10 Steps to Great Bones

I just finished reading Dr. R. Keith McCormick’s latest book, Great Bones: Taking Control of Your Osteoporosis. Since joining the “thin bones club,” I’ve read several books on the subject. This latest entry is by far the best. It provides a comprehensive review of the subject matter and associated research in a way that’s accessible to the novice while still whetting the appetite of medical practitioners (and nerds, like me).

If you’re not interested in wading through all the material, you could skip to the final chapter and avail yourself of Dr. McCormick’s 10 steps to great bones.

  1. human skeletonWork with your doctor to get a comprehensive set of labs to see if your current diet and supplements are providing all the nutrients you need to support bone health. They’ll also tell you whether or not your bone remodeling has stayed in balance. Use the reference materials in the book to review your own numbers and take action, as needed.
  2. Create an anabolic body by pursuing a diet high in fruits and vegetables, low in sugars and processed foods, and replete with good, clean water. Add fermented foods to keep the microbiome happy,
  3. Fuel muscles and bones with high quality protein to sustain muscle mass and strength.
  4. Optimize cellular metabolism by eating minimally processed, bioactive foods, and supplementing with bioactive compounds. Plants are loaded with phytochemicals that limit free-radical damage and reduce oxidative stress. Get a rich variety of them by eating produce across all the colors of the rainbow.
  5. Ensure good digestion and bowel heath. Eat slowly; savor as you chew. Get plenty of fiber. Consider HCl supplementation if older and experiencing bloating after meals as HCl decreases with age.
  6. Reduce free radical exposure and oxidative stress to minimize damage to cells and tissues. Eat food rich in antioxidants (fruits and vegetables), consider antioxidant supplementation (e.g., alpha-lipoic acid, NAC, CoQ10, resveratrol, quercetin, vitamin C), limit alcohol consumption, and don’t smoke.
  7. Improve body acid-alkaline balance. The blood serum likes to be slightly alkaline and draws calcium from bones should it become acidic. Diets high in fruits and vegetables with adequate protein generally does the trick.
  8. Watch your salt intake as excess intake increases calcium loss through urine, contributes to low-grade metabolic acidosis, and increases bone resorption.
  9. Do weight bearing exercise and strength training to improve bone health. Areas of weakened bone can only repair if the body is active.
  10. Get adequate sleep. Folks who consistently get only 5 hours of sleep per night tend to have lower bone density. It makes sense. The body needs sleep to rest, restore, and repair. Give it the time it needs to get the job done!

I’ll add an 11th step: Buy the book and read it. You’ll get a clear sense for why all of these recommendations make sense and have a superb reference manual to answer questions as they arrive. As I said earlier, it’s excellent!

A Tearful Good-Bye to Bakie

bakie wardIn the wake of several weeks of declining health, my dear friend Bakie Ward left her earthly body this morning. My heart is breaking.

We met in early 2001 as a group of eight women joined together to read Cheryl Richardson’s Life Makeovers and see where that journey might take us. We called ourselves Chicks in Change (and eventually just Chicks) and met every other week.

From that auspicious beginning, our little book group brought forth treasured friendships that have seen marriages, divorce, and other adventures in romance; graduations, career explorations, and job changes; relocations, road trips, and vicariously enjoyed travels; aging and spirited discussions about health; and, a myriad of joys and sorrows freely shared. These women have been an incalculable blessing in my life.

As I hold Bakie in the light, I feel the warmth of love reflecting back on me. For indeed, Bakie was love incarnate.

  • bakie readingShe loved her family and reveled in all the moments they shared together.
  • She loved her friends – those with whom she shared a life time, those who entered later in life, and those who had the privilege of more recent acquaintance.
  • She loved books and the beauty of language. She dedicated her life to supporting those who enjoy the written word.
  • She loved bridge and was a skilled card player and enthusiastic (and patient) teacher.
  • She loved learning and pursued with enthusiasm anything that piqued her curiosity.
  • She loved life and sustained hope, gratitude, and optimism even when things weren’t rosy.

No doubt the gates of heaven have opened wide to welcome its newest angel.

