Connecting the dots; The Mediterranean diet, exercise and bone loss

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There are many factors when it comes to bone loss including age, body weight, diet and physical activity. The key to minimizing bone density loss is the inclusion of weight bearing exercises such as lifting weights.

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Photo: Robert Anasch/Unsplash

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by Matt Sheehan
OSF Healthcare

ROCKFORD - There’s always plenty of discussion when it comes to the benefits of diets.

In one recent study in the JAMA Network Open, researchers found the lower-calorie Mediterranean diet combined with exercise, helped older women lose weight with beneficial effects on bone mass density.

The study was completed in hospitals and medical centers across Spain and included more than 900 women who ranged in age from 55 to 75. Half the group was instructed to eat a Mediterranean diet with no calorie restrictions and were not required to exercise. The other half was encouraged to walk for at least 45 minutes a day for six days a week and do strength exercises three days a week. This group saw significant improvement in stronger bones.

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A lack of calcium and vitamin D are also major factors in bone density loss.

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There are many factors when it comes to bone loss including age, body weight, diet and physical activity. Nicole O’Neill, a dietitian with OSF HealthCare, says the Mediterranean diet and exercise can prevent bone loss, if weight bearing exercise, such as lifting weights, is part of the program.

“This was not studied specifically for the Mediterranean diet and bone loss,” she explains. “It was something they found incidentally and then studied it closer. It's not that it's wrong, it's just that it's inconclusive.”

Nicole O’Neill, Dietitian

A lack of calcium and vitamin D are also major factors in bone density loss. “The Mediterranean diet overall limits the amount of dairy, so most people get the majority of their calcium and vitamin D from dairy products,” says O’Neill. “So, say you were doing three glasses of milk a day. If you switched to a Mediterranean diet and dropped down to one glass of milk, you could cause bone loss because you're getting less calcium and vitamin D if you're not careful.”

The typical American standard diet includes plenty of processed foods and lacks in fruits and vegetables.

Key Takeaways:

• A study found the Mediterranean diet combined with exercise may have some positive effect on bone mass density in older women.
• The key is the inclusion of weight bearing exercises such as lifting weights.
• The Mediterranean diet is popular because it promotes fruits and vegetables and fewer processed foods.
• Always consult with your provider before starting any diet.

The Mediterranean diet is popular because it features simple, plant-based cooking, with each meal featuring fruits and vegetables, whole grains, beans and seeds and an emphasis on extra-virgin olive oil. The diet is rich in nutrients that help bone health. Vitamin C from fruits and vegetables can help support bone cells and vitamin K found in spinach can help with bone formation.

“I really do like the Mediterranean diet,” O’Neill says. “There are a lot of pros. The cons are it’s a little fussy. You have to push and pull things around, and you have to be careful to fill in the gaps with foods that are appropriate. If you're not used to having that bigger load of fruits and vegetables and whole grains, that's a lot of fiber that maybe your guts are not used to. So, a slow, incremental approach might be the best way to start.”

Regarding any study, O’Neill says it’s important to read and do your research before coming to any conclusions. Don’t rely on information from the Internet, she adds. You’re likely to get misleading information. Instead, talk to your provider or a dietitian who can interpret the numbers found in the study.

“There are really a lot of moving parts,” O’Neill says. “When you start a new diet, we don't want a crash course. We want it to be sustainable. We want it to be long term, and we want it to be something that fits for you and that makes sense.”

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Diet program showed remarkable weight loss success

SNS - University of Illinois researchers found that flexible, personalized diet plans were crucial for weight loss in a regimen high in protein and fiber. Participants in a 25-month study within a self-directed dietary education program achieved the most success when they devised their own plans.

An ideal addition to your diet if you are trying to lose weight is raw pears because they are high in fiber. An average, medium-sized piece usually contains about 5.5 grams of dietary fiber.

