Osteonecrosis (ON), also known as “bone death,” is a condition in which bone tissue dies as a result of reduced blood flow. Avascular Necrosis is most common in advanced cancer patients, particularly those with multiple myeloma (MM) and cancers that have spread to the bones. High-dose chemotherapy and certain medications, such as corticosteroids, anticoagulants, anti-blood-clotting agents, and immunosuppressive drugs, increase the risk of ON.

Before we get started, take a look at this description-

Charaka quotes “तत्र यान्याहारमधिकृत्य भूयिष्ठमुपयुज्यन्ते तेषामेकदेशं वैरोधिकमधिकृत्योपदेक्ष्यामः- न मत्स्यान् पयसा सहाभ्यवहरेत्, उभयं ह्येतन्मधुरं मधुरविपाकं महाभिष्यन्दि शीतोष्णत्वाद्विरुद्धवीर्यं विरुद्धवीर्यत्वाच्छोणितप्रदूषणाय महाभिष्यन्दित्वान्मार्गोपरोधाय च||” in the context of Viruddh Ahara (incompatible food items).

Charaka gives an example: fish should not be cooked or consumed with milk. When these two factors are combined, they result in two outcomes:

विरुद्धवीर्यत्वाच्छोणितप्रदूषणाय –  Because of the polar opposite energies, it vitiates the blood.

महाभिष्यन्दित्वान्मार्गोपरोधाय – The passages are blocked due to the heaviness/cloudiness of the atmosphere.

This provides insight into the wisdom of Ayurveda in terms of understanding the importance of diet for avascular necrosis.

ON’s precise causes are unknown; however, a lack of blood supply to bone marrow cells has been proposed as one cause. Another theory proposes that influenza vaccination may cause ON in patients who are predisposed to the condition. Additionally, alcohol abuse may increase the risk of AVN.

It is difficult to make a direct comment on the Dietary recommendations for avascular necrosis. However, AVN treatment is insufficient without dietary understanding. I’m going to talk about the diet for avascular necrosis.

Basics of Bone Health

The main issue is that we don’t understand the fundamental distinction between osteoporosis and avascular necrosis. Most of the time, we believe that the diet for osteoporosis and avascular necrosis should be the same. Because bone decay is common in both.

However, the nature of bone decay varies.

Avascular necrosis was previously thought to be caused by ischemia.

Today, we know better. The histological image of the necrotic bone shows vascular channels that are plugged with proteinaceous material and contain erythrocytes.

There are also a large number of osteoclasts that continue to erode the bone and may occasionally create a cleft or crater.

Do you know what these phenomena are called?

You were incorrect about osteoporosis! The correct answer is avascular necrosis.

Osteoporosis does not result in bone depressions and craters, but rather in cortical bone thinning. So there should be a distinction between the diets for AVN and osteoporosis.

Diet for avascular necrosis that wreaks havoc on bone health

Everything I mention under diet for avascular necrosis is food that is bad for your bones. Because knowing what foods can be harmful and eliminating them will aid in slowing the progression of the disease.

So let’s start with foods that are bad for you.

There are no “because I think” details. All of this is possible because of scientific understanding. And, amazingly, science is the same for both Ayurveda and Allopathy.

Some foods, however, can harm bone health by lowering calcium levels or acting as antinutrients to the body’s ability to absorb nutrients from other sources.

Foods high in oxalate and phytic acid are two examples because they bind with minerals such as calcium, impairing its absorption and utilization in the body. These minerals then pass through your system unnoticed. To assist the body in stopping the progression of avascular necrosis, we must avoid these two categories.

We need to understand the structure and requirements of bone in order to better understand the diet for Avascular necrosis.

The AVN diet is not about calcium.

When you first learn about AVN, you, your family, and your friends begin looking for calcium-rich diets and foods.

But this is not the case.

Osteoblasts and osteoclasts are the two types of cells.

Osteoblasts are the cells responsible for bone formation, while osteoclasts consume bone.

When their activities are out of balance, osteoporosis-like conditions develop. However, new nutrition is not available in the case of Avascular necrosis. And in this condition, the osteoblasts completely cease to function.

On the one hand, we don’t have a blood supply, and on the other, the toxins continue to accumulate in the bone.

Despite providing calcium, we must ensure adequate blood supply to the bone. This is something we must adhere to.