“But should the angels call for [her],
Much sooner than we’ve planned.
We’ll brave the bitter grief that comes,
And try to understand.”  – Edgar A. Guest

Why I Miss Estrogen

estrogen

As I transitioned into menopause years ago, I was happy to have been relieved of the monthly menstrual cycle and grateful to have experienced relatively minor symptoms. Hot flashes were not fun, but they weren’t all that bad either, especially when maintaining a sense of humor about them. My doctor never raised the possibility of hormone replacement therapy (HRT) based on findings from the Women’s Health Initiative (WHI) which deemed risks (stroke and breast cancer) greater than benefits (bone density).

I’ll confess that I knew very little about estrogen at the time. I was certainly aware that its presence governed my monthly cycles and likely contributed to sustaining a youthful appearance. But I had no sense that its loss would be implicated in my struggle to sustain adequate bone mineral density.

Estrogen stimulates bone building in several ways:

  • It increases the efficacy of Vitamin D in promoting calcium absorption in the intestine and limits calcium loss through urine.
  • It acts as a “switch manager” in the differentiation of mesenchymal stem cells. These cells reside in bone marrow and assume responsibility for production of adipocytes (which specialize in storing fat), cartilage (connective tissue), and osteoblast (bone-building cells). Estrogen tips the scales in favor of osteoblasts.
  • It helps regulate parathyroid activity to ensure the proper levels of calcium, phosphorus, and Vitamin D in the blood.
  • It increases production of Insulin-like Growth Factor 1 (IGF-1) which stimulates growth of all cell types.
  • It lowers sclerostin levels which would otherwise dampen osteoblast activity.

Estrogen also works to keep a lid on bone resorption (a.k.a. demolition) activity. Osteoclasts secrete acid phosphatase to dissolve bone crystals. They trace their origin to hematopoietic (blood-oriented) stem cells located in the bone marrow. These cells can differentiate into red blood cells, immune response cells (T-Cells, dendritic cells, microphages), and osteoclasts. Elevated levels of inflammation and oxidative stress stimulates hematopoietic stem cell activity, which in turn lets loose the bone demolition team. Estrogen tamps this down by:

  • Helping maintain a healthy gut biome and, thereby, reducing the risk of gut permeability. This action ensures proper absorption of essential vitamins and minerals and keeps toxins from entering the blood stream.
  • Calming the immune response by limiting the presence of proinflammatory cytokines (IL-1, IL-6, and TNf-α) and RANKL, a messenger molecule that activates immune cells and osteoclasts.
  • Stimulating mitochondrial production of glutathione, a powerful antioxidant.
  • Minimizing Reactive Oxygen Species (ROS) and oxidative stress.

Beyond the bones, estrogen increases muscle mass and strength, improves the speed of muscle regeneration, protects against muscle damage, increases the collagen content of connective tissue, and decreases stiffness of tendons and ligaments. All of the foregoing promotes an overall level of fitness and reduces risk of injury. It also contributes to a health cholesterol panel by increasing HDL and decreasing LDL.

I wish I’d had the opportunity for a spirited discussion about HRT when I went through menopause. We now know that HRT risks differ depending on type, dose, duration of use, route of administration, timing of initiation, and use of progestogen. According to my naturopath, low dose, transdermal applications of bioidentical hormone carry far less risk than oral ingestion of synthetic hormone. Per the North American Menopause Society, the risk-benefit profile also improves for women within 10 years of menopause onset who have no contraindications for their use. Beyond age 60, the absolute risk of coronary heart disease, stroke, venous thromboembolism, and dementia make such treatment ill-advised.

It’s likely too late for me to do much about the foregone menopausal opportunity. But all is not lost. I simply have to work harder on diet and exercise to maintain a healthy gut biome, minimize inflammation and oxidative stress, and sustain good muscle tone.

A healthy lifestyle always seems to come back to diet and exercise, doesn’t it?

Mindfulness of Thought

I attended my first meditation class in the early 1990s. At the time, I had a high-stakes, high stress job that had me fully absorbed by day and haunted me by night. I kept thinking about work after hours and had a hard time shutting down my brain at bedtime. A friend suggested that I try a meditation class. From what little I knew, I assumed that it would help me clear my mind and get much-needed rest. So, even though it was a hassle to get to the center and one more thing on my busy schedule, I figured it would be worth it.

