More about Fosamax and femur fractures

If your doctor was to prescribe you a "bone-sparing" drug, such as Fosamax, or Aledronate and you were aware that the US courts are filling up with cases alleging that these drugs were the cause of increased fracture risk, would you still take the drug?

Look at these figures for Fosamax alone!

Fosamax femur fracture lawsuits numbers as of March 31, 2015:

515 cases have been filed in California state court for femur fracture

1,040 were pending in the Fosamax femur fracture MDL in federal court; and
3,050 cases have been filed in New Jersey state court for femur fracture

975 cases alleging osteonecrosis of the jaw

Yikes!  I wonder what the figures are in New Zealand where it is next to impossible to sue for this kind of harm?

Source of these figures below (refer PDF - pages 20-21).

You will get a fright when you see all the cases pending for osteonecrosis of the jaw (ONJ) as well (this refers to the death of the jaw bone which is a horrific side effect of these drugs):

Merck Quarterly Report 2015

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The advice in these articles is given freely without promise or obligation. Its all about giving you and your family the tools and information to take control of your health and fitness.

Let's place Granny on the Suds - Bisphosphonates: Updated

I have written often about osteoporosis (weak bones) and I want to explain more about why we should be very concerned about the wholesale prescribing of bisphosphonate class drugs for preventing the progress of osteoporosis. It is increasingly likely that Granny will be prescribed these drugs if there is any hint of osteoporosis. Bisphosphonates are the same class of phosphate chemicals that are found in some laundry detergents. If this does not put you off these drugs right away, read on...

Bones are living organs that are being constantly rebuilt by the actions of two very special cells in your bones - osteoblasts and osteoclasts.

These cells perform a rather miraculous balancing act. The osteoblasts make the bone framework, while the osteoclasts break it down. Between the 2 of them, they make sure that the bones are healthy and maintain their proper shape. If a bone gets damaged, the osteoblasts make new bone to repair the damage. The osteoclasts break down any extra bone framework that the osteoblasts make. When the bone forms, the osteoblasts are trapped within it. They are then called osteocytes. Although they no longer make new bone, they are involved in maintaining the bone structure.

This is where it gets interesting: Exercise, including daily activities like walking to the shops, putting out the washing and making the beds, stimulates the osteoblasts into action, laying down new healthy bone, while the osteoclasts remove the old stuff. If there is no activity, the osteoclasts just keep on doing what they do with the result that there is an overall loss of bone. Especially if there is also a shortage of essential nutrients, like Calcium, magnesium, protein and vitamin D.

So, if Granny is inactive and if her diet is poor and if she is not getting any sunlight, she will start losing bone mass. The obvious remedy is daily activity, a nutrient rich diet and plenty of sunlight. The javelin thrower in the picture to the right is a wonderful example of somebody who is doing the right things to maintain healthy bones regardless of age.

The following has to be the most cynical action ever when it comes to dealing with a health problem: Some smart person discovered that the chemicals in soap powders kills off these hard-working bone cells - no bone loss. So, here's a way to make billions of dollars - make the stuff into a pill, give it a misleading name like "Fosamax" and sell it as a cure for osteoporosis.

The problem is dead bone becomes brittle bone. Worse still, dead bone does not heal when damaged. When damaged, the bone just ulcerates away. The condition is called "osteonecrosis". Google the word and be prepared to be disturbed, if not horrified. So, routine procedures like dental work can turn into an incurable nightmare of jaw rot.

If a relation of yours is on any of these "bone drugs", I urge you to question the need and to ask why natural therapies (sunshine, nutrition, exercise and diet) have not been prescribed.

Test your doctor's knowledge about Bisphosphonates: Updated

In response to my recent articles about bisphosphonate drugs, some readers have questioned their doctors about side effects of taking these. The responses have been astonishing: "No knowledge of any adverse reports", or that any side effects are "extremely rare", or merely "bothersome".

I guess that having your jaw drop off is "bothersome".

When it comes to your health, there is no margin for error. Unlike your car, you can not replace your body if your doctor blunders.

