The Catskill Chronicle

By Mort Malkin

In previous columns, B & B took note of the complexity of the body in both structure and chemistry. The care and feeding of that body and brain require a vast number of nutrients, not just burgers and fries. Among the 80 or so mineral elements we need are the macro nutrients sodium, potassium, and calcium.

Sodium, despite the common advice to restrict its intake, is the major ion found in the blood with a level of 140 meq. Sodium is the principal intercellular element, as well. It is so important; our kidneys are programmed to reabsorb it maximally as urine is formed. But salt makes food taste good, and so we overuse it in our diets. Just a little, please.

Potassium, as the major intracellular ion, is needed in even larger amounts. It is especially important in muscle contraction, both voluntary muscle and cardiac muscle, but hardly anyone speaks of it except the nephrologists who worry that patients with end stage renal disease might be eating too much food with a high potassium content. Watch those bananas.

Today, we focus on calcium. Calcium is not only the major structural mineral of our bones, it is necessary for nerve transmission, muscle contraction, and blood clotting. To those ends, the body maintains a narrow range of blood calcium concentration (9-11 mg/deciliter). The bones with their calcium capital are used as a bank — an old fashioned savings bank, no credit default swaps or securitized derivatives. Calcium deposits and withdrawals are used to hold blood calcium steady.

It is so important to maintain blood calcium concentration at Goldilocks levels [not too little, not too much], the body has several mechanisms to influence blood calcium. First comes absorption from the intestines. On average, we absorb only 30% of the calcium present in food, and even that relatively small percentage is dependent on adequate amounts of vitamin D. It’s a safety valve against a calcium rich diet. Calcium is abundant in green leafy vegetables and in dairy products. But, in many green leafies oxalic acid is also present. The oxalic acid chemically binds calcium, and absorption is foiled. Watch out for spinach, collards, chard, kale, and mustard greens. We can finesse the dastardly chemistry by blanching these veggies and discarding the water.

Next, the parathyroid glands secrete parathormone, which can increase blood calcium by making withdrawals from the body’s bone bank. There is a safety valve here, too. The thyroid gland, next door to the parathyroids, produces not just thyroid hormone but also calcitonin which lowers blood calcium and deposits it in the bones. The pharmaceutical companies naturally tried to make an end run around Nature’s calcium balancing act and came up with a drug to increase the mineralization of bones: Fosamax (bisphosphonate). As with every other drug for every other condition, there were a couple of dozen possible side effects. For Fosamax, the latest one to be reported was increased brittleness of bones and resultant fracture. Mother Nature must delight in satire — increasing the risk of fracture when we take the very drug meant to strengthen the bones.

The answer is not to hit the panic button or to prepare yourself for the orthopedic surgeon’s knife. If the intent of taking the now dreaded drug was to increase bone density and decrease this risk of osteoporosis and fracturing a bone, sports medicine has come to the rescue. A combination of aerobic and strength training exercises will do even more than increase bone density. The choice of actual exercises is basic, universal, and hardly intimidating: aerobic walking and small free weights. The weights (5 to 15 lbs) will increase the strength of the hands, wrists, arms, and upper body. It will also increase bone width and mineralization. Aerobic walking will: increase walking speed, strengthen the supporting muscles of the entire lower body, improve balance and coordination, and increase the mineralization of the bones. In addition, walking outdoors heightens your production of vitamin D, the sunshine vitamin. Elderly walkers and runners do not fracture their bones unless they fall into an open manhole in the street. You develop strong bones by using the musculoskeletal system, not by eating ice cream sitting on a couch before a TV screen. Nor does exercise in moderation have any of the adverse side effects seen with prescription drugs. Rather, it stabilizes all the facets of the calcium balance of your body. Have fun.

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* Dr. Malkin is the author of “Aerobic Walking—The Weight Loss Exercise”