People on plant-forward diets also need to be aware that different types of plant foods vary widely in the amounts and kinds of nutrients they contain. This is especially important when it comes to amino acids, which are the building blocks of proteins. And only a very few plant foods supply any of the three key bone-health nutrients—vitamin B12, vitamin A, or iron—in a form that the human body can absorb.Are these obstacles to bone health? Again, most certainly not. Preparing plants in a way that releases their nutrients and eliminates their interfering chemicals is quick and easy; combining plants to supply the full complement of nutrients is as simple as the click of an online nutrient calculator; and finding vitamin B12 along with vitamin A and iron the body readily absorbs is a matter of planning and a bit of knowledge, nothing more. We wrote this book about food and healthy bones because we wanted you to know what scien-tists know and what Laura’s clinical experience has demonstrated treating dozens of patients with low bone density and high fracture risk: No matter how far you are from peak bone density when starting this journey, and whether you are aiming to top up your bones’ reserves against later decline, arrest bone density decline, or treat osteoporosis naturally, you
can
protect and treat bone health while eating some, mostly, or only plant foods. And, we are
P
lants and bones are the perfect pair. Plant foods are a rich source of the very vitamins, minerals, enzymes, and protein-building amino acids that help bones grow strong and stay dense. Despite that, there is evidence that bone density is lower and fracture risk is higher among people who rely mostly or solely on plant foods. This perplexes physicians and patients alike and raises the ques-tion: Can people who wish to eat more, mostly, or entirely plant foods have healthy bones?Our answer is yes, it’s entirely possible to maintain bone health on a plant-forward diet, and this book explains the why (the science) and the how (what to eat and how to prepare it) and provides more than 100 recipes to support you on your journey.Most of the nutrients humans need to absorb from food do exist in plant foods and edible fungi, including greens and grains, legumes, beans, fruits, edible flowers, nuts, seeds, and mushrooms. How-ever, while the nutrients in animal foods exist in forms we humans can readily absorb, in concentra-tions we need, and include all the nutrients key to bone health, the same is not true for plant foods. The body does not readily absorb many key nutri-ents in the forms found in plant foods. Many of those precious plant nutrients end up being excreted. Plus, some of the natural chemicals in plant foods lock up nutrients and can be damaging to our health.
INTRODUCTION
Plants and Bones
A Dynamic Relationship
2
•
Introduction
science explains why natural biochemicals present in plant foods can protect bones, and we share this exciting science with you in this book. The chapters that follow make clear why nutrition is the founda-tion for healthy bones and provide a basis for understanding how to prepare and combine plant foods to prevent and treat osteoporosis.
Genetics, Nutrition, and Health
Here’s a powerful truth: The nutrients in your food directly influence the action of genes, which in turn directly shape your health, your incidence of disease, and your longevity. This interaction is how food and nutrition influence health outcomes, and it happens via a mechanism termed
gene expression
. Simply put, we will not have healthy gene expres-sion unless we eat foods that provide certain critical compounds that act as signals to activate or silence individual genes. This interaction is an exquisite chemical dance that happens in your body every day, and what it means is that you have a responsibil-ity. Genes carry potential—potential for supporting health but also potential for favoring disease. And that potential must be regulated by you, through the choices you make about what to eat. We delve more deeply into this critical topic in chapter 2, including a specific discussion of how two common plant foods—beets and lentils—can be powerful superfoods that support DNA function.The idea that all nutrients are, in fact, regulators of genetic expression is dramatic and exciting. After the first sequencing of the human genome in 1990, many scientists were drawn to the new field of
nutrigenomics
—scientific investigation that sheds light on the way components of food affect genes that influence health and disease.
Nutrigenetics
, the companion science to nutrigenomics, identifies genetic differences in an individual that influence the response to nutrients.delighted to report, learning to cook with plant foods can have a very high return in overall health.
