Gwyneth Paltrow, Osteopenia, and Diet Advice from the Daily Mail

At her health site Goop.com, Gwyneth Paltrow recently revealed that a broken leg she suffered several years ago was due to osteopenia, or brittle bone disease, possibly caused by sun avoidance and low vitamin D:

I suffered a pretty severe Tibial plateau fracture a few years ago (requiring surgery) which led the orthopaedic surgeon to give me a bone scan, at which point it was discovered I had the beginning stages of osteopenia. This led my western/eastern doctors in New York to test my Vitamin D levels, which turned out to be the lowest they had ever seen (not a good thing). I went on a prescription strength level of Vitamin D and was told to … spend a bit of time in the sun! I was curious if this was safe, having been told for years to stay away from its dangerous rays, not to mention a tad bit confused. [1]

Low vitamin D can certainly cause osteopenia and fractures. Bone density is highest and fracture rates lowest when serum 25(OH)D levels are between 32 and 45 ng/ml. [2] (As an aside, 25(OH)D levels should be tested routinely. It’s remarkable that Paltrow’s doctors waited until she had fractured a bone to measure her vitamin D levels.)

In Paltrow’s case, however, it’s quite likely that other nutritional and dietary deficiencies were also at work.

For 11 years Ms. Paltrow has avoided meat and dairy and eaten a macrobiotic diet in which most calories come from grains and legumes – two of the toxic foods that the PerfectHealthDiet counsels avoiding.

Grain consumption has long been known to damage vitamin D status and bone health. Indeed, it is difficult to induce bone frailty in laboratory animals without feeding them grain. In Edward Mellanby’s original experiments leading to the discovery of vitamin D, he induced rickets by feeding dogs a diet of oats or wheat bread. [3] In human infants, wheat bran induces rickets. [4] In addition to interfering with vitamin D, grains also contain high levels of phytic acid, which interferes with bone mineralization by blocking absorption of calcium and magnesium.

Another crucial factor in bone health is vitamin K2. Since dairy fats are the leading source of vitamin K2, it’s likely Ms. Paltrow was deficient in this crucial vitamin. Most people are deficient in vitamin K2 – let alone those who avoid meats and dairy.  In clinical trials, vitamin K2 supplementation reduced non-vertebral fractures by a remarkable 81%. [5]

Given Paltrow’s avoidance of animal fats, it’s likely that omega-6-rich vegetable oils were an outsized share of her diet, and fatty seafood a small share. But a high omega-6 to omega-3 ratio reduces bone density. [6]

The long and the short of it is that Ms. Paltrow would benefit from more meat, more fat, more fat-soluble vitamins, and fewer grains and legumes.  A commenter in Britain’s Daily Mail quipped:

Maybe if she started having a nice juicy steak for dinner each day instead of the poached peelings from half an apple … [7]

Hyperbolic, no doubt, but good advice!

[1] Gwyneth Paltrow, June 17, 2010, http://www.goop.com/?page=newsletter_vn&id=177. Hat tip Frank Hagan, http://www.lowcarbage.com/2010/06/27/gwyneth-paltrow-and-osteopenia/.

[2] Bischoff-Ferrari HA et al. Positive association between 25-hydroxy vitamin D levels and bone mineral density: a population-based study of younger and older adults. Am J Med. 2004 May 1;116(9):634-9. http://pmid.us/15093761.

[3] Mellanby E. (March 15 1919) An experimental investigation on rickets. The Lancet 193(4985):407-412.

[4] Zoppi G et al. Potential complications in the use of wheat bran for constipation in infancy. J Pediatr Gastroenterol Nutr. 1982; 1(1): 91-5. http://pmid.us/6310074.

[5] Cockayne S et al. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Arch Intern Med. 2006 Jun 26;166(12):1256-61. http://pmid.us/16801507.

[6] Watkins BA et al. Dietary ratio of n-6/n-3 PUFAs and docosahexaenoic acid: actions on bone mineral and serum biomarkers in ovariectomized rats. J Nutr Biochem. 2006 Apr;17(4):282-9. http://pmid.us/16102959. Watkins BA et al. Dietary ratio of (n-6)/(n-3) polyunsaturated fatty acids alters the fatty acid composition of bone compartments and biomarkers of bone formation in rats. J Nutr. 2000 Sep;130(9):2274-84. http://pmid.us/10958824.

