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Choline and Aging
Dr. Susan E. Brown

Help Combat Unhealthy Aging with Choline

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By Cameron Vazquez, MPH

So many of us try to fight the natural aging process. Products everywhere claim to have anti-aging properties that defy the natural course of life and keep you younger. Here at the Center for Better Bones, we don’t fight aging — we embrace it! However, it is imperative to distinguish between healthy aging and unhealthy aging.

While many of us are living longer than previous generations, we don’t necessarily enjoy a higher level of health in our senior years. Even though the average person in the U.S. has a life expectancy of almost 80 years, the age for developing a serious illness is 63. (1)

These last 17 years or so of life are spent in poor health, plagued by one or more degenerative diseases. This is “unhealthy aging.” On the other hand, there are those in this culture and around the world who enjoy a high level of health, free from degenerative diseases and disability almost to their final days. This is “healthy aging” and suggests an extension not just of ones “lifespan” but of ones “health span,” that is, the length of time spent as a healthy, happy, and fully functioning member of society.

What can we do for unhealthy aging?

A highly underrated nutrient that can help fight unhealthy aging is choline. Never heard of choline? You’re not alone. Considering that 90% of Americans are deficient in choline, many are unaware of this vital nutrient and its dramatic influence on our aging process even from before the very day we were born! (2)

Keep reading to find out why we need to start talking about choline to combat the unhealthy aging of our bones and brains.

What is choline? 

Choline is classified as an essential nutrient that is crucial for numerous physiological processes in the body, including neurotransmitter synthesis, cell-membrane structure and signaling, lipid transport, and methylation. (3)

The main functions of choline

Choline’s key roles in so many significant bodily functions make it just that important. It can impact our brains, heart, liver, muscles, and bones in a major way. Some of its most important functions include:

  • Preventing non-alcoholic fatty liver disease and liver damage (4)
  • Helping muscle function (5)
  • Improving athletic performance (6)
  • Reducing negative birth outcomes (5)
  • Aiding proper signaling, transport, and repair of cells (4)
  • Enhancing magnesium uptake to the cells

Choline and your bones

Choline is a key player in keeping bones healthy and strong. For instance, it regulates homocysteine levels in the body. High homocysteine levels are associated with decreased bone mineral density and increased bone fragility. (7) Choline deficiency is also associated with other inflammatory markers that can damage bone. (8)

Choline is associated with an increased risk of osteoporosis. One study found that those with choline intakes of less than or equal to 300 mg per day had 2.5 times the prevalence of osteoporosis compared to those with choline intakes of 600 mg per day or more. Overall, this study found an association between an increased risk of osteoporosis and low dietary choline intake. (9)

Another study had similar results. Amongst subjects with the lowest choline intakes, there was a significantly higher risk of having low femoral neck bone mineral density compared to those with the highest choline intakes. Ultimately, a positive association between choline from diet and BMD in middle-aged and elderly participants was found. (10)

This research confirms our previous findings on the importance of choline on bone. In the past, we have found that choline-stabilized orthosilicic acid impacts bone. Now we know that both choline-stabilized orthosilicic acid and choline itself influence bone health!

Choline and your brain

Choline is a nutrient that impacts the brain throughout our lifespan. Research emphasizes choline’s importance within the first 1,000 days of life due to its impact on fetal brain development, birth outcomes, behavioral patterns, (11) and its protective abilities against fetal alcohol exposure. (12)

However, choline also drastically affects our brains in the later stages of life.

Aging leads to decreased cognitive function and an increased risk of developing Alzheimer’s disease. Currently, more than 6 million Americans have Alzheimer’s disease. This number is expected to increase to 13 million by the year 2050. Sadly, Alzheimer’s and other dementias kill more seniors than breast cancer and prostate cancer combined. (13)

Alzheimer’s disease is linked to the neurotransmitter, acetylcholine, that tells our brain to store memories. Specifically, low concentrations of acetylcholine have been found in those afflicted with Alzheimer’s disease. (14)

What does acetylcholine have to do with choline? Without choline, our bodies cannot form acetylcholine. Therefore, it’s important to make sure you’re supplying your brain with enough choline to produce this crucial neurotransmitter.