Walking into the center, I was encouraged by how peaceful it seemed, reinforcing my expectations for a mind-clearing class. I had on my corporate clothes and noticed that pretty much everyone else was dressed casually which planted a seed of: “You’re different. I don’t think you belong here.” It bothered me. I sat in the back and listened attentively to the dharma talk. I liked it. It was interesting.

meditationAs we began the meditation, my mind started darting around all over the place. I could hardly get through a single breath without my attention being drawn away to a random thought. With the teacher’s encouragement, I kept returning to the breath, but I could not hold it there. Far from clearing my mind, it felt as though it was getting busier. At the end of 20 minutes, the hoped-for blank slate looked like a Jackson Pollack painting.

I was confused and mad at myself. How could I be so laser-focused at work in a chaotic environment and yet unable to sustain attention on the simple act of breathing in a calm one? It didn’t help when the feedback period was populated by those who had thoughtful commentary about the dharma talk and a Buddha-like experience of their meditation. I gave myself a failing grade and left discouraged.

I stayed with the for several more weeks but continued to have frustrating experiences with meditation. In the end, I decided that I was bad at meditation and would never get better at it. It was something that other people mastered, not people like me. It took me 20 years before I gave it another go.

I now know that many people share my inaugural meditation experiences, and that there are sound physiological reasons why. When our minds are not occupied with something specific, they tend to engage in introspective activities such as contemplating the past or future, running simulations of prospective activities, and daydreaming. This activity is mediated by a system of connected brain areas known as the Default Mode Network (DMN). It does not go silent when we go silent; it starts thinking!

Experienced meditators have quieter DMNs than inexperienced ones, but they still regularly experience these spontaneously generated introspective thoughts. That being said, even new meditators – with a modicum of training and a real-time bio feedback – can decrease their DMN activity so long as they just let their thoughts be rather than try too hard to shut them up.

With that in mind, I try to be an observer of my thoughts rather than identify myself as the thinker of them during meditation. I treat my thoughts like the ticker tape of the New York Stock Exchange. I watch them stream pass as though I’m just curious and interested, not an engaged investor with money on the line. From that vantage point, here are a few things that I’ve noticed:

  • Sometimes, it’s an active trading day and lots of stuff breezes by. Other days, it’s slow. Either way, I just allow it to be what it is.
  • I don’t feel a sense of ownership over everything in that stream of consciousness. Sometimes I find myself thinking: “Hmmm. I wonder where that thought came from!”
  • Whatever shows up on the ticker tape doesn’t last long when I hold the entire stream lightly. Thoughts only seem to stick when I let them. Otherwise, they just pass by.

Whether engaged in formal or informal mindfulness practice, I remind myself that my thoughts may not be true. A thought is just a thought. It often helps when I add the prefix “I’m having the thought that…” I notice it without getting attached to it or needing to react to it.

We each think thousands of thoughts per day, a high percentage of which are the same thoughts we had the prior day. I bring an interested and compassionate attention to the Top 10 Hits on my internal radio network. It gives me a road map as to where I might make changes in my life to relieve anxiety or simply tune the dial elsewhere. The great thing about the brain – we can quite literally change our minds!

Mindfulness of Emotion

I’ve been thinking lately about how the culture in which I live relates to emotions. A brief look at common idioms tells the tale:

  • Beside oneself (i.e., overcome by emotion)
  • Blowing hot and cold (i.e., vacillating between extremes of emotion)
  • Chewing the scenery (i.e., displaying excessive emotion when performing)
  • Cold fish (i.e., an unemotional or heartless person)
  • In the heat of the moment (i.e., proceeding rashly without due thought)
  • Laying it on thick (i.e., exaggerating emotion)
  • Make a scene (i.e., garners unnecessary attention due to an emotional outburst)
  • Touchy-feely (i.e., driven by emotion or sensitivity)

They don’t cast emotion in a favorable light. Moreover, in my experience of the working world, “being emotional” is not a good thing. The preferred persona shows up as cool-headed, logical, highly skilled, prepared, confident, bullet-proof. It’s a calling to live within the seemingly controlled realm of the head and to distance oneself from messy emotions. But here’s the rub:

  • According to Dr. Bab Shiv, emotions drive choice. Human beings make snap decisions and then process all subsequent data through filters that support these subconsciously rendered assessments. (This mechanism holds true for men and women!)
  • Our moods effect how we experience the world and move within it. A positive (happy) or neutral mood primes us for action; a negative mood primes us for inaction.
  • In Atlas of the Heart, New York Times best-selling author, and highly viewed TED Talker Dr. Brené Brown notes: “If I don’t know and understand who I am and what I need, want, and believe, I can’t share myself with you. I need to be connected to myself, in my own body, and learning what makes me work.”