[7] “Gwyneth Paltrow:  I’m suffering from brittle bone disease,” Daily Mail, June 26, 2010, http://www.dailymail.co.uk/tvshowbiz/article-1289644/Gwyneth-Paltrow-Im-suffering-brittle-bone-disease.html.

Leave a comment ?

19 Comments.

  1. A lot of the bizarre eating habits of female celebrities comes from wanting to look cadaverously thin. We like to watch old films and we’re continuously amused that the glamorous women in them look positively chubby compared to the women in modern films and on TV.

    • Surely true, erp. Although we also watch old movies, and I have to say that Audrey Hepburn was exceptionally slender in Breakfast at Tiffany’s, which we saw last week. I see in Wikipedia that she broke her back in 1959, and had three miscarriages. She died of cancer at 63. Wouldn’t be surprised if she was on a macrobiotic diet too…. I see on answers.com that “Hepburn was whittled down by a diet that sometimes consisted only of flour made from tulip bulbs” — this was during World War II. Afterward a Good Housekeeping report in 1959 had her eating a pretty sound diet, but apparently with very small portions; but elsewhere her friend Audrey Wilder said “she was always eating spaghetti or a version of it.” If so, not very far from Gwyneth Paltrow’s diet.

      One thing that’s remarkable to me is how little help these celebs get from their expensive doctors. You’d think wealth and fame would buy good care, but maybe it just buys yes-men who flatter the patient to keep their gig.

  2. pj, Audrey Hepburn may have started the trend toward extreme emaciation. To be fair, women may only want to be thin and don’t think too much about their health and their doctors make that happen. Perhaps few women can be both.

  3. How did I miss this? « The Bone Architect - pingback on July 3, 2010 at 8:31 am
  4. Bone Architect,
    You are the knucklehead!! Leafy greens only contain vitamin K1, which is NOT the same as K2. Vitamin K2 is much more important for bone health. Educate yourself!!
    http://www.lef.org/magazine/mag2008/mar2008_Protecting-Bone-And-Arterial-Health-With-Vitamin-K2_01.htm

  5. Thanks, Jade, for defending my honor.

    Bone Architect, leafy greens are excellent, healthy foods, and vitamin K1 may help conserve vitamin K2, but as Jade points out vitamin K1 is mainly used to make clotting factors and vitamin K2 is the key for bone health.

  6. Hey Paul:

    Mea culpa! If you’ll go read my entire reply to Jade (which of course, you can’t), you’d see I acknowledged my error. That’s what I get for to trying to read before being fully awake. I’ve since edited that post and admitted my error. OOPS. Didn’t see the K2 distinction.

    As I mentioned to Jade, back in November of ’09 I stumbled across the Japanese studies done on K2/bone resorption. My problem is I’ve eaten hard cheese and yogurt all my life and still have really awful bone density (at age 48). So how to get the K2 without the dairy, since there are some theories out there that think the high acidity in meat and dairy cause osteoporosis?

    I ended up getting the K2 from supplementation rather than foods (as much as I hate to do that.) Oddly enough, I bought the same brand of K2 that Jade referenced in her defending-your-honor-post.

    It seems to be working well. Combining an alkalizing diet with daily yoga (using Dr. Loren Fishman’s Yoga vs. Osteoporosis poses), and getting my low vitamin D levels up with D3, I’ve managed to go from osteoporosis to osteopenia in 3 out of the 5 test sites after only 10 months. Not bad huh?

    Sorry about the knucklhead thing. I’ve now learned the hard way not to engage in name calling! Big-time blushing here. You can read about the Yoga vs. Osteoporosis thing over at my blog: thebonearchitect.wordpress.com

    Again, many apologies
    Raye

    • Hello Raye, Thanks for coming. I’m sorry to hear about your osteoporosis. K2 supplements are essential, good for you. You might check out our diet, it’s great for bones and teeth. Some of the most helpful steps for bones: vitamin C, 1 g/day; magnesium citrate, 200 mg/day; sufficient vitamin D or sunshine along with K2; reducing omega-6; obtaining regular omega-3 from fish; avoiding grains; avoiding sugar; and muscle-building exercise with good posture. Esther Gokhale’s posture book is helpful at teaching how to “stack” the vertebrae for good weight-bearing loads that stimulate bone growth.

