The Connection between Blood Glucose and Bone Health
Dr. Joel Fuhrman - January 23, 2020 11:50 AM
In addition to
following a diet that is made up of whole plant foods, it’s important to keep
the glycemic load of your diet in mind. Using more beans, nuts, and seeds as major calorie sources, instead of
grains and potatoes, reduces the overall glycemic load of the diet. As more and
more research is conducted, we are learning that blood glucose levels are
relevant to most chronic illnesses, not just diabetes.
Type 2 diabetes increases fracture risk
Evidence suggests
that patients with type 2 diabetes are at greater risk of bone fractures.1
Among patients with type 2 diabetes, poorer glycemic control is associated with
impaired bone turnover, meaning slower replacement of old bone tissue with new
bone tissue.2,3
This suggests that elevated blood glucose could weaken bone.
Hyperglycemia harms bones
Bone tissue constantly rebuilds itself. Bone-building cells called
osteoblasts and bone-resorbing cells called osteoclasts work together to
maintain bone mass and bone strength, striking a balance between building new
bone and breaking down old bone.
Elevated blood
glucose impairs the bone-building effects of osteoblasts. A study in healthy
women found that a single bout of hyperglycemia resulted in measurable
decreases in markers of osteoblast activity. This impaired bone building
structurally compromises bone, leading to elevated fracture risk. For example,
another study found that patients with inadequately controlled type 2 diabetes
had higher fracture risk (compared to healthy people and those with adequately controlled
type 2 diabetes) and altered bone architecture in the femur – thinning in the
middle and thickening at the ends – which suggests susceptibility to fracture.
In addition to
compromising bone turnover, elevated blood glucose accelerates the production
of advanced glycation end products
(AGEs), which drive oxidative stress and damage collagen in bone tissue.
Production of the bone-derived hormone osteocalcin is also diminished in T2D
and in response to hyperglycemia. In addition to its bone-building activities,
osteocalcin is involved in metabolism; a form of osteocalcin prompts insulin
release and increases insulin sensitivity in muscle and fat tissue. Hyperglycemia
also promotes calcium loss via the kidneys and reduces osteoblasts’
responsiveness to vitamin D.
Nuts, seeds, and beans can help
In a vegan or near-vegan diet, when high-glycemic foods like potatoes,
rice, and white flour products are used as the staple calorie sources, the
glycemic load of the diet can get excessively high. Lower-glycemic calorie
sources like beans, nuts, and seeds help shift the glycemic load of the diet
lower, which, as mentioned earlier, affects many aspects of health, including
bone health.
How almonds may promote bone health
Nuts may contain
additional phytochemicals that promote bone turnover, according to an
interesting study. Healthy volunteers consumed three different meals, each
containing the same number of calories; the meals were made up primarily
of almonds, potatoes, or rice. Cultured osteoclast precursor cells were then
treated with serum from the volunteers. Serum taken after the almond meals
reduced the number of osteoclasts formed and osteoclast-specific gene
expression and reduced calcium release from bone cells. No effects of the
potato or rice meals were detected. This suggests that phytochemicals derived
from almonds help to keep the balance between osteoblast and osteoclast
activity. This could be due to anti-inflammatory or antioxidant
phytochemicals, as there is evidence that the anti-inflammatory effects of
other polyphenols (such as plum polyphenols) help prevent bone loss, and
oxidative stress is known to stimulate osteoclast activity, leading to bone
loss.
A vegan diet in
itself is not enough. A focus on high-nutrient foods, including lots of green
vegetables, beans, nuts, and seeds, keeps glucose and insulin favorable while
providing nutrients crucial to bone
health.
This blog was originally posted on Dr.
Joel Fuhrman’s website. Click here to read.
Joel Fuhrman, M.D. is a
board-certified family physician, nutritional researcher and six-time New
York Times best-selling author. He serves as
the President of the Nutritional Research Foundation. Dr. Fuhrman has
authored numerous research articles published in medical journals and is on the
faculty of Northern Arizona University, Health Science Division. His two most
recent books are “Eat to Live Quick” and
“Easy Cookbook and Fast Food Genocide.”