An Interview with Renée Newman
What are you best known for?
Most people know me as an author of jewelry and gem books. In each of them, I explain how to evaluate gems and have positive buying experiences. Many of the consumer principles I stress in my gem books can be applied to the subject of health care. In both instances, you should be informed and deal with competent professionals who provide you with good documentation.
Why are you concerned about osteoporosis?
My mother had osteoporosis and broke her hip when she was just 62, which made me aware of the dangers of osteoporosis. I became more concerned after I was diagnosed with low bone mass and lost seven to ten percent of my bone density in various parts of my hip during a period of 2 1/2 years before menopause. This occurred despite lots of exercise, a good diet, a healthy lifestyle, adequate calcium & Vitamin D, no drugs and excellent health. Because I volunteer in the orthopedic ward of a hospital and see firsthand the results of broken bones, that too has heightened my concern.
Why did you write a book about osteoporosis?
I wrote this book because I saw a need for a consumer-oriented book that gave a patient's perspective on osteoporosis prevention and that provided guidelines on how to select test centers, understand bone density reports and get maximum benefit from DXA tests.
Another reason I wrote this book was to encourage doctors and bone density centers to offer preventive advice to their patients and to discuss the results with them. I interviewed many people throughout the US about their experiences with bone density tests of their hip and spine. Most of them did not have an opportunity to discuss the results face to face with a doctor or health professional. If we want to prevent osteoporosis, this situation must change. Every time a person is tested, a health professional should explain the results and give the patient a copy of the test results, although with the recent cuts in Medicare reimbursements of bone density tests, that may not be financially feasible. However it wouldn't cost anything to e-mail patients a copy of their reports. My bone density reports are what made me take action to reverse my bone loss. They also provided information that helped me avoid back problems.
How did you research the subject of osteoporosis?
I read osteoporosis books, medical journals and texts and searched the Internet for information. I also consulted with health professionals and had them check over what I wrote. In addition, I got tested at frequent intervals (6 to 9 months) and compared my results from one period to another. Then I analyzed the consistencies and differences between the periods to find out what worked best for me. In addition, I've attended lectures by some of the world's foremost osteoporosis researchers, and I've had the manufacturers of bone density machines (densitometers) show me how their devices work. I still attend bone-related conferences and keep updated on the latest osteoporosis research.
Did you learn anything that helped you?
Yes. Perhaps the most important thing I learned was that I needed to add bone and muscle strengthening exercise for my hips, back, shoulders, arms, wrists, etc. instead of only doing general weight-bearing exercise such as walking, running and dancing.
I also learned that vitamin and mineral supplements can be harmful when taken to excess and that it's important to take calcium along with other important bone nutrients such as vitamin D and magnesium. One of the goals of my book is to help you determine if you're getting too little or too much of the important bone nutrients.
I learned, too, that bone density tests don't just indicate your bone density and degree of bone loss. They can also help detect joint disease, alignment problems and fractures. My reports showed which area of my spine was getting too much stress and prompted me to pay more attention to body mechanics and discontinue exercises that were doing more harm than good.
Don’t people have the same bone density throughout their body?
Bone density often varies throughout the body. One reason for this is that bone loss and gain can be either systemic or localized. An inadequate diet or loss of estrogen, testosterone, or progesterone can cause a generalized loss of bone throughout the body. The effects of exercise and daily activities, however, are more localized. For example, baseball pitchers and tennis players have a higher bone density in their playing arm than in the non-playing arm. The bone density can be as much as 35% higher in the playing arm (J Bone Joint Surgery Am, 1977, 59: 204-208).
How did you determine what your weak areas were?
I studied the data and images on my bone density reports. Fortunately the centers that tested me provided detailed reports that gave the bone densities of each of the various parts of my hip(s) and lower spine and indicated how they compared to the densities of a young adult. I also discussed the results with an osteoporosis specialist.
What did you do to improve your bone density?
I took Fosamax® to help prevent bone loss. However, that wasn’t sufficient to prevent a decrease in the density of my spine during one period when my back didn’t get much exercise. When I added exercises that targeted my weak areas, my bone densities went up significantly to the point that they were normal. Weight-training turned out to be the most effective type of exercise. I don't need Fosamax now because my bone density levels are in the normal to mildly osteopenic range. Most medical professionals today are opposed to prescribing drugs as a means of preventing post-menopausal bone loss in women without osteoporosis. I believe it's safer, better and more cost-effective to take a weekly preventive drug such as Fosamax (alendronate) or Actonel (risedronate) for a year or two during menopause if bone loss is increasing significantly than to lose a high percentage of bone and have to take a drug later in life. The serious side effects that have been reported with bisphosphonates are most likely to occur when drugs are taken for more than three years, given in large doses as a once-a-year drug or taken incorrectly. For example, you must take Fosamax with a full glass of water, not just a gulp of water in order to avoid esophageal problems.
Why didn't you try taking natural hormones or strontium before taking Fosamax?