      Your blog looks fun. Great dancing photo! And entertaining story about the Buddhist neighbor. As for yoga, I used to do it regularly, but now I except for occasional stretching and mobility exercises I mostly focus on strength and running.

  7. I’m always amused by the change in ideal body image for women in media that happened at roughly the same time Americans became more obese. There might be some psychological link between the two things there. I did a post about it at Low Carb Age where I have an edited picture showing Marilyn Monroe’s tummy in her 1954 Playboy spread (probably safe for work as I cropped it before showing the NSFW stuff, but it does show her naked thigh in a side profile).

    The sad thing is that in Paltrow’s case she is doing it for health reasons, and believes she is doing the right thing. And most doctors wouldn’t disagree with her: reduce meat, exercise like crazy, and stay out of the sun. Sounds like a good routine for a gopher, not a human, but that’s the kind of advice you tend to get from most doctors these days.

  8. Heh. Great line, Frank – it is a good routine for a gopher.

  9. Hi Paul,

    Found your site today via Chris Kesser and really liking it!

    Am reducing supplements and relying increasingly more on Real Food, so a question occurred to me:

    – Read recently that free radicals are not all bad; some are used as signaling molecules(?) at the biochemical level… so, would 1g vitamin C (presumably a very high dose from the paleo perspective) interfere with proper signaling? Kind of the same principle as the gene-blocking effects of modern drugs?

  10. Hi Jim,

    Well, they have observed some substitution of vitamin C for innate antioxidants at gram doses.

    I think somewhere between 500 mg and 1 g vitamin C per day is optimal.

    Partly this is prophylactic: vitamin C deficiency is disastrous, whereas vitamin C excess has trivial harm.

    Free radicals are important signaling molecules, which is why you want to avoid introducing an excess with bad diet.

    Vitamin C is definitely better for you than many of the plant antioxidants found in vegetables. It directly raises glutathione levels and is essential for human health.

    I think the lesson is that you want all the natural human antioxidants to be in balance. This means avoiding deficiency of iron (for catalase), copper and zinc (for superoxide dismutase), selenium (for glutathione peroxidase), glutathione, and vitamin C.

  11. I want to thank you for this informative read, I actually appreciate sharing this good post. Maintain up your work.

  12. My apologies for joining in a bit late, but I can’t help but add my comment about this topic. I was also told to avoid the sun but after personal research I found out that may have been wrong.

    No regarding bone health, will it be better to get k2 from natural sources (such as fermented foods) or supplements? A friend recommended http://products.mercola.com/vitamin-k/ but I want to weigh my options first.

    Thanks!
    Mika

  13. Where would our ancestors have naturally gotten K2 and vitamin D3 from?
    I read your other post on vitamin D3 toxicity from bone broth, so perhaps bone marrow is a good source. But what about K2? Where would one get that in food if supplements weren’t available?

    • Hi S,

      Egg yolks are a good source of K2, but the content varies significantly based on the species of bird. A duck egg yolk contains about 25 mcg of K2 (in comparison to only 5 mcg for a chicken egg yolk).

      Beyond ancestrally-available foods, aged cheese is a good source of K2, but again the content varies significantly based on the variety of cheese. An ounce of Jarlsberg cheese contains about 35 mcg of K2 (in comparison to only about 10 mcg for an ounce of most other cheeses).

      Food sources of vitamin D are difficult to find. But your body will make its own vitamin D when skin is exposed to noontime sun (or any light source containing UV wavelengths near 295 nm).

      Best,
      -Eric

  14. Hi Amanda,

    The chart you linked says chicken egg yolks contain 37 mcg of K2 per 100 grams. Note that 100 grams of egg yolk is about 7 chicken egg yolks.

    I could not find a reference for the K2 content of duck egg yolks, so I purchased several samples (raised in different states) and paid for lab testing of their K2 content. Every sample had close to 25 mcg per yolk.

    By the way, the data for goose liver in that chart is based on measuring a single sample. To get an idea of how much variation there was, I tried measuring another sample and got a result that was an order of magnitude lower… So be warned that some samples of goose liver might be that high, but it’s not a reliable source like egg yolks.

    Best,
    -Eric

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