Nov 17, 2013 11:34PM ruthbru wrote:
Along with weight bearing exercise (which is VERY important!) & the vitamin D, another thing you can do which can actually build bones is to eat a serving of prunes a day.
Talk with others about bone density, osteopenia and osteoporosis, and ways to keep your bones strong
Posted on: Nov 17, 2013 10:51PM
My baseline bone density testing (before hormonal therapy) was near normal and slightly osteopenic, so imagine my surprise last year when my bone density decreased 12-16% with full osteopenia. In fact, one area tested was very close to osteoporosis, so I assumed this year's test would put me over. I also felt quite guilty because, due to an unrelated chronic illness, I had not been exercising.
Imagine my surprise this year when my bone density results barely changed and were almost the same--with no osteoporosis! I feel as if I've been granted a much-needed "second chance" at maintaining my bone health.
Since I didn't exercise this past year, I wonder how much my vitamin D supplementation had to do with the good results. Per my MO, I'd been taking 5000 IU of vitamin D along with my calcium for 4 months. When my blood was re-checked, my vitamin D levels went from roughly 30 (prior to the higher supplementation) to 40+ after.
So, either the Arimidex started out with a bang to decrease my bone density and then just leveled out OR my higher vitamin D level played a role. I know it was not exercise, but since I've been granted a second chance I'm going to walk at least a mile every day for bone and general health.
Has this happened to anyone else?
Posts 1 - 30 (34 total)
Nov 17, 2013 11:34PM ruthbru wrote:
Along with weight bearing exercise (which is VERY important!) & the vitamin D, another thing you can do which can actually build bones is to eat a serving of prunes a day.
Nov 18, 2013 06:56AM Momine wrote:
I had an initial drop in bone density on my hip after starting femara, but by the next Dexa it had stabilized and even improved a little. Since my bone density on the hip was 110% before femara, it is now normal, even with the initial loss.
So, yes, I don't think continual loss is a given at all. Now if I can just get my spine to understand that.
Nov 20, 2013 04:18PM peggy_j wrote:
Ruth, thanks for the reminder on prunes. I finally bought some yesterday. Did you eat yours as dried fruit everyday? I'm thinking I'll need to mix things up and put them in recipes. (I found one breakfast recipe; instead of oatmeal, it's quinoa with chopped prunes and a couple other things).
Nov 20, 2013 11:14PM ruthbru wrote:
I like prunes so eat them as a snack. If your recipe turns out good, you should share!
Continual loss in certainly not a given. A friend of mine went into Arimidex already having osteopenia, and did not lose any more ground during her 5 years on it. She is a religious exerciser, which I am sure helped.
Nov 21, 2013 03:47AM Momine wrote:
Ruth, what about all the sugar in the prunes? I do eat some fruit and even a little dried fruit (in my breakfast), but if I added prunes, I would probably have to cut the apple I usually have in the afternoon. I could do that, but I would love to know how prunes help (before doing this, also because I find prunes revolting, lol)?
Nov 21, 2013 08:36AM mamabee wrote:
Ruth, I looked at the prune/bone density study. They ate about 10 prunes a day. That seems like a lot - is that how much you eat too?
Nov 21, 2013 09:17AM ruthbru wrote:
There are quite a few studies out there. This is from July 3, 2012 so it pretty recent.
Momine, I am posting this one because it compares the prunes (dried plums as they are now called) to the apples you eat.
mamabee, in this study they are 100 grams a day. Which would be about 10-12 depending how big they are. I only eat half that many, but I also take vitamin C plus D suppliments, make sure to get in a couple servings of dairy, and exercise every day. Near the bottom they also mention poppy seeds, so many we should all mix them into the diet too?
Jacob Schor, ND, FABNO, is a graduate of National College of Naturopathic Medicine and now practices in Denver. He served as president to the Colorado Association of Naturopathic Physicians, and is now on the board of directors of the Oncology Association of Naturopathic Physicians and is recognized as a Fellow by the American Board of Naturopathic Oncology. He serves on the editorial board for the International Journal of Naturopathic Medicine. In 2008, he was awarded the Vis Award by the American Association of Naturopathic Physicians. His writing appears often in Naturopathy Digest and Naturopathic Doctor News and Review.