Photo: David Trinks/Unsplash

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At the one-year mark, successful dieters — 41% of participants — had shed 12.9% of their body weight, compared with the remainder of the study sample, which lost slightly more than 2% of their starting weight, according to a paper published in Obesity Science and Practice.

The dieters were enrolled in the Individualized Diet Improvement Program (iDip), which employs data visualization tools and intensive dietary education sessions to enhance participants' understanding of essential nutrients. This approach allows them to create personalized, safe, and effective weight-loss plans, said Manabu T. Nakamura, a professor in Nutrition Science at the University of Illinois Urbana-Champaign and the study's leader.

The main goal of the iDip program is centered around boosting protein and fiber intake while consuming 1,500 calories or less daily.

The iDip team created a one-of-a-kind, two-dimensional quantitative data visualization tool that plots foods’ protein and fiber densities per calorie and provides a target range for each meal. Starting with foods they usually ate, the dieters created an individualized plan, increasing their protein intake to as much as 80 grams and their fiber intake to close to 20 grams daily.

A total of 22 people finished the program, including nine men and 13 women. Most of them were between 30 and 64 years old. They said they had tried to lose weight at least twice before. Many of the participants had other health problems—54% had high cholesterol, 50% had bone or joint issues, and 36% had high blood pressure or sleep problems. Some of them also had suffered from diabetes, liver disease, cancer, or depression.

Throughout the program, participants experienced significant body transformations. They reduced their fat mass from an average of 42.6 kilograms to 35.7 kilograms after 15 months. Additionally, their waistlines shrank by about 7 centimeters after six months and a total of 9 centimeters after 15 months.

Tracking participants' protein and fiber intake, the team identified a strong link between higher consumption of these nutrients and weight loss at three and 12 months.

"Flexibility and personalization are key in creating programs that optimize dieters’ success at losing weight and keeping it off," Nakamura said. "Sustainable dietary change, which varies from person to person, must be achieved to maintain a healthy weight. The iDip approach allows participants to experiment with various dietary iterations, and the knowledge and skills they develop while losing weight serve as the foundation for sustainable maintenance."

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Spillin' the tea; drinking it regularly will help you live longer and healthier

Photo: Andrea Piacquadio/PEXELS

Drinking three or more cups of green tea a day has been proven to maintain and improve cardiovascular health.

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by Matt Sheehan
OSF Healthcare

PEORIA - So, what’s the tea?

You may have heard that tea is good for you, but when walking through the grocery aisle and being confronted by a barrage of options, it can be hard to choose.

Ashley Simper, the manager of dietetic services with OSF HealthCare, has done the research and has some helpful guidance.

Photo provided

Ashley Simper, Manager
Dietetic Services

To start, it’s best to understand the different kinds of teas and where they come from. Simper says black, white, oolong and green tea all come from the Camellia sinensis plant. Herbal teas come from root, stems and flowers of various plants, and they all have different benefits.

What’s the overall healthiest tea?

Overall, Simper says green tea shines above the rest. But diving into the specific benefits of each tea can help people choose what’s right for them.

“Consuming three or more cups of green tea a day leads to the most health benefits when it comes to cardiovascular disease, cancer and the overall risk of mortality,” Simper says. “The research is a little stronger when it comes to promoting heart health. The consumption of three to five cups of green tea a day has also been shown to lower blood pressure, stroke risk, and LDL (bad cholesterol),” Simper says.

Consuming three to five cups of green tea or black tea has also been shown to lower the risk of developing diabetes.

In 2022, a large study in the Annals of Internal Medicine showed that drinking black tea resulted in a modest reduction of overall death. A research team from the National Institutes of Health’s (NIH) National Cancer Institute (NCI) investigated roughly half a million adults, ages 40-60, in the United Kingdom (UK), who enrolled in the UK Biobank study between 2006-2010. The researchers followed participants until 2020 and found a 9-13% lower risk of death among people who drank at least two cups of tea per day than non-tea drinkers.

What makes tea so healthy?

