8/8 — WHEN LIFESTYLE ISN'T ENOUGH For established osteoporosis, recent fragility fracture, T-score at or below −3.0, or multiple risk factors — lifestyle is the foundation, not the whole answer. Escalate without apology. Denosumab (Prolia) — potent anti-resorptive, every six months, strong fracture reduction at spine and hip. Never stop abruptly without transitioning to another agent. Teriparatide (Forteo) — anabolic, actually builds new bone. Daily injection, typically limited to two years, then follow with an anti-resorptive to lock in the gains. Romosozumab (Evenity) — dual action. Monthly for 12 months, then transition. Note the cardiovascular boxed warning — screen carefully. Sequence matters enormously: in very high-risk patients, starting with an anabolic and then following with an anti-resorptive produces larger density gains than the reverse order. Here's where I've landed after twenty years. I no longer treat bone as secondary. Independence in your final decades is not a lifestyle preference — it's everything. Bone is not destiny. It is living tissue that responds to the signals you send it. Send it better ones. Starting this week.

Childhood poverty rates 🇺🇸 21.1% 🇬🇧 15.8% 🇮🇹 14.5% 🇨🇦 14.0% 🇱🇺 13.5% 🇵🇹 12.5% 🇬🇷 12.3% 🇫🇷 12.0% 🇦🇹 9.8% 🇩🇪 9.1% 🇨🇭 9.1% 🇨🇿 8.8% 🇰🇷 8.5% 🇸🇪 8.4% 🇳🇱 8.4% 🇧🇪 7.9% 🇳🇴 6.9% 🇮🇪 6.8% 🇫🇮 4.6% We must end the outrage that in the richest country in the history of the world, more than 1 in 5 children live in poverty.

WATCH: One year ago, doctors calmly continued operating on a cancer patient as a powerful magnitude 8.8 earthquake—the joint sixth-largest ever recorded, according to the USGS—shook Russia’s Kamchatka Peninsula.

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