So, here is a short test of your doctor's knowledge about Bisphosphonate Drugs:

• What is the estimated half life in the body for these drugs if I stop taking them today?
• Answer: As long as 10 years
• What is the name of the cells in the bone that the drug inhibits
• Answer: Osteoclasts (Not Osteoblasts).  But it does eventually kill off the osteoblasts as well, so the answer should probably be "Both".  Read this:  http://blog.garymoller.com/2010/02/new-warnings-about-dangers-of-leg.html and:  http://blog.garymoller.com/2006/06/lets-place-granny-on-suds.html
• What is "Fossy Jaw"?
• Answer: Jaw bone death related to this class of drug. In the 19th Century match factory workers were found to develop "Phossy Jaw" or "Fossy Jaw", the death of bone tissue in the jaw that led to hideous deformation, a draining of disgusting and smelly pus, and an inability to eat or talk, that led to death unless the jaw was surgically removed (a remedy that didn't always work). This disease was so terrible that many people killed themselves. Fossy Jaw was related to the phosphorus from the matches that found its way into the bony structure of the jaw, inhibiting bone turnover, and causing death of the bone cells (medical term: osteonecrosis of the jaw).
• Have there been any reports recently of spontaneous fractures of the femur related to this class of drug (bisphosphonates)?
• Answer: Yes.  Read here:  http://blog.garymoller.com/2009/08/fosamax-doubles-risk-of-subtrochanteric.html

If your doctor can not answer all of these questions correctly I suggest that you change doctors.

I will be writing more about exercise and nutrition for bone health in future articles so keep a watch for them.

Do you have a question?
Email Gary: gary at myotec.co.nz (Replace the "at" with @ and remove spaces). Please include any relevant background information to your question.

Has Actonel and lately Fosamax caused my jaw pain?

I have been taking Actonel and lately Fosamax for about three and a half years. In mid April, totally out of the blue, I started experiencing serious pain and very severe clicking in the right side of my jaw: my dentist decided there was no problem with my teeth or my bite. He is puzzled and so is my rheumatologist who did prescribe the drugs.

By chance the other day, I stumbled on your website and heard about possible jaw problems and the drugs I have been taking. I am terrified because I can no longer eat normally. How can I find out whether there is a causal effect between these 2 drugs and my symptoms and are you aware of any test that could reveal if they are beginning to cause damage to my jawbone.

I would very much appreciate any feedback as I am at a loss what to do short of discontinuing these drugs.
______________________________________________

Gary responds:

I do not think the problem with your jaw is due to jaw bone death; however there is a link between bisphosponate drugs and joint and muscle pain and this might be what is going on. It should be of no puzzle to your specialist. At the very least, you should be taken off these drugs which have no health use whatsoever and are known to cause horrific harm. I am not aware of a specific test other than a biopsy. You will need to talk to your specialist about this.

Why did your specialist prescribe these drugs in the first place? Tell me and I may have further comment to what follows. Do they read the medical research bulletins?

Test your doctor's medical knowledge about bisphosphonates - Go here

If you suspect there has been harm from the use of these drugs I urge you to contact Tom Lamb. His law firm is one that is leading the legal battle to get redress for victims. Here is what he has to say about Fosamax:

"Fosamax is Merck's osteoporosis management drug, generically known as alendronate, which is part of a class of drugs known as bisphosphonates. Fosamax is used to treat osteoporosis and bone pain caused by some cancers. Recent studies have shown a possible link between using Fosamax for osteoporosis and developing osteonecrosis of the jaw. Osteonecrosis, or ONJ, is the destruction of bone tissue, sometimes associated with interference of the blood supply to bone. Osteonecrosis of the jaw can be very painful and may lead to other complications such as infection, breakdown of the jawbone, ulcerations in the mouth, non-healing wounds, and osteomyelitis (inflammation of bone marrow). Once necrosis begins, it is irreversible. Merck was advised by the FDA in 2004 to include a warning in the drug label but failed to comply until almost a year later."

I just can not for the life of me understand why these drugs continue to be prescribed in the face of mounting evidence (and law suits) that they can and do cause irreversible harm! Can somebody please tell me?

If you are on a Bisphosphenate drug, what do you do?

Stop taking it

There is no medical harm from stopping taking these drugs, so there is no problem stopping taking these. Osteoporosis, the reason for prescribing these to otherwise healthy people, does not progress overnight. Of course you should consult your doctor and ask for evidence that this class of drug does no harm while you are at it. If he/she can not provide valid evidence of benefit that outweighs risk, then I recommend you fire him/her and consider instigating legal proceedings.

