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Hip Fracture Usually Requires Hip Replacement

The most-feared injury among serious bicyclists is a broken hip. The femur hip bone is shaped like a shepherd's crook. The blood supply to the ball at the top of the hip bone comes in through the neck just below the ball. If the neck or ball are broken, the blood supply is usually shut off and the top of the hip bone dies. To prevent this from happening, fractures of the ball or neck of the hip bone are usually treated with immediate hip replacement. Try to avoid this drastic surgery by keeping your bones as strong as possible.

1) All exercise strengthens bones. Bicycling strengthens bones, but not as much as sports that exert greater forces on bones such as running or lifting weights. (Medicine & Science in Sports & Exercise, March 2009).

2) Exercise increases calcium absorption, which is necessary for strong bones. As I reported last week, even non-impact exercises such as swimming and cycling increase calcium absorption from the intestines by upregulating the calcium transporter genes. (American Journal of Physiology, Endocrinology and Metabolism, April 2009).

3) Those most likely to suffer broken bones during exercise are people who have low levels of vitamin D (Journal of Bone and Mineral Research, September 2006). When you lack vitamin D, ionizible calcium drops. This causes the parathyroid glands to put out large amounts of parathyroid hormone which takes calcium out of bones to weaken them and increase fracture risk.

4) High blood levels of parathyroid hormone (from vitamin D deficiency or any other cause) are a major risk factor for bone fractures during exercise (Bone, August 2005).

If you ever are unable to expose a few inches of skin to sunlight for at least 20 minutes four or five times a week, get a blood test called vitamin D3. If it is below 75 nmol/L, you need to take a vacation in a sunny place, or take at least 3000 IU of vitamin D per day until you can get some sunlight.

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Dear Dr. Mirkin: What is the link between rheumatoid arthritis and infections?

Rheumatoid arthritis is a disease of inflammation. This means that the proteins in your bloodstream that are supposed to attack and kill germs, instead attack, dissolve and destroy your own tissue. A recent report from Case Western in Cleveland shows that curing gum disease lessens arthritic pain, the number of swollen joints and the degree of morning stiffness in people who suffer from rheumatoid arthritis (Journal of Periodontology, June 2009).

More than ten studies show that the antibiotic, minocycline, is far more effective than placebo in treating rheumatoid arthritis, yet most physicians will prescribe drugs that suppress immunity instead of antibiotics. I think that your doctor should look for something that makes your immunity overactive, such as gum disease or another hidden infection. More on rheumatoid arthritis

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Dear Dr. Mirkin: Why are my triglycerides high?

Your body makes triglycerides from dietary sugar. When blood sugar levels rise too high, your pancreas releases large amounts of insulin. Insulin converts sugar to triglycerides. High levels of triglycerides increase risk for clotting, so your good HDL cholesterol carries triglycerides to your liver and blood levels of HDL drop. Then excess triglycerides can accumulate in the liver to damage it and cause a fatty liver. Many people who have a fatty liver that is not caused by infection already have diabetes and may not know it or develop diabetes very soon afterwards.

To get your triglycerides to normal (under 150), change your life style to follow all the rules for preventing diabetes:
• Avoid sugar, especially sugared drinks (including fruit juices), and foods made with flour -- except during exercise
• Lose weight if you are overweight
• Get adequate vitamin D
• Exercise regularly and vigorously

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Recipe of the Week:

Lentil Tabbouleh Salad

You'll find lots of recipes and helpful tips in The Good Food Book - it's FREE

June 22nd, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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