Eating and living for    
         musculoskeletal health 

Did you skip out of bed this morning feeling good, ready to face the day ahead, or did you emerge, slowly unfolding your aching body, feeling stiff and thinking to yourself “boy, I’m getting old!”

  Whether you make your living farming the land, delivering packages or hunched over a computer, your physical body is your home here on earth, your vehicle for experiencing life and moving around. Whether simply shuffling around your apartment or traveling the world, your body is either a source of freedom and joy, an impediment (or worse; a source of suffering). It’s probably safe to say most of us, if given the choice, would choose option #1. Guess what - good news! - we do have a lot of say in the matter! Let’s look at how in a little more detail. And if you’re not one to geek out on the scientific nitty-gritty, you can skip to the end of the article and head straight for the action steps.

  Whether you feel pleasure or pain as you move around, or simply sit in your chair, depends mostly on your musculoskeletal system; the system of muscles, tendons, ligaments, bones and joints and associated tissues, such as the fascia, that move the body and maintain its form. This system is made of specific proteins, fats and minerals, and like all other parts of the wonder of you, it is constantly in the process of breaking itself down and building itself back up. In order to for this process to go smoothly and result in strong, healthy tissue we have to supply our DNA with the right signals and our body with the right building blocks. So how do we do this? 


  Food and your DNA

  Far from being something set in stone, your DNA actually has many blueprints for how to construct you. Assume that as you were growing up, your diet was rich in minerals and all the other building blocks for bones. To the DNA this would signal that it is safe and appropriate to build a large (tall) skeletal structure, whereas the DNA of a child eating a diet poor in minerals would be prompted to activate plan B, an alternate blueprint for a shorter stature, rather than build a tall, but porous and weak skeleton. The same holds true for adults - even deficiency of one mineral, say Magnesium, leads to decreased bone building activity and therefore weakening of the bone, aka osteoporosis (1). We can observe the same effect even through the lens of history: hunter-gatherer populations were taller and stronger than the agricultural societies that followed them (2). due to the switch to a grain-based diet (more later about why).


 Our changing food supply is changing our bodies

  Changes in our dietary habits have affected us in other ways, too. Our ancestors, both paleolithic and more recent, tended to consume a much greater variety of animal products (hint: animals are made of the same building blocks our bodies are made of!) and thus ingested eg more minerals and collagen than today’s boneless-skinless-chicken-breast-eating populations. They drank mineral-rich water from natural sources and ate vegetable matter growing in mineral-rich soil. Todays’ agricultural practices have unfortunately lead to severely depleted soil, so that we despite a higher yield are receiving fewer nutrients (minerals, vitamins etc) from our food (3). Most of our meat is from animals that are not only kept in inhumane conditions that induce stress in animals, but also fed an unnatural diet. You know what cows like to eat, right? Grass. But CAFO (concentrated animal feeding operation, aka animal factory, aka anything but meat guaranteed to be organic, grass-fed and grass finished) cows are fed a diet of (genetically modified) corn, soy and sometimes candy (yes, you read that right!) (4), (5) and fed and injected with hormones and antibiotics. This has a profound effect on the healthfulness of the resulting product, rendering once healthful foods, ruminant meat, organ meats and milk from these poor animals unhealthy.

The nutrients we are missing out on, and the things we really, really should avoid

 Apart from nutrient-poor foods and de-mineralized water there is another dietary novelty that is robbing us of our health and well-being, and like a Trojan horse it’s tricking us to let it in. What I’m talking about is the addition of foods, until very recently unknown to mankind, that are contributing to inflammation in our bodies. One is refined sugar and the overuse of refined carbohydrates in general, and the other one is vegetable seed oils such as canola, cottonseed oil, soybean oil, safflower oil etc.

 Sugars, and foods that turn into sugar in the body (most carbohydrates)  are necessary for the body. But they are also harmful if they remain in our bloodstream unused. This happens when we eat them often and  in large amounts, as we do today, encouraged by convention, taste and the ubiquitous and perhaps somewhat unfortunate “food pyramid”.  One way in which they wreak havoc is by creating the appropriately named AGEs (advanced glycation end-products) that destroy proteins, including collagen in our bodies. Collagen is what gives us our form, holds us together, gives muscles and tendons their form and strength, gives our skin its strength and suppleness. Collagen breakdown equals tissue breakdown.

