When bad food means bad bones

One of the common responses I hear from a patient when I explore dietary patterns that may be contributing to their health challenge is “but I don’t eat fast food”.  Generally, fast food is highly processed, loaded with artificial ingredients, fat and sugar all associated with a broad array of health problems such as obesity, diabetes and heart disease.  The response that “I don’t eat fast food” is a recognition of this relationship.

What most people fail to recognize is that a high percentage of packaged food is very similar in content to fast food.  Literally, a very large percentage of processed food bought in grocery stores is also “fast food” which carries similar health risks.(1)  In discussing all of this, Joel Fuhrman, MD uses a telling term, “fast food genocide”.

The commonality between fast and much of the packaged food is that it is highly processed which researchers studying the relationship between this type of food and disease term “ultra-processed food” (UPF).  The traits of this type of food is that it is highly altered, is low in nutrients, and is high in non-nutritive additives and sugar.  An example of highly altered is refined flour.  The major loss in refining is the fiber which, in a whole grain, slows the absorption of the sugars lessening their conversion to stored fat.  This is made additionally worsened by the added sugars to cover the bland taste of refined flour.

UPF has been strongly linked to almost all of the chronic diseases including diabetes, heart disease and several cancers.  Recent research has added yet another disease to the list, osteoporosis.(2)  The research looked at data from a large, ongoing study of different lifestyle factor and disease, the National Health and Nutrition Examination Survey. 

The study examined almost 11,000 adults of which 454 had been diagnosed with osteoporosis.  Subjects were divided into either low or high UPF groups based on careful dietary intake analysis.  Compared to the low UPF consumers those consuming high amounts of UPFs had a 79% greater incidence of osteoporosis of the hips.  The high UPF group was defined as that type of food comprising more than 57% of their diet.  That may sound high but if a little over 50% of one’s shopping cart has highly processed, packaged food in it, it’s there.

Understanding how much UPF is in the diet can be seen in the Nutrition Facts box and ingredient list which must be on all foods except those completely un-processed such as an apple or head of lettuce.  The grams per serving of sugar must be shown in the nutrition facts box.  Generally, a packaged food with more than 4-5 ingredients suggests that it is more highly processed. 

We literally, must rebuild all tissues many times during our lives.  The epithelial cells that line the gut are replenished in about 1-2 weeks.  We replace 10% of our bone structure each year which means we must rebuild all of it every decade. 

The impact of diet is two-fold.  One connection of the UPF diet is pro-inflammatory.  Inflammation is a driving factor in virtually all chronic diseases including osteoporosis. Diet also supplies the raw materials needed for this ongoing rebuilding of tissue including bone. Inflammation accelerates tissue degeneration as does lack of the nutrients used in rebuilding. 

Yes, diet is related to osteoporosis!

1. Fuhrman J.  THE HIDDEN DANGERS OF FAST AND PROCESSED FOOD.  Am J Lifestyle Med. 2018 Sep-Oct; 12(5): 375–381.
2. Wang et al.  ASSOCIATION BETWEEN ULTRA-PROCESSED FOOD AND OSTEOPOROSIS: A CROSS-SECTIONAL STUDY BASED ON THE NHANES DATABASE.  Nutr Metab (Lond), 2024;21(1):69.