Did you know that heart disease and osteoporosis are closely linked — to such an extent that it’s been suggested those with heart disease should be screened for osteoporosis and vice versa? According to emerging science, the two conditions are tied together by one major factor: inflammation.
So that’s why, for February’s Heart Health month, I’m recommending you obtain one simple blood test that’s capable of detecting runaway inflammation and its related antioxidant deficit: C-reactive protein (CRP). In fact, some authorities suggest that the high-sensitivity CRP test could predict the risk of developing serious heart disease (and other chronic illnesses) years in advance (He et al., 2010; Li et al, 2017).
What is C-reactive protein?
C-reactive protein (CRP) is produced in the liver in response to inflammation; its job in the body is to attach itself to phosphocholine (a chemical produced by both microbes and cells that are dying) to “flag” the unwanted cells for the immune system to remove.
If there’s an actual infection or injury present, inflammation and the resulting high CRP aren’t such a bad thing — you want your immune system to be activated so it can find and eliminate bacteria or dead and injured tissue — but in heart disease and other chronic illnesses, the high level of CRP signals continual inflammation that doesn’t go away.
You might remember a 2004 Time magazine cover story alerting the public to the clear link between inflammation and heart disease. That was when elevated CRP was first understood for its role in the development of chronic inflammation (Rifai & Ridker, 2001). It was linked not only to heart disease, but also diabetes, stroke, metabolic syndrome, and many other serious, long-term illnesses — including osteoporosis.
There are dozens of studies that have looked at CRP levels in individuals with low bone density and osteoporosis and have found a clear relationship between high CRP and weak or thin bones (Ganesan et al., 2005; de Pablo et al, 2012). Interestingly, there was a greater relationship between bone weakness and CRP than bone density. One study (Schett et al., 2006), concluded that “hs-CRP level is a significant and independent risk predictor of non-traumatic fracture. This finding is consistent with the hypothesis of a tight interplay between low-grade inflammation and bone turnover.” And where osteoporosis coexists with other inflammatory conditions, like emphysema, CRP highlights that association too (Samaria & Bhatia 2015).
Lowering elevated CRP levels
- So now that we know elevated CRP is a red flag for both your bones and your cardiovascular health, what do we do about it? Happily, many of the recommendations I offer for bone health also help reduce inflammation and lower CRP.
- Eat an Alkaline for Life diet focused on whole foods and filled with colorful fruits, berries, veggies, nuts and seeds — and dark chocolate. By doing so, you’ll increase your intake of antioxidants, such as vitamin C, alpha lipoic acid, selenium, and curcumin, as well as the fat-soluble vitamins A, D, E, and K, and important minerals such as magnesium.
- Eliminate sugar, fried and processed foods, and reduce alcohol — all of these encourage inflammation.
- Exercise has been found to lower CRP levels and strengthen bone at the same time. Mindful exercises like tai chi and yoga can be helpful for people just starting out — and they help lower stress levels, which not surprisingly are also associated with higher CRP and inflammation.
- Rest! Getting insufficient sleep has been shown to increase inflammation and CRP levels. (And no—taking a nap won’t do the trick. You need your eight hours at night.)
I encourage you to learn more about keeping your heart and bones healthy, including the amazing benefits that vitamin K2 offers your heart and your bones. Read my blog — Is Vitamin K2 your body’s best buddy? — for more.
Barbour KE, et al. Inflammatory markers and the risk of hip fracture: The Women’s Health Initiative. J Bone Mineral Res. 2012 ;27(5):1167-1176. de Pablo P, Cooper MS, Buckley CD. Association between bone mineral density and C‐reactive protein in a large population‐based sample. Arthritis Rheum. 2012;64(8): 2624–2631.
Ganesan K, Teklehaimanot S, Tran T-H, Asuncion M. Relationship of C-Reactive Protein and Bone Mineral Density in Community-Dwelling Elderly Females. J Natl Med Assoc. 2005;97(3):329–333.
He LP, Tang XY, Ling WH, Chen WQ, Chen YM. Early C-reactive protein in the prediction of long-term outcomes after acute coronary syndromes: a meta-analysis of longitudinal studies. Heart. 2010 Mar;96(5):339-46. doi: 10.1136/hrt.2009.174912.
Jaffe R, Mani J. Predictive biomarkers in personalized laboratory diagnosis and evidence based best practices outcome monitoring. Townsend Letter Jan 2014; http://www.townsendletter.com/Jan2014/predbio0114.html.
Li Y, Zhong X, Cheng G2, Zhao C, Zhang L, Hong Y, Wan Q, He R, Wang Z1. Hs-CRP and all-cause, cardiovascular, and cancer mortality risk: A meta-analysis. Atherosclerosis. 2017 Apr;259:75-82. doi: 10.1016/j.atherosclerosis.2017.02.003. Epub 2017 Feb 9.
Rifai N Ridker PM. High-sensitivity C-reactive protein: a novel and promising marker of coronary heart disease. Clin Chem. 2001 Mar;47(3):403-11.
Samaria JK, Bhatia, M. It’s all too much: COPD Comorbidities: Raised CRP Levels Associated With Osteoporosis In Patients With COPD. Am J Respir Crit Care Med. 2015;191: 1.
Schett G, Kiechl S, Weger S, et al. High-Sensitivity C-Reactive Protein and Risk of Nontraumatic Fractures in the Bruneck Study. Arch Intern Med. 2006;166(22):2495-2501. doi:10.1001/archinte.166.22.2495.
Xu W Chen B, Guo L, Li Z, Zhao Y, Zeng H. High-sensitivity CRP: possible link between job stress and atherosclerosis. Am J Ind Med. 2015 Jul;58(7):773-9. doi: 10.1002/ajim.22470.
I’m Dr. Susan Brown. I am a nutritionist, medical anthropologist, writer, and speaker. Get my free weekly newsletter here.