WEBVTT
1
00:00:00.318 --> 00:00:30.052
Hey, it's Christy from Lululemon, and I'm here at the office checking out the Shake It Out shorts. These have been my go-tos, and I kind of think of them as a middle ground between a true run short and a more playful, athletic, sporty short. They have all the performance you want for running, so a comfy liner, our lightweight, swift fabric, even a pocket for your keys. But what I really like is the flowy fit and layered hem. It gives it a little bit of volume, a little bit of fun, so they feel as good on a run as they do just at coffee afterwards. You can find the Shake It Out shorts in-store now or online at lululemon.com.
2
00:00:32.617 --> 00:00:59.195
Chevy is called the heartbeat of America for a reason. With SUVs made to move with your rhythm. The versatile Equinox tackles your entire day. The spacious Traverse fits your crew and your whole weekend. And Trax brings style with value you can count on. All infused with tech that has your back. So your drive always hits the right chord. Chevrolet. Together let's drive.
3
00:01:01.135 --> 00:01:29.823
This episode is brought to you by Google Health. Stop chasing someone else's definition of health. What matters is what's healthy for you. Google Health offers a new kind of coach, built with Gemini for effortless tracking, sleep insights, and holistic coaching tailored to you. Visit googlestore.com to learn more and start a new relationship with your health. Requires Google account, Google Health app, internet, and Google Health premium subscription. Features subject to change. Availability and results vary. Not intended for medical purposes. Works independently of Gemini apps. Check responses for accuracy.
4
00:01:30.380 --> 00:01:41.163
Calcium alone. Hmm. Permence fractures? No. The reason why this is dangerous is calcium alone has been shown in big studies to increase the risk of heart attack.
5
00:01:41.399 --> 00:02:04.180
Now, fortunately, not a lot of people are taking it alone anymore because generally you can't say the word calcium without saying the word vitamin D after it. And the good news is it turns out that even like a whiff of vitamin D brings that risk back down to baseline. So I don't think anybody is taking a thousand milligrams of calcium alone. If you are, please don't. But just a little bit of vitamin D. I mean, 400 IU of vitamin D will bring that risk back down to zero.
6
00:02:04.332 --> 00:02:27.333
Walking is enough to build bone. False. We hear people go to their doctor or their doctor says, hey, you should consider taking this drug and calcium and vitamin D and do weight-bearing exercise. I really don't like that term, weight-bearing exercise, because I don't even know what that means. I've got weight on me and I'm bearing it. We're sitting on our tailbone, right? Like, is this a weight-bearing exercise? No.
7
00:02:27.333 --> 00:02:53.742
And so people don't know what that means, and I think they're misled by it. And yes, walking can potentially slow down bone loss. That actually has been shown in research. But will it reverse osteoporosis? Not a chance. Okay. Only thin elderly women are at risk for osteoporosis. Absolutely not. Some people you've worked with, young men with certain risk factors like celiac disease. But honestly, we see a large spectrum right now, especially of certainly thin bones.
8
00:02:53.742 --> 00:03:09.740
frail looking sarcopenic women are at risk, absolutely. But with the obesity epidemic, we're now also seeing this interesting obese women, especially, that also have osteoporosis, even if they haven't lost weight yet. If they have lost weight,
9
00:03:09.740 --> 00:03:25.450
then we're really concerned because rapid weight loss, especially with the advent of GLP-1s and the ability to really be on a restricted calorie diet, we're seeing tremendous loss of bone density and quality. So now we have a whole spectrum of people who you would not think are at risk, they're at risk.
10
00:03:25.552 --> 00:03:52.265
So is it the GLP-1 that's causing the bone loss, or is it the rapid weight loss due to the high dose of the GLP-1 causing the bone loss? Yeah, I hope I said it clearly, which is people on GLP-1s who are severely calorically restricted, right? Because it's not the GLP-1s. In fact, there is philosophy theory that GLP-1s should actually be protective of bone. And there's some recent literature to support that you can at least maintain bone
11
00:03:52.265 --> 00:04:22.252
while you're losing weight on a GLP-1, which is really great news. But if you take especially the larger pharmacologic doses, it's really difficult to eat adequate protein. And so this is where we need to help steer people who are on GLP-1s to avoid that excess lean mass loss. I wanted to make sure we really hit that because the latest crazy fear all over Instagram is, of course, GLP-1s cause bone loss. It's crazy. If your DEXA is normal,
12
00:04:22.353 --> 00:04:43.160
you're safe. No. In fact, over 50% of fragility fractures occur in women without a diagnosis of osteoporosis. In other words, they do not meet the diagnostic criteria on T-score of osteoporosis, and yet they are having fragility fractures. Bone density is just one part of that equation. Wow. How can we...