When Dr. Brown asked 7,500 people to identify the emotions that they could recognize and name as they experienced them, the average person only came up with three – mad, sad, and glad. Rather thin emotional literacy! But why do these three resonate?

Think about a time when you got angry. What did it feel like in your body? Perhaps a tightness in the chest and shoulders? A roiling belly? Did you feel like an Instant Pot that had built up pressure such that if anyone pressed down on the pop-up red button, you’d blow out a lot of steam? What does it feel like in the body to hold all that steam in? To try desperately not to give into anger (or even admit that you’re feeling it)?

Now think about a time when you were sad. How did that feeling show up in the body? An aching in the heart? Perhaps the body drooping forward with the head hanging low, closing in on itself, protecting the sensitive heart? A weariness? Tears forming and awaiting release?

Finally, bring to mind a joyful occasion. I’m remembering a spur of the moment break from studies, going to a comedy club with friends, and finding out that the headliner would be Robin Williams. I don’t think I’ve ever laughed so much! What was happening in my body? Openness. Big smile on my face. Lightness of being. Deep, deep release of built-up tension. Embraced by the warmth of community.

The common denominator: Emotions make their presence known in the body. So, how do we build awareness of our emotions and find healthy ways to make room for all of them?

My go-to practice – in fact my favorite practice – goes by the acronym R.A.I.N. for Recognize, Allow, Investigate, and Nurture. It presents an invitation to pause, connect to what’s happening in the moment, and take a compassionate interest in the interior landscape.

The R of R.A.I.N. invites me to recognize and name the primary emotion that I’m feeling.

The A of R.A.I.N. asks me to let that emotion just be. Not label it right or wrong, good or bad, appropriate or inappropriate. Not judging myself for feeling it or stuffing it in a box and putting it on a shelf. Just saying “YES” to it. This, too, is part of the human experience. And this is what I’m feeling in this moment. The A of R.A.I.N. doesn’t give me license to act unskillfully but simply acknowledge what’s there.

The I of R.A.I.N. invites me to bring an interested and kind attention to the experience. What sensations does it evoke in the body, and where are they located? Are other emotions along for the ride? What stories am I telling myself in this moment?

The N of R.A.I.N. calls for a nurturing response from the wisest and most compassionate part of my being in answer to the question: What is it that I need right now?

While it’s ideal to practice R.A.I.N. in the moment, it works just fine after the fact. After the R.A.I.N., I like to reflect on takeaways from the practice. What new insights about the situation under investigation showed up? What have I learned about myself and the practice?

Although the nurturing aspect of R.A.I.N. suggests its use for challenging emotions, it’s a wonderful practice for examining pleasant sensations – to get a visceral sense of was it feels like to be open and uplifted.

Mindfulness of the Body

The Buddha said: “There is one thing that, when cultivated and regularly practiced, leads to deep spiritual intention, to peace, to mindfulness, and clear comprehension to vision and knowledge, to a happy life here and now, and to the culmination of wisdom and suffering. And what is that one thing? Mindfulness centered on the body.”

When I first heard that reflection, I considered it an odd thing for one of the world’s great spiritual leaders to say. I had always thought becoming more enlightened meant transcending the body and all its messy aches and pains and cravings and limitations. Also, as a devotee of the original Star Trek series, I have it on high authority that the most intelligent alien species have big brains and waif-like bodies if not just brains or pure consciousness itself. [Wink, wink, nudge, nudge.] But it turns out that’s not the case!

mindfulness of the bodyMindfulness is about connecting with the body and bodily sensations, NOT transcending the body. Why? Because we are embodied creatures, and everything that arises is experienced in the body:

  • We engage the world through our five senses.
  • Our emotional states find expression in the body.
  • There’s compelling research – if not our own lived experience – to suggest a strong mind-body connection.
  • And when we are awake in the body, we live life in the here and now – not reflecting on the in the past, not anticipating the future, and not lost in thought or imagination.