Help reverse any damage

• Take 2-4,000iu of vitamin D per day
• Take Coenzyme Q-10 per day - 200mg for a week then reduce to 100mg and keep taking this ongoing
• Take 1-2,000mg per day of a non acid vitamin C
• Get some whey protein and have a dessertspoon about three times a day in addition to a balanced diet that includes quality proteins and plenty of vegetables
• Get a quality multimineral, plus multivitamin with vitamins E, A and K and take daily

(You can get these off me if you like)

Other (important!)

• Ensure that you are not taking any other medicines that could be interfering with bone health (examples: blood thinners, statins). Talk to your doctor about this.
• Get a gentle massage of the jaw, neck and shoulder muscles once weekly. You may have spasms in these muscles that may be the cause of your jaw pain. Massage, plus the nutrients, will help give lasting relief.
• Lift a modest weight from the floor to high above the head. Use a weight you can lift up and down safely about 10 times. Do this set of ten lifts once or twice daily to stimulate strengthening of the bones.

Please take heart, these measures take time. The body has a remarkable capacity for recovery if only one gives it the nutrients and the encouragement to do the job. Please let us know how you get on by giving regular progress updates. Thank you.

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Do you have a question?
Email Gary: gary at myotec.co.nz (Replace the "at" with @ and remove spaces). Please include any relevant background information to your question.

Fosamax osteoporosis drug linked to atypical low-energy fractures

"On March 20, 2008, The New England Journal of Medicine published a physician group report of 15 women taking Fosamax who experienced "atypical low-energy fractures," which means their bones broke doing almost nothing – a serious kind of injury typically seen in very elderly individuals in declining health. The fact that the NEJM is reporting this is a major wake up call to anyone who hasn't figured out that Fosamax is dangerous to your health". ((http://content.nejm.org/cgi/content/ful...)
Source: www.naturalnews.com
________________________________________
Gary Moller comments:
I have been warning readers about the dangers of bisphosphenate drugs for osteoporosis for more than a year now and every concern raised back then is being confirmed.

Here on Prime Time New Zealand television there is a reassuring celebrity named Judith Dobson who fronts a "Health Diary" advertising campaign. Right now she is pushing Fosamax-Plus with vitamin D "For added benefits". Yeah right! This advertising campaign is nothing more than misleading rubbish encouraging women to medicate with a drug that does nothing at all of benefit and much harm, including the much feared "Fossy Jaw" or bone rot in which the jaw bone literally falls to pieces. The same rotting process occurs in the rest of the skeleton, resulting in the kind of catastrophe that can be seen in the x-ray image above.

What the research report quoted above does not tell readers is that these bones have little or no healing capacity, so the prognosis for these poor women is not good.

How doctors can continue to prescribe these poisons beggars belief. Do they read? Please warn your family about these horrific class of drugs and please forward this article onto others.

Advice about dental work, osteonecrosis (Fossy Jaw) and Fosamax

"My oral surgeon just alerted me to the possible side effects of Fosamax, which I have been taking for 3 years. We are considering jaw surgery and orthodontic work to correct a severe overbite. He has ordered a CTX test (I believe that's what he called it) to help determine my risk level for such a procedure. I am not familiar with this test and am wondering if it is accurate at predicting a successful recovery and healing."
Margie

I asked women's health researcher, Gillian Sanson, for advice:

"The CTX test is a bone marker test measuring collagen cross links. Osteoclast activity is measured by the breakdown products of collagen. When bone is resorbed collagen is broken down and fragments that contain the cross-linking molecules are released and excreted in the urine. High levels can indicate high levels of bone resorption. My understanding is that these tests are not a particularly accurate way of measuring bone metabolism, fracture risk, healing or otherwise because of the great variability in bone turnover, and the day to day variability of metabolic processes. But I am not an expert in this area. I don’t know about the use or value of this test in relation to osteonecrosis of the jaw.
Best wishes
Gill"

"We recommend that patients about to start oral and intravenous bisphophonates should have an oral inspection by the rheumatologist, and if there are any doubts then the patient should be referred to an appropriate dental surgeon for further advice.

Secondly, we recommend that patients who are already taking oral bisphosphonates should not stop these when they go for dental surgery as the risk of ONJ is very small and the half-life of the bisphosphonates long.

