Namaste Readers!Yoga and Osteo Cover Photo copy

Yoga has become so popular in our culture that it seems to pop up on the Internet, in alternative medicine and even amongst scientists and doctors. It is typically recognized as an exercise that makes our body more flexible and stronger!

There are many types of yoga that target different parts of our body. Some are meant just for relaxation, while others teach us to strengthen our muscles. So the burning question some of us are asking is, “can yoga help osteoporotic bones?”

Yoga is a great exercise and can strengthen and build balance in almost anyone. Yoga is also now being studied for helping to correct unwanted spine curvature like scoliosis and initial results show promise. Some also say that yoga can help increase our bone mass, although research in this area is not yet conclusive and needs more studies.

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The caveat with yoga is that many of the poses done in a yoga program can harm osteoporotic bones. Yes… harm… so it seems like yoga and osteoporosis may not really go together like a peanut butter and jelly sandwich. Here are some reasons why:

  • Healthy, strong bones can withstand extra stress acting on the skeleton during certain yoga poses. For example, when we bend forward to touch our toes, the spine curves forward and stretches the back leg muscles, such as during the Downward Dog pose. This puts pressure between the bones that make up our spine (called vertebrae). Osteoporosis can seriously weaken our spine bones, which can then fracture even with a little extra pressure, such as during a forward spine bend.
  • Other common yoga poses, such as the Triangle, Half-Twist or Warrior poses require our torso to rotate around the hips. Although they are great ways to relieve muscle tension, the twisting motion, in osteoporotic skeleton, places tension on the spine causing unwanted stress.

Sometimes osteoporosis can lead to several spine bones being compressed and collapsed due to numerous fractures resulting in a permanent forward hunch (called ‘kyphosis’). This osteoporotic hunch can cause chronic pain, disability and negatively influence health and self-esteem. At this point, even simple things like pulling the knees towards the chest while on the back can add stress to weakened spine.

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Therefore, if you have been diagnosed with osteoporosis and want to exercise safely and effectively, please avoid drastic movements and poses that place stress on your bones, especially your spine, like forward spine bending, spine twisting, lifting arms above shoulder height or high-intensity jumping.

If you have osteoporosis and are still tempted to do yoga, talk to your doctor to see what they recommend, or at least talk to the yoga instructor and ask them to modify spine bends and twists during the class for you. Just remember that you need to be careful to not place too much stress on your bones, like your spine, to cause them to fracture.

Do you have other questions about yoga and osteoporosis?  Comment in the box below.

By Isabel Rodrigues, Kevin Chia, and Dr Luba Slatkovska. Infographics by Kevin Chia.


Canadian Musculoskeletal Conference (CMC) 2016

Registration for #CMCTO2016 for health professionals is now open.  Visit our link on the menu for further details or register at:

We hope to see you there!


What is Trabecular Bone Score (TBS)?

Trabecular Bone Score or TBS provides information about the quality of bone structure in the spine bone. This information complements bone mineral density measurement, and can be helpful to clinicians in determining fracture risk and discussing lifestyle management or treatment options with patients. It is conveniently measured during a standard bone density test. We are pleased to announce that our program, the Osteoporosis Program at University Health Network, has recently installed innovative software to measure TBS in our clinic patients. Click on the image below to learn more about TBS.


TBSBy Luba Slatkovska, PhD

Our Research – Does vitamin E help bone health?

Aging causes an increase in oxidative stress and inflammation in our bodies. Along with declining estrogen levels, these changes may lead to bone loss in postmenopausal women. The effects of estrogen on bone have been investigated in great detail, but not much is known about the effects of antioxidants and anti-inflammatory substances on bone. Since vitamin E has both antioxidant and anti-inflammatory properties, it may be beneficial to bones. In order to assess whether vitamin E can affect bone loss, our group studied the relationship between vitamin E and bone turnover markers in postmenopausal women. Bone turnover markers are chemicals in the body that can provide information about bone formation and bone resorption (bone loss) and are measured by either a blood test or urine test.  Bone turnover markers can be used in research studies to test the short term effects of diet on bone health. The bone turnover markers that we looked at were :  1) bone alkaline phosphatase (BAP) which is a bone formation marker in the blood and, 2) urinary N-telopeptides/creatinine (uNTx/Cr) which is a bone resorption maker in the urine.

In our study, we looked at relationships between blood levels of two forms of vitamin E and bone turnover markers in a sample of healthy postmenopausal women in the US who participated in a national survey in years 1999-2002. These two forms of vitamin E were alpha-tocopherol and gamma-tocopherol, and are described below in more detail:

Alpha-tocopherol: Has a high antioxidant activity and is the most common form in dietary supplements.