For most people, even with an intention to be in the body, the exit door is always open, if not beckoning us to cross over. And there are a lot of good reasons why that happens.

From an evolutionary perspective, we rose to the top of the food chain NOT because we were the biggest and baddest in the jungle but because we developed big brains. We place our trust in its ability to negotiate the environment and help us survive. It provides a sense of control, a feeling we generally do not hold with our bodies. It’s a place of refuge.

We’re attracted to things we find pleasant and averse to things we find painful or unpleasant. So, we’re perfectly fine to inhabit our bodies to enjoy awesome views, delicious food, great sex, and the roar of an appreciative crowd. We’re likely to exit our bodies and the present moment when we feel stressed out, uncomfortable, upset, sad, annoyed. We even exit when the body is in pain – something that you’d think would draw us to the present moment – because we get caught up thinking about the pain and developing narratives about it rather than experiencing it. That rumination causes suffering.

Our culture places a great deal of emphasis on how our bodies look. The US fashion industry is worth hundreds of billions of dollars and provides exemplars of how the most attractive among us should look. Roughly 1.5 million cosmetic surgical procedures are performed annually. The diet and weight loss industry tops $70 billion. If thinking about the body brings up harsh criticism and dissatisfaction, it’s not likely that it will be a comfortable place to inhabit.

And though I marvel at what modern medicine can do – I really do – I think it encourages a view of the body as a machine to be manipulated, controlled, and fixed if broken. It becomes a thing and not a source of being.

The practice of mindfulness of the body entails learning how to increase the range of sensations to which we are able to direct attention and cultivating the ability to name and tap into those sensations at will.

In everyday, mindfulness of the body can be nothing more than a quick check-in. Right now, I notice tension in my back and shoulders. I can take a couple of deep breaths while dropping my shoulders and pausing to relax. In a few minutes, I’ll head to the kitchen for a meal. Rather than mindlessly shoving food in my mouth on the run, I can pay attention to the sights, smells, and taste of what I’m eating and savor the experience.

So, the question becomes – how do we learn to reconnect with our bodies in a way that is helpful and supportive? And how do we do so in a way that is gentle and with interest?

One of my favorite meditations is a mindful body scan. It normally begins by lying down in a comfortable position on the back with arms extended outward at a 45° angle and the legs splayed, using a pillow for support as needed. After spending a few moments connecting to the breath, the practitioner starts at the bottom and works up (or the top of head and working down) and focuses on one body part at a time to notice sensations (or an absence of sensation). Questions to explore in the process include:

  • What’s happening within me?
  • What’s is like right now?
  • Can I let it be?
  • And, can I be with it?

Beyond engendering familiarity with the body, it can be useful as a relaxation technique to relieve stress and anxiety or to prepare the mind and body for sleep. When I have trouble coming into presence during a routine sitting meditation, I often use a body scan to give myself a way to focus my attention. Whether I connect with sensations or not, it generally confers some benefit.

What is Mindfulness?

It occurs to me that I have written a few posts about mindfulness without ever defining what is it. Let me remedy that oversight!

I like using Jon Kabat-Zinn’s definition. He’s the founder of the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School and the progenitor of the highly acclaimed Mindfulness-Based Stress Reduction program. He says:

“Mindfulness is the awareness that arises from paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.” On purpose, present, and non-judgmentally.

I’ll unpack those three things.

ON PURPOSE: At any given moment, our brains sift through an ocean of input:

  • objects of awarenessFrom the five senses (sight, sound, taste, smell, touch)
  • From interior signals (breath, heartbeat, digestion, body temperature, etc.)
  • From feeling states (happy, sad, angry, calm, anxious, excited, etc.)
  • And from mental activities (planning, analyzing, remembering, imagining, ruminating, etc.)