  The other novelty, the industrial seed oil, comes to us masquerading as a health food. Canola oil bottles, for example, will often feature labels boasting that it is high in omega 3, a fatty acid that has anti-inflammatory effects on the body. However, that omega 3 has likely ceased to be healthful, as the fragile polyunsaturated oils have been exposed to a refining process (6) involving high heat and solvents (hexane) resulting in harmful trans fats. Industrial seed oils don’t only cause damage inside our bodies by virtue of their own oxidized fats, but actually by starting an oxidative cascade that damages other fats, too, thereby damaging blood vessels, cell membranes and  bones as well as affecting hormonal signaling inside the body (7). I don’t know about you, but messing with hormonal signaling something I'd rather not do.

  These fats end up on our plates and in our bodies because we use them in cooking, trusting the marketing claims. They are also get into our bodies via restaurant food. They are so much cheaper than healthy oils like butter and coconut oil that only upscale restaurants will avoid them. They are also found in virtually every processed food product you can think of. We also absorb them through our skin. (Try using unrefined coconut oil instead, or this wonderful balm http://www.vintagetradition.com/ )

Technically, the effect of these Tojan horses is know as lipid peroxidation (8) and glycation (9), respectively, and constitutes one of the major reasons for degeneration and aging.

Mind your minerals

Grains and legumes (soy!) contain phytates, which hamper mineral absorption from the food they are in. So while grains contain minerals, you will probably not absorb them well due to the phytates they contain, so be sure to get minerals from other sources. Nuts tend to be high in phytates, too. Even healthful vegetables such as spinach contain mineral-absorption hampering oxalates. Our more recent ancestors minimized these effects by soaking, sprouting and fermenting grains, nuts and legumes, and you can still benefit from this ancient technology for example by  soaking your beans for a day before cooking them.

Speaking of bones, vitamin K2 is essential for them, and may protect you from calcification of tissues that you’d probable rather keep soft (arteries, for example). Vitamin K2 is found in some food and can be manufactured in our guts, but most of us would benefit from supplementation. Studies show that vitamin K2 far outperforms osteoporosis drugs, with none of their side-effects.

Bone broth  http://wellnessmama.com/5888/how-to-make-bone-broth-tutorial/ , has become quite fashionable, and if taken several times a week, will supply you with valuable minerals. However, given that most people are deficient in Magnesium, you may want to supplement with at least this important mineral. There are several forms of Magnesium, some better absorbed that others. Magnesium glycinate is one of the better absorbed ones (unless you want to go for ionic minerals http://www.angstrom-mineral.com/ ). Magnesium is vital for maintaining a normal muscle tone, and therefore some of the many symptoms of magnesium deficiency include tight and sore muscles, muscle cramps, angina and high blood pressure.

Inflammation causes pain

It is no coincidence that many pain medications (think Motrin or Cortisone) are anti-inflammatories. Inflammation, whether for a good reason, such as your tennis game two days ago that triggered muscle and bone growth, or for a bad reason (inflammatory foods) is painful and, if prolonged, causes damage to the body. One of the most important steps to maintain, or regain, a healthy pain-free body and lead a long, happy and productive life is to minimize unnecessary inflammation. You already know that large amounts of sugar trigger changes that lead to inflammation. Your choice of fats play an important part, too. Avoid vegetable oils and trans fats, and balance out your omega 6 to omega 3 ratio (by avoiding vegetable oils, favoring olive oil instead, and eating wild-caught fatty, cold water fish fish and grass-fed meat) ideally making it  1/1.

Nuts (with the exception of Macadamias) also contain high amounts of omega 6 polyunsaturated oils, which may both sometimes be rancid and otherwise contribute to inflammation by skewing the critical omega 3/omega 6 ratio, so while nuts definitely belong in a healthy diet, using large amounts of nut flour for baking in order to avoid grains may not be ideal.