“The compound in tea that leads to these health benefits is polyphenols. Polyphenols are a type of antioxidant, and antioxidants are linked to decreased inflammation and reduced risk of chronic disease,” Simper says. “The highest antioxidant compounds are in the green tea, followed by the oolong, black and then white teas.”

She adds that green tea and white tea contain an amino acid called L-theanine. Amino acids are the “building blocks” of protein, Simper adds.

“L-theanine has been linked to decreased anxiety, improved sleep and boosting mental clarity,” Simper says.

Green tea, high in antioxidants, offers the most health benefits. In beverage or dietary supplement form, it has been linked to improved mental alertness, relieving digestive issues and headaches, and assist with weight loss.

Photo: NipananLifestyle.com/PEXELS

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Cancer: Mixed reviews, additional safety tips

“When it comes to cancer, the research is conflicting. People who drank higher amounts of green tea had a decreased risk of liver, ovarian, lung and breast cancers. But it is important to keep in mind, that if you’re drinking really hot tea, you have a higher risk of esophageal and gastric cancers,” Simper says.

To avoid the tea being scalding hot, Simper recommends allowing the just-boiled water to cool down for an appropriate amount of time before taking a sip.

Tea’s impact on the flu

“In lab and animal studies, they have found an antiviral effect with the consumption of green tea. In Japan, they did a study with kids that showed anywhere from one to five cups of green tea a day lowered the risk of flu,” Simper says. “There was also a study where they gargled green tea in a bottle, green tea extract or black tea extract, and there was a 30% decreased risk of flu.”

How to prepare your tea

As Simper mentioned, scalding hot tea can come with its own risks, more than just burning your mouth. But there are other ways, she says, to make sure you’re receiving the most benefit from drinking tea.

“They recommend boiling your own water and steeping it yourself instead of putting the water in the microwave to heat it up. They found you lose some health benefits if you microwave the water in your tea. Fresh is best, steep your own, and boil your own water. But let it cool down to a comfortable temperature before you consume it. “Freshly brewed tea with minimal additives, especially things like sugar and milk, is the way to go when it comes to adding tea to your daily intake,” Simper adds.

Benefits of herbal teas

Depending on which symptoms you’re dealing with, or health benefit you’re looking for, different herbal teas have different purposes.

Peppermint teas – Helps with upset stomach

Ginger tea – Helps with nausea

Chamomile teas – Can help decrease cardiovascular disease and some cancers. It can also help with premenstrual syndrome and help boost immunity, Simper says.

But what about all the caffeine?

“The caffeine in tea is about half the amount of coffee. You would have to drink eight or more cups of tea a day to get to that highest level we would recommend for caffeine. So, it’s not that much of a risk for people,” Simper points out. “However, if you’re going to start drinking three to five cups of tea a day, and you’re not normally a caffeine consumer, you might notice the effects of the caffeine.”

Connection to weight loss

If you’re looking to tea for weight loss, you might be waiting for some time, Simper says. She says the research is conflicting, and weight loss is minimal due to drinking tea. However, switching out caffeinated tea for sodas and coffees filled with sugar would be the healthier choice.

Commentary |Your body already has a built-in weight loss system that works

Photo: Annushka Ahuja/PEXELS

Christopher Damman
Associate Professor of Gastroenterology School of Medicine

Wegovy, Ozempic and Mounjaro are weight loss and diabetes drugs that have made quite a splash in health news. They target regulatory pathways involved in both obesity and diabetes and are widely considered breakthroughs for weight loss and blood sugar control.

But do these drugs point toward a root cause of metabolic disease? What inspired their development in the first place?

It turns out your body produces natural versions of these drugs – also known as incretin hormones – in your gut. It may not be surprising that nutrients in food help regulate these hormones. But it may intrigue you to know that the trillions of microbes in your gut are key for orchestrating this process.

I am a gastroenterologist at the University of Washington who studies how food and your gut microbiome affect health and disease. Here’s an inside-out perspective on the role natural gut hormones and healthy food play in metabolism and weight loss.