We can’t possibly bring conscious awareness to all of that input, all of the time. So, our amazing brains use a lifetime of experience to process and interpret that raw data. (Where am I? What’s happening? Who am I with? Is there danger or opportunity? And so on…) They decide what will be brought into consciousness awareness, what they’ll store, and what they’ll discard. At root, it’s all about keeping us alive and safe.

Imagine that you are out for a walk in the woods, fully absorbed by an audiobook. If nothing of particular import is happening, you won’t notice all of the perceptual work that your brain is doing. But if there’s danger afoot – say the sound of a rattle – then that sound and the attendant fight-flight-freeze stress response will present a call to action.

Conscious awareness functions like a spotlight that focuses on specific stimuli or state of being. Again, it can be sensory data, an interior signal, a feeling, a thought, an intuition. And it can jump around from one to another, sometimes quite rapidly. Mindfulness teaches us to pay attention to what garners the spotlight – in other words, to notice what we’re noticing – to help make choices about where and how to focus attention, and to give us the freedom to interpret that input with interest, curiosity, and compassion.

IN THE PRESENT MOMENT: Human beings spend quite a bit of time with our brains disconnected from what’s happening in the moment. We think about things that transpired in the past or might happen in the future. We image circumstances and run simulations for events that may never come to pass. And we escape into our imaginations.

Harvard psychologists Matthew A. Killingsworth and Daniel T. Gilbert measured this phenomenon using a special “track your happiness” iPhone app. They gathered data from 2,250 subject of varying ages on their thoughts, feelings, actions, and happiness as they went about their daily business. On average, mind-wandering consumed 46.7% of their time, and the more their minds wandered, the less happy they were. Further analysis revealed that the subjects’ mind-wandering was generally the cause, not the consequence, of their unhappiness.[1]

If, like me, you are interested in being more content, mindfulness can help us notice when our minds go adrift and invite us to come home to the present moment.

NONJUDGMENTALLY: As noted before, our brains process lots of data, rendering assessments about what is crucial vs. trivial, good vs. bad, friendly vs, hostile, healthy vs. unhealthy, and so on. Of necessity, they are rather judgy. And that characteristic carries over into conscious awareness.

Mindfulness encourages us to notice our judgments while remaining curious, open, and accepting – not to put us in harm’s way, but to provide the means to think, speak, and act wisely.

Mindfulness can be practiced informally as we go about our day-to-day activities or formally through meditation. The latter develops our “noticing,” “now,” and “nonjudgmental” muscles. We learn to pay attention to what arises and put out the welcome mat for the experience. And we train ourselves to bring into consciousness a whole gaggle of thoughts, feelings, and sensations that might otherwise habitually fall beneath our radar.

[1] Steve Bradt, Wandering Mind Not a Happy Mind, The Harvard Gazette, November 11, 2010 (See https://news.harvard.edu/gazette/story/2010/11/wandering-mind-not-a-happy-mind/)

What Dr. Greger Says About Osteoporosis

I regularly avail myself of the short videos available on Dr. Michael Greger’s website nutritionfacts.org. His group of researchers scour and vet peer-reviewed scientific journals to present best evidence on a variety of health-related topics. A recent series on osteoporosis caught my attention. Here are high-level findings that I gleaned from it:

thin boneWeak bones do not present issues in the absence of excessive load caused by a fall or heavy lifting. They generally don’t break in the course of normal life activities. Only 15% of bone fractures can be tied to osteoporosis in women. Roughly 40% of hip fractures are due to impaired balance. Not surprisingly, hip fracture risk increases 13-fold between the ages of 60 and 80 when muscle weakness and loss of balance tends to become commonplace.

The best advice for preventing hip fracture: Don’t fall. Keep things within easy reach; avoid using step stools. Use non-stick mats in the bathroom and add grab bars to showers and toilet areas. Keep floors clutter free. Get rid of decorative throw rugs. Use hand rails when going up and down stairs. Don’t walk outdoors during inclement weather.

Balance and strength training reduces the risk of falls by 34% and cuts fracture rates by half. They combat age-related risk factors for falls. Moreover, weight-bearing exercise and impact training at moderate-to-high intensity encourages bone growth when pursued consistently. Want a simple bone-building exercise to add to the daily regimen? Hop up and down on each foot 50 times!