According to Ayurveda, the two Dhatus are to blame for Avascular Necrosis. Majja and Asthi. Vata Dosha is the second.

No movement can occur when the passage of Vata dosha is blocked. This causes an imbalance in Majja Dhatu (bone marrow), which leads to the Asthi’s destruction (bone). The other issue is vitiated Rakta Dhatu, which is the root cause of everything.

So we must consider three things at once:

Rakta Dosha, Vata Dosha, and Bone (which are dosha and dhatu, both).

As a result, we will go over the following points:

  1. Foods that aggravate the blood
  2. Dietary habits that aggravate Vata.
  3. Food causing bone damage.
  1. Foods that aggravate the blood

Pitta and blood are inextricably linked. As a result, any qualities that inhibit blood flow also cause rakta vitiation. Increased or decreased pitta vitiation generally results in the same degree of rakta vitiation.

In Ayurvedic texts, the blood is said to be impure due to the presence of the following factors:

Unhealthy, spicy, and fiery food.

High-alcohol-content alcoholic beverages

Large amounts of food are consumed.

Meals that are high in salt, alkaline, acidic, or pungent

Horse gram, black gram, flat bean, and mustard oil are commonly consumed in excess.

Water yam (Dioscorea alata Linn), radish, and tamarind are all to be avoided.

The “mouth-eaters” category includes Anoopa (marshy animals), Bileshaya (living in holes), and Prasaha (living beings that use their teeth, claws, and/or boneless tails to capture food); the Jalaja species is an aquatic animal that eats by tearing flesh from others.

Sour drinks include sour curd (Dadhi), sour whey (Amla mastu), tart fermented preparations (Sukta), wine (Surra), and spirituous beverages.

Food poisoning refers to a variety of illnesses caused by consuming contaminated food or liquid. It includes, among other things, spoilt (Upaklinna) meals, putrefied/fetid (Pooti) meals, and bad food combinations.

I’m not sure how ayurvedic seers knew about the impact of “alcohol” on the condition of Avascular necrosis. Because of this clarity, Ayurveda can be used to treat Avascular necrosis.

planning Diet for Avascular Necrosis

We didn’t have Avascular necrosis 5000 years ago. But how did they (Ayurvedic seers) know so much about a disease that so-called modern-day doctors knew so little about?

So, let’s take a look at the next section, which can help you with your diet- Vata Dosha aggravating factors.

  1. Vata Exacerbating Dietary Plan

Vata is not the same as air. This is a characteristic. Something that regulates all movement.

Every possible movement. Yes, your blood is moving to your bones.

Dryness, constriction, and roughness are Vata characteristics that are involved in Avascular necrosis. As a result, diets that enhance these characteristics should be avoided entirely.

Pasteurized honey that has been heated. Foods that have been cooked with honey. Anything that can contribute to dryness.

Artichoke, Melon with a bitter taste, Broccoli, Spinach, Brussels sprouts, The root of burdock

Raw Cabbage, Cauliflower raw, raw Celery, Corn, Onions raw, Peppers Radish raw, Sprouts, Barley, Corn, Oats

These are the items you should avoid in all circumstances. This is specifically mentioned in Ayurvedic texts.

  1. Foods that worsen AVN

Should I eat raw or uncooked food if I have Avascular Necrosis?

However, in terms of Ayurveda and the concept of diet in Ayurveda. Because no other full-fledged medical system has spoken as clearly about the importance of diet as Ayurveda.

So far, we know that Vata dosha is a prime suspect in Avascular Necrosis, but the game changes when blood is involved (Rakta Dhatu). So, as previously discussed, we must consider a few aspects of the food: the food should not be –

Dry (increases bone brittleness), Rough (causes microfractures), Constricting (blocks blood supply), Vidahi- pollutes and aggravates the blood.

However, all of these characteristics can be found in the Raw food diet for avascular necrosis.

Aside from these characteristics, raw food has its own set of limitations.

Diet for Avascular Necrosis
Diet for Avascular Necrosis

Raw Food and the Ayurvedic diet for avascular necrosis

To meet the needs of the growing population, artificial methods of food growth and cultivation, such as the use of artificial fertilizers and pesticides, are also in use. Commercial farming has also grown in popularity, destroying natural rainforests and converting them to farmland. As a result, foods obtained from distant locations, grown with the aid of artificial fertilizers and pesticides, preserved with chemicals, refrigerated, and transported are hazardous to one’s health.