Hooshmand S, Chai SC, Saadat RL, Payton ME, Brummel-Smith K, Arjmandi BH. Comparative effects of dried plum and dried apple on bone in postmenopausal women. Br J Nutr. 2011 Sep;106(6):923-930.
Randomized non-blinded comparative study
All 160 participants in this study were women, 1–10 years postmenopausal, not on hormone replacement therapy or any other prescribed medication known to influence bone metabolism. The participants were randomly assigned to 1 of 2 treatment groups.
Study Medication and Dosage
One group consumed dried plums (100 gram/day). The second group acted as a comparative control and ate dried apples instead of dried plums (100 gm/day). Participants in both groups took calcium (500 mg/day) and vitamin D daily (400 IU/day).
Bone mineral density (BMD) of lumbar spine, forearm, hip, and whole body was assessed at baseline and at the end of the study using dual-energy X-ray absorptiometry. Blood samples were collected at baseline and 3, 6, and 12 months to assess bone biomarkers. Physical activity recall and 1-week food frequency questionnaire were obtained at baseline and 3, 6, and 12 months to examine physical activity and dietary confounders as potential covariates.
Consumption of dried plums significantly increased the bone mineral density of ulna and spine in comparison with dried apple. Only the dried plum significantly decreased serum levels of bone turnover markers, including bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase-5b.
These finding confirm the results of a series of earlier studies that suggested consumption of dried plums improved bone mineral density (BMD) by suppressing rate of bone turnover.1 Daily consumption of prunes should now be considered a valid strategy for prevention and treatment of osteoporosis.
Many women are hesitant to utilize the current drug treatments prescribed for osteoporosis. This research confirms the benefit of the "prune diet" treatment for osteoporosis and provides an alternative treatment option.
[NOTE: Prunes underwent an official name change in 2000 and are now, under Food and Drug Administration (FDA) rules called dried plums.]
Bahram Arjmandi, who is listed as a coauthor of the current paper, has been investigating dried plums for more than a decade; his first paper was published in 2001.2
The current report is very similar to a pilot study Arjmandi published in 2002. He had previously shown that dried plums were "highly effective in modulating bone mass in an ovarian hormone-deficient rat model of osteoporosis." So Arjmandi conducted a study "to examine whether the addition of dried plums to the diets of postmenopausal women positively influences markers of bone turnover." In that study, 58 post-menopausal women were randomly assigned to eat either 100 grams of dried plums or 75 grams of dried apples every day. The prunes but not the apples "significantly increased serum levels of insulin-like growth factor-I (IGF-I) and bone-specific alkaline phosphatase (BSAP) activity."
High levels of both of these chemicals are associated with faster bone formation. Serum and urinary markers of bone resorption, however, were not affected. The drugs typically used to treat osteoporosis focus on the other side of the equation; they slow bone resorption.
Since then Arjmandi has written a string of papers using animal models of osteoporosis in order to better understand the action dried plums have on bone. In a 2005 paper using ovariectomized rats, he reported that dried plum restored femoral and tibial bone density, increased lumbar bone density, and improved bone quality and trabecular microarchitectural properties.
