It’s time to polish up my crystal ball and make my 2020 predictions for osteoporosis and your bone health! With so much new research to draw from, I see a year filled with bone health advancements. Take a look at what I think will become true in 2020 for osteoporosis, fracture risk assessment, bone health nutrition — and much more.

Prediction: Osteoporosis will no longer be diagnosed through bone density testing 

Thoughtful doctors will move away from using the infamous bone density -2.5 T score for deciding who has osteoporosis.  This change will stem from a growing awareness that most osteoporotic fractures occur in people who have osteopenia or even normal bone density.  Scientists will scramble to set new criteria for the diagnosis of fragile bones. 

Caution alert: You will see a move toward using CT scans to assess bone strength and diagnosis osteoporosis.  Think twice about this as CT scans expose involve high levels of DNA damaging radiation.

Prediction: Osteoporosis stem cell therapy will surface 

Stem cells are cells with the potential to develop into many different types of cells. Mesenchymal stem cells are important to bone as they can develop into bone-building osteoblasts (favoring development of bone strength) or bone marrow fat cells (which weaken bone). You will be hearing of important plant compounds which influence these mesenchymal stem cells to morph into bone- building osteoblasts rather than bone-damaging bone marrow fat. 

Curcumin, quercetin, vitamin C (ascorbate), resveratrol, olive and green tea compounds will be used to favorably activate these stem cells. 

Prediction: Alterations in gut microbiome will be fully documented to enhance bone strength  

Scientists have already documented that those with fragile bones have altered gut microflora. The next step will be to identify which type and what balance of microflora serve to reduce bone loss and strengthen the skeleton. 

Prediction: The Australian Bone Clinic will scientifically prove that older women can reverse osteoporosis  

The myth that older women cannot regain lost bone mass is about to be busted in a big way by female scientists “down–under”.  The Australian Bone Clinic will lead the way documenting that with just 2 weekly sessions of well supervised high impact strength training older women can build bone strength and reverse osteoporosis. Keep an eye of the clinic’s work. 

Prediction: Personalized multiple risk factor assessment will become the most accurate way to predict real fracture risk.  

The “one size fits all” approach to predicting fractures by T score is clearly ineffective.  In its place you will see individualized multiple risk factor assessment.  As osteoporosis authority Dr. Robert Cummings documented decades ago, the vast majority of osteoporotic fractures occur in a small percentage of individuals exhibiting a high number of bone-depleting risk factors. Interested in assessing your total load of fracture risk factors?  Consider taking the new Better Bones quiz.

Prediction: Doctors will begin recommending their patients supplement with a wide range of bone building nutrients, not just calcium and vitamin D 

Daily we see new research detailing the vast nutrient influences on bone health.  For example, a recent scientific review article detailed 16 nutrients as key for bone health. One day soon mainstream researchers will catch up with us and recommend appropriate levels of all the 20 essential bone-building nutrients  we identified 2 decades ago. 

Prediction: China will be recognized as the world’s leader in osteoporosis research  

China’s need to prevent fracture among its massive and ever-increasing aging population will stimulate an impressive burst of osteoporosis research. Their research will be all encompassing including validation of traditional Chinese herbal formulas and acupuncture for osteoporosis, Qi Gong and Tai Chi to reduce fracture risk, pulsed electromagnetic field therapy and vibration platform therapy for bone, as well as bone drug development. 

Prediction: The “redistribution of bone” phenomenon will see the light of day  

Quite by chance a handful of researchers have detected a phenomenon by which both weight lifters and water polo athletes gain bone mass in many parts of the body but lose mass in other part of the skeleton.  They detected that with loading exercise bone can be redistributed. For example, both male and female weightlifters have been found to gain bone mass in hips and arms, but lose bone mass in the skull. Specifically, male weightlifters were found to have 3% higher bone density in the total body and 10% higher hip density, yet their skull bone was 10% less dense than that of non-athletes. Female weight lifters also build substantial bone in the total body and hip yet had 7% less skull bone density than controls.

Similarly, water polo athletes were found to undergo a redistribution of bone mass from the lower limbs to the upper limbs.  The same redistribution of bone can occur when using bone drugs.  For example, it was recently reported that recombinant human parathyroid hormone drugs (Forteo®) increased bone density of the lumbar spine, but reduce bone density of the hip.

Prediction: Doctors will be required to tell patients of the “Number Needed to Treat” when prescribing a bone drug 

The “Number Needed to Treat” is a calculation that reveals how many people need to be treated with a particular drug to see the claimed benefit. Recently the Journal of the American Medical Association mentioned that the “Number Needed to Treat” for bisphosphonate drugs like Fosamax and Reclast was 77.  Specifically, it was reported that 77 women had to be treated for 3 years with these bone drugs to prevent one single hip fracture. Even worse, an international study I reported on earlier found that 175 postmenopausal women with bone fragility had to be treated for 3 years with bisphosphonates to prevent one single hip fracture. 

In other words, imagine you go to the dentist with a tooth ache, finding decay he says, “I recommend this new dental filling, serious side effects have been reported, but I really like it, and one out of even just 77 people will find it stops future decay in this tooth. 

Tip: When bone drugs are recommended, ask your doctor to give you the “Number Needed to Treat” and to show you the research documenting this.  Remember that those with the most risk factors stand to benefit the most from bone drugs. 