13
00:04:43.160 --> 00:05:08.287
look at all of it to figure out what if they're at risk then is there a real way to do it it's challenging so this is something that i don't have a clear answer to other than i think that we can look at trajectory of bone density over time if that's all we can measure uh you and i have talked about this before where the ideal time to start measuring density is in early adult life and so depending on your starting point you're going to want to be more proactive about your bone
14
00:05:08.287 --> 00:05:32.131
potentially later. But also, if you're seeing a decline, even from normal bone density, and you're seeing a decline, and you have other risk factors for fracture, let's call it genetics, family history, history of steroid use, these things that are going to degrade bone quality, even without measuring bone quality, which you can kind of do, but even without that, you should be more alert to your increased fracture risk. So those risk factors again, let's go through them.
15
00:05:32.131 --> 00:05:42.998
Yeah, there's a ton. But just off the top of my head, family history is one of the easiest ones to ask, right? Did your mom have a hip fracture? Did your grandmother have a hip fracture? If so, you really need to pay attention.
16
00:05:43.218 --> 00:06:08.868
There are some genetic studies that you can do that are going to show you and really objectify that risk. But ultimately, just ask your family history if you know it. So family history is a huge one. History of fracture is another big one, right? So if you've already had a fragility fracture, you are at high risk of another one. But a fragility fracture versus the other thing. Yeah, let's define it. Yes. If you were in a car accident and you were going 75 miles an hour and you rolled over your car and you had a hip fracture, that's not a fragility fracture.
17
00:06:08.868 --> 00:06:29.742
Fragility fracture is defined as a fracture of, and there's a couple different definitions, but generally it's the hip, it's the pelvis, it's the wrist, it's the upper arm. These are the bones that can fracture with a very minimal mechanism if you are fragile. And that mechanism could be something as simple as turning, you know, literally turning a chair,
18
00:06:29.928 --> 00:06:54.346
and you could actually hear a pop, right? Standing up, reaching over and getting your keys, you break, and then you fall to the ground. That's the most extreme example of a hip fracture from a fragility fracture. But also, a fall from standing height shouldn't break a hip, right? If you were to just trip going over to pick up your bag, you should not break a hip. And if you do, then we need to look deeper at your bone quality. Same thing with the wrist. If you were to, you know,
19
00:06:54.346 --> 00:07:13.381
gently fall over and put your hand down, you should not break a wrist. If you fall down a flight of stairs, different story. And it's not obvious, it's not black and white, but if there's suspicion like, hey, that mechanism didn't really make sense for this injury, that's when we need to be concerned. If you have osteoporosis, drugs are the only solution.
20
00:07:13.837 --> 00:07:30.661
This is something that I used to be actually really aggressive about. I've backed off quite a bit because there is a time and a place for drugs. I'm not anti-drug, but the challenge I see with the drugs is that they are over-prescribed and not because doctors are bad people or they're mean or they wish you poor,
21
00:07:30.661 --> 00:07:47.131
they're over-prescribed because it's the only tool they have. If you go to a doctor in the conventional medical system, they are not a bone health specialist. They're a, potentially, a bone drug specialist, right? Like they only have one tool to help you prevent fracture. So they're going to use that tool if you're at high risk for fracture.
22
00:07:47.131 --> 00:08:16.156
But the drugs have a limited time span in which you can use them. They have some risks. They have some potentially severe risks. But the biggest thing for me is that they don't really work with metabolism of bone. If your goal is to not need a drug ever or in the future, if your goal is to do this naturally, the drugs could potentially work against you. And especially if you're young, and this is one of the things we do is to help people to understand how much bandwidth or runway is another way to say it. How much runway do you have to do this naturally before a fracture?
23
00:08:16.156 --> 00:08:31.968
Obviously, I can't put a number on that, but I'll give you some extreme examples. So if you are 85 and you are in relatively poor health and you have a diagnosis of osteoporosis, let's say you can't really exercise very well, you have limited capacity to change what you eat,
24
00:08:32.137 --> 00:08:56.099
Let's face it, a drug is probably in your best interest. But if you're 45 and you went through an early menopause and you're also diagnosed with osteoporosis simultaneously and that same drug that was offered to the 85 year old is then offered to you at 45, does this make sense? Not a chance. But again, the doctors don't have any other tools. So if you meet criteria at 45, you're still likely to be prescribed that exact same drug.