Dr. Gregor recommends 9 servings of fruit and vegetables daily. They decrease inflammation and oxidation and promote a healthy acid-base balance in the blood stream. (The body leaches calcium from bones when the blood gets too acidic.) Foods that are especially good for bone health include prunes, onions, leeks, garlic, cruciferous vegetables, and tomatoes.

Stop smoking. It’s bad for the bones and bad for health overall. Enough said.

Even though they are routinely recommended by general practitioners, calcium supplements may not be beneficial. To be sure, the body needs a steady supply of calcium to support bone growth and other metabolic functions. However, supplementation may cause unhealthy calcium spikes in the bloodstream. Dr. Greger cited a study in which 1,000 people used calcium supplements for 5 years. While their usage prevented 26 fractures, participants reported 14 heart attacks, 10 strokes, and 13 deaths that were attributed to calcium supplementation.

Dr. Gregor invites us to get the recommended daily dose of calcium through the diet. Food presents calcium in combination with other substances that aid in absorption while spreading the required amounts throughout the day. Put dark leafy greens such as kale, collard greens, and Bok choy on the menu. Avoid milk due to the presence of galactose (sugar) which causes bone loss due to oxidative stress and inflammation. In fact, studies show that hip fracture rates correlate positively with milk consumption. If a fan of daily, switch to yogurt or cheese; the fermentation process reduces sugar.

Vitamin D supplementation appears to support healthy bones when taken in amounts between 1600-3200 daily. Vitamin D increases calcium absorption in the intestines and stimulates the kidneys to reabsorb calcium from urine. Supplementation more than 4000 IU daily has been associated with higher fall risk.

Dr. Greger takes a dim view of pharmaceutical intervention, listing the most popular medication (Fosamax) by name. Fosamax disrupts normal bone remodeling by killing off osteoclasts (a.k.a. the bone demolition team) and thereby diminishing osteoblast activity (a.k.a. the bone building team). Physicians typically prescribe this medication when osteoclasts outpace osteoclasts, resulting in sustained bone loss year by year. Clinical trials showed that it cut the 5-year hip fracture rate by half. Dr. Gregor argues for a natural approach to reducing fracture risk while avoiding complications associated with disrupting the body’s normal bone remodeling processes.

Father Greg

Father GregI just finished reading an incredible book by Father Gregory Boyle, a Jesuit priest who has served the poorest Catholic parish amidst the highest concentration of gang activity in the Greater Los Angeles Area for over 30 years. Having witnessed the devastating impact of gang activity, Father Greg, his parish, and community members launched an organization to work with those who had been left behind with no hope. Starting in 1988, they put the welcome mat out for former gang members, helped them deal with substance abuse, removed tattoos, and provided gainful employment and training. They also offered critical services to community members in need.

Today, Homeboy Industries is the largest gang rehabilitation and re-entry program in the world. Their organizational model has become the blueprint for over 400 organizations worldwide. They share a common mission in “hope, training, and support to formerly gang-involved and previously incarcerated people, allowing them to redirect their lives and become contributing members of our community.”

Tattoos on the Heart: The Power of Boundless Compassion bears witness to Father Greg’s ministry and the individuals who cross the threshold of his open door and open heart. For those among us whose only exposure to gangs comes through mass media, it’s a heartbreaking read. Scads of young people in his backyard grew up amidst absentee (often incarcerated) parents, economic hardship, substance abuse, violence, and precious little (if any) tenderness, understanding, or love. Some managed to find a way out of “the life” and recapture their humanity and sense of worth. Some left this world early in random acts of violence. Others were cut down on the brink of a new and productive life. Again – heartbreaking… and unimaginable.

Suffice it to say, I have tremendous respect for Father Greg and his commitment to this community. But I can’t help but wonder: What gives him the strength to pursue this mission year after year when the toll it takes on the heartstrings must be terrible?

As a man of faith, Father Greg finds inspiration in the life of Jesus Christ, a man who consistently located his ministry among folks on the margins. It was not about being in service to them; it was about his abiding love and compassion for their suffering. As Father Greg says:

“Compassion is not a relationship between the healer and the wounded. It’s a covenant between equals… a shift from the cramped world of self-reoccupation into a more expansive place of fellowship, of true kinship. We are bound together.”

