Quit smoking — the benefits start 20 minutes after your last cigarette

I was drawn in by a new study thDeep breathing smoking blogat identifies the specific reason smoking weakens bone.

Then my colleague — a former smoker — asked “Why not motivate people by telling them how quickly their bodies begin to recover when they quit smoking? It might make a bigger impression rather than going on and on about what will happen if they don’t!”

She’s right!

We’ve known about the dangers of smoking since the 1964 report “Smoking and Health: Report of the Advisory Committee to the Surgeon General” and there’s been strong evidence for decades that smoking is a risk factor for osteoporosis.

Are you aware of how quickly damage can be reversed?

In the case of bone, fracture risk appears to decline after 10 years of nonsmoking — not such a long time if you think about it in terms of your full lifespan.

As for the rest of your body, the experts at the American Cancer Society show that the benefits of quitting smoking start a mere 20 minutes after quitting. Here’s their timeline for health improvements.

When smokers quit – What are the benefits over time? (from the American Cancer Society)

20 minutes after quitting: Your heart rate and blood pressure drop. (Effect of smoking on arterial stiffness and pulse pressure amplification, Mahmud A, Feely J. Hypertension. 2003:41:183)

12 hours after quitting: The carbon monoxide level in your blood drops to normal.(US Surgeon General’s Report, 1988, p. 202)

2 weeks to 3 months after quitting:Your circulation improves and your lung function increases. (US Surgeon General’s Report, 1990, pp.193, 194,196, 285, 323)

1 to 9 months after quitting: Coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) start to regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection. (US Surgeon General’s Report, 1990, pp. 285-287, 304)

1 year after quitting: The excess risk of coronary heart disease is half that of a continuing smoker’s. (US Surgeon General’s Report, 2010, p. 359)

5 years after quitting: Risk of cancer of the mouth, throat, esophagus, and bladder are cut in half. Cervical cancer risk falls to that of a non-smoker. Stroke risk can fall to that of a non-smoker after 2-5 years. (A Report of the Surgeon General: How Tobacco Smoke Causes Disease – The Biology and Behavioral Basis for Smoking-Attributable Disease Fact Sheet, 2010; and Tobacco Control: Reversal of Risk After Quitting Smoking. IARC Handbooks of Cancer Prevention, Vol. 11. 2007, p 341)

10 years after quitting: The risk of dying from lung cancer is about half that of a person who is still smoking. The risk of cancer of the larynx (voice box) and pancreas decreases. (A Report of the Surgeon General: How Tobacco Smoke Causes Disease – The Biology and Behavioral Basis for Smoking-Attributable Disease Fact Sheet, 2010; and US Surgeon General’s Report, 1990, pp. vi, 155, 165)

15 years after quitting: The risk of coronary heart disease is that of a non-smoker’s.(Tobacco Control: Reversal of Risk After Quitting Smoking. IARC Handbooks of Cancer Prevention, Vol. 11. 2007. p 11)

If you’re feeling motivated the American Cancer Society also offers tips for how to quit smoking. I encourage you to take a look.



The Journal of Clinical Endocrinology & Metabolism February 1, 2007 vol. 92 no. 2 428-429 doi: 10.1210/jc.2006-2651  http://jcem.endojournals.org/content/92/2/428.full (accessed 09.09.12)

American Cancer Society report.  http://www.cancer.org/Healthy/StayAwayfromTobacco/GuidetoQuittingSmoking/guide-to-quitting-smoking-benefits(accessed 09.09.12)


I’m starting a Revolution — and I need your help!

I’ve been writing this blog since 2008, but I believe this may be my most important post — because I’m ready to start The Better Bones Revolution and I want you to join me.

I’m in a revolutionary state of mind because during my decades of work, I’ve seen thousands of women frightened needlessly about their bone health and the options they’ve been given. I’ve worked diligently to help them — and maybe you —understand that none of us needs to be afraid of osteoporosis. We can all take charge of our lives to build and maintain and strong, healthy bones and bodies.

But we need to do more. We need to give every woman the knowledge and tools she needs to enjoy strong bones for life, naturally. Because, I still hear from so many women who are confused about osteoporosis and think prescription drugs may be their only option.

Here’s how you can help by encouraging 10 friends to also become informed and empowered by reading the articles on this website and signing up for my weekly blogs.

Now is the time to take heart and take action — for your bones, your body and your peace of mind. Let’s get started with The Better Bones Revolution!