The Science and Art of Being Well
The Constitution of the World Health Organiza-tion states that “health is basic to the happiness of all peoples.” If we, as providers and consumers, push this most basic right through access to nutritional medicine, the paradigm can shift and medicine can focus on the art of being well.In the past twenty years, the United States gov-ernment has taken big steps forward in changing the paradigm of the nutritional benefit programs they support. Medicaid-supported Food as Medicine pilot programs in Arkansas, California, Massachu-setts, and Oregon specify and pay for prepared meals and groceries, including produce.This is a welcome first step, because proper nutri-tion is the foundation for good health, and emphasizing that good food is prevention as well as medicine is exactly the shift we need. That said, the implementation is flawed. Policymakers have not yet established guidelines for premade meals that rule out highly processed ingredients and certain food additives and require whole foods that are properly prepared for nutrient absorption. Thus, not only is the situation ripe for quick-fix financial opportunism, but the meals are not yet being designed as true food as medicine.Some medical schools are also starting to acknowl-edge the importance of nutrition in human health by offering their students nutrition courses and, in a few cases, cooking classes. However, conventional medi-cine’s focus on pharmaceuticals is long-standing, and it will likely take a new generation of thinkers who have mastered the complexity of natural medi-cine to move a new paradigm forward.Research is showing us how to use plants to pre- vent and treat disease and chronic illness. The
Introduction
•
3
nutrition doesn’t work for maintaining healthy bones is wrong. The most efficient way to bone health is to know how you are built (what your genes are) and what nutritional assistance you need, which can be determined by nutrition testing.As it turns out, plant sources of calcium appear to trigger more helpful genetic expression, and build better bones, than rock calcium does, and plant pro-tein can in many cases provide more health benefit than animal protein—so we know we can faithfully rely on plants to help us thrive.I hope this book is a contribution to the knowl-edge of how to prepare and cook plant foods in ways that maximize their nutrient value, so that people of all ages may know how to protect body and bones and improve their health while enjoying more plant-based meals.
Helen’s Story
Despite consuming greens, grains, mountains of calcium pills, and a wide array of dairy products, I was diagnosed with osteoporosis at age 48. For more than twenty years, every DEXA scan showed more bone loss. As Laura and I discussed this health dilemma, she had an insight that turned out to be powerfully consequential for my health: If we con-sume the nutrients our bodies use when making bone, and the nutrients are in a bioavailable (readily absorbable) form, we can prevent osteoporosis, arrest bone loss, and—depending upon age, life-style, nutrition status, and genetics—possibly grow new bone. We figured out what I should eat to sup- ply my body richly with nutrients for building bone, and I followed that nutrient route for eighteen months. My next DEXA scan showed no bone loss in any region of my body. My doctor, incredulous, insisted I retest. With only nutrition as medicine, I had arrested osteoporotic bone loss—something my doctor had thought improbable if not impossi-ble. As Laura began to work with patients using this The use of nutrigenomics and nutrigenetics as a tool kit for health is set to become widely adopted within the next ten years. Such a tool kit would allow each of us, on our own or with a health care professional, to create detailed nutrient and food prescriptions to either prevent or treat chronic dis-ease in an elegant and efficient way. We will have the ability to design nutrition to positively modify metabolism, creating a new and welcome medicine that is relatively low cost, environmentally positive, and accessible to all.
Laura’s Story
I have learned a lot since 2016, when my mother and I put together our first book,
The Healthy Bones Nutrition Plan and Cookbook
. As the esteemed Dr. Sidney MacDonald Baker wrote in the foreword to that book, precision medicine—treating the indi- vidual, not the disease—has shown itself to be the most effective way to achieve health.In applying precision medicine to bone health, I have been able to understand how an individual’s genetic profile contributes to their bone density, and in this context know more precisely how to improve their recovery, as well as whether lifelong attention to their bone health is needed.Using precision medicine in my practice has entirely changed how I practice, to great result. DEXA scan results show impressive gains for many of my patients—18 percent, 28 percent, 29 percent, 44 percent density increases. Some clients have achieved gains solely through attention to nutrition, while others have combined nutrition and estrogen (at very low dose) or in concert with pharmaceuti-cals. Even people with genetics working against them for bone health have increased their bone density.These gains are far more impressive than the average increase that results from taking a bisphos- phonate drug such as Fosamax, so you can confidently read this book knowing that anyone who tells you