He references the Sermon on the Mount in which Jesus offers nine Beatitudes. Father Greg tells us that this list of blessed ones is not so much a recounting of those favored in God’s sight. Rather, it’s a prescriptive for where disciples of Jesus should locate themselves – amidst the poor, the mourners, the meek, the merciful, the pure in heart, the peacemakers, the persecuted, and those who follow Jesus’ example. Father Greg simply heeds that call, even when it’s painful to do so.

When looking past Homeboy Industry’s services and advocacy, a common theme emerges: the healing power of love, compassion, and kindness. In and through relationship, folks discover that they are valued and valuable. They discover their own light and realize that they are right and true and wholly acceptable just as they are. They are exactly what God intended when God made them – talented, gifted, good. Resilience comes from being grounded in this fundamental truth.

Father Greg used a metaphor for helping others that resonated with me. He casts the helper as one who has a flashlight in a dark room. The helper can illuminate light switch, but the one who wishes to come out of darkness must flip the switch and realize that light is better than dark. In the spirit of mutuality, one may wield the flashlight this time but be the one who needs it the next.

A final thought ties it all together: “If kinship were our goal, we would no longer be promoting justice, we would be celebrating it.” Our circle of compassion would be inclusive. We would belong to one another and feel our worth.

Missing Out at Rush Hour

morning commute

In early 2007, the Washington Post conducted a little experiment in collaboration with virtuoso violinist Joshua Bell. They wanted to see how ordinary people would respond to one of the world’s finest classical musicians when encountering his artistry unexpectedly during the morning rush hour. Would exquisite beauty give people pause during the busy-ness of life?

On Friday, January 12th, 2007 at 7:51am, Bell donned street clothes, went to the L’Enfant Plaza Metro station in Washington DC, took out his Stradivarius, and put some seed money in the open case. He then commenced to deliver a 47-minute concert of six glorious pieces for solo violin.

Three days before appearing at the Metro Station, Bell filled Boston’s Symphony Hall with patrons shelling out $100 each on average to hear him play. Two weeks later, standing room only crowds in North Bethesda, MD were so enraptured by his artistry that they dare not cough for fear of disrupting the experience. But on that Friday, Bell presented himself as just another street musician trying to make a buck.

So, how did he do?

Of nearly 1,100 people who passed him by on their way to work, only seven stopped to listen for a minute or more. A mere 27 people opted to give him money. His total haul: $32.17.

Despite my great love for classical music, I would have counted myself among the throngs of humanity in a great big hurry to get on with my commute and the day ahead. I doubt that I would even have stopped to toss a coin in the case. If I’d opened myself to the music at all, I’d likely have considered myself lucky to have pursued a career in business instead of the performing arts. After all, if a guy that good had to make his living in a subway station, what chance would I have had?!

While that story was brought to my attention several weeks ago, I still find myself in a great big hurry to get somewhere. My penchant for getting things done and checking items off my “to do” leaves me with a kind of tunnel vision that prevents me from taking in the small wonders of life.

As a case in point, my husband and I reside in a townhouse for which we have no yard for the dog. His calls of nature launch a negotiation between us as to who’ll suit up and take him out. When it’s my turn, I generally try to get through it as quickly as possible. My “hurry up” attitude generally flies in the face of an excitable Scottie who’s all about enjoying the moment and exploring the sights and smells of the neighborhood.

A snowpocalypse arrived in the Portland Metro Area last weekend, plunging temperatures into the teens and far lower with wind chill. On the blustery walks, I had an understandable desire to get back in the house as quickly as possible. Even my dog got on board with that! But during the final walk Saturday night, I had a transcendent moment. The snow-covered streets and sidewalks reflected the light from the street lamps, making the whole area glow. No one else was out and about; no cars were on the move. The opening lines of Silent Night filled my head: “Silent Night. Holy night. All is calm. All is bright.” That ordinary moment was peaceful and joyful and breathtaking.

I doubt that single moment will break me of the habit of rushing when life does not demand it of me. But I will make every effort going forward to slow down and take in my surroundings… perhaps even pause to listen to the birds sing and catch a whiff of the clean, fresh air.