Arjmandi pointed out the unique action dried plums had on bone: "Loss of bone volume accompanied by loss of trabecular connectivity is generally believed to be an irreversible process, but our observations suggest that dried plum improves trabecular microstructure of tibia after losses have already occurred."3
Similar benefits were obtained using castrated male rats and reported in 2006, with dried plum completely preventing the castration-induced decrease in whole body, femur, and lumbar vertebra bone mineral density. The bone resorption biomarker deoxypyridinoline (DPD) rose by 36% in the castrated rats but dropped 57% in those rats consuming dried plums.4
Several additional papers of interest have been published while this trial was underway. A 2008 paper explained, "Dried plum polyphenols inhibit osteoclastogenesis by downregulating NFATc1 and inflammatory mediators."6 A 2009 publication tells us that the polyphenols in dried plums "attenuate the detrimental effects of TNF-alpha on osteoblast function."7
Of particular interest is a 2010 paper reporting that combining dried plum and fructo-oligo-saccharide (FOS) supplements increased both of their bone-restoring effects. In fact this combination had a greater effect at increasing bone density than any other functional foods yet tested.8 Also of note, an additional mouse study published in 2010 showed that dried plum supplements could restore lost bone mass in aged mice.9
This current study leaves little doubt that consuming dried plums can preserve bone. The pertinent question then is what percentage of patients can actually be compliant with this treatment? The daily dose of dried plums, 100 grams, is equivalent to about a dozen prunes. Although the mechanism has yet to be delineated, the fact is well accepted that prunes have a laxative effect. Some patients may find it difficult to comfortably consume a therapeutic dose. One option is to simply prescribe dried plums "to bowel tolerance" and to then increase the dose as tolerance improves over time.
Another option would be to combine the prunes with other agents or foods that have the opposite effect on bowel transit times (BTT). Calcium has long been associated with slowing BTT. Poppy seeds also have a pronounced slowing effect on BBT. It is perhaps noteworthy that both ground poppy seed pastes and prune pastes have been traditionally consumed in close proximity in certain cultures. It also may be possible at some future point to isolate either the active factors that impact bone density and concentrate them or identify which elements create the laxative effect and remove them.
Fortuitously, a fair percentage of patients who may benefit from "prune therapy" have relatively slow BTT, and this prescription for osteoporosis may relieve their constipation.
1. Hooshmand S, Chai SC, Saadat RL, Payton ME, Brummel-Smith K, Arjmandi BH. Comparative effects of dried plum and dried apple on bone in postmenopausal women. Br J Nutr. 2011;106(6):923-930.
2. Arjmandi BH. The role of phytoestrogens in the prevention and treatment of osteoporosis in ovarian hormone deficiency. J Am Coll Nutr. 2001;20(5 Suppl):398S-402S; discussion 417S-420S.
3. Deyhim F, Stoecker BJ, Brusewitz GH, Devareddy L, Arjmandi BH. Dried plum reverses bone loss in an osteopenic rat model of osteoporosis. Menopause. 2005;12(6):755-762.
4. Franklin M, Bu SY, Lerner MR, et al. Dried plum prevents bone loss in a male osteoporosis model via IGF-I and the RANK pathway. Bone. 2006;39(6):1331-1342.
5. Bu SY, Lucas EA, Franklin M, et al. Comparison of dried plum supplementation and intermittent PTH in restoring bone in osteopenic orchidectomized rats. Osteoporos Int. 2007;18(7):931-942.
6. Bu SY, Lerner M, Stoecker BJ, et al. Dried plum polyphenols inhibit osteoclastogenesis by downregulating NFATc1 and inflammatory mediators. Calcif Tissue Int. 2008;82(6):475-488.
7. Bu SY, Hunt TS, Smith BJ. Dried plum polyphenols attenuate the detrimental effects of TNF-alpha on osteoblast function coincident with up-regulation of Runx2, Osterix and IGF-I. J Nutr Biochem. 2009;20(1):35-44.
8. Arjmandi BH, Johnson CD, Campbell SC, Hooshmand S, Chai SC, Akhter MP. Combining fructooligosaccharide and dried plum has the greatest effect on restoring bone mineral density among select functional foods and bioactive compounds. J Med Food. 2010;13(2):312-319.
9. Halloran BP, Wronski TJ, VonHerzen DC, et al. Dietary dried plum increases bone mass in adult and aged male mice. J Nutr. 2010;140(10):1781-1787.
Nov 21, 2013 10:03AM Momine wrote:
Ruth, thanks. That is interesting. Just to be clear though, they compared the prunes to dried apple. Dried apple has much more sugar in 100 grams than fresh apple. I will look into this for sure, though, thanks again.