As we mentioned before, choline plays a role in regulating the levels of homocysteine in our body. And Alzheimer’s disease and dementia are associated with high levels of homocysteine. Adequate choline intake may be able to lower these high levels of homocysteine. (15)

Despite these scary statistics, there is hope in the form of choline!

The clinician who has developed the most effective clinical program for preventing and reversing cognitive decline, Dr. Dale Bredesen, MD, has detailed the importance of choline and cognitive functioning in his book, The End of Alzheimer’s Program.

Other researchers have shown that choline by itself can improve cognitive function in those with mild and moderate Alzheimer’s disease. (16)

Protect your bones and your brain

At the Center for Better Bones, we always recommend pure choline citrate instead of choline bitartrate because choline bitartrate can contain irritating antigens, such as corn starch. The optimum level of choline citrate is between 650–1,300 mg/day, which is about 1 to 2 teaspoons of liquid choline citrate.

If you are using choline citrate to combat a loose stool from magnesium, take 1 teaspoon of liquid choline citrate each time you take magnesium. You can listen to a brief video of Dr. Brown explaining how to take choline citrate here.

If you’d like to know more about magnesium uptake, read our blog, Enhance Your Magnesium Uptake and More with Choline Citrate.

 

Protect your future self with choline!

Click to view References

References:

  1. Peterson, T. 2017. Healthspan is more important than lifespan, so why don’t more people know about it? Harvey A. Friedman Center for Aging Blog Page, Washington University in St. Louis Institute for Public Health.
  2. Wallace, T. C. and V. L. Fulgoni, III. 2016. Assessment of total choline intakes in the United States. Journal of the American College of Nutrition 35(2):108-112.
  3. Zeisel, S. H. and K. A. da Costa. 2009. Choline: An essential nutrient for public health. Nutrition Reviews 67(11):615-623.
  4. NIH (National Institutes of Health). 2021. Choline: Fact sheet for health professionals. NIH Office of Dietary Supplements website. Accessed May 2022.
  5. Korsmo, H. W., et al. 2019. Choline: Exploring the growing science on its benefits for moms and babies. Nutrients 11(8):1823.
  6. Conlay, L. A., et al. 1992. Exercise and neuromodulators: Choline and acetylcholine in marathon runners. International Journal of Sports Medicine 13(Suppl 1):S141-S142.
  7. Fratoni, V. and M. L. Brandi. 2015. B vitamins, homocysteine and bone health. Nutrients 7(4):2176-2192.
  8. Detopoulou, P., et al. 2008. Dietary choline and betaine intakes in relation to concentrations of inflammatory markers in healthy adults: The ATTICA study. The American Journal of Clinical Nutrition 87(2):424-430.
  9. Zhang, Y. W., et al. 2021. Low dietary choline intake is associated with the risk of osteoporosis in elderly individuals: A population-based study. Food & Function 12:6442-6451.
  10. Øyen, J., et al. 2017. Dietary choline intake is directly associated with bone mineral density in the Hordaland Health Study. The Journal of Nutrition 147(4):572-578.
  11. Derbyshire, E. and R. Obeid. 2020. Choline, neurological development and brain function: A systematic review focusing on the first 1000 days. Nutrients 12(6):1731.
  12. NIH (National Institutes of Health). 2020. Choline supplements in young children with fetal alcohol spectrum disorder have lasting cognitive benefits. NIH National Institute on Alcohol Abuse and Alcoholism Research Update website. Accessed May 2022.
  13. Alzheimer’s Association. 2022. Alzheimer’s disease facts and figures. Alzheimer’s Association website. Accessed May 2022.
  14. Jia, J. P., et al. 2004. Differential acetylcholine and choline concentrations in the cerebrospinal fluid of patients with Alzheimer’s disease and vascular dementia. Chinese Medical Journal 117(8):1161-1164.
  15. Smith, A. D., et al. 2018. Homocysteine and dementia: An international consensus statement. Journal of Alzheimer’s Disease 62(2):561-570.
  16. Moreno Moreno, M. D. J. 2003. Cognitive improvement in mild to moderate Alzheimer’s dementia after treatment with the acetylcholine precursor choline alfoscerate: A multicenter, double-blind, randomized placebo-controlled trial. Clinical Therapeutics 25(1):178-193.
Tips to maintain Vitamin D
Dr. Susan E. Brown

5 Vitamin D Tips to Use Today

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Almost every day it seems like researchers are discovering fascinating new details about Vitamin D.  What’s more, you can put many of their findings into use immediately to help ensure you maintain the optimum 50-60 ng/ml blood level of Vitamin D.