What all of these changes in what ends up on our plates amounts to could be summarized as quantity over quality. Good for industry, not so good for you and me. Luckily you can take many steps (ideas at the end of the article) to improve the quality of your food.

Lifestyle changes play a big part, too

Remember how what we eat affects what blueprint our DNA activates? We can affect the choice of blueprint in other ways, too. Sleep is, as mentioned in my previous post, critical. We need somewhere around 8 hours as adults and much more in childhood. Anything less will results in decreased time allowed for growth, decreased amounts of growth hormones (which are released during sleep10), increased levels of Cortisol and an increased desire for carbohydrate-rich foods (leading to more inflammation).

Last, but most definitely not least, the physical forces our bodies are exposed to strongly signal to our bodies whether we should be using our resources to build a strong frame or not. Bone and muscle is living tissue that needs to be stressed in order to stay strong (11). Astronauts exposed to weightlessness have discovered this the hard way - even relatively short stays in space have lead to significant osteoporosis in these brave men and women.

So what other steps can we take to make sure things go right, resulting in a strong physical frame that will serve us well over the course of a long life and function properly, carry us around and be a source of pleasure and joy? Turns out, there’s quite a lot we can do. Below, I have listed some of those action steps in a hopefully easy-to read (and implement!) format.

Action steps for a healthy musculoskeletal system:

-Match the use of sugars and carbohydrates to your activity level

Sugar from carbohydrates is used for some structures in the body, such as mucus, tears, joint fluid etc. But most of all it's fuel. Don't eat much more carbohydrate than you will burn for your body's basic  needs and physical activity at any given time. The rest  will be stored as fat, after it's circulated in your body  and may have raised your insulin unnecessarily, causing inflammation. Go easy on sugar, fruit juices, soft drinks, desserts etc. Fruit also contains sugar, especially since all modern fruits are hybrids bread for their high sugar content. Minimize use of refined foods, especially low-fat varieties, which contain a lot of “hidden” sugar.

-Minimize the use of vegetable seed oils

Use animal fat including butter (choose grass-fed aka pastured butter) and olive oil instead. 

-Include healthy fats and protein in your diet - your body is made of them

Saturated fats (from healthy animals  and tropical oils) are building blocks for our bodies, are a source of energy and protect the fragile mono-unsaturated fats that we also need. Eat grassfed organic ruminant meat (beef, lamb, goat, bison), pastured butter or ghee, grassfed dairy, olive oil and fatty fish such as salmon and sardines. People with stain genetic traits may need to keep their saturated fat intake a bit lower than others, but contrary to long-circulated soundbites saturated fat does not "clog arteries".

The above-mentioned meat and fish are also a safe source of proteins (apart from fats and minerals, we are made from protein!) 

-Get sun and organ meats

The sun triggers the formation of vitamin D in the body, while organ meats supply valuable nutrients such as vitamin A, found in large amounts in liver) to balance and work with vitamin D. You already know that vitamin D is necessary for growth, but did you know that it also has many more functions, including modulating inflammation 12? Liver is also an excellent source of valuable B-vitamins (and no, it does not filter or store toxins).

-Make bone broth, slow-cooked stews and eat meat on the bone

Cooking bone and the connective tissue (contained in the fascia in the meat and cartilage on the bone) frees these valuable nutrients into liquid and build these same tissues (bones and other connective tissues such as tendons, fascia and skin as well as joint cartilage and discs) in our bodies. 

-Supplement wisely

Whenever possible, choose whole foods and a natural lifestyle over supplementation. However, there are some supplements that may be necessary due to the changes to our environment and lifestyle detailed earlier.

Vitamin D3

Getting enough sun exposure in the summer is the ideal way to raise your vitamin D levels. In the Midwest, winter months are dead-zones for vitamin D production and supplementation is necessary to reach healthy levels.Bone mineralization is optimized at serum 25-hydroxyvitamin D levels near and above 40 ng/ml 13.  

Vitamin K2

As mentioned, K2 builds bones, treats osteoporosis and makes sure calcium ends up where we want it to end up. It’s even been shown to reverse calcification of arteries. Now that’s an offer you can’t refuse!