If I only knew then what I know now — my grandmother’s story

I’ve previously shared memories of my grandmother, an exceptionally vibrant and wise woman who died at the age of 102 with her mind still as sharp as any youngster’s. She died from complications of a hip fracture a year after falling in the bathtub — and her story is part of the reason I came to dedicate myself to exploring the human potential for natural bone health.

Back when my grandmother was alive, it was only late in her life that any of us realized she had extreme bone weakening due to severe vitamin D deficiency. This is known as “rickets” in children and “osteomalacia” in adults. Without enough vitamin D, my grandmother’s body could not properly absorb calcium or phosphorus, and she developed serious osteoporosis and visibly weak bone.

To give you a little more history: after fracturing her collar bone and wrists in her 60s and 70s, she lost a great deal of height over the years and her legs became bowed — typical signs of the most severe vitamin D deficiency.

Even though I saw my grandmother every few days when I was growing up, I had no awareness of what was happening to her skeleton. But if I had known then what I know now, my grandmother could have been treated early on with vitamin D and all the other key bone nutrients.

I always wonder how long she might have lived if she hadn’t been forced to live with such extreme bone weakness. She might’ve been the most sound of mind, longest living woman in this country!Yet, on the other hand, I marvel at how well she managed, carrying out her daily household tasks even into her 101th year, never voicing even one complaint, or one mention of pain.

Nearly everyone who fractures a hip has inadequate vitamin D. The simplest thing you can do for yourself and the elders in your family is to test the vitamin D level and supplement to bring that level to 50 to 60 ng/mL year-round.


Bone health in 2012: My top five wishes

Happy 2012! It’s time for my annual wish list for bone health in the coming year. And this time, I’m also including a suggestion — or two — along with each wish — that can serve as a little push for its fulfillment. After all, our wisdom and our collective focus can actually make wishes come true — especially important to remember in an area as essential as bone health!

My 2012 wish list:

1. 2012 will herald a new age of partnership between physicians and their patients. Physicians will partner with each individual woman to develop a unique bone strengthening program appropriate for that woman and the way she lives.

And just in case this wish needs a little push… If your healthcare provider thinks that your bone health situation is serious enough to warrant use of a bone drug, then we know it’s serious enough to warrant a full medical workup looking for the hidden causes of bone loss. Take my osteoporosis medical workup recommendations to your doctor and say you also are concerned about your bone health and would like these tests to look for possible causes of osteoporosis.

2. Everyone will be tested for vitamin D adequacy. It will be widely recognized that as many as half of all osteoporotic fractures could be prevented by maintaining a minimum 32 ng blood level of vitamin D. This awareness will inspire universal vitamin D testing.

And just in case this wish needs a little push… If you can’t obtain vitamin D testing from your healthcare provider, you can order an at-home vitamin D test online from public interest groups such as the Vitamin D Council and Grassroots Health.

3. Everyone who experiences a fracture that occurs without great trauma will take the hint from nature and get serious about implementing my Better Bones approach.

And just in case this wish needs a little push … Make it a New Year’s resolution to spend some time reading my articles on Better Bones.com. You will see that our Better Bones Package offers a life-supporting approach that fortifies bone while it strengthens your entire body. Even if you feel your fracture was due to trauma, you will be inspired to further strengthen your bone by joining us in our natural Better Bones Revolution.

4. The “Alkaline for Life” concept will become a household saying and even restaurants will offer alkalizing meal alternatives.

And just in case this wish needs a little push… Make it another of your New Year’s resolutions to include two cups of vegetables for lunch and dinner, use more spices and herbs, consume two or three fruits a day and reduce your intake of excess protein, caffeine, sugar, alcohol and processed foods. And explore these alkalizing menu possibilities.

5. Chronic stress, excessive worry, and fear will become recognized as key emotions that disrupt neuroendocrine functioning and weaken bone.Meditation, stress reduction techniques, and mindful exercises such as yoga, tai chi, and qigong will become essential elements of all osteoporosis prevention and treatment programs.

And just in case you get this message before the insurance companies do… Commit yourself to creating peace and inner quiet on a daily basis. Take 10-15 minutes a day, close your eyes and just relax. Notice your breath and entertain the idea that all is well, even amid any turmoil in the present moment.

Let’s make all of our wishes come true in 2012!


Get your ZZZZZZZZZZZZZZZs for bone health


In my hyperactive modes, I wonder why can’t I just go full steam ahead all the time — why do I have to “waste” time sleeping?

