Annemarie Colbin, PhD Oakland, CA: New Harbinger Publications, Inc.:2009
“Ms. Smith, your bone density continues to decline, I think we should discuss treatment options.”
“Doctor, I am really not a pill person. Can’t I keep my bones healthy with diet and exercise?”
If you are Ms. Smith, Annemarie Colbin’s The Whole-Food Guide for Strong Bones was written for you. If you are not Ms. Smith, and are currently taking prescription medication for bone health, you could still benefit from her holistic advice. Avoiding processed foods, limiting alcohol intake, not smoking, avoiding refined sugar, staying physically active--these are all essential components of a healthy lifestyle that are hardly controversial.
Dr. Colbin also presents very strong assertions regarding calcium metabolism, protein balance, the negative effects of acidic food, and the dangers of nightshade vegetables. However, because a substantial number of the references on these topics are from books rather than peer-reviewed journals, these opinions are derived from sources potentially lacking in scientific rigor. The scientific studies from respected journals that the author does discuss demonstrate a marked selection bias--focus almost entirely on risks, while ignoring potential benefits of medications.
Additionally, much of her advice is anecdotal or theoretical. At the conclusion of Part 2, she describes a case study of a woman named Nina who, after being diagnosed with weak bones, made a concerted effort to decrease her stress, reframe her thinking, attend to her soul, intensify her exercise, undergo acupressure, consume herbs, and modify her diet. The author reports a dramatic improvement. However, the only hard data she presents concerns Nina’s wrist (this site is not relied upon by bone experts in the diagnosis of osteoporosis), and the score is reported as “compared to her peers” (this is a Z-score, which is not an essential marker in defining osteoporosis). Nina’s story is inspirational, but not supported by data that would be applicable to the current standard of care for bone health.
When I was assigned this book to review, the author’s name seemed familiar to me. I soon realized that I own one of her cookbooks, The Natural Gourmet, and I have relied upon it for many tasty and healthful meals. In the course of reviewing The Whole-Food Guide for Strong Bones, I prepared several of the recipes offered in the last section of the book, and found them to be delicious (as well as nutritious). The meals are certainly more appealing, less expensive, and not as controversial as a pill, but there is no scientific evidence that they will significantly decrease my risk of fracture.
As the subtitle implies, this book offers a holistic approach to bone health, and is not intended to discuss traditional medical regimens. The holistic approach can be beneficial for patients who choose to embrace it, but it should not necessarily lead to the exclusion of established treatment options. The author’s bias against data-supported medical regimens and her dismissive disdain of the medical establishment is potentially misleading to readers who are looking for a broad and balanced range of options for preventing osteoporosis and fracture.
Dr. Colbin compels us to be critically attuned to our food choices, urges us to integrate nutrition concepts into our daily lives, and highlights the importance of attending to our physical, mental, emotional, and spiritual health. These are valuable messages. While I would not recommend it as the sole treatment plan for someone who has been diagnosed with significant bone loss, this book is a potentially valuable resource for patients with normal bones who wish to maximize their preventive efforts, and it could be used as an adjunct resource for women using more traditional treatments.
Elizabeth HB Mandell, MD, NCMP
Midlife Health Division
Obstetrics and Gynecology
University of Virginia