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The Fountain of Youth May Spring From Our Bones

Our May 1, 2020, Update included a FAQ (14) explaining that bone mass-and-health top out between 25 and 30, and that how active we are in our early years affects our bones for the rest of our life.

After 30, exercise and diet determine how much bone mass and strength we retain. Every year or so our oldest bone matter is expelled and replaced by fresh bone. Exercise and active living make the fresh bones stronger than doing nothing.

In short, lifestyle determines bone health at every stage of life. While the most practical form of exercise varies somewhat with age, impact and effort appear to be the most important factors. (See options below)

A review article by scientists from Korean universities published November 2, 2018, in the journal Endocrinology and Metabolism concluded that "resistance exercise (RE), either alone or in combination with other interventions, may be the most optimal strategy to improve the muscle and bone mass...even in the older population." They add, however, that "RE is seldom prescribed with evidence-based criteria as there are no data on the anti-fracture effect of RE...In addition, if a sophisticated molecular mechanism related to the increased muscle and bone mass due to RE can be identified in the future, it would be helpful to discover the novel therapeutic targets for [bone strength] and sarcopenia."

In short, more information is needed on the “how and why” of resistance and other forms of exercise, either alone or in combination with other interventions, in improving and preserving muscle mass and bone health in all ages.

What follows doesn’t exactly fill the bill. It may, in fact, be better—a remarkable benefit springing from strong and healthy bones.

While the breakthrough studies were mainly with mice, the larger role for bone appears to be widely accepted.

Youth Hormone

Several decades of research have transformed—expanded—our understanding of bones. Our bones may hold a key to living long and healthy.

An article by David Cox in the US edition of The Guardian (July 4, 2020) chronicles the startling discoveries in plain language, and is our main source for what follows.  

Like muscle, bone has come to be recognized as a key player in bodily function, “talking” to all parts of the body.

Osteocalcin, one of the most abundant protein/hormones in bone, appears to hold the key to bone remodeling and other age-related matters.

Mr. Cox’s main authority is Associate Research Professor Mathieu Ferron, who heads up a lab studying bone biology at the Montreal Clinical Research Institute.

Ferron was a student of Gerard Karsenty, who did the ground-breaking research on osteocalcin, observing that mice low in osteocalcin appeared to be fat and cognitively impaired.

“Mice that don’t have osteocalcin have increased circulating glucose, and they tend to look a bit stupid,” says Ferron. “It may sound silly to say this, but they don’t learn very well, they appear kind of depressed. But it took Karsenty and his team some time to understand how a protein in bone could be affecting these functions. They were initially a bit surprised and terrified as it didn’t really make any sense to them.”

Almost 15 years later, Karsenty would publish the first of a series of landmark papers that would revolutionize our perspective on bone and the skeleton in general. We used to view our skeleton as primarily a mechanical structure whose main role is to serve as a scaffold for the rest of the body. But our bones are very much live organs, which we now believe play a role in regulating a whole range of vital bodily processes ranging from memory to appetite, muscle health, fertility, metabolism and many others.

“Karsenty has ushered in the idea that bone is involved in communicating with other tissues in the body that wasn’t really understood or investigated before,” says Thomas Clemens, a professor of orthopaedic surgery at the Johns Hopkins Center for Musculoskeletal Research.

We now know that bones communicate by participating in a network of signals to other organs through producing their own hormones, proteins that circulate in the blood. Karsenty’s mice eventually led him to realize that osteocalcin was in fact one such hormone, and could have future implications in terms of public health interventions.

“The idea that bone could produce a hormone affecting metabolism or even your liver initially came as a bit of a shock,” says Ferron. “People did not expect that. But other scientists have since replicated the results, and even discovered new hormones also produced by bones. It’s opened up a completely new field in bone research.”

The Role of Exercise

After 30, as I explained in our FAQ, exercise and diet determine how much bone mass and strength we retain.

Once again, mice show the way, bringing osteocalcin into the picture.

“Osteocalcin acts in muscle to increase the ability to produce ATP, the fuel that allows us to exercise,” says Karsenty. “In the brain, it regulates the secretion of most neurotransmitters that are needed to have memory. The circulating levels of osteocalcin declines in humans around mid-life, which is roughly the time when these physiological functions, such as memory and the ability to exercise, begin to decline.”