Thirdly, we recommend that in patients who are already having intravenous bisphosphonates and who have planned dental surgery, the administration of the bisphosphonates should be delayed until after healing has been completed."
http://rheumatology.oxfordjournals.org/cgi/content/full/46/7/1049
_____________________________
Gary Moller comments:
Margie, I am sorry that the following is rather grim; but best got out and understood.

Few adverse side effects ever get reported for a raft of reasons. So, if rates of complications are x/100,000 one can assume that the real rate is much higher. Claims that newer versions of these biphosphonates have fewer complications are rubbish. How can such claims be made when it takes ten or so years to really know? If I were to be taking medication from a particular class of drugs, I would probably prefer the one that has the longer track record - warts and all! None at all, if I could get away with it. If you troll the user support websites, you will see there is growing unease among the patients about this class of drugs and a disturbing number of reports of adverse reactions.

Bisphoshonates, including Fosamax, progressively kill off the little cells in the bone that are constantly working hard to remodel bone to withstand the stresses and strains of daily living on the skeleton. Killing these cells (osteoclasts and osteoblasts) gives just a couple of years of possible reduction of fractures. But this comes at a shocking cost.

Healthy bone is never more than about 7 years old regardless of age. The cost of taking bisphoshonates is the development of old and lifeless bone that, once damaged, will never again heal. Not only do these poisons kill off the cells that maintain the bones they remain in the body for an estimated 20 years (Estimated 1/2 life of 10 years) doing their damage.

The term "Fossy Jaw" is a play on Fosamax and refers to the horror of jaw bone death associated with the use of biposphonates. The reason why the jaw is so vulnerable is because it is constantly stressed by the chewing action and the pressure of teeth on the jaw bone. The rate of bone turnover in the jaw is very high so the poisoning effect of biphosphonates may be first seen in the jaw. Basically what happens is bone damage such as during orthodontic work and even simple extractions may result in non-healing lesions on the bone - ulcerations andf progressive loss of jaw bone. I will say no more, other than to say that this is one topic that makes my blood boil!

There may be similar processes of bone death caused by the use of blood thinners like Warfarin (rat poison). But this is another article!

Margie, that is the bad news over with; now for the good news.


The good news is that you are only a few years into it and the sooner you stop the better. You can stop right away; but I do recommend that you talk about your intentions with your doctor. The fact that your orthodontist felt required to carry out tests to try to assess your bone cell activity should be sufficient warning to you to take positive and assertive action. Get off the stuff!

Can you delay the orthodontic work for a couple of years? Surely it can wait? Talk frankly to your orthodontist about this. I think you should give your jaw bone time to recuperate from any effects of the biphospenates. The orthodontic work requires tip-top bone health.

Strengthen and revitalise your bones through natural health measures:

• Get your vitamin D levels tested and follow the guidelines on this website to aggressively get your levels up to about 120nmol (details on this site)
• Have a daily mineral rich cup of beef/lamb bone broth
• Take daily supplements of vitamin A rich cod liver oil
• If you can get full cream raw milk, do so and then have 1-2 cups per day (Keep and eye on this website because I am looking at publicising sources)
• Exercise daily including lifting light weights above your head (My book on back pain has suitable illustrated exercises for you.

Bone up on osteporosis: Go to the Search This Blog box in the upper right hand column of this website and do a search for terms like "osteoporosis" and "fosamax" and have look at all of the articles on this site, linked sites and the rest of the web.
Margie, the best response is ACTION! So get moving and please keep us posted about what you do and how it all goes.

Spontaneous fractures and Fossy Jaw

Bisphosphonate drugs for Osteoporosis,

like Fosamax and Actonel, are taken up by osteoclasts with resulting loss of osteoclast activity and inhibition of bone resorption, and bone remodeling. Although DEXA scanning confirms increased bone density and studies such as the FIT suggest reduced fracture rate, Susan Ott, MD raises questions about the long term safety of bisphosphonates. Although the bisphosphonates appear to have short term benefits, she speculates that after 5 years of use, there is severe suppression of bone formation with negative effects such as microdamage and brittleness.

Spontaneous Fractures of the Mid-Femur

Jennifer P. Schneider, MD, PhD reports a 59-year old previously healthy woman on long-term alendronate. While on a subway train in New York City one morning, the train jolted, and the woman shifted all her weight to one leg, felt a bone snap, and fell to the floor, suffering a spontaneous mid -femur fracture. This is not an isolated report.Avacular Necrosis of the Jaw.