These silly thoughts soon come crashing down — just as I do after even a short period of inadequate sleep. In all of nature, our activity is based on rest, and the proper amount of sleep is essential for uncounted biological and physiological processes.

Now a recent Chinese study shows us how adequate sleep is critical for optimum bone health.

When looking at sleep patterns and bone density of 602 premenopausal and postmenopausal Chinese women, researchers found that “With decreased sleep duration, women were more likely to have lower total and all body regional BMD.” Specifically those sleeping eight, or even seven, hours had significantly higher BMD than those sleeping six hours or less.

And exactly how does sleep deprivation reduce bone mass?

This is due, at least in part, to the rise in bone-depleting cortisol and over activity of pro-inflammatory responses. Adequate sleep provides a time and environment for repair and regeneration. Inadequate sleep is a pro-inflammatory stressor that results in “repair deficit”— a deficit that goes bone deep.

How’s your sleep? Are you getting enough? Is it of high quality?

Let me know if you would like some tips on getting to sleep and staying asleep.


Fu, X et al. 2011. Association between sleep duration and bone mineral density in Chinese women.  Bone, 49 (2011) 1062-1066


My new idea for cigarette warning labels: Smoking increases fracture rates

While it remains to be seen where we end up with the nine new cigarette packaging warning labels proposed by the US Food and Drug Administration, I have a very strong opinion on making the number of labels an even 10 by adding “Smoking increases fracture rates.”

Honestly, there really is no argument at this point about the harmful effects smoking has on our bones. As far back as 1976 there was a suggestion of an association between smoking and osteoporosis, and study after study since then has added to our knowledge of how smoking has an impact on bone health — such as showing that approximately 19% of hip fractures were attributable to tobacco smoking.

What’s also important to me is that many researchers are now examining the effects smoking has on younger people — where many previous studies focused on elderly people. As one example, a recent Belgian study looked at 649 healthy young men at the age of peak bone mass (ages 25-45 years). The smokers in the group reported more fractures and measured lower in bone density. Another study focused on young Swedish men and found that smoking was associated with decreased bone volume, which researchers speculated could contribute to increased fracture risk.

This research highlights our belief that we need to rethink osteoporosis by recognizing that all bone damage has a cause — even at a very early age and even among men.

Let’s hope it also helps label smoking for what it is — a real bone health risk.



Hoidrup, S., E. Prescott, T.I. Sorensen, et al. 2000. Tobacco smoking and risk of hip fracture in men and women. Int J. Epidemiol Apr; 29(2):253-9.

Taes, Youri. Early smoking is associated with peak bone mass and prevalent fractures in young healthy men. ABMSR, 2009, poster session III

Lorentizon, Mattias. Smoking is associated with impaired trabecular micro-architecture due to reduced trabecular thickness in young Swedish men — the GOOD Study. ABMSR, 2009, poster session III


Tips for autumn bone health

Wisdom-based cultures around the world have long recognized that the change of seasons is a time of transformation, a time when nature changes and so should we.

Autumn signals the transition out of the warm and expansive summer into the colder, more constrictive time. It is a season of “letting go” when the lush vegetation of summer drops away and the earth prepares for a long winter’s rest.

So just what can we do to help our bodies adapt to this particular change of season? In this blog I would like to share some of the things I do to facilitate my body and my bones making a smooth transition into winter.

Warming, alkalizing foodsoup apples 009 (2)

First off, the minute the thermometer drops, I move to “heavier food” — soups, stews, and casseroles. I also set aside cooling salads, cold sandwiches, and any form of cold drinks. Baked root crops such as potatoes, sweet potatoes, yams, turnips, and beets become a daily staple, as does all manner of baked squash. All of these are not only “warming” and filling, but they are highly alkalizing. Alkalizing lentil soup is another regular, and I find my digestion is stronger if I take this soup or a vegetable broth at the beginning of my meal. Finally, a hot drink is always at hand, my favorite being a warming and detoxifying fresh brewed ginger tea, with or without honey and lemon.

Protection from the cold

Fall brings with it wind which is drying and often chilling. I take seriously the ancient medical wisdom from both India and China suggesting we protect ourselves from the wind and cold. I turn to cozy fleece jackets and scarves — and I always try to keep my feet warm, just as the ancients suggest. I also love the ancient Indian “warm sesame oil massage” for a fall boost of the immune and nervous systems.

