We will always act with integrity.



When it comes to the advice that we give individuals who have a bone density scan with us, we promise to act with integrity, honour and truth. We will also promise to keep our knowledge of osteoporosis prevention up to date.

Why has this post come about?

In the past, we have been contacted by individuals who are keen to use our service to help them promote supplements or nutritional 'aids' . As we only ever seemed to receive these calls rarely, we tended to ignore them, but more recently we have noticed an increase in this type of interest - we thought we had better set the record straight!

1. We do not accept commission - from anyone - for promoting or supporting any product, whether or not it has been proven to have an effect on bone density. We have a strong stance on this, because we believe that it may compromise the advice we give you. We do promote certain products, books, and services - but only because there is an extensive body of evidence that demonstrates that whatever we are promoting has a valid chance of either increasing bone density or reducing fracture risk.

2. In the overwhelming majority of places we test, it is the establishment that takes a small fee for having us. This is a modest amount which is solely to reimburse the establishment for the use of their space, and for making their members or employees aware of our impending visit. A number of establishments have wanted 'more money' for hosting us - we politely decline these arrangements.

3. If you are interested in promoting a medication or supplement, and using us to help you do so - don't give up just yet: before you contact us, make sure that you have an extensive body of evidence to support whatever it is that you are promoting. If you can provide us with peer reviewed journals, we will look at them and decide whether there is evidence enough for us to work with you. One journal will not be enough - ideally your product or service will have support from either a large meta analysis (As found in, for example, the  Cochrane Collaboration) or approval from the F.D.A.; or be recognised as an effective treatment by N.I.C.E. . Be warned! We are also avid readers of Quackwatch ! Even if you do have an extensive reference list to support you, we will not accept payment for promoting your service, but we may accept payment for providing tests free of charge to a population who will benefit from what you provide.

4. In many cases we will accept advance payment for providing bone density tests to an organisation. A number of council offices, universities, and schools have paid, or subsidized, us to provide their staff with low cost or free bone density tests. This is fine, as the organisation is not a 'vested interest' group and our accepting payment to provide the tests to the staff for free will not compromise the advice that we give the individuals that we test.

5. If you are a gym, fitness, leisure or health centre, we may well be interested in working with you, because there is longstanding evidence to support exercise for the reduction of fracture risk. We sing the praises of many of the health centres that we work with - in particular, some of the ladies only health franchises (even though there is often some healthy rivalry!) offer stunning service to their members and quite literally transform the lives of some of the ladies that have had the good fortune to join. We don't need to accept payment to say this - if you go along to some of the places we have tested (check out future events for more) , you can speak to the members yourself!

We really hope that this clarifies our position. If you've read this and would like to arrange a day with us, great - we look forward to working with you! Go to Hosting a Day for more info.

In moderation!


Tucker, K.L., Jugdaohsingh, R., Powell, J.J., Qiao, N., Hannan, M.T., Sripanyakorn, S., Cupples, L.A., & Kiel, D.P. (2009). Effects of beer, wine and liquor intakes on bone mineral density in older men and women. American Journal of Clinical Nutrition, 89(4):999 – 1000.

This study looked at the alcohol intake, and bone density at the hip and spine, in 1182 men, 1289 post-menopausal women, and 248 pre-menopausal women. The participants were aged between 29 and 86. The difference between this study and other studies looking at bone density and alcohol, was that this study looked at different types of alcohol, and attempted to determine whether one type of alcohol was more beneficial than another for bone density.

The study results showed that men tended to be more likely to drink beer, whereas women tended to drink wine (But we knew that already, didn’t we!).  Interestingly, bone mineral density at the hip was 3.4 – 4.5% greater in men who consumed 1-2 drinks of alcohol or beer compared to non-drinkers, however, men than drank more than two drinks per day had significantly lower hip and spine bone mineral density (3 – 5.2% lower than those that drank 1-2 drinks per day) – seemingly cancelling out the beneficial effect of the first drink!

Bone mineral density at the hip and spine was significantly greater in postmenopausal women consuming more than 2 drinks per day of total alcohol or wine (5.0 – 8.3% greater than in non-drinkers).

The researchers adjusted the data to see whether it may be the silicon content of the beer that was causing the improvement in bone density. The adjustment reduced the benefits of beer on bone density, suggesting that perhaps it is the silicon content of the beer that is causing the improvement in bone density in beer drinkers. However, this did not explain the improvements in bone density seen by the wine drinkers. The researchers suggested that there may be another compound (or other compounds) in other alcoholic drinks, yet to be defined, that is the reason for the benefit in other types of alcoholic drink.

 The pre-menopausal women did not seem to benefit from any type of alcoholic drink.

Other studies have suggested that there may be a benefit to supplemental silicon intake, particularly where calcium intake is insufficient:

http://www.ncbi.nlm.nih.gov/pubmed/19034393?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

We say: Something is causing an improvement in the bone density of people that drink alcoholic beverages (in moderation!), but it may not be the alcohol!

The researchers did not look at the possible role of the mineral boron in this study. Wine is a good source of boron. There has been a certain amount of research surrounding this area, with mixed results – but enough to know that boron has a role in bone health. Boron is also found in fruit and vegetables, something that we know many people in the UK don’t get enough of. It may be that the boron in the wine was replacing that which should have been found in the fruits and vegetables of the participants!