Prediction: Bone quality will be found more important than bone density 

Realizing that bone density does not accurately predict fracture, scientists will expand their search for non-invasive says to measure bone quality and strength. Muscle mass and strength will be proved to reflect bone strength better than current bone density testing. Also novel techniques will be developed to assess quality of the living bone protein matrix. Among other things, skin ultrasound will be used as a markers of bone collagen maturity and connective tissue health  

Futuristic prediction for the new decade…  

The 2020’s will witness a mass awakening of human consciousness creating an appreciate for the dignity and oneness of all humanity and a demand for protection for our natural environment, our Mother Earth.  

Let’s see what comes true and please know that I am wishing you an abundance of peace, happiness and great blessing for improved bone health in 2020 — and beyond!

– Dr. Susan Brown

If you’re familiar with my work, you know I write a lot about the importance of exercise in the Better Bones, Better Body program. Exercise is a wonderful thing for adults, but imagine the impact if we all incorporated enough exercise throughout our younger years of growth and development. Could exercise be the secret to helping children avoid osteoporosis in the future? The research says yes, so let’s take a deeper look. 

Weight Bearing Exercise for Children

Bone is developing rapidly in childhood and adolescence, and peak bone mass is not reached until the age of 30. A 5 to 10% increase in peak bone mass in young adolescents can translate to a 50% reduction of fracture risk in older age.

Bone responds to the load placed upon it, so weight-bearing exercise will is key for developing an optimal peak bone mass. However, as our lives become more and more sedentary, children are exercising less and therefore setting their bones up for failure later in life. An analysis of NHANES data from 2001-2006 found that adolescents spend an average of 8.2 hours per day sitting, and 59% spend 2 hours or more per day watching television or other videos (Yang et al 2019). 

Jumping for Joy

Tell your kids to jump for joy and at every chance they get, because a four-year study found significant gains in bone density from jumping! The study included 107 girls and 98 boys with an average age of 8.5 years. In the standard education curriculum, the intervention group simply added jumping exercises. At the end of the study, the group that performed the jumping exercises regularly had higher bone density in the lumbar spine, total hip, femoral neck, and whole body than the control group.

Daily Exercise Is Key

Another study investigated childhood exercise and fracture risk later in life. Researchers studied 3,534 children ages 6 to 8 years old for up to seven years. One group engaged in gym classes one day a week for 60 minutes, while another group had gym classes every day for 40 minutes. At the end of the seven-year study, the group that exercised every day had almost half the rate of fracture incidence compared with their once-a-week counterparts. 

If you have a child or grandchild in your life, my advice to you is simple: try working out together and share the gift of better bone health. Helping children avoid osteoporosis later in life is easy — and fun!

I’ve seen a lot of anxious, worried people who’ve just been diagnosed with osteoporosis and are struggling to cope with what it means. One thing I tell them is that getting a diagnosis of osteoporosis is a good thing. Really! Here’s why.

Osteoporosis can be completely silent — until it isn’t

When you have undiagnosed osteoporosis, you lack a key piece of information that you need to take action — you can’t solve a problem you don’t know exists. If you’ve gotten an osteoporosis diagnosis, it means that “silent” disease is no longer hiding from you. That means you can do something about it, hopefully before you experience a fracture.

Here’s the thing about osteoporotic fractures: Even when you have them, you may not know you have them unless you have been diagnosed with osteoporosis and have had your bones assessed with x-rays or DEXA scans. Many osteoporotic fractures (especially vertebral fractures) are tiny and relatively painless, so they go unnoticed for months or even years. This allows the underlying imbalance in your bones to worsen until suddenly that “silent” bone loss turns into a potentially devastating major bone break.

A lot of people only find out they have significant bone loss when they have a low-impact bone fracture — one where they have an obvious (and, yes, painful) bone break under a situation that normally wouldn’t cause one, like breaking a bone in your foot after slipping off a curb. If instead of a small foot fracture you wind up with a major fracture to an arm, leg, or worst of all, a hip, it can be life-altering — so if being diagnosed with osteoporosis helps you avoid that, it’s something to be thankful for!

Osteoporosis shines a spotlight on your health

Being diagnosed with osteoporosis offers a window into the health of your entire body. It may simply be showing you that you need more exercise to strengthen your muscles, or better nutrition to provide your bones the building blocks they need to become stronger and more resilient — but it could also be illuminating a hidden health problem that may be uncovered through further testing. And without the osteoporosis finding, you might never have known to look.

A diagnosis is an opportunity

If it sounds like I’m urging you to “look on the bright side” of a finding most people would dread, well, I am — positive thinking is a good way to support your bones, after all — but there’s more to it than that! The most important benefit of getting an osteoporosis diagnosis is the opportunity it gives you to improve your bone health, as well as your overall health. Being told you have osteoporosis is a wake-up call and reminding you to take care of yourself — which is especially important if you’ve spent much of your life taking care of others.

The diagnosis opens the door to building better bones in a better body and learning new things — like the importance of pH balance and the multi-dimensional roles that vitamin D plays, or even how to assess your own nutritional adequacy. And it motivates you to explore exercise — clearly a very important way to build bone and to increase overall sense of well-being and overall health.

There are many options available to address the problem once you understand it exists — and my Better Bones, Better Body program was developed specifically to guide you in solving it.