Fossy Jaw

Dimitrakopoulos reports on 11 patients presenting with necrosis of the jaw, claiming this to be a new complication of bisphosphonate therapy administration, i.e. osteonecrosis of jaws. He advised clinicians to reconsider the merits of the rampant use of bisphosphonates. Osteonecrosis of the jaw is a common finding in pycnodysostosis. The bisphosphonates recreate the same clinical profile of spontaneous mid femur fractures, failure of bone healing and jaw necrosis which tormented the famous French artist, Toulouse Lautrec.

For links to references and more information see my newsletter:Fosamax, Actonel, Osteoporosis and Toulouse Lautrec's Disease

Jeffrey Dach MD

__________________________________________

Gary Moller comments:

I am dismayed at the wholesale prescription of these drugs to people as early as in their 40's. With a half life estimated to be about 10 years, these drugs may continue to wreak damage for as long as 20 years after stopping taking them.

Why are doctors prescribing these drugs in ever-increasing quantities? One can only speculate: Is it sheer ignorance? Is it because they buy the drug industry propaganda? And, for the industry; is it because the profits today far outweigh the future costs of any law suits?

The consequences of dead bone are straight out of a horror movie: Dead bone and bone rot; fractures that do not heal and loss of jaw bone (Fossy Jaw).

It is good to know that some doctors like Dr Dach are speaking out.

Warfarin linked with brain bleeds

"Warfarin is often prescribed to prevent blood clotting and help combat the most common type of stroke, known as ischemic stroke. However, warfarin itself has been linked to intracerebral brain hemorrhage, another type of stroke caused by ruptured blood vessels and subsequent bleeding in the brain." (Click on the title for the full article).
_________________________________
Gary Moller comments:
As with most medicines, the full extent of adverse side effects goes largely unnoticed. This is because there is usually no direct link between taking a drug and the adversity.

For example (A real one), a dentist may be conducting a routine tooth extraction to be horrified to find that a chunk of dead jaw bone comes out with the tooth! Of course this means the patient is in real trouble. The condition is called osteonecrosis for which there is no effective treatment. Tests are completed, specialists are consulted and there is no reason for this happening in a 50'ish patient. The only suspiscion the dentist has is that the patient has been taking Warfarin (rat poison) for a decade for a heart condition; but the association is dismissed by the experts.

Here is my take on what is happening: The Warfarin is causing micro-bleeding into the bone of the jaw. Why it shows mostly in the jaw is because the jaw is constantly stressed by the action of chewing on the teeth, thus causing the micro bleeds. Bone is very sensitive to bleeding - the delicate bone cells die off similar to what happens when taking biphosphenates that cause "Fossy Jaw".

My experience is that the majority of people I come across who have been placed on Warfarin need not be on it and non drugs strategies should first have been explored and exhausted.

If for example a patient has atrial fibrilations that may increase risk of a clot that might settle in the brain, how about a course of:

• Fish oil plus vitamin E to stabilise the heart electrical activity and condition the blood to reduce clotting risk
• A multi mineral with magnesium and calcium that relax the heart, nerves and stabilise blood pressure
• A course to learn to breathe properly using the diaphragm and thus stabilise body PH - over-breathing is known to cause heart irregularities that can be so severe as to be mistaken for a heart attack
• Sunbathing to increase vitmamin D levels to at least 120 nmol - low vit D is associated with heart disease (Have you had a blood test for your own vitamin D yet?)

Should these fail to brig about a resolution after about 21 days then the option of medication can be considered.

Chiropractic News - Bones of Contention

HEALTHY LIFESTYLES FOR CHIROPRACTORS AND CHIROPRACTIC
PATIENTS – BONES OF CONTENTION FROM THE WORLD OF RESEARCH
Editor’s Comment: "Estrogen supplementation was also thought for years to increase bone density, but many researchers now consider that it did this by inhibiting old bone removal (osteoclastic activity). So bone material would remain, but not be remodeled..."

To read the full commentary, follow the link above. Refer page 3

This editorial comments on a full reprint of my article "Let's place Granny on the suds". I am delighted that health professionals are beginning to talk about this important issue.

Was it worth it? Fosamax

Here is an excerpt from a person who has been taking Fosamax: "After about 6 months I experienced gradually worse joint pain that changed me from healthy and athletic to almost crippled. I can barely walk up a stairs one stair at a time and leaning on the railing. Pain and weakness in my knees and hips, both sides is the main problem.