Nov 21, 2013 10:08AM Momine wrote:
Wow! 100 grams of prunes has 64 grams of carbs and 38 grams of sugar. For comparison, a medium apple has 21 grams of carbs and 16 grams of sugar. I will definitely consider this remedy, but it would mean cutting all the carbs from one of my meals in exchange.
Nov 21, 2013 10:47AM edwards750 wrote:
ByFaith - I was already osteopenia when I was dx so wasn't a good plan to take Arimidex but that's what my ONC prescribed for me along with my taking 1200 mg of calcium and an additional med to contribute to the calcium loss. The additional drug was expensive but the first year BCBS picked up the tab. After the cost was on me I talked to my ONC about switching to Tamoxifen which doesn't rob you of calcium. She agreed and since then I have had a bone density test and my numbers are better. Factor in that I was walking almost every day around the track and on the treadmill so I think exercise is key. Also I began having cereal with milk for breakfast every other day. Now my cholesterol number has dropped to 180 and my LDL is 90 which is really good for bad cholesterol. So exercise and additional calcium has worked for me. No one wants to have osteoporosis; my Ob-Gyn told me if I have a "fall" it will be tough to come back from. Diane
Nov 21, 2013 12:48PM - edited Nov 21, 2013 12:50PM by ByFaith
I'm going to add in prunes and exercise more, for sure. Very convincing study, ruthbru. I'd love to find organic prunes.
Ruthbru -- Excuse me if you've already mentioned this, but did you ever take hormonal therapy?
Nov 21, 2013 01:03PM QuinnCat wrote:
Ruthbru - from your article above on prunes:
The prunes but not the apples "significantly increased serum levels of insulin-like growth factor-I (IGF-I) and bone-specific alkaline phosphatase (BSAP) activity."
This caught my eye because I've seen some journal articles surrounding IGF-1 (or IGF-1R) and it's affect on BC.
Several studies indicate that IGF-IR activation is associated with the growth, invasion, and metastasis of breast cancer (1) and where estrogen receptor (ER) is present, also interplays with this steroid hormone receptor to promote growth (2).
I'm not one to study these journal articles as though I'm going to be tested, but maybe a more patient soul could ferret out the meaning of all this. I always find in life that things aren't always so simple, cause and affect wise. For every action there is an equal and opposing action, etc., etc..
Nov 21, 2013 01:14PM peggy_j wrote:
momine, I'm no expert on carb exchanges but I know prunes have a ton of fiber. The package I have said that 5 prunes have 12% of our daily fiber, so 10 prunes would be almost 1/4 of our fiber intake today. I know endocrinologists are big fans of using fiber as a means to offset the glucose spikes, which is why they are anti-juice and pro-whole-fruit. Do you know how much of an apple is water? I did a quick google search and answers range from 60-80% so I'm betting a lot of the 100 grams of apple is actually water. (the study ruth posted compared dried prunes against dried apples. Maybe that would be a closer nutrient comparison, or maybe substitute 50 gr of dried fruit for 100 grams of water-filled whole fruit?)
ruth, thanks for letting me know you only ate about 1/2 the prunes each day. That makes it easier! Here's the recipe (haven't tried it yet)
Nov 21, 2013 05:13PM - edited Nov 21, 2013 09:58PM by ruthbru
ByFaith, yes, I took Arimidex for 5 years.
Kam, I have read a little about those studies, but I think you have to balance it all out, and prunes seem like more of a positive than a negative to me. My doctor commented that if every person would eat a serving of prunes a day, there would be many fewer cases of colon cancer....since by having BC, we are at an increased risk of that too; it seems to me that, for most people, adding some prunes would be a good thing to add to their regular diet for that reason also.
Peggy, you try the recipe first and let me know if I can't live without it!
Nov 21, 2013 09:55PM mamabee wrote:
Thank you Ruth, going to get some prunes tomorrow.