Cooking is all about conversion. It is necessary to substitute the natural characteristics or form of food substances in order for them to be consumed. They must be altered or processed into a different form in order to change the characteristics or shape of meals; this is referred to as “transforming” or “processing” them. This would make food components easier to consume and digest.

Ayurveda describes various food preparation processes. These include changing the shape and consistency of meals to make them more palatable and digestible.

One of the most common methods of modifying food is through the use of fire. Food components that are too heavy to eat raw are cooked in order to make them more digestible. For example, raw rice is heavy (hard to digest). After being cooked over fire, it becomes light for digestion (easy to digest).

So, in a nutshell, the timeless wisdom of Ayurveda says NO to eating only raw foods as a diet for Avascular necrosis.

Fat Cells’ Role in Bone Health

Here are two excerpts from two well-known research papers:

Adipocytes and osteoblasts are derived from the same pluripotent mesenchymal stem cell (or other lines) that has the same potential to differentiate into adipocytes or osteoblasts (or other lines) when several transcription factors are activated.

The obesity of bone

Recently, it was discovered that fat-depleted bone marrow plays an important role in the paracrine and endocrine activities of this depot, which controls osteogenesis and hematopoiesis.

Role of bone marrow adipose tissue in bone health

We all value “science” because it is current, knowledgeable, and evidence-based (PubMed publications?). However, when I return to Ayurveda for more information, it mentions-

रसाद्रक्तं ततो मांसं मांसान्मेदस्ततोऽस्थि च| अस्थ्नो मज्जा ततः शुक्रं शुक्राद्गर्भः प्रसादजः||१६|| This verse is from Charaka Samhita’s Grahani Chikitsa Adhikar. Charak. The bold letters indicate that adipose tissue is in charge of bone development.

Are people all convinced that losing weight will benefit their bones?

Second, avoiding all fats in food and eating raw is a challenge for Avascular Necrosis.

There can’t be a standard that applies to everyone. Something that works for me may not work for someone else. So don’t go on a diet to get rid of body fat.

In such circumstances, the word that comes to mind is ADEQUATE. You should consume an adequate amount of fat in your diet because it is beneficial to your health.

Incompatible Foods to Avoid in diet for avascular necrosis

Many of us have probably heard the word “गरम सर्द”, a Hindi “saying” that describes a sudden change in temperature. Something regarded as a source of disease. In Ayurveda, the concept of incompatible foods is nearly identical.

Diseases occur when two things that can “interact” negatively enter the body at the same time. This is Virrudha Ahaar’s concept. The one we discussed earlier- fish and milk.

The main issue with the globalization of food and culinary skills is that we have begun to mix everything into everything. We don’t think twice about adding milk and buttermilk to a recipe, and we also season it with lemon.

You might have heard your grandmother yell at you not to drink milk with mooli paratha. However, the Ayurvedic wisdom that was part of family traditions faded. 

There is a list of foods that are incompatible with each other. These should not be part of anyone’s diet if they have Avascular Necrosis.

Kidney Function in Bone Health

The study, conducted at the University of Salford, looked into whether kidney tissue produced osteoblasts (bone-forming cells) or osteoclasts (bone-breaking cells) (cells involved in the resorption of bone). This was accomplished using animal models and samples from rat kidneys as well as human renal biopsies. The findings revealed that there were more osteoblasts than expected on average.

The findings also show that different cell types contribute to the production of each type of cell (osteoblast or osteoclast), implying a balance between cells that form bone and cells that resorb bone.

The kidneys, according to the researchers, play an important role in fine-tuning the balance between forming and resorbing new bone tissue. This is known as bone turnover, and it is essential for maintaining healthy bones throughout life. The study raises the possibility that factors such as ageing or kidney disease could alter the balance of cells involved in forming and resorbing bone tissue, potentially leading to osteoporosis or more easily breaking bones.

We know that Medas/Fat play a more complex role in bone health. According to Ayurveda and Western science, the same fat is controlled by the kidneys.

Thus, foods that are bad for the kidneys should be avoided in the diet for Avascular Necrosis to improve bone health.

Oxalates: A Big No-No in the diet for avascular necrosis

Researchers discovered a strong link between high oxalate intake and low bone mineral density, which increases the risk of osteoporosis and the progression of avascular necrosis.