Minerals

Bone broth and other healthful foods will supply you with some the Calcium you need. Magnesium is another story, and most will benefit from supplementation. Organ meats, meat and other foods supply minerals, as does high-quality water. A tissue mineral analysis http://www.arltma.com/HairAnalysis.htm may show you  where you stand, although this test hasn't yet been properly validated. Important minerals you want to make sure you get enough of include Iodine (especially if you live in the Midwest), Selenium, Potassium (instead of reducing salt, increase Potassium by eating more vegetables)


Protein

If you are over 65 years of age, your body is less receptive to the muscle-building signals of the protein in your food. You need to eat approximately 25% more protein in order to maintain your lean body mass (muscle and bone) and to reap the benefits of exercise.


A special note on Osteoporosis

Women, especially, tend to be understandably fearful of osteoporosis and tend to follow the somewhat misguided advice to supplement with large amounts of Calcium without simultaneous attention to other factors contributing to this debilitating degeneration of our frame. Other culprits of osteoporosis are deficiencies of vitamin D, vitamin K2 15 and Magnesium as well as  the low activity levels typical of our society.  Including collagen-rich foods in the diet, minimizing inflammation and increasing physical activity, all mentioned in this post, are also of great value.

An another one on digestion

We are not what we eat, but what we digest. With time and some conditions our production of stomach acid may decrease. If this happens, digestion suffers and our absorption of body-building substances such as protein and minerals suffer. Symptoms of low stomach acid include heartburn, heavyness and bloating after meals, gassiness or abdominal distention, poor resistance to infections, slow emptying of the stomach, fatigue and illness. Note that salt is an important source of the Chloride needed to produce hydrochloric acid. As mentioned before, most of us would benefit from increasing Potassium and Magnesium rather than decreasing Sodium e.g.  in order to normalize blood pressure.

So there you have it! Avoid inflammation, supply your body with the right building blocks and lead an  active lifestyle and get plenty of sunshine and sleep to signal to your DNA to build a strong, health body.

Free bonuses include: more beautiful skin, increased energy for all the wonderful things you want to do with your life, decreased risk of erectile dysfunction and other forms of vascular disease and much, much more. Now that’s what I call a great deal!


References:
1)http://www.ncbi.nlm.nih.gov/pubmed/19828898
2)http://www.proteinpower.com/drmike/low-carb-diets/nutrition-and-health-in-agriculturalists-and-hunter-gatherers/
3)http://www.scientificamerican.com/article.cfm?id=soil-depletion-and-nutrition-loss
4)http://www.cascadebrookfarm.com/wp-content/uploads/2011/12/Grass-Fed-Basics.pdf
5)http://www.animal-science.org/content/74/11/2559.short
6)http://www.westonaprice.org/know-your-fats/the-great-con-ola
7)http://www.ncbi.nlm.nih.gov/pubmed/15998628
8)http://en.wikipedia.org/wiki/Lipid_peroxidation
9)http://en.wikipedia.org/wiki/Glycation
10)http://www.sciencemag.org/content/165/3892/513.short
11)http://www.spaceref.com/news/viewpr.html?pid=19970
12)http://www.sciencedaily.com/releases/2012/02/120223103920.htm
13)http://www.ncbi.nlm.nih.gov/pubmed/15093761?dopt=AbstractPlus
14)http://www.ncbi.nlm.nih.gov/pubmed/15949902
15)http://www.ncbi.nlm.nih.gov/pubmed/7821350

Disclaimer: the information shared in this blog is not intended to diagnose or treat illness. It is presented as information and inspiration only. If you have a medical condition, use medication or believe that you may have a medical condition, please work with a doctor (medical, osteopath, naturopath, doctor of oriental medicine etc).    




As important as sleep is to our health,  and as much time as we spend doing it, it is sometimes frustrating to discover that sleep is not something you can decide to do. It sort of either seems to happen, or not. But as you will discover, it might be more accurate to say that even though we can’t decide to fall asleep, we can decide to create circumstances that invite and induce sleep.