My bone density has increased, but who would want to live this way? I've gone from hiking and biking to practically needing a wheelchair. I've had to move because I couldn't do the stairs to my second floor apartment. I went off it after about a year and I'm desperately hoping my joint function will return. It hasn't improved yet after 1 month off the drug."
_____________________________________
Gary Moller Comments:
As I said in an earlier article, I predict that these anti-osteoporosis drugs are going to be the largest and worst medical scandal in history. While they may increase bone mineral density in the first few years, they are nothing short of being a slow poison. It is disturbing that the 1/2 life of this drug is about 10 years.

Keep informed of this scandal as it develops by going here and then bookmarking this page.

What is Osteonecrosis of the Jaw ("Fossy Jaw")?

Watch this video and you will understand what all the fuss is about the excessive and totally irresponsible prescribing of Fosamax and other biphosponates to counter the mythical osteoporosis epidemic

Fosamax Side Effects May Include 'Dead Jaw'

"Fosamax, one of the most-prescribed drugs in America, causes bone death in some patients, even though it was prescribed to prevent bone loss in women and men with osteoporosis".

To read the whole terrifying article, click on the linked title above.
___________________________
Gary Moller comments:
The prescribing of bisphoshonates to millions of people worldwide is an uncontrolled medical experiment on a scale never seen before.

The estimated half life of these drugs is 10 years. This means that 50% of the drug that is trapped within the body tissues will still be there 10 years later if the user stopped taking it today. It will take as long as 20 years to rid the system completely of the drug residue which poisons bone cells. This amounts to a life sentence for most people who are on these drugs.

In my opinion, we are witnessing the beginnings of what may become history's largest global medical disaster. Bookmark my newsfeeder on the topic and watch it unfold before your eyes.

Low vitamin D levels linked to increased risk of falling in elderly populations

NEW YORK (Reuters Health) - Older men and women with vitamin D deficiency are more likely to fall multiple times in the course of a year than their peers with adequate vitamin D levels, researchers in The Netherlands have found. Vitamin D may be best known for its role, along with calcium, in maintaining bone health. However, vitamin D is also important for muscle mass and strength, and compromised muscle function may explain the fall risk seen in this study, according to the researchers. The findings suggest that older adults should be sure to get adequate vitamin D from food and multivitamins, lead study author Dr. Marieke B. Snijder, of Vrije Universiteit Amsterdam, told Reuters Health. However, she added, clinical trials are needed to prove that this actually prevents falls. Snijder and her colleagues report their findings in the Journal of Clinical Endocrinology & Metabolism. For their study, the researchers measured blood levels of vitamin D in 1,231 adults age 65 and older, then followed them for one year to track any falls they suffered. During that time, 33 percent fell at least once, according to "fall calendars" that each participant kept. Just over 11 percent fell two or more times. Overall, men and women who were deficient in vitamin D at the outset were 78 percent more likely than those with adequate levels to fall at least twice. Their risk of falling three or more times was more than doubled.
____________________________
Gary Moller comments:
Notice that the good researcher conveniently omitted to recommend sunlight as a source of vitamin D! Is it because it is not PC to make such recommendations?

I am currently investigating falls prevention programmes in NZ, of which there are a couple. The Otago exercise programme to prevent falls in older adults is a well researched example that reduces falls injuries by about 35% in over 65's.

While I am impressed with the programme's format and content, I am dismayed that none of the programmes I have looked at so far, this one included, seem to pay any attention at all to assessing participants' nutritional status (including vitamin D) and then correcting any identified deficiencies. When up to 90% of some elderly populations are nutritionally deficient in some way, assessing the nutritional status of elderly populations who are at high risk of falling would seem an obvious thing to do. But it isn't. With regards to vitamin D, it is hardly ever tested. When was the last time you had it done?

If an elderly person is, say, vitamin D deficient, low in dietary protein, anaemic or washed out of essential minerals and vitamins, then no amount of exercise therapy is going to work all that well. While there may be initial gains, this is hardly likely to be sustained and the individual will quickly back-slide. Strong bodies are not created out of thin air - they need good food to be built and to then be maintained over the long term.

I have demonstrated many times with elderly people under my care that it is possible to double their physical work capacity in as little as 12 weeks by taking a comprehensive approach to their care, including tidying their nutrition.