Nuts and grains are some of the worst offenders when it comes to high-oxalate foods. Black tea, chocolate, rhubarb, beets, and greens like spinach, kale, and Swiss chard are also high in oxalate. However, because of their oxalate content, these foods can be problematic even in small amounts for many people with kidney problems or arthritis (RA).

Foods with lower oxalate levels include

Citrus fruits such as oranges and grapefruit; an abundance of dairy products; green beans, carrots, and peas; herbs such as basil, cilantro, and parsley; and grains such as oats.

When we return to Ayurveda, the same concern surfaces in a different form. The problem with Avascular Necrosis at the Gunas level is that dryness increases, which accelerates bone decay. Because bone is brittle in and of itself. As a result, foods high in dryness are bad for bones.

When I look at the list of these “oxalate” rich foods, one thing stands out: DRYNESS. As a result, these foods should be avoided in the Ayurvedic diet for avascular necrosis.

Antinutrient diet for avascular necrosis: Phytic Acid

A high intake of phytates, like a high intake of oxalates, can lead to lower bone mineral density. Phytic acid is naturally found in many plant foods, especially seeds, grains, and nuts, but phytates can also be introduced through food processing techniques.

Some sources recommend chewing nuts and seeds thoroughly, soaking or sprouting them before eating, or baking them at a low temperature for 15 minutes first to reduce the impact of these antinutrients on calcium absorption.

Bone health and phosphorus

Phosphorus is another mineral that is essential for bone health. It is abundant and widely distributed throughout the body, including bones and teeth. While phosphorus can be obtained from foods such as dairy and seafood, it is also added to a variety of processed foods such as soft drinks, candy bars, baked goods, cereals, and canned goods.

High-phosphate diet for avascular necrosis, like calcium supplementation, has been linked to an increased risk of osteoporosis and hip fractures.

Excess phosphates, according to the researchers, can lead to lower blood pH levels over time, which stimulates the kidneys to release more calcium into the bloodstream while inhibiting bone reabsorption. This eventually leads to an increase in urinary calcium.

Protein Is More Than Just a Building Material

Although it is not as common as phosphorus or oxalates, protein is an important factor to consider when discussing bone health. Protein contains the amino acids required for the formation of new bone cells.

Getting enough protein every day is critical for maintaining healthy bones throughout life. Beans and legumes, tofu, whole grains like quinoa, nuts and seeds, dairy products like milk, cheese, and yoghurt, eggs, fish, chicken, beef, pork, lamb, and bison are all vegetarian protein sources.

Focus on incorporating a variety of these different foods into your diet for avascular necrosis to ensure that you are getting adequate amounts of protein.

However, this cannot be applied universally. Patients with kidney problems or other autoimmune conditions should avoid a high-protein diet for avascular necrosis. And never ever miss the word “adequate”.

Phytoestrogens: A Bone-Health Advantage?

While phytoestrogens can cause problems for those with thyroid issues, there are some advantages to consuming these plant oestrogens.

Isoflavones, the primary types of phytoestrogen found in soy products, have been shown in studies to help prevent bone loss and fractures, particularly in menopausal women. Other studies have found similar results when it comes to osteoporosis prevention in postmenopausal women who consume soy foods on a regular basis.

Fermented soy foods such as tempeh and miso, as well as tofu and edamame, are examples of soy foods. Flax, chia, and hemp seeds are high in phytoestrogens, as are legumes like chickpeas and lentils, the spice turmeric, and fruits like apples, berries, plums, peaches, and pears.

Read More Completely Treat Avascular Necrosis

My Perspective on the diet for avascular necrosis

I personally do not support any sort of diet regimen. Because life is not about following the rules. Normal living is what life is all about. “Dieting makes you more sensitive to stress, and stress makes you sick,” it has been scientifically proven. Thus, it is not prudent to acquire stress in an effort to combat disorders like avascular necrosis.

Those of you who have tried to stick to a diet know exactly what I mean when I say that diets are the worst. They restrict your diet down to the foods you can eat and the amounts you can consume, and they can make eating feel like a full-time job. Yet, in my honest opinion, these regulations only encourage dishonesty. After all, your body, like any other person, does not appreciate being told what to do. One thing that all humans have in common is that we like to buck the system whenever we can.

Don’t give in to the temptation of “rule-breaking,” then.

Follow the don’ts that can hurt your bone and make Avascular Necrosis worse.