If you are one of the sleepless, you are not alone. It is estimated that over 15-80% of the adult population suffers from problems with sleep(1, 2). And many more simply feel they don't have time to sleep the 7-8 hours an adult needs. Some believe they don’t need as much sleep as the average person, but many who feel they are doing great on 6 hours a night actually turn out to be chronically sleep deprived when tested, and would benefit from sleeping more.

But what's the big deal with sleep, you may ask, and why on earth would a physical therapist choose it as a subject for a blog? Lets look at some of the effects of not getting enough sleep.

Sleep is part of our circadian rhythm. We are very specifically adapted to life on this planet, and our life cycles around it's position in space. The various functions in the body follow a certain daily and monthly pattern, and the correct timing of these functions in necessary for good health. Every cell has an internal clock telling it what time it is, and this system allows for the various functions in the body to be synchronized, sort of like an orchestra where a great number of instruments are playing together in beautiful harmony. Now what would happen to the symphony if all instruments were played randomly? Chaos, instead of beautiful music. 

Our body functions in the same way; it needs for the clocks of the cells to be synchronized in order for our bodies to function harmoniously. If we disrupt the rhythm, chaos ensues.

Sleep is one of the important metronomes of the body. When sleep is disrupted, shortened, happens randomly or at the wrong time (think shift workers) our balance is disrupted, resulting in an endless array of problems - infertility, obesity (3), depression, cancer, heart disease, diabetes, poor immune function and of course poor cognitive functioning and general grumpiness. The list could go on, but you get the picture, sleep is crucial to your health and well-being. Famously, a tired driver is a greater danger on the roads than a slightly intoxicated one(4). But at the same time, good and regular sleep is also the result of properly maintained biological rhythms. 

Our ancestors probably didn’t have nearly as many problems getting enough zzz’s as we do. They lived in a world where nature set the pace. Our modern-day inventions have freed us from many of the constraints of the natural world, but at the same time that new-found freedom may be hurting us. It behooves us to live in such a way that we are benefiting from all the wonders of modern technology without allowing them to harm us.

Lack of sleep also makes you hurt more(5), hence my choice of topic for this blog. The mechanisms through which sleeplessness makes us hurt are many. For one, nighttime is the time for repair. Every part of the body is constantly being broken down and replaced - you literally don't have the same body you did a few years ago. All the cells have been replaced. Lack of sleep interrupts this rebuilding process. Exercise and even normal use of the body creates microscopic breakdown of muscle tissue, and as this is repaired at night the body emerges from sleep stronger.  But what if you don't sleep? Well, you can guess the answer to this one - you feel stiff and sore. And yes, athletes need even more muscle repair, and hence more sleep.

The National Sleep Foundation lists the following effects of a good night's sleep: blood supply to muscles increases, tissue growth and repair, memory consolidation and release of hormones regulating growth and appetite, release of hormones such as growth hormones, which are essential for growth and development, including muscle development, maintenance of a healthy immune system.

Normal sleep has many stages, from lighter to deeper non-REM sleep, and REM, or dream sleep. The patterns vary depending on a persons age, degree of sleep deprivation and whether sleep is natural or chemically induced through the use of sleep medication.It is believed that tissue repair and release of growth hormone happens during the deepest stage of sleep. Growth hormone stimulates protein synthesis, helps break down fat (wohoo, right?)) that supplies energy for tissue repair and stimulates cell division. This repair process is essential to recovering from athletic endeavors and the wear and tear of everyday life. In fact, some scientists theorize that the decline of deep sleep as we age may contribute to physical decline by depriving us of growth hormone.

With that in mind, here are some practical steps to incorporate into your life in the new year to help you fall asleep easier and experience a better quality of sleep. 

-Think of sleep as something that happens when your body knows that it is nigh-time. 

-Think of your activities during the entire day as signals to your body about what time it is. Signal appropriately, i.e. do not engage in activites at night that tell your body it’s morning, and vice versa. This can be though of as circadian rhythm enhancement.