Here are five of the newest ways you can take action:

1. “D” stands for daily.

While we tend to think that Vitamin D is stored in the body, recent research suggests that one very important type of Vitamin D, cholecalciferol, has a very short half-life.  This means that to ensure the disease-protective benefits of Vitamin D it must be taken daily.  This also might explain why studies giving six months of Vitamin D in one large dose often show no beneficial effects.

2. You likely need more D than you are taking.

At the recent American College of Nutrition Conference, Vitamin D authority Dr. Robert Heaney reported that to reach his recommended target 40-60 ng/ml Vitamin D blood level the average person needs to supplement with 4,000-5,000 IU a day.  This is the same intake level I recommend for my clients at the Center for Better Bones and for you!

3. You can calculate your true supplemental need.

Scientists now know that for every 1,000 IU increase in your Vitamin D supplementation your blood level will increase by about 10 ng/ml.  So if you’re taking 2,000 IU a day and your Vitamin D blood test says you have a 30 ng/ml level, then adding 2,000 IU more will likely give you a 50 ng/ml level, and adding 3,000 IU more should give you a 60 ng/ml level. Test Your Vitamin D at Home!

4. Overweight and obese individuals need more Vitamin D.

We’ve known for a while that those of us with excessive body fat have lower Vitamin D levels.
At first it was thought that fat cells sequestered Vitamin D and were reluctant to release it.  But new research shows that obese individuals have higher Vitamin D binding proteins and thus less free, available Vitamin D.  Whatever the cause, if you are overweight, I suggest you have your Vitamin D level tested.

5.  Not absorbing your Vitamin D well?  Try this.

I also learned from Dr. Heaney’s recent lecture about the new unpublished finding that Vitamin D can be absorbed from the buccal lining tissues in the mouth.  If you can’t bring up your Vitamin D level with the supplements you are taking, try opening a capsule of dry Vitamin D and let it dissolve under your tongue.

Please let me know if these tips are helpful.  Be well and thrive!

Dr. Susan E. Brown

Can Your Bones Benefit from Omega-3s?

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By Dr. Susan Brown and Cameron Vazquez, MPH

You’ve heard of omega-3s for brain health and heart health, but have you heard about omega-3s for bone health? Given the myriad benefits these crucial anti-inflammatory nutrients have on our health, it was only natural to explore whether these benefits extend to bone. And indeed, they do. Omega-3 fatty acids have been shown to reduce fracture risk and decrease bone loss, making them another key nutrient to support bone health.

Omega-3s and Fracture Risk

Numerous studies assert that omega-3s directly influence fracture risk in general and risk of hip fracture in particular.

A 2015 study (1) found that men who had the highest levels of polyunsaturated fatty acids (PUFAs), omega-3s, and EPA had the lowest risk of general fracture compared to men with the lowest levels of PUFAs, omega-3s, and EPA. The women in this study experienced a lower risk of general fracture when they had higher levels of PUFAs.

This study also found that daily fish oil consumption, a substance with high concentrations of omega-3s, during midlife reduced a woman’s fracture risk by 25% and a man’s fracture risk in late life by 36%.

Another study examining postmenopausal women found a similar trend when looking at hip fracture. In fact, the study asserts that the amount of α-linolenic acid (ALA), eicosapentaenoic acid (EPA), and total omega-3 polyunsaturated acids (PUFAs) in red blood cells is a major predictor of hip fracture. Higher levels of omega-3 fats were associated with a lower risk for fracture. (2)

Omega-6/Omega-3 Ratio and Fracture Risk

Many studies cite high levels of PUFAs as protective against bone. This includes both omega-6 PUFAs and omega-3 PUFAs. However, research has found that there is significance in the ratio of omega-6 PUFAs to omega-3 PUFAs. For instance, a study examining postmenopausal women found that a higher omega-6/omega-3 ratio predicts a higher risk for hip fracture. In fact, the participants with the highest n-6/n-3 suffered from double the hip fractures. (2)