Autumn reflections

I feel our whole mind-body-spirit complex benefits by following nature’s lead. Just as the once vibrant leaves “let go” and drop willingly to the earth, so might we consider what we might allow to “let go.” The dramatic autumn transition can well serve as a time of reflection, introspection, organization, and protecting boundaries. But I encourage you to not become over organized and overscheduled and to take some time to reflect and be calm as well. This may be a good time to begin meditation or mindful exercise such as yoga, tai chi, or qigong.

As the leaves fall, so may vitamin D levels

Without the vitamin D-producing summer sunshine, vitamin D levels often fall by 30% from the end of summer to the end of winter. I like to remind people to test their vitamin D levels in the fall. This “end of summer level” will be the highest you’ll likely have all year. Remember, year round, we like to maintain a minimum of 32 ng/mL for bone protection and suggest that a 50-60 ng/mL level is more optimum for overall health. I continue to see interesting research showing even more reasons vitamin D is so vital to bone health. For example, a recent study reported that more severe vitamin D deficiency was associated with more severe osteoporotic hip fractures. Here’s where to learn more about the importance of a testing your vitamin D levels in the fall.

Now, I’m off to enjoy a walk (with a few bone-building hops or heel drops) in the crisp autumn air. Happy fall!


What if modern medicine didn’t exist? Rest and sleep

Resting is a classic, time-honored tradition. Long before the techniques of “modern medicine” existed, when you got sick, you went to your place of rest or sleep and you didn’t get up until you felt better. In fact, I always remember this about the Bari Indians of the Colombian Amazon region with whom I spent some time. Within this native and then isolated group, when one felt poorly one would take to her/his hammock, stay there and not eat until they felt better. Resting and saving all energies for healing was the cure.

This was the case with my grandmother. I’ve told you how she inspired my interest in bone health and that she passed away at the age of 102 after experiencing a hip fracture. Well, when she fell in the bath tub and broke her hip at age 101, my dad asked her if she wanted to go to the doctor. She replied, “No, I have been there before” and that she had taken care of her sons for 100 years and now they should take care of her. Her inner wisdom told her to take to her bed where she spent one year pain-free and mentally alert watching Ronald Reagan and MASH on TV and resting with her family and friends attending to her.


My grandmother chose rest. Yes, I can hear you shouting, “but what the heck… she was 101 years old!” Well, my point is that even us youngsters might do well to rest more often. My grandmother and the Bari Indians in a sense were very wise, understanding the body’s need to reserve its energies for healing. That is the need for rest.

Today most of us feel the need to “push through it” when we feel exhausted or ill, rather than listen to what our body is telling us. Even as more and more research appears on the healing potential of rest and sleep — or how your body responds when you don’t get enough.

For example, we know that sleep plays an important role bone health. In the South Dakota Rural Bone Health Study, men who were sleep deprived (which the study considered less than 6.5 hours a night) had smaller, thinner, and weaker bones than men who were not sleep deprived, and women who were sleep deprived had lower bone density than the women who were not sleep deprived.

I personally find that getting to bed by 10:30 PM and raising at 6:30 AM leaves me vital and energetic. When I get fatigued in the afternoon, I remind myself to take a few minutes to meditate or even nap. Such a short break refreshes and enlivens my body, mind and spirit.

Adequate rest and sleep both have been part of our innate healing process for hundreds of thousands of years. The next time you hear your intelligent body providing the call to rest, sleep or take a refreshing break, I hope you will recognize its wisdom. Myself, I’m off to take a swing in the hammock right now.

Be well and thrive.


Specker, B et al.2007. Volumetric bone mineral density and bone size in sleep-deprived individuals. Osteoporosis International. Volume 18, Number 1, 93-99, DOI: 10.1007/s00198-006-0207, URL: http://www.springerlink.com/content/g263772865842g60/export-citation/ (accessed 08.22.2011)


18,568 steps to prevent hip bone loss? Thin women should try a weighted vest instead

How many steps a day does it take to prevent hip bone loss as we age?

Dr. Brown and HardyYou might have heard the common suggestion that we strive for 10,000 steps a day to enhance overall health. Looking specifically at bone health, however, the daily step recommendation looks a bit different — and the news is not good for thin women.

Researchers found that for thin women to prevent hip bone loss as they age, the recommended 10,000 steps a day had to be increased to 18,568 for women who were lighter than average (114 lbs or less). Women of average weight (143 lbs or more), however, could maintain bone with many fewer steps per day. The estimate was about 5,000 steps a day for a woman of average weight. The reason? The lighter you are, the less impact you deliver to your bones with each step.