25
00:08:56.099 --> 00:09:26.086
And so this is when we say, what kind of runway do you have? A 45-year-old woman who is otherwise healthy likely has a very long runway before a fracture. And she can at least give this a trial to see if she can improve her bone density and quality without a pharmaceutical. Which then comes to the can bone loss, because the big myth is bone loss cannot be reversed. Yes. I think this comes mostly from the endocrinology side. There's a paper that I quote from Dr. Lewicki. He's an endocrinologist in, I think, somewhere in New Mexico.
26
00:09:26.457 --> 00:09:53.947
And he's a super smart guy, lots of papers, respect his work. I think the title of this paper is Treated Osteoporosis is Still Osteoporosis. And a lot of doctors will take that to say, we should not say that you can reverse osteoporosis. And I understand his perspective, which is look, if you have diabetes or high blood pressure and we put you on medication for those things and your biomarkers for diabetes normalize, your blood pressure normalizes, but you're treated, you're on medication,
27
00:09:53.947 --> 00:10:11.935
Do you still have those diseases? The answer is, yeah, you do, right? So then with osteoporosis, in theory, this is the same thing. If you have a T-score of negative three and I put you on reclassed this phosphonate drug for osteoporosis, which will reliably increase your bone density, it goes to negative two.
28
00:10:11.935 --> 00:10:33.164
By definition, you don't meet the diagnostic criteria of osteoporosis, but you're treated and your risk factors remain the same. So you should not say that it's reversible under those circumstances. But I love the way that he puts this in this paper because it gives me the opportunity to point out the other side, which is if that person who is obese, diabetic and hypertensive
29
00:10:33.316 --> 00:10:52.958
high blood pressure, figures out what the underlying cause is, changes the way that they eat, the way they sleep, all the things that you talk about, JJ, and their weight comes down, their blood pressure comes down, their blood glucose, their A1C, and their insulin all normalized, and they are not on a medication. Did they reverse their high blood pressure and their diabetes? Yes.
30
00:10:52.958 --> 00:11:13.782
So the same thing is true with osteoporosis. If we can treat that thing, you should be able to see bone loss plateau, bone loss start to go the other direction, you should be able to build bone density and quality assuming you're able to execute on it, and then eventually your T-score will cross over that negative 2.5 line, and by definition you don't have osteoporosis. To me,
31
00:11:13.782 --> 00:11:30.691
that's reversal of osteoporosis. I've had lots of endocrinologists reach out to me and tell me that I'm potentially putting people at risk. But my point is, is that you should be able to improve bone density if you can act on it. You should be able to reduce fracture risk if you can act on it.
32
00:11:30.691 --> 00:11:55.582
And if you can, then I don't think that we need to consider you as still having the disease. Now, are you at risk of it coming back? Of course. Same thing's true with the obese, diabetic, hypertensive patient, right? They were predisposed to it. They are still predisposed to it. But if you continue with the lifestyle intervention, the things that you did to reverse it, then you should be able to continue down that path. Osteoporosis is inevitable with aging.
33
00:11:55.700 --> 00:12:22.852
One of the things I show, and I'll show it in my talk here tomorrow, is this graph of predictable bone loss as we age. And it's predictable, right? You see in both men and women, we peak in late 20s, early 30s, and then there is a predictable decline. You want to put a number on, and it's around 0.5% to 1% per year over the course of a lifespan. Now, women, there's this dip around menopause where you can lose up to 20% of your bone density over the five to seven years after menopause. That's a really big deal.
34
00:12:22.852 --> 00:12:34.715
But I remember looking at this after starting the practice, after seeing reversal over and over again in age ranges from 20s all the way through 80s and realizing, well, wait a minute,
35
00:12:35.035 --> 00:13:02.052
If my patients can reverse their bone loss and we see their bone density increasing without pharmaceuticals, do we really need to accept that bone loss is a mandatory part of aging? I think the answer is no. In fact, I've gone so far as to say that really, if you're losing bone, I think we need to consider that something is wrong, right? Like, why are you losing bone? And then now we look at bone health in a totally different way because we can track it. It's one of the coolest chronic diseases that you can track, right?
36
00:13:02.052 --> 00:13:17.459
It's hard to know what's happening with your heart or with your brain, but with bones, we can look at the metabolism day by day. We can look at imaging over time. So now I say, look, bone health, it actually should be considered a biomarker of longevity. It's a biomarker of healthspan. If you're losing bone, better figure out why.