It makes sense that a high omega-6 to omega-3 ratio would increase the risk of hip fracture. It is well known that having too many omega-6s compared to omega-3s contributes to a variety of serious inflammatory diseases such as heart disease, cancer, and autoimmune disorders. (3)

Omega-3s and Bone Mineral Density

Not only does data support that omega-3s dramatically reduce fracture risk, but also the research suggests that omega-3s directly impact bone mineral density. This is done by facilitating bone mineralization, reducing inflammation, and protecting against excessive bone breakdown. (4)

Bone mineral loss is the result of an imbalance between bone formation by osteoblast cells and bone resorption by osteoclast cells. Omega-3s can increase bone-building cell activity and reduce the activity of bone breakdown cells. One study even suggested that 4.5 to 6 grams per day of EPA and DHA can have curative effects on bone loss. (5)

Not only have the bone benefits of omega-3s been replicated in populations all over the world, including in South Korea (6), China (7), Spain (8), and Iceland (1), but they have also been seen in studies conducted by NASA on astronauts who have lived beyond our world. Astronauts lose bone because of the weightlessness they experience in space travel. On average, astronauts lose 1 to 1.5% of bone per month while living in space. (9)

To combat this bone loss, researchers investigated the effects of omega-3s and found that astronauts who consumed more fish (and therefore more omega-3s) suffered less bone loss following their return from 4- to 6-month space flights. (10)

Omega-3s and Steroid-Induced Osteoporosis

Glucocorticoids such as prednisone, are the main cause of secondary osteoporosis and osteoporosis before the age of 50. (11)

Reducing the damage to the bone from steroid medications is very important and a recent Russian study suggests that omega-3 fats can help. Although this was an animal study, it demonstrated that omega-3 fats can prevent bone loss from steroid use. This is most likely due to the anti-inflammatory actions of omega-3 fats. (12)

We look forward to more human studies, as well as newer and more innovative studies in the future to confirm these findings.

Better Your Bones with Omega-3s

Here at the Center for Better Bones, omega-3 fats rank amongst the important bone-building nutrients, as does the ratio of omega-6s to omega-3s. Now, with breakthrough technology, it is possible with a simple at-home blood spot test to get a comprehensive analysis to measure both your omega-3 fats and your omega-6 to omega-3 ratio, and to detect if you have toxic trans fats.Omega 3 Master class

Click for References

References:

  1. Harris, T. B., et al. 2015. Plasma phospholipid fatty acids and fish-oil consumption in relation to osteoporotic fracture risk in older adults: The Age, Gene/Environment Susceptibility Study. American Journal of Clinical Nutrition 101(5):947-955.
  2. Orchard, T. S., et al. 2013. The association of red blood cell n-3 and n-6 fatty acids with bone mineral density and hip fracture risk in the women’s health initiative. Journal of Bone and Mineral Research 28(3):505-515.
  3. Simopoulos, A. P. 2006. Evolutionary aspects of diet, the omega-6/omega-3 ratio and genetic variation: Nutritional implications for chronic diseases. Biomedicine & Pharmacotherapy 60(9):502-507.
  4. Sharma, T. and C. C. Mandal. 2020. Omega-3 fatty acids in pathological calcification and bone health. Journal of Food Biochemistry 44(8):e13333.
  5. Fazelnia, F. and N. Khodabandehloo. 2019. Preventive and curative effect of omega-3 supplementation on bone mineral density in people aged 60 years and older: A systematic review. Internal Medicine and Medical Investigation Journal 4(1):9-15.
  6. Moon, H.-J., et al. 2012. Positive correlation between erythrocyte levels of n-3 polyunsaturated fatty acids and bone mass in postmenopausal Korean women with osteoporosis. Annals of Nutrition and Metabolism 60(2):146-153.
  7. Chen, Y. M., et al. 2010. Higher sea fish intake is associated with greater bone mass and lower osteoporosis risk in postmenopausal Chinese women. Osteoporosis International 21:939-946.
  8. Lavado-García, J., et al. 2018. Long-chain omega-3 polyunsaturated fatty acid dietary intake is positively associated with bone mineral density in normal and osteopenic Spanish women. PLoS ONE 13(1):e0190539.
  9. Stavnichuk, M., et al. 2020. A systematic review and meta-analysis of bone loss in space travelers. Npj Microgravity 6:article 13.
  10. NASA (National Aeronautics and Space Administration). 2010. NASA studies find omega-3 may help reduce bone loss. Science Daily 11 May 2010.
  11. Briot, K. and C. Roux. 2015. Glucocorticoid-induced osteoporosis. RMD Open 1(1):e000014.
  12. Elbahnasawy, A. S., et al. 2019. Protective effect of dietary oils containing omega-3 fatty acids against glucocorticoid-induced osteoporosis. Journal of Nutrition and Health 52(4):323-331.
Bone builder and tomatoes
Dr. Susan E. Brown