-Light is one of the most powerful circadian rhythm regulators (6). Expose yourself to bright light in the morning and during the day. A brief walk outside first thing in the morning, working in front of a window and using light boxes  http://www.verilux.com/light-therapy-lamps/happylight-6000/ are ways to accomplish this. As the sunlight gradually fades outside, so should the lights in your home - otherwise you are signaling to your body that it’s daytime when it actually is night. Trying to fall asleep 10 minutes after you’ve been telling your body it’s 12 noon is not going to work very well!  In the evening, use orange-colored lights instead of white light bulbs. the orange/red end of the light spectrum does not suppress Melatonin production the way the blue light (in sunlight, regular white light bulbs etc) does. Install http://stereopsis.com/flux/ on your computer. This program will change the light on your computer screen according to the time of day to filter out the blue lights that most strongly signal “daytime!” in the evening. Another way to filter out blue lights is to use orange-tinted glasses http://www.amazon.com/Uvex-S1933X-Eyewear-SCT-Orange-Anti-Fog/dp/B000USRG90/ref=pd_bxgy_hi_text_y while watching TV or using a computer or other backlit device in the evening. Also remember that the intensity of light is important, so dim your lights as much as you can in the evening. Sleep in a completely darkened room, using black-out curtains and a sleep mask http://www.amazon.com/Bucky-Blinks-Sleep-Mask-Lacey/dp/B007MEBEXY/ref=sr_1_cc_3?s=aps&ie=UTF8&qid=1356889817&sr=1-3-catcorr&keywords=bucky+sleep+mask if needed.


-Seek social interaction, even just images of human faces, during the daytime.

-Take vitamin D supplements in the morning, not at night. Take your Magnesium supplement at night.

-Eat food during daylight hours only and eat your last meal around 7pm. Eating signals “daytime” to your body. If you often have trouble sleeping, eat more of your carbohydrates later in the day, and make sure your breakfast contains sufficient amounts of protein.

-Be aware of the effect of temperature: a drop in body temperature such as after exercise or after a warm bath signals “night-time”. Keep your bedroom temperature cool.

-Research the temporary or occasional use of Melatonin supplementation at night, and/or 5HTP or Tryptophan to support Serotonin levels during the night. Melatonin is produced by the Pineal gland in your brain when your eye is not exposed to light, i.e. at night. It has multiple very important functions in the body and when taken as a supplement it can help you fall asleep and stay asleep.

-Research the use of calming herbs such as Valerian, Hops etc at night-time as a temporary support or when weaning off prescription sleep medication.

-Consider health-promoting forms of care such as acupuncture to help support normal sleep rhythm.

-Decrease your overall stress levels through changing your life situation and changing how you react to your life situation. Living in a constant state of “fight or flight” is not exactly the ideal prelude to sleep. Think about how dangerous it would have been for our ancestors to fall asleep if danger was lurking right outside the tribe’s compound! Your body is equipped with the same reaction to danger, even though it isn’t very helpful when the perceived danger consists of real-estate taxes or health concerns.

-Use and Earthing pad or sheet http://www.earthing.com/product_p/umck.htm

Earthing technology supplies the body with a steady flow of electrons to compensate for  our modern-day lack of contact with the ground, resulting in a multitude of benefits, including normalization of diurnal cortisol secretion (7). Cortisol is the body’s activity/daytime- or stress hormone, and like other hormones is secreted in a specific pattern during a 24-hour cycle. High levels of Cortisol at night are a common reason for sleeplessness. 

-Incorporate meditation into your life. Mediation helps normalize bodily functions and supports normal sleep (8). Tech-loving folks can harness the power of the em wave
http://bio-medical.com/products/emwave2-personal-stress-reliever.html?gclid=CKuRurDiwrQCFetDMgodckgAUQ to achieve many of the effects of meditation.

Keep in mind that even when you’ve started treating your body in a way more consistent with it’s natural rhythms, change make take some time. Be patient and equip yourself with knowledge, support and the openness to listen to your bodymind and its signals.

Sweet dreams in 2013 and beyond!

1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2040284/
2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC181172/
3. http://www.ncbi.nlm.nih.gov/books/NBK19961/
4. http://www.aasmnet.org/articles.aspx?id=472
5. http://www.aasmnet.org/articles.aspx?id=3489
6. http://www.ncbi.nlm.nih.gov/pubmed/18419318
7. http://www.ncbi.nlm.nih.gov/pubmed/15650465
8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3328970/