Products sold as "natural" hormones are typically man-made in a lab, and can have side effects similar to prescription hormones. I would rather risk getting an ulcer from Fosamax than getting cancer, blood clots or a stroke from hormones. In addition I prefer to take regulated products that have been properly tested in clinical trials instead of taking unregulated products with no proven track record.
Strontium ranelate is a prescription drug in Europe and has a slight risk of causing blood clots. Non-prescription strontium supplements are not regulated and haven't undergone extensive testing to determine their safety or proper dosage.
Like any drug, when taken in excessive amounts, Fosamax and similar bone drugs can have detrimental effects, e.g., osteonecrosis of the jaw and over suppression of bone remodeling, leading to brittle bones and spontaneous fractures. I haven't heard of any deaths resulting from once-a-week Fosamax or Actonel, unlike some over-the-counter drugs such as Tylenol. On the other hand, once-a-year bisphosphonate drugs can have life-threatening side effects.
Did you have any side effects from Fosamax. No, I never had any type of side effect from it ( I took a 70 mg tablet). However, I always took it with a full glass of water and I didn't lay down afterwards, which is important when taking bisphosphonate drugs such as Actonel, Boniva and Fosamax. In addition, while I was on Fosamax, I never took other drugs that might irritate the stomach or intestines, such as aspirin.
What supplements do you take? Each day I usually take 500 mg of calcium citrate, 500 mg of magnesium citrate, 1000 IU of Vitamin D3 and about 600 mg potassium citrate. I also get supplemental vitamins and minerals from fortified cereal and orange juice. I started taking potassium citrate after a water aerobics teacher recommended potassium and magnesium for alleviating cramping in the pool. The potassium and magnesium seemed to help prevent cramping. I take the citrate versions of the minerals because they can help prevent kidney stones and have an alkalizing effect on the body, which is supposed to be beneficial for bones.
I drink a lot of non-fat milk and eat more than ten servings of fruits and vegetables per day along with nuts, fish, whole grains, eggs etc. which helps me get the necessary vitamins and minerals such as calcium. People who eat less than I do or who eat non-nutritious food normally should take a multi vitamin and more calcium than what I take.
As long as I am not vitamin or mineral deficient, I don't think supplements have much of an effect on my bone density. When I analyze the results of the several sets of my bone density reports, it appears that the type and amount of exercise I did was the key factor in determining whether my bone density went up, down or stayed the same.
What types of exercise do you do? Over the years, I've done a variety of types of exercise which has included running, bicycling, dancing, swimming, and yoga. I started doing weight training in 2004 with a trainer. I no longer have a trainer, but instead attend a body works class twice a week and work out on my own using both free weights, weight machines and an elliptical machine. In 2007, I started attending agua (water) aerobics classes and found them especially helpful for increasing endurance and safely working all parts of the body against the resistance of the water. Walking is already a normal part of my every day activities, so there's no point in doing it as part of an exercise routine.
As mentioned previously, daily walking and running were not sufficient for preventing bone loss in my hip and spine, even though I think they helped maintain it in my legs and ankles. Strength training twice a week for about a half an hour was also not sufficient for maintaining bone. The three periods where I had bone density gains of 3% or more had one thing in common. They occurred when I exercised at least four to five times per week doing site specific exercise such as squats, lunges, push-ups, single leg lifts with weights and using the lat pull down and cable machine rows. This is consistent with research studies that have shown strength training exercise to be the most effective type of exercise for building bone. My 3%+ gains were made during periods ranging from six to ten months.
Who is your target audience?
1. Anybody who wants to avoid getting osteoporosis
2. Anybody who has osteoporosis
3. Medical professionals who treat patients with osteoporosis.
4. Medical professionals who are interested in preventative care.
Why would medical professionals want to read an osteoporosis book written by a patient and directed to at consumers?
Osteoporosis Prevention is written from the perspective of a patient and consumer writer. As a result you'll find different information in it than in books by doctors. The book shares my experiences with various types of exercise and osteoporosis prevention methods, and it has more consumer-oriented sections such as how to choose a certified trainer, how to evaluate a bone density report and how to avoid being duped by testimonials. Osteoporosis Prevention also goes into much greater depth on bone density reports and test centers than other books.
Medical professionals have told me that my book helps them explain complex medical osteoporosis information in terms a patient can understand. In August 2009, a Chinese translation of Osteoporosis Prevention was published by the Yee Lee Book Company in Taiwan. Leading Taiwanese researchers, doctors and past presidents of the Taiwan Osteoporosis Association are recommending my osteoporosis book to both patients and medical professionals. You can see some of their endorsements on the book information page.
Do you sell osteoporosis-related products?
No. Neither I nor any of my family members sell or have a financial interest in any of the products or services mentioned in Osteoporosis Prevention or on this website. I earn my living from the sales of my gem and jewelry books. That allows me to be more objective and open to all points of view.
How did you get involved in writing about gems and jewelry?
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