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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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April 09, 2018

Dear Mark: Power Yoga, Pelvic Floor, Keto Reset and Osteoporosis

By Mark Sisson
33 Comments

Dear_Mark_Inline_PhotoFor today’s edition of Dear Mark, I’m answering three questions. First, is power yoga—a more “intense” version of yoga that includes strength exercises—a suitable alternative to strength training for aging women? Probably not, but that doesn’t make it bad or wrong to do. Second, what’s the deal with pelvic floor dysfunction after menopause? What’s the best way to improve that situation? And third, is the Keto Reset right for older women with osteoporosis?

Let’s find out:

Shannon asked:

Would you consider power yoga “lifting heavy things”? I do power yoga 2-3 times a week and it involves a lot of standing strength and arm/hand stands? Thanks and I love everything on Marks Daily Apple!

Not quite. Nothing can really compete with strength training and high-intensity work for building bone resilience and strength. Your bones need impact and intensity, and yoga generally doesn’t supply enough of it.

That’s why hopping in place can help strengthen hip and thigh bones in older folks. The jarring impact of landing—even from a modest height of six or eight inches—triggers bone resorption and remodeling in the legs.

That’s why lifting heavy things makes bones strong. The bone acts (along with the muscle) as a lever during the lift, which places a lot of stress on the bone. To recover from the activity and be ready for the next time it has to fulfill lever duty, the bone remodels itself, gaining density and getting stronger and more durable.

Power yoga is closely related to ashtanga yoga, long considered a more “intense” form of yoga. Yet an 8-month study found that Ashtanga yoga yielded only mild benefits to bone health. As for strength, another 8-month Ashtanga study by the same group found that it improved leg press strength but little else. It’s better than nothing, but it’s probably not enough to stave off the worst effects aging has on muscle and bone.

Still, if yoga is something you love, continue doing it. Yoga will improve your balance, coordination, flexibility, and even strength under certain contexts. Throwing in a single day or two of dedicated strength training on top of the yoga is a great way to have it all. One day a week is “enough,” two days a week is better (a recent study found that while older women training one day a week maintained strength, training twice a week was necessary to gain ever-critical lean muscle mass).

Power yoga varies a lot from place to place, so it really depends on how your instructor chooses to implement it. I just wouldn’t bank on it providing enough stimulus for your muscles and bones.

Michelle Reese wrote:

I’d like to know a little about how to strengthen and support the pelvic floor, which really gets compromised after menopause, making it hard to do the squats. I’ve really noticed the decline in function after menopause, even though I’ve been working out consistently my entire life. Thanks for doing the research and sharing today’s wisdom!

My pleasure. Thanks for reading!

Realize that the pelvic floor is a system of muscles, and muscles need to be used and loaded, lest they degenerate—which only speeds up as we age. The same thing applies to the rest of your muscle. It’s just that actively using the pelvic floor muscles is harder and less intuitive than actively engaging your biceps or hamstrings. They’re also hidden, so it’s easy to forget they even exist and need our attention.

For pelvic floor stuff, go with Katy Bowman. Check out her articles and books on the subject. Her expertise is unmatched.

Vicki M asked:

No doubt this has been discussed before…..however, for a 60 year old post menopause woman with osteoporosis (but still active, going to gym, walking etc), is Keto reset a good option?

The bad news is that this particular diet has never been studied in this particular population.

The good news is that, as a human, your species has been well-represented in the ketogenic diet literature.

In a long-term 5 year study of human adults, ketogenic dieting failed to produce any negative effects on bone health.

In a shorter study, a low-carb, high-fat diet (no word if it was “ketogenic” or not) failed to worsen bone turnover markers.

Some critics claim that ketogenic diets (and pretty much any diet that includes “evil” animal protein) “dissolve” bones by throwing off the acid/base balance, such that the body must break down bone to ameliorate the acid load. It’s not true, but if it were? In a recent study, elite female race-walkers on a ketogenic diet saw no change in their acid/base balance.

There are more wrinkles to the keto/bone health story, which I’ll explore in the near future. Stay tuned for that.

But long story short, keto reset is fine, provided you don’t just go keto and do nothing else. You still have to train (including strength training), get plenty of sleep, get vitamin D, and focus on the micronutrient content (including the bone-relevant potassium, calcium, magnesium) of your diet and not just the macronutrients.

