When you’re stressed out and cortisol, the main stress hormone, is wildly fluctuating, many things happen in a cascade of badness…

• Your serotonin, the happy brain chemical, falls off a cliff. Result? You feel like crap: weepy, despairing, and not like your happy self.
• You deposit belly fat, as in suddenly you stare down at a beach floatie at your midsection.
• Your hippocampus – the part of your brain in charge of memory consolidation and emotional regulation – shrinks. Then your attention span is shorter, you can’t remember why you walked into a room, and inappropriate mood swings take over your life. (Note that the mood swings may feel very appropriate at the time!)

If that’s not enough to get your attention, another silent and insidious problem is that you may lose bone strength and bone density when cortisol is high,[i] although this is not conclusively proven in women of all ages,[ii] nor is it absolutely clear that run-of-the-mill chronic stress is causal when it comes to bone loss (though it certainly shortens telomeres). Still… ouch! Inflammation – the low-grade fire that leads to disease and often originates in your gut – may suppress bone metabolism.[iii] Plus high cortisol is linked to decline in muscle mass and strength as you age.[iv]

How’s that?

Bad stress and wayward cortisol do a number on your body. We know that about 95 percent of disease is caused by or worsened by bad stress. Unremitting, unmanaged, and/or “bad” stress worsens your sleep and keeps you from assimilating key nutrients –  and set you up to be deficient in vitamin Bs, vitamin C, magnesium, and zinc.

High glucocorticoids, of which cortisol is a member of the family, reduces bone building and increases bone resorption, which are the ways that your bone remodels itself intelligently. Additionally, high glucocorticoids, from high stress and adrenal dysregulation – perhaps even taking corticosteroids like Prednisone – muck with your ability to assimilate nutrients from food such as calcium and may indirectly lower other hormones like estrogen and thyroid.

Short version: You’re stressed out, you get cranky, fat, and ADD, and then your bones dissolve. Not being an alarmist, just want to help you de-stress in novel ways so that you can look hot in your bathing suit from inside out.

Newsflash: Boniva Isn’t the Answer (Sorry, Sally!)

Remember Sally Fields of Norma Rae? Love her, but I don’t love the marketing campaign she did for Boniva as an answer for protecting your bone.

Bis-phosphonates, such as Boniva and Fosmax aren’t the magic pill that Big Pharma would like you to believe.  In fact, bis-phosphonates can actually weaken your bone.[v]

What’s a Smart Woman to Do?

I don’t want to dissolve into a pile of bone dust, and you don’t either, so let’s fix this situation now.

Step 1: Remove 10 foods that raise cortisol (a.k.a. “The Dr. Sara Blacklist”)

Stay away from the foods that are on the blacklist for triggering the immune system. Top research shows that bugging the immune cells in the gut may raise your stress hormones.

Some of the most common allergy-inducing foods include:

• Gluten
• Dairy
• Peanuts
• Soy
• Yeast
• Eggs
• Corn

Additionally, these items can overstimulate your delicate nervous system and trigger a stress response.

• Alcohol
• Sugar and sugar substitutes
• Coffee

Step 2: Fill your nutrient gaps

• Get the magnesium you need.
• Obtain calcium from food.[vi]
  
• Take a multivitamin with minerals.
• Take Vitamin D3 – I recommend 2000 IU per day, and studies show that > 700 IU is needed to improve bone density and many mainstream investigators remain skeptical.[vii]
  

Step 3: May the force be with you

Ah, yes… exercise! Tell me you’re regularly getting physical activity, because I get depressed when I read that fewer than 30% of 65- to 74-year-olds and less than 15% of adults >75 report moderate physical activity lasting >10min in the previous 4weeks.[viii] No, no, no. Our bones need movement.

Vertical weight bearing – that is, vigorous, high impact exercise – helps the bones most, such as jumping, plyometrics, stair climbing, squatting, and running.[ix] So get your vertical loading on, but mix it up.[x] But… running raises cortisol, which is why I recommend chi running and/or burst running. Additionally, the vertical weight bearing (defined in studies as >4g) seems to be very good for adolescents and young adults, but it’s not clear it’s enough of an impact in older adults.

Here’s what we know:

• If you’re premenopausal, go for progressive, high-intensity resistance training. It helps the bone density in your spine, but may not impact your hips.[xi] Wonder what I do? Find me at the gym, doing plyometrics and burst training with weights, or at a Barre class.
• Is walking enough? Probably not.[xii]
• Young women with low body fat don’t benefit as much from vigorous exercise.[xiii]
• More active kids have stronger hips than less active kids.[xiv]
• The Cochrane Database reviews says exercise is not a definitive treatment if you already have a spine (vertebral) fracture.[xv] Even so, my opinion is that it’s helpful for many reasons – bone remodeling, to help you develop agility (so you can fall well), and to improve one’s mental performance. My genius bar at UCSF concurs – more physical activity stimulates bone formation and is associated with fewer hip fractures.[xvi]

Ultimately, we need more data. Check out this new randomized trial that will finally assess exercise versus no intervention in post-menopausal women with a vertebral fracture (and join it, if you can!).[xvii] Sheesh! We still need to figure out the right impacts to prevent, treat, and reverse osteoporosis for those of us in middle and older age.

Now it’s your turn. Let me know on Facebook what’s happening for you by going here and leaving me a comment! Tell me….

• Have you had a problem with bone density? At what age, and what did you do to change the situation?
• Have you measured any nutrient gaps in your body? If so, what was low, and how did you replete?
• Do you exercise for your bones? If so, what do you do?