… well, we know what happens then. Health deteriorates. Life shrinks. Besides, who wants to live with fear?

Quick reminder – the following foods are great sources of Vitamin B: whole grains, meat and fish, eggs and dairy, beans and lentils, nuts and seeds, dark leafy veg, avocados, bananas and citrus fruit.

The following are great sources of calcium: cheese, seeds, sardines and salmon (canned with the bones), yogurt, beans and lentils, almonds.

Note: women over 50 need extra calcium. An extra 20% a day is usually recommended (1,200 mg rather than 1000 mg of calcium).

If you haven’t had a bone density test (ladies) and you’re 50 or over, please ask your GP for a DEXA as a matter of urgency. Knowing I have osteopenia enabled me to make changes to my exercise programme and eating habits that I might not otherwise have made.

To my age-well goals for 2020 I’ve added: I will not get osteoporosis. It’s a powerful motivator.

Finally, pictured above is the new Canadian eating model, the first major update since 2007. Every country has guidelines on how best to eat. And they’re all a bit different. The Canadian guidelines downplay the role of dairy, acknowledging that calcium can be found in tofu, almonds and leafy greens. Note, too, the small quantities of meat. We like this model, but we’re still fans of cheese and yogurt in moderation. Both are good sources of probiotics as well as calcium, magnesium and other nutrients vital for … bone health! Read more about the Canadian food model here.

We’ve also written about bone health here and cheese here. And we’ve lots of recipes for building strong bones, so do have a dig, using the search bar and the word ‘bones’.

Happy new year!

Annabel