And thank you Peggy for the recipe. One of my favorites is Chicken Marbella which has a cup of prunes - www.oprah.com/food/Chicken-Mar...
Nov 25, 2013 10:31AM del4 wrote:
With ruthbru, I did my 5 years on Arimidex with no change in bone density. Thanks to (ruthbru gets a HUGE cheer here) prunes, vitamin D3 ( I need 8,000ius to get it up to 42!) and calcium 1,200/magnesium600, exercise with free weights, & GOOD GENES. IT's the GENES which make a huge, HUGE, difference re: bone density. If your mom, grandmother, had good bone density, that 's a real PLUS for you too. Learned that from my docs, when they were so surprised at how good my bone density was after 5 years on Arimidex.
Nov 25, 2013 11:33AM corky60 wrote:
I really think it's in the genes. I am trying lots of things to keep bone density up but osteopenia was there prior to Aromasin. Both grandmothers and possibly mom had osteoporosis. Genes play such a large role but we tend to be hopeful that we can overcome, work around or work through our heredity.
Nov 25, 2013 11:51AM QuinnCat wrote:
Once an orthopedist told me I'd never have a problem with my bones, "they are so thick." That's parlance for "big boned," I guess. I wonder if that is even true? My bone density scan pre-aromasin show slight osteopenia in the lumbar, but I hadn't done any weight-bearing exercise for 10 years (before that I was an exercise maniac for decades). Back to mania now, so will be a test of his prediction (next year).
Nov 25, 2013 09:05PM ruthbru wrote:
Agreed that genes are a huge factor, but we can all do a lot of 'tweaking' of our diet, lifestyle etc. to limit the 'bad gene' effect as much as possible.
Nov 25, 2013 09:23PM Furfriend2 wrote:
Great info on the prunes-dried plums. I really like prunes so I will now stock them in my pantry!
Dec 5, 2013 03:29PM Safetyyfirst wrote:
It is ironic that you mentioned colon cancer many times follow bc. My colon was discovered first as a met.
I was given a body scan to find the primary site and it was bc. Both breast. I myself discovered
One lump months ago but was in total denial. I had been told after a few mammo some years ago
My breasts were very dense. On two past mammo I was called back to have them redone because
They thought there was a problem. But it was the density I was told. Unfortunatey, this caused me
To forego mammo for a few years. Now I'm here with you lovely ladies.
Have a blessed day.
Dec 6, 2013 09:55PM - edited Dec 6, 2013 10:23PM by Safetyyfirst
Thanks Ruth. I am on letrozole, I also get an injection for the bone mets to strengthen them.
And 50,000 units wkly of vitamin D
Tonight I started taking the letrozole at night after reading many of you are doing that. I sleep very
Little at night so I hope this helps. I am eating organically, juiceing, and have added dried date. (read somewhere they were needed).
Cannot seem to remember to pick up the dried plums yet. Thank you all for you helpful information.
Everyone have a blessed wk end.
Dec 7, 2013 11:31AM PoohBear-61 wrote:
Cant find the dried prunes you are all talking about ...is it the same as pitted prunes found next to the raisins and figs....????
I don't see how this helps bone density ....the pitted prunes I bought indicate 2% of your daily value of calcium in a serving which is not much .
Dec 7, 2013 11:35AM dogsandjogs wrote:
Prunes are dried plums and are in the section with the raisins and other dried fruits.
Dec 7, 2013 12:03PM corky60 wrote:
Pooh I read somewhere that prunes (dried plums) contain boron and other minerals which can help strengthen bones. But I wonder about the issue of dependence. Prunes stimulate the colon (large intestine.) Will it become dependent on prunes in order to function properly?
Dec 7, 2013 12:05PM ruthbru wrote:
Prunes are great for colon health! My GP says that if everyone ate a daily serving of prunes, there would be many fewer cases of colon cancer.
Dec 7, 2013 12:14PM corky60 wrote:
I will have to ask my dr. about the possible dependence issue. I am just curious if that could become a problem in the future. Maybe I am overthinking the issue.