So what’s a thin woman to do? Now, I suppose you could try to walk faster for a greater impact, but only two out of 66 thin women in the study were able to increase their speed enough to reduce the step requirement to 10,000 steps a day.

I think the other option suggested by researchers — to artificially increase body weight during walking — makes more sense. Maybe because I am already doing it! Every morning when I take my dog for a walk, I use my weighted vest. It is simple to use and builds bone mass and increases muscle strength. Here’s a photo of me in my vest walking my dog Hardy!

In fact, a weighted vest’s long-term use has been shown to be as effective as drug therapy in building bone mass. And by the way, and if you don’t like the weighted vest idea, stay tuned. I am thinking a lot about how to prevent bone loss in thin women…more ideas will be forthcoming.



Boyer, KA et al., Maintaining femoral bone density in adults: how many steps per day are enough? Osteoporosis International, February 12, 2011.


The problem everyone wants — unless they have it

In a recent post, Beauty is Bone Deep, I commented on the health effects of trying to obtain a thin physique for the sake of an unrealistic beauty ideal. But there are many women who try to gain weight rather than lose it, often to no avail. They don’t have an eating disorder or anorexia — they simply can’t gain a single pound.

Now, many women out there will read this and think, “Gee, that’s a problem I wish I had.” But the struggle to gain weight is actually harder than the struggle to lose it. If you search the internet, you’ll find most information on weight gain is for bodybuilders and focuses on building bulky muscle, but that’s not something most women really want. And contrary to the suggestions some of my underweight clients hear, eating cheeseburgers, ice cream and cookies 24/7 does not help, and it’s a highly acidifying, bone-damaging way of life as well.

It’s true that some people are naturally thin, and if you eat a varied diet with good nutrition, get sufficient (but not excessive) exercise, and have good coping methods for stress, being thin need not be a concern for your bones. But for many women, thinness has the following implications for their health — and their health care:

• Small-boned, thin women are more likely to be handed a diagnosis of osteopenia or osteoporosis. As I noted in my blog post about BMD testing bias, DEXA scans don’t actually measure bone density, they measure bone area — and if you are naturally thin and small, your bones will likely fall below the standard used to assess bone density, leading to a diagnosis of osteopenia or even osteoporosis. At this point, many women are offered bone drugs and warned that they have a high fracture risk — without any real indication that they have a significant issue with bone loss or bone weakness at all.

• Underweight women have less social support for their weight-related health concerns. As I mentioned earlier, the common response to women who can’t gain weight in our overly weight-conscious society is envy — not empathy. There are very few recommendations offered for women seeking to gain weight, other than suggestions that they pack their diet full of junk food (and we already know what’s wrong with that approach!) Thin women may also face social stigmas of the sort experienced by obese women — that is, the message that there “must be something wrong with you” and hints that perhaps they’re mentally unstable or have some sort of eating disorder. While there are certainly women with eating disorders that make them excessively thin, there are many others who have a healthy relationship with food… but still can’t gain weight.

• Women with naturally small and “thin” bones have less leeway when they reach the menopause transition. Menopause for most women is accompanied by a certain amount of bone loss, related to the hormonal changes that naturally accompany this life stage. If your bones are small to begin with, you have less “wiggle room” when it comes to how much bone you can afford to lose. Now, that doesn’t mean you’ll automatically develop osteoporosis, but it could mean you need to pay attention to factors that can limit your bone loss — factors I discuss at greater length in my article on bone loss in menopause.

When it comes to thin women and bone health, I want everyone to know three specific points:

First, if your bones are small and “thin”, it doesn’t mean they’re weak — even if you’ve had a DEXA scan that indicates you’re in the osteopenic or osteoporotic range. Fracture risk is a combination of multiple factors, and bone density is just one of those — so take our Bone Health Assessment to get a better sense of where you stand when it comes to fracture risk.

Second, if you are at risk of fracture, there are steps you can take to reduce that risk — and they don’t necessarily involve bone drugs. We offer both quick tips on how to prevent weak bones as well as comprehensive information on key nutrients for bone health and how to change your lifestyle for better bones in our articles.

Finally, understand that osteoporosis and bone fractures are not inevitable for thin women. No matter how many scary osteoporosis statistics you hear, if you assess your risk factors and take steps to reduce them, your bones will respond as Nature meant them to — no matter how old (or young) you are!

In an upcoming blog post, I’ll offer some specific tips for how underweight women can gain weight, so stay tuned!