A broken gut

Specialized bacteria in your lower gut take the components of food you can’t digest like fiber and polyphenols – the elements of plants that are removed in many processed foods – and transforms them into molecules that stimulate hormones to control your appetite and metabolism. These include GLP-1, a natural version of Wegovy and Ozempic.

GLP-1 and other hormones like PYY help regulate blood sugar through the pancreas. They also tell your brain that you’ve had enough to eat and your stomach and intestines to slow the movement of food along the digestive tract to allow for digestion. This system even has a name: the colonic brake.

Prior to modern processed foods, metabolic regulatory pathways were under the direction of a diverse healthy gut microbiome that used these hormones to naturally regulate your metabolism and appetite. However, food processing, aimed at improving shelf stability and enhancing taste, removes the bioactive molecules like fiber and polyphenols that help regulate this system.

Removal of these key food components and the resulting decrease in gut microbiome diversity may be an important factor contributing to the rise in obesity and diabetes.

A short track to metabolic health

Wegovy and Ozempic reinvigorate the colonic brake downstream of food and microbes with molecules similar to GLP-1. Researchers have demonstrated their effectiveness at weight loss and blood sugar control.

Mounjaro has gone a step further and combined GLP-1 with a second hormone analogue derived from the upper gut called GIP, and studies are showing this combination therapy to be even more effective at promoting weight loss than GLP-1-only therapies like Wegovy and Ozempic.

These drugs complement other measures like gastric bypass surgery that are used in the most extreme cases of metabolic disease. These surgeries may in part work much like Wegovy and Ozempic by bypassing digestion in segments of the gastrointestinal tract and bathing your gut microbes in less digested food. This awakens the microbes to stimulate your gut cells to produce GLP-1 and PYY, effectively regulating appetite and metabolism.

Many patients have seen significant improvements to not only their weight and blood glucose but also reductions in important cardiovascular outcomes like strokes and heart attacks. Medical guidelines support the use of new incretin-based medications like Wegovy, Ozempic and Mounjaro to manage the interrelated metabolic conditions of diabetes, obesity and cardiovascular disease.

Considering the effects incretin-based medications have on the brain and cravings, medical researchers are also evaluating their potential to treat nonmetabolic conditions like alcohol abuse, drug addiction and depression.

A near-magic bullet – for the right folks

Despite the success and prospect of these drugs to help populations that may benefit most from them, current prescribing practices have raised some questions. Should people who are only a little overweight use these drugs? What are the risks of prescribing these drugs to children and adolescents for lifelong weight management?

While incretin-based therapies seem close to magic bullets, they are not without gastrointestinal side effects like nausea, vomiting, diarrhea and constipation. These symptoms are related to how the drugs work to slow the gastrointestinal tract. Other more severe, but rare, side effects include pancreatitis and irreversible gastroparesis, or inflammation of the pancreas and stomach paralysis.

These drugs can also lead to a loss of healthy lean muscle mass in addition to fat, particularly in the absence of exercise. Significant weight gain after stopping the drugs raises further questions about long-term effects and whether it’s possible to transition back to using only lifestyle measures to manage weight.

All roads lead to lifestyle

Despite our greatest aspirations for quick fixes, it’s very possible that a healthy lifestyle remains the most important way to manage metabolic disease and overall health. This includes regular exercise, stress management, sleep, getting outdoors and a balanced diet.

For the majority of the population who don’t yet have obesity or diabetes, restarting the gut’s built-in appetite and metabolism control by reintroducing whole foods and awaking the gut microbiome may be the best approach to promote healthy metabolism.

Adding minimally processed foods back to your diet, and specifically those replete in fiber and polyphenols like flavonoids and carotenoids, can play an important and complementary role to help address the epidemic of obesity and metabolic disease at one of its deepest roots.

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Christopher Damman, Associate Professor of Gastroenterology, School of Medicine, University of Washington

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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