00:00We are doing now a special deep dive at Bloomberg Business Week Daily.
00:03We're talking about health technology and health care.
00:05And more on that, specifically when it relates to women's care.
00:10And there's been some research that's out.
00:12Yeah, the Menopause Society reporting that osteoporosis,
00:15which is highly prevalent in post-menopausal women,
00:18has long been associated with an increased risk of fractures.
00:20There's a new study that suggests it may also increase women's overall risk of death by as much as 47%,
00:26especially within specific ranges of bone mineral density.
00:30Results of the study were published just last week in Menopause, the journal of the Menopause Society.
00:34And it's not just women.
00:34It's men, too, although women have a higher prevalence than men.
00:38Let's get into this.
00:39It's somebody we've talked to before about this area.
00:41It's great to have back with us, Dr. Doug Lucas.
00:43He's an orthopedic surgeon leading the clinical side for bone health and longevity science over at LifeMD.
00:48He's here in studio.
00:49He also has his own YouTube show.
00:51It's called the Dr. Doug Show, Longevity Through Bone Health.
00:54Welcome back.
00:55Nice to talk with you again.
00:57Thank you for having me back.
00:58I have to say, I was surprised.
00:59I think we were surprised kind of reading in that, yes, it impacts both men and women, but it's more
01:04prevalent.
01:04It seems to be much more discussed about for women.
01:07Why is that?
01:09I'm not complaining.
01:10I'm glad we get attention somewhere.
01:12But it impacts all of us as we age.
01:16True.
01:16It is more common in women simply because women have lower bone density to start with.
01:21So men just have a bigger room to lose bone density before they actually reach that threshold of osteoporosis.
01:26So when we think about it from what new research has told us or given us, is there any indication
01:34that we can start doing stuff earlier for preventive measures, eating differently?
01:42Last time you were on, we talked a lot about what's being done with hormone replacement therapy.
01:46What does the data say?
01:48What do the data say?
01:49Yeah, so the challenge with osteoporosis is that in the conventional model, we really look at it as a chronic
01:55disease.
01:56And like most chronic diseases in the conventional model, we tend to just think pharmacology or maybe surgery.
02:02But like most chronic diseases, osteoporosis does respond really well to dietary interventions, exercise interventions, potentially even some over-the
02:12-counter supplement-type things, depending on what your diet looks like.
02:15So there is a lot of room for opportunity to actually improve bone density.
02:19How early, though?
02:19Yeah.
02:20Well, we start losing bone in our early 30s, both men and women.
02:24So I would argue let's start as early as possible.
02:27Let's learn what our bone density is, what our trajectory is, and then intervene when we need to.
02:32Are the health insurers, you know, game for this, for you to start early?
02:36Because it just feels like there's so many parameters about what's okay in terms of testing.
02:40Yeah, it's difficult with insurance because insurance is generally going to want to pay for the doctor's visit and the
02:46drugs if you need them, if you qualify for them.
02:48Prevention is challenging in our conventional medical model.
02:51Why is that?
02:52Why is that?
02:53We're supposed to be about preventive medicine.
02:57We've been talking about that for years.
02:58And yet?
02:59Well, we're better than we used to be.
03:00So now some preventive services are covered.
03:03But the system as it's built is just not good at educating on nutrition in a way that's meaningful for
03:09bone health especially.
03:11Not good at focusing on sleep because these things take time.
03:14They take a lot of question and answers and back and forth and accountability.
03:18And the system is just not built for it.
03:20But I guess what I don't understand is in the long run, wouldn't they save the safe resources?
03:24Would it mean less stress on the system?
03:27And by system, you know, I mean for our own bodies but also the health system.
03:31Yeah, I mean financially if we could prevent chronic disease, of course the system would spend less on chronic disease.
03:37There just isn't a way that I can see in the system to do that.
03:40Yeah, I mean I think about this too.
03:41Like what I was thinking about your YouTube and what you must focus on.
03:45And I don't know if people can call in and ask questions.
03:47But I mean, you know, what are we all doing wrong when it comes to bone health?
03:50So if we have to be kind of our own activist, right, and advocate, what should we be doing from
03:56age 30 on?
03:58Well, I love looking at, you mentioned my YouTube channel, the longevity piece, right?
04:01I love looking at bone health through the lens of longevity because I think every 30-year-old wants to
04:07live as long and as healthy as possible.
04:09And when you look at it through bone health, it gives you a recipe for that.
04:13So the diet that's good for bone health is good for your brain, it's good for your heart, it's good
04:16for your skin, it's good for your energy, it's good for your sleep, right?
04:20So focusing on eating a protein-forward whole foods diet gives you all the tools that you need.
04:25Exercise that gets you out and moving, resistance training for your muscles, potentially impact for your bones if you can
04:30tolerate that.
04:31That's the foundational pieces.
04:33And you can just keep stacking on top of that, better sleep, better mindset, potentially hormone optimization for those that
04:38qualify.
04:40Yeah, I mean, the food, there's a lot of stuff that we can dive into here.
04:43I want to dive into the food part a little bit.
04:44Do you think there's a misunderstanding?
04:45I want to take notes.
04:46Well, do you think there's a misunderstanding about, like, saturated fats, fats?
04:51Because if you think about a protein-forward diet, some people might say, wait a second, if I'm going to
04:54eat all that yogurt, for example, to get all that protein,
04:57then I'm going to just blow past what the USDA recommends for, or FDA recommends for saturated fats.
05:04Are we a little behind when it comes to this stuff?
05:06It's challenging, because if you look at the saturated fat recommendations, it's for the entire population.
05:11But the entire population is not sensitive in a bad way to saturated fat.
05:15So we have to kind of step away from these global recommendations from a nutrition perspective and start getting really
05:21individualized.
05:22What I need to eat, what you need to eat, and what you need to eat are all different.
05:26So, yes, I think saturated fat and dietary fat in general has been demonized in a bad way, and so
05:31people are afraid of it.
05:32And that does result in less protein, especially from animal sources being consumed.
05:36Like, I do think about that with nutritionists.
05:38Like, should we all be seeing a nutritionist early?
05:41Like, I can see your kind of, your facial expression, not so sure.
05:45Why?
05:47So, nutrition's a very challenging space.
05:49There is honestly not great research, because it's difficult to do nutrition research in a randomized control trial meaningful way.
05:56There's too many inputs.
05:57So, a lot of the older mindset in the nutrition space is really set off of these dogmas from the
06:0450s, the 70s, the saturated fat, dietary fat restriction, that really no longer applies and has been hurting us for
06:11a long time.
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