1
00:00:00.318 --> 00:00:30.052
Hey, it's Christy from Lululemon, and I'm here at the office checking out the Shake It Out shorts. These have been my go-tos, and I kind of think of them as a middle ground between a true run short and a more playful, athletic, sporty short. They have all the performance you want for running, so a comfy liner, our lightweight, swift fabric, even a pocket for your keys. But what I really like is the flowy fit and layered hem. It gives it a little bit of volume, a little bit of fun, so they feel as good on a run as they do just at coffee afterwards. You can find the Shake It Out shorts in-store now or online at lululemon.com.
2
00:00:32.617 --> 00:00:59.195
Chevy is called the heartbeat of America for a reason. With SUVs made to move with your rhythm. The versatile Equinox tackles your entire day. The spacious Traverse fits your crew and your whole weekend. And Trax brings style with value you can count on. All infused with tech that has your back. So your drive always hits the right chord. Chevrolet. Together let's drive.
3
00:01:01.135 --> 00:01:29.823
This episode is brought to you by Google Health. Stop chasing someone else's definition of health. What matters is what's healthy for you. Google Health offers a new kind of coach, built with Gemini for effortless tracking, sleep insights, and holistic coaching tailored to you. Visit googlestore.com to learn more and start a new relationship with your health. Requires Google account, Google Health app, internet, and Google Health premium subscription. Features subject to change. Availability and results vary. Not intended for medical purposes. Works independently of Gemini apps. Check responses for accuracy.
4
00:01:30.380 --> 00:01:41.163
Calcium alone. Hmm. Permence fractures? No. The reason why this is dangerous is calcium alone has been shown in big studies to increase the risk of heart attack.
5
00:01:41.399 --> 00:02:04.180
Now, fortunately, not a lot of people are taking it alone anymore because generally you can't say the word calcium without saying the word vitamin D after it. And the good news is it turns out that even like a whiff of vitamin D brings that risk back down to baseline. So I don't think anybody is taking a thousand milligrams of calcium alone. If you are, please don't. But just a little bit of vitamin D. I mean, 400 IU of vitamin D will bring that risk back down to zero.
6
00:02:04.332 --> 00:02:27.333
Walking is enough to build bone. False. We hear people go to their doctor or their doctor says, hey, you should consider taking this drug and calcium and vitamin D and do weight-bearing exercise. I really don't like that term, weight-bearing exercise, because I don't even know what that means. I've got weight on me and I'm bearing it. We're sitting on our tailbone, right? Like, is this a weight-bearing exercise? No.
7
00:02:27.333 --> 00:02:53.742
And so people don't know what that means, and I think they're misled by it. And yes, walking can potentially slow down bone loss. That actually has been shown in research. But will it reverse osteoporosis? Not a chance. Okay. Only thin elderly women are at risk for osteoporosis. Absolutely not. Some people you've worked with, young men with certain risk factors like celiac disease. But honestly, we see a large spectrum right now, especially of certainly thin bones.
8
00:02:53.742 --> 00:03:09.740
frail looking sarcopenic women are at risk, absolutely. But with the obesity epidemic, we're now also seeing this interesting obese women, especially, that also have osteoporosis, even if they haven't lost weight yet. If they have lost weight,
9
00:03:09.740 --> 00:03:25.450
then we're really concerned because rapid weight loss, especially with the advent of GLP-1s and the ability to really be on a restricted calorie diet, we're seeing tremendous loss of bone density and quality. So now we have a whole spectrum of people who you would not think are at risk, they're at risk.
10
00:03:25.552 --> 00:03:52.265
So is it the GLP-1 that's causing the bone loss, or is it the rapid weight loss due to the high dose of the GLP-1 causing the bone loss? Yeah, I hope I said it clearly, which is people on GLP-1s who are severely calorically restricted, right? Because it's not the GLP-1s. In fact, there is philosophy theory that GLP-1s should actually be protective of bone. And there's some recent literature to support that you can at least maintain bone
11
00:03:52.265 --> 00:04:22.252
while you're losing weight on a GLP-1, which is really great news. But if you take especially the larger pharmacologic doses, it's really difficult to eat adequate protein. And so this is where we need to help steer people who are on GLP-1s to avoid that excess lean mass loss. I wanted to make sure we really hit that because the latest crazy fear all over Instagram is, of course, GLP-1s cause bone loss. It's crazy. If your DEXA is normal,
12
00:04:22.353 --> 00:04:43.160
you're safe. No. In fact, over 50% of fragility fractures occur in women without a diagnosis of osteoporosis. In other words, they do not meet the diagnostic criteria on T-score of osteoporosis, and yet they are having fragility fractures. Bone density is just one part of that equation. Wow. How can we...