That’s it for today, folks. Thanks for reading, writing, and commenting. Include any further questions or input you have down below and have an incredible day!

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33 Comments on "Dear Mark: Power Yoga, Pelvic Floor, Keto Reset and Osteoporosis"

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NaturalGirl
NaturalGirl
14 days 11 hours ago

Excellent and informative article.

Elizabeth Resnick
14 days 10 hours ago

Great questions and answers! And love the whole convo that took place with last week’s post about women’s fitness changing with age. Based on all the comments this is clearly a topic of interest to your followers. Personally, I feel amazing at 51 eating what I call a borderline keto diet (nothing is tracked or measured because that would drive me crazy,) getting plenty of movement, and lifting heavy things with my part time bartending job and some home workouts. Mindset and attitude are also so important.

Starmice
Starmice
14 days 5 hours ago

Seconded! Great article. Am very happy to see more posts along these lines – am 49 and also do a borderline keto diet (don’t measure anything either) and now have lost all the weight I’ve wanted to lose! I’ve never been in this situation before, lol! I too, lift twice a week during crossfit sessions plus a yoga class once a week and a teeny bit each morning plus random zumba, u-jam dance classes.

Elizabeth Resnick
13 days 22 hours ago

wow, Starmice…good for you!

Lisa Z
14 days 10 hours ago

Thanks for linking to Katy Bowman for the pelvic floor question. I’ve been following her for years, and as you said, her expertise on this and other topics is unmatched–as well as unconventional, and the word needs to be spread.

Lynn
Lynn
14 days 9 hours ago

In case you forgot, today is the end of the 1,000 day challenge!! (See blog post July 14,2015). Was hoping to see some follow up post!

Dan
Dan
13 days 10 hours ago

Same here! I had it marked on my calendar and was hoping I wasn’t the only one who remembered!

Liver King
14 days 8 hours ago
Wife is a holistic biological dentist of over twenty years… she prescribes Bone Marrow, Beef Liver, sensible sunshine (or vitamin D3), fermented veggies like kimchi (or vitamin K2) and magnesium oil for virtually every patient. Yes, this makes a world of difference in tooth remineralization… it also makes a world of difference in bone remineralization and remodeling too. Combine these raw ingredients with adequate loads, good things tend to happen for bone health. — Vitamins A, D, and K2 cooperate synergistically not only with each other, but also with essential minerals like magnesium and zinc, with dietary fat, and with… Read more »
Elizabeth Resnick
14 days 7 hours ago

Always appreciate your input Liver King!

Markus
Markus
14 days 7 hours ago

Agreed – Liver King always has good stuff to share.

Liver King
14 days 5 hours ago

Thank you… feeling’s mutual. Love the advice that you gave to Jenifer over the weekend!

Curtis
14 days 6 hours ago

Does she do video consultations? I have questions about my dental health and would love to speak to a professional with her primal mindset.

Liver King
14 days 5 hours ago
Many of you have already seen this… I didn’t retype any of it, but… there is an UPDATE at the end that you may find helpful. Our early ancestors didn’t brush… didn’t floss… didn’t get cavities. This is my “go to” line because it seems that the more we brush and floss and use fluoride, the more cavities we get. Obviously, brushing and flossing aren’t the answer, but don’t tell this to the multi-billion dollar dental industry (nor to the allopathic dentist). We all have the ability to remineralize our teeth… to withstand acidic insults… to arrest and resist decay.… Read more »
Andrea
Andrea
13 days 2 hours ago

Right now, my husband and I are into a deep remineralizing and dental health improvement project. (esp. for hubby) Our research dovetails with yours closely, but I appreciate your added details. We are eating chicken livers, (not beef) along with other supplements mentioned. Is it ok to brush with bentonite clay alone? That’s what we are currently doing. Thanks for this vital information!

Liver King
14 days 1 hour ago

Hey Curtis, I tried to respond earlier with quite a lengthy comment… not sure if it will eventually post. I’ll look out for it; if it doesn’t show up, I’ll figure out a way to get the information to you. Thank you for your interest.

amy_baggett@hotmail.com
amy_baggett@hotmail.com
14 days 2 hours ago

Need advice for those of us who cant process tyramine – can’t eat fermented foods/bone broth without getting sick? How can we maintain good gut health and mineralization of bones?