In recent years, Karsenty has conducted a series of experiments in which he has shown that by increasing the levels of osteocalcin in older mice through injections, you can actually reverse many of these age-related ailments.

“Osteocalcin seems to be able to reverse manifestations of ageing in the brain and in muscle,” he says. “What is remarkable is that if you give osteocalcin to old mice, you restore memory and you restore the ability to exercise to the levels seen in a young mouse. That makes it potentially extremely attractive from a medical point of view.”

Scientists have also found that for humans, one way of naturally maintaining the levels of this hormone in the blood, even as we age, is through exercise, something that makes intuitive sense, as physical activity has long been known to have anti-ageing properties. Ferron is hoping that these findings can be used to support public health messages regarding the importance of staying active through middle age and later life.

“If you exercise regularly, then it stimulates your bone to make more osteocalcin, and that will have these beneficial effects on muscle and brain,” he says. “From epidemiological studies, we know that people who are very active tend to have less of a cognitive decline with age than sedentary people. With time, maybe people will be more aware of this connection, and think of their bone health as being just as important as other aspects of staying healthy.”

For more details, here’s the link to the entire Guardian piece: https://tinyurl.com/y8hp9ucr

Many Options

Any form of exercise done regularly is better for bone health than no exercise. A consumer guide from Australia lists the good and not so good. Remember that impact and effort are the key requisites.

For children, moderate to high weight-bearing exercises, such as hopping, skipping, climbing, and running are recommended.

For adults, a combination of progressive resistance training and moderate impact weight-bearing activities such as basketball, tennis, jumping rope, running, jogging, hiking, and stair climbing are recommended.

Leisure walking, yoga, swimming and cycling don't load the skeletal system enough to regenerate the highest quality bone tissue.

Other sports make your bones very strong, but can be hard on your joints. I would put football, rugby, wrestling, gymnastics, and competitive weightlifting in that category. I made it thru high school wrestling without any negative effects, but my middle fingers remember the hook grip I used to hold on to the bar during two decades of Olympic lifting.

Finally, variety in exercise is better than repetition.

My Take

As might be expected, scientists and others are hard at work on drugs to put osteocalcin to work in one way or another.

David Cox tells us that around 20 million adults in the UK are insufficiently active, and that both Professors Karsenty and Ferron are working on ways other than exercise to provide that group with the benefits of healthy bones.

Karsenty is working on a means of artificially increasing the levels of osteocalcin in the blood and has even filed a patent on using it to treat cognitive disorders.

“We’re exploring various ways of doing this, but the idea would be eventually to have something which could be used to treat age-related diseases such as sarcopenia and memory decline," he says. "This is really going to profit the elderly the most, but anyone with a decline in muscle function, because of a hip fracture or another condition, could also benefit from this treatment.”

“Treatments like that tend to be more costly and more difficult as protein injections don’t have a very long half life,” says Ferron. “My lab is developing a stabilized form of osteocalcin so it can stay longer in the body, but the best solution would be to have some sort of small pharmacological molecules that could be put in a pill to target the receptor of osteocalcin to stimulate its activity. So that’s the idea I see for the future.”

While that's well and good, I prefer the exercise route whenever possible. Self-help is something you can do on your own. The only cost is sweat equity. No insurance premiums.

The options listed above show that there are many ways to keep your bones going strong. As you've heard me say many times, what you enjoy and do well works best for most people. The key is to keep challenging your muscle and bones in safe ways. Again, variety is better than repetition.


Running or hiking up hill, combined with strength training, provides both impact and effort. Carol and I go up and down this hill regularly.

Photo by Guy Appleman

The new discoveries on the dynamics of our bones are indeed exciting, giving us another avenue for taking care of ourselves. Knowing that both our muscles and our bones are impacting all parts of our body is an amazing motivator. Fit muscles and bones translate to a healthy body. A concept that would've been unthinkable not long ago--when aerobic exercise was considered the where all and end all of fitness and health.

Bob Hoffman and Joe Weider would be thrilled to have one more underpinning for the strength and health lifestyle.

Exercise truly is the best medicine.

What else does the Fountain of Youth have in store for us? 

October 1, 2020

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