Unfortified food sources: sunflower seeds, almonds, hazelnuts, peanuts; sunflower, safflower and grapeseed oils; avocados; green vegetables

Gamma-tocopherol: Has a high anti-inflammatory property and is the major form of vitamin E in North American diets

Unfortified food sources: Pecans, peanuts; soybean and canola oils

We also looked at the relationship between alpha-tocopherol intake (data was not available for intake of gamma-tocopherol from food sources) from food and supplements and bone turnover markers.  It has been shown that high intakes of alpha-tocopherol from dietary supplements can lower blood levels of gamma-tocopherol. We do not know how this change can affect our health. The results of our study were published in June 2012 in the Journal of American Bone and Mineral Research.  There were no relationships between alpha-tocopherol intake from food sources and bone turnover markers. As expected, we found that women who used vitamin E supplements had high blood levels of alpha-tocopherol and low blood levels of gamma-tocopherol. These women also had lower levels of BAP (a bone formation marker). We found no relationships between blood levels of alpha-tocopherol and gamma-tocopherol and uNTx/Cr (a bone resorption marker). These results suggest that vitamin E supplements may not help bone health. More research is needed in this area to find out if vitamin E intake from food sources can improve bone health or not.

So what is the bottom line?  As long as you have a balanced diet, and do not overeat or completely eliminate one food group, you will not be causing imbalances in your blood levels of various nutrients. Also, unlike supplements, whole and unprocessed foods contain a mixture of different types of vitamin E as well as many other nutrients all of which may play a role in our health.  For example almonds are high in vitamin E but they are also high in calcium and magnesium two other important nutrients in bone health. In conclusion, we believe the best way to get nutrients, including vitamin E, is to get them from food sources.

By Maryam S. Hamidi, PhD and Hajera Khaja, M.Sc

Our director, Dr. Angela M. Cheung, has been awarded the Tier 1 Canada Research Chair in Musculoskeletal and Postmenopausal Health

Congratulations to our director Dr. Angela M. Cheung for being awarded the Tier 1 Canada Research Chair in Musculoskeletal and Postmenopausal Health! The Canada Research Chair program attracts and retains the world’s most accomplished and promising scientists. The focus of Dr. Cheung’s work is to improve the quality of life, health and healthcare of people with musculoskeletal conditions, especially postmenopausal women.

Dr. Cheung is a professor of medicine at the University of Toronto, a staff physician at the University Health Network and the founding director of Osteoporosis Program, Centre of Excellence in Skeletal Health Assessment and Women’s Health Program at the University Health Network and Mount Sinai Hospital.

We are all very proud to be part of her team.

UHN news release

Dr. Angela M. Cheung


Resources for healthy eating


There are many resources on the internet these days, but not all of them provide reliable, evidence-based information.  Check out some of the Reliable Resources that our Osteoporosis Program staff at the University Health Network and Mt Sinai Hospital use to help educate patients and blog readers.  Today’s Reliable Resources are for healthy eating. Click on the image below to upload the handout.

Resources_healthy eating_final

We hope you found this information helpful. If you have any other questions, feel free to comment in the box below or email us at

Good Moves


New Year, new beginnings and resolutions…

Are you looking to move and exercise more this year to help prevent osteoporotic fractures? We applaud you! Physical activity is important for people with osteoporosis or low bone mass. It can help improve strength and balance, and prevent falls and injuries that lead to osteoporotic fractures.

Are you hesitant to get started, because you have osteoporosis, and are worried about fracturing as you move and exercise? It is wise to be cautious. There are certain movements and exercises that are unsafe for people with osteoporosis. But don’t let this caution hinder you completely!

Are you keen to learn which movements and exercises are “bone-unsafe”, and which are “bone-healthy”? You’re in the right place. Consider our Good Moves handouts. Each Good Moves handout aims to describe one bone-unsafe move (and how it increases risk for osteoporotic fracture) or one bone-healthy exercise (and how it can improve muscle strength or balance).

Without further ado, here is our first Good Moves handout. It focuses on a common, bone-unsafe movement: spine rotation or spine twisting. Click on the image below to upload the handout.

Good moves _Spine twisting v5

Stay tuned for more Good Moves handouts in the upcoming months. Also, consider learning more about exercise and osteoporosis from these resources:

  • OsteoConnections pages that describe the link between osteoporosis and exercise
  • Osteoporosis Canada’s exercise recommendations for people with osteoporosis or low bone mass
  • Osteoporosis Canada’s tips for getting started for individuals who are not accustomed to exercise