13
00:04:43.160 --> 00:05:08.287
look at all of it to figure out what if they're at risk then is there a real way to do it it's challenging so this is something that i don't have a clear answer to other than i think that we can look at trajectory of bone density over time if that's all we can measure uh you and i have talked about this before where the ideal time to start measuring density is in early adult life and so depending on your starting point you're going to want to be more proactive about your bone
14
00:05:08.287 --> 00:05:32.131
potentially later. But also, if you're seeing a decline, even from normal bone density, and you're seeing a decline, and you have other risk factors for fracture, let's call it genetics, family history, history of steroid use, these things that are going to degrade bone quality, even without measuring bone quality, which you can kind of do, but even without that, you should be more alert to your increased fracture risk. So those risk factors again, let's go through them.
15
00:05:32.131 --> 00:05:42.998
Yeah, there's a ton. But just off the top of my head, family history is one of the easiest ones to ask, right? Did your mom have a hip fracture? Did your grandmother have a hip fracture? If so, you really need to pay attention.
16
00:05:43.218 --> 00:06:08.868
There are some genetic studies that you can do that are going to show you and really objectify that risk. But ultimately, just ask your family history if you know it. So family history is a huge one. History of fracture is another big one, right? So if you've already had a fragility fracture, you are at high risk of another one. But a fragility fracture versus the other thing. Yeah, let's define it. Yes. If you were in a car accident and you were going 75 miles an hour and you rolled over your car and you had a hip fracture, that's not a fragility fracture.
17
00:06:08.868 --> 00:06:29.742
Fragility fracture is defined as a fracture of, and there's a couple different definitions, but generally it's the hip, it's the pelvis, it's the wrist, it's the upper arm. These are the bones that can fracture with a very minimal mechanism if you are fragile. And that mechanism could be something as simple as turning, you know, literally turning a chair,
18
00:06:29.928 --> 00:06:54.346
and you could actually hear a pop, right? Standing up, reaching over and getting your keys, you break, and then you fall to the ground. That's the most extreme example of a hip fracture from a fragility fracture. But also, a fall from standing height shouldn't break a hip, right? If you were to just trip going over to pick up your bag, you should not break a hip. And if you do, then we need to look deeper at your bone quality. Same thing with the wrist. If you were to, you know,
19
00:06:54.346 --> 00:07:13.381
gently fall over and put your hand down, you should not break a wrist. If you fall down a flight of stairs, different story. And it's not obvious, it's not black and white, but if there's suspicion like, hey, that mechanism didn't really make sense for this injury, that's when we need to be concerned. If you have osteoporosis, drugs are the only solution.
20
00:07:13.837 --> 00:07:30.661
This is something that I used to be actually really aggressive about. I've backed off quite a bit because there is a time and a place for drugs. I'm not anti-drug, but the challenge I see with the drugs is that they are over-prescribed and not because doctors are bad people or they're mean or they wish you poor,
21
00:07:30.661 --> 00:07:47.131
they're over-prescribed because it's the only tool they have. If you go to a doctor in the conventional medical system, they are not a bone health specialist. They're a, potentially, a bone drug specialist, right? Like they only have one tool to help you prevent fracture. So they're going to use that tool if you're at high risk for fracture.
22
00:07:47.131 --> 00:08:16.156
But the drugs have a limited time span in which you can use them. They have some risks. They have some potentially severe risks. But the biggest thing for me is that they don't really work with metabolism of bone. If your goal is to not need a drug ever or in the future, if your goal is to do this naturally, the drugs could potentially work against you. And especially if you're young, and this is one of the things we do is to help people to understand how much bandwidth or runway is another way to say it. How much runway do you have to do this naturally before a fracture?
23
00:08:16.156 --> 00:08:31.968
Obviously, I can't put a number on that, but I'll give you some extreme examples. So if you are 85 and you are in relatively poor health and you have a diagnosis of osteoporosis, let's say you can't really exercise very well, you have limited capacity to change what you eat,
24
00:08:32.137 --> 00:08:56.099
Let's face it, a drug is probably in your best interest. But if you're 45 and you went through an early menopause and you're also diagnosed with osteoporosis simultaneously and that same drug that was offered to the 85 year old is then offered to you at 45, does this make sense? Not a chance. But again, the doctors don't have any other tools. So if you meet criteria at 45, you're still likely to be prescribed that exact same drug.