Liver King
14 days 1 hour ago

Include everything on the ancestral menu (liver, bone marrow, sun, magnesium, egg yolks, egg shells, egg shell membranes, ghee, etc), including adequate mechanical loads, and substitute the fermented foods with freeze-dried whole bone (bone matrix, bone marrow, cartilage goodness). I talked about this recently in another post… how our early Inuit ancestors intuitively knew to freeze-dry animal bones, pulverize them and devour. Whole bones have been on the menu for millennia upon millennia. There’s also wild fish eggs and then there’s whole, bone-in small fish.

Zoltan
Zoltan
13 days 17 hours ago

Liver King, how much beef liver and bone marrow does she prescribe per week?
I happen to love both bone marrow and liver, but I don’t eat them every day.

Liver King
13 days 13 hours ago
It depends on the individual… an already healthy person (without dental needs) can easily maintain good health with two to three servings a week of each — this happens to be what most ancestral nutrition authorities recommend (e.g. Chris Masterjohn, Nora Gedgaudas, WAPF, etc.) A person with intensive dental needs may work up to three to four servings a week of each. Bear in mind that the fat soluble system (especially vitamins A and D) work cooperatively and protectively together so think bigger picture, in harmony with nature. Zoltan, since you happen to love marrow and liver, you’ll have no… Read more »
Vive
Vive
14 days 7 hours ago

I’m so glad to see these posts on women’s health, and especially post-menopause health. I’ve been hoping for more of these from MDA. As I approach 50, five years after surgical menopause, I’m aware that I live in a different body than I once did. I appreciate your focus on the specific needs and nuances of this stage of life.

sue nelson
sue nelson
14 days 7 hours ago

I will echo others in offering you sincere gratitude Mark, for taking post-menopausal primal woman health seriously and including us in your audience. It is so hard to find information for this sub-group. Thank you thank you thank you!!!

Christina
Christina
14 days 3 hours ago

Adding to the pelvic floor discussion, chiropractic care has been shown to help control for both pregnant women and those who have never had children. The link below is a general info publication but contains links to the full research studies. https://spinalresearch.com.au/ground-breaking-study-approved-publication-chiropractic-pelvic-floor-control-3/

Kyle Craig
14 days 6 minutes ago
I’ve followed Marks Daily Apple for several years now. Unfortunately I have gotten off track a bit the last few years as we have added new little ones to the home. My metabolism has taken a major hit, would it be best to do a keto reset or take it slow and do the 21 Day Transformation. The discipline used to be there, and I feel like I can get it back. First go round I had lost about 80 lbs and hoping to do something close to that this go round. i am hoping that this becomes more of… Read more »
Kathy
Kathy
13 days 14 hours ago

Thank you Mark for discussing the pelvic floor issue. I have gained 10 lbs in the last year because I am not allowed to run, jump, climb stairs do deep squats or lift heavy things. This is an amazing site. Keep up the good work.

Jay
13 days 13 hours ago

Nice thoughts!! Very rightly

Janelsa
13 days 1 hour ago

The Keto diet is a massive trend in Australia! I know so many people on it.

Bill
11 days 18 hours ago

very interesting thoughts

Jeb
Jeb
11 days 14 hours ago

Good article. I also want to know why women seem to be the target of most bone health discussion. I’ve assumed it must have to do with estrogen. But if that were the case wouldn’t men be continually suffering bad bone health? Is there a physiological reason to this or is it a holdover from the pharmaceutical industry choosing a target market for osteoporosis prescriptions? I ask because my father shrunk down faster than my mother in old age, proportionally speaking.

Vicki M
6 days 22 hours ago

Thanks Mark for the reply to my question re osteoporosis. Puts my mind at rest. Look forward to hearing any more you have to say on the subject 🙂

Alex
Alex
4 days 8 hours ago

Regarding the question of how power yoga could stand in for lifting heavy things, I just ran across a study earlier this week that showed that Bikram yoga (hot yoga) improved the students’ ability to deadlift by 13.1% (increased strength). I’m not sure if Bikram and power yoga are on par with one another — but maybe Bikram could be a happy medium for the person who just does NOT want to lift anything heavier than their own body weight?? Here’s the study’s link: https://breakingmuscle.com/fitness/science-says-bikram-yoga-helps-your-deadlift

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