Many people will be amazed how small a ‘moderate’ amount of alcohol is. A 125ml glass of wine contains 1.6units of alcohol – so in other words, a glass of wine this size on a daily basis may give benefits to bone, but any more will likely be counterproductive! It’s worth measuring out 125 ml of water and pouring it into the wine glass you usually use at home – stand back and be amazed how little it is.

Be very careful before taking a boron supplement (or any type of supplement) though. Many of these micro-nutrients can be very toxic in excess. We would always suggest that you try to increase your intake of these minerals through your diet, unless you are under GP advice.

Finally, the bones of the pre-menopausal women did not benefit from the inclusion of alcoholic drinks in their diet. Looks like younger ladies will have to stick to the healthy lifestyle!! Sorry girls!

Another article from Osteoporosis International:

Ball, J.M., Cagle, P., Johnson, B.E., Lucasey, C., & Lukert, B.P. (2009). Spinal extension exercises prevent natural progression of kyphosis. Osteoporosis International, 20: 481 - 489.

Many of you will have seen older ladies with a pronounced 'hunched back' or bent over posture - it is sometimes called a dowagers' hump, and it is often associated with osteoporosis. If individuals have brittle bones in their spine, and if these bones then fracture, they often 'compress' down before they heal. These 'compression' fractures are one of the main reasons for substantial height loss in elderly women (small amounts of height loss (less than 1 and 1/2 inches) can be caused by other things).

I found a good picture of what a compression fracture looks like here

We were very interested in this study, because we are interested to see if there are any ways, through exercise, that you can prevent the onset of spinal curvature as you get older (or at least, reduce the risk!). If you have poor posture, you can be at increased risk of compression fracture - a rounded back means more gravitational force through the shoulders - much better if you have good posture.

This study, conducted at Kansas University Medical centre, was divided into two parts. The first part sought to determine at what age the progression of height loss and spinal curvature, was fastest. The second part looked to see whether spine extension exercises would reduce the progression of height loss and spinal curvature with age.

Part one involved 250 women, aged between 30 and 79. All of the women had osteoporosis or osteopenia, but none of them had fractures in their spine (known as vertebral fractures, or vertebral compression fractures, of course). The researchers found that the greatest loss of height occurred in women between the ages of 50 and 59.

As the greatest height loss was found to occur in women between the ages of 50 and 59 , the second part of the study looked at the women in this age group.

Half of the women were assigned spine extension exercises to do, three times per week.  The other half were told to continue with their normal daily activities. The study continued for one year.

At the end of the year, the researchers found that the women that did the spine extension exercises had no height loss, and no increase in spinal curvature, compared to the women that had not done the exercises, who did, on average, lose height.

There were a couple of flaws with the study (as there are with any study!). In particular, there was a very high dropout rate in the group of women told to complete the spine extension exercises (for example, many of the women did not do all of the exercises, or gave up some way through the year). The problem with a high dropout rate is that you don't know why people have dropped out - if they had back pain, for example, that was worsened by the exercises, their results would not have been included in the results of the 'exercising' group - and yet this could have increased the risk of height loss. An individual who had the same type of back pain in the other 'non exercising' group, would still very likely have had his or her results included, as she would not have had to do the exercises and so therefore would not have 'dropped out'.

On the other hand, there is usually a high dropout rate in this type of 'exercise intervention' study, so it may well have been motivation, rather than a physical factors, that caused individuals to drop out. The authors noted that the dropout rate was not particularly high compared to other similar studies.

We say: This is still a very encouraging study. What we thought was particularly interesting was how simple the exercise program was - it would have taken the average individual less than 10 minutes to complete, three times per week. Furthermore, although no one in the study had a history of fractures in the spine, it has been demonstrated that by maintaining a good posture, you reduce the risk of the fractures becoming 'wedge shaped' (crushed on one side more than the other - typically the narrowest part will be at the front of the vertebra), thereby increasing spinal curvature.

We have recently read the following study, which we thought of great interest, here is the reference:

Mavroeidi, A., Stewart, A.D., Reid, D.M., & Macdonald, H.M. (2009). Physical Activity and Dietary Calcium Interactions in bone mass in Scottish postmenopausal women. Osteoporosis International, 20: 409 - 416.

The study looked at 1847 women aged between 60 and 82. It found that, with regard to bone density, physical activity particularly had beneficial results in individuals that had a low to medium calcium intake.

Throughout the study, a number of interesting points were made. Here are a few quotes:

"It is now well accepted that in addition to genetic factors, environmental influences, such as diet and lifestyle, are also important contributors to the population variance in bone mineral density"

"Bone mineral density is limited, but not controlled by diet, and regulated by mechanical loading"

In particular:

"It has been postulated that the reduction in habitual Physical Activity, a product of the increased mechanisation of everyday life, could be one of the main reasons for the doubling of hip fracture rates in both sexes, over the past 30 years in the UK."

We say: This was an encouraging study. We'd also add that exercise reduces fracture risk in other ways than by simply increasing bone density - by improving an individuals balance, co-ordination, and flexibility, for example. It is still the case that over 90% of osteoporotic fractures occur after a fall, so if you can reduce the risk of falling, you dramatically reduce the problems associated with osteoporosis.

We bought three pairs of these for our grandmothers!

http://www.inside-hospitals.co.uk/x-features/news/Win%20Health.html

There is some evidence that they reduce the risk of hip fracture - if you can get your 

grandparents to actually wear them, that is...

Good Luck!