25
00:08:56.099 --> 00:09:26.086
And so this is when we say, what kind of runway do you have? A 45-year-old woman who is otherwise healthy likely has a very long runway before a fracture. And she can at least give this a trial to see if she can improve her bone density and quality without a pharmaceutical. Which then comes to the can bone loss, because the big myth is bone loss cannot be reversed. Yes. I think this comes mostly from the endocrinology side. There's a paper that I quote from Dr. Lewicki. He's an endocrinologist in, I think, somewhere in New Mexico.
26
00:09:26.457 --> 00:09:53.947
And he's a super smart guy, lots of papers, respect his work. I think the title of this paper is Treated Osteoporosis is Still Osteoporosis. And a lot of doctors will take that to say, we should not say that you can reverse osteoporosis. And I understand his perspective, which is look, if you have diabetes or high blood pressure and we put you on medication for those things and your biomarkers for diabetes normalize, your blood pressure normalizes, but you're treated, you're on medication,
27
00:09:53.947 --> 00:10:11.935
Do you still have those diseases? The answer is, yeah, you do, right? So then with osteoporosis, in theory, this is the same thing. If you have a T-score of negative three and I put you on reclassed this phosphonate drug for osteoporosis, which will reliably increase your bone density, it goes to negative two.
28
00:10:11.935 --> 00:10:33.164
By definition, you don't meet the diagnostic criteria of osteoporosis, but you're treated and your risk factors remain the same. So you should not say that it's reversible under those circumstances. But I love the way that he puts this in this paper because it gives me the opportunity to point out the other side, which is if that person who is obese, diabetic and hypertensive
29
00:10:33.316 --> 00:10:52.958
high blood pressure, figures out what the underlying cause is, changes the way that they eat, the way they sleep, all the things that you talk about, JJ, and their weight comes down, their blood pressure comes down, their blood glucose, their A1C, and their insulin all normalized, and they are not on a medication. Did they reverse their high blood pressure and their diabetes? Yes.
30
00:10:52.958 --> 00:11:13.782
So the same thing is true with osteoporosis. If we can treat that thing, you should be able to see bone loss plateau, bone loss start to go the other direction, you should be able to build bone density and quality assuming you're able to execute on it, and then eventually your T-score will cross over that negative 2.5 line, and by definition you don't have osteoporosis. To me,
31
00:11:13.782 --> 00:11:30.691
that's reversal of osteoporosis. I've had lots of endocrinologists reach out to me and tell me that I'm potentially putting people at risk. But my point is, is that you should be able to improve bone density if you can act on it. You should be able to reduce fracture risk if you can act on it.
32
00:11:30.691 --> 00:11:55.582
And if you can, then I don't think that we need to consider you as still having the disease. Now, are you at risk of it coming back? Of course. Same thing's true with the obese, diabetic, hypertensive patient, right? They were predisposed to it. They are still predisposed to it. But if you continue with the lifestyle intervention, the things that you did to reverse it, then you should be able to continue down that path. Osteoporosis is inevitable with aging.
33
00:11:55.700 --> 00:12:22.852
One of the things I show, and I'll show it in my talk here tomorrow, is this graph of predictable bone loss as we age. And it's predictable, right? You see in both men and women, we peak in late 20s, early 30s, and then there is a predictable decline. You want to put a number on, and it's around 0.5% to 1% per year over the course of a lifespan. Now, women, there's this dip around menopause where you can lose up to 20% of your bone density over the five to seven years after menopause. That's a really big deal.
34
00:12:22.852 --> 00:12:34.715
But I remember looking at this after starting the practice, after seeing reversal over and over again in age ranges from 20s all the way through 80s and realizing, well, wait a minute,
35
00:12:35.035 --> 00:13:02.052
If my patients can reverse their bone loss and we see their bone density increasing without pharmaceuticals, do we really need to accept that bone loss is a mandatory part of aging? I think the answer is no. In fact, I've gone so far as to say that really, if you're losing bone, I think we need to consider that something is wrong, right? Like, why are you losing bone? And then now we look at bone health in a totally different way because we can track it. It's one of the coolest chronic diseases that you can track, right?
36
00:13:02.052 --> 00:13:17.459
It's hard to know what's happening with your heart or with your brain, but with bones, we can look at the metabolism day by day. We can look at imaging over time. So now I say, look, bone health, it actually should be considered a biomarker of longevity. It's a biomarker of healthspan. If you're losing bone, better figure out why.