Tomatoes: Summer’s unexpected bone builder

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It’s tomato season! The brilliantly-colored summer treats common in all our gardens are major players in one of today’s leading-edge research topics in osteoporosis: how oxidative damage causes the inflammation which leads to bone breakdown.

What makes tomatoes so interesting to the scientists studying the effects of oxidative damage? Tomatoes are particularly highly in a bone-protective antioxidant known as lycopene. It has long been noted that people who consume more tomatoes, tomato paste, sauces, juice, and tomato products of all sorts experience a lower fracture rate than those who consume less.

So how can you get from 12 to 30 milligrams of lycopene a day without taking extra supplements? It’s really quite easy if you like tomatoes as I do. Bright red tomatoes — in sauces, soup, juices, or just plain sliced up on the plate—are loaded with lycopene!

Tomato products and lycopene content

Tomato product               Serving Size          Lycopene content

Tomato paste                  1/4 cup                  18.84 mg

Tomato puree, canned      1 cup                     54.38 mg

Tomato sauce, canned      1 cup                     34.25 mg

Pasta sauce, canned         1 cup                    31.66 mg

Vegetable juice cocktail     1 cup                    23.38 mg

Tomato juice                   1 cup                    21.91 mg

Tomato soup                   1 cup                    13.05 mg

Tomato, raw                   1 whole                   3.17 mg

Oh, and if you don’t like tomatoes, enjoy watermelon, papaya, grapefruit — also good sources of lycopene.
Finally, I hear this question a lot, “But aren’t tomatoes acid forming?” True, tomatoes are slightly acid forming, but their benefits outweigh any small acid contribution, which can be easily buffered with our Alkaline for Life Diet®. Be well and enjoy the fruits of summer! Here’s a recipe to get you started:

Bone-healthy salsa recipe

•    4 large tomatoes (or 6 plum tomatoes) chopped
•    1 small white onion, diced
•    Juice from 1 lemon
•    Handful of fresh cilantro
•    Salt to taste
Mix together and serve (or add a chopped cucumber for a great summer tomato salad).

References:

Sahni, S et al., Protective Effect of Total Carotenoid and Lycopene Intake On The Risk Of Hip Fracture: A 17 Year, Follow-Up From the Framingham Osteoporosis Study, JBMR, Vol. 24, No.6.2009:10861094.

Mackinnon, ES et al., Supplementation with the Antioxidant Lycopene Significantly Decreases Oxidative Stress Parameters In The Bone Resorption Marker N-telopeptide  Of Type I Collagen In Postmenopausal Women.  Osteoporosis international (2011) 22:1091-1101

US Dept. of Agriculture, Agriculture Research Service. USDA National Nutrient Database For Standard Reference, Release 24, Lycopene.

 

Dr. Susan E. Brown

Vegetarian and Vegan Diets: What They Mean for Bone

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Studies from around the world document that a diet high in whole-food vegetables, fruits, nuts, seeds, herbs, and spices reduces disease risk. Witness a new study from Iran (1) reporting reduced inflammation and lower bone breakdown in those consuming more plant foods; a Spanish study (2) linking higher plant intake to lower blood pressure; a large US study (3) revealing how high plant intake supports healthy brain aging; another (4) showing variety in fruit and vegetable intake can reduce the risk of life-threatening heart disease; and another study that focuses on kidney failure. (5)

Further, a diet high in nutrient dense plant foods has shown benefits for bone in the form of reduced bone loss and decreased risk of fracture. (6, 7)

Vegetables are great for our bones, but how does our skeleton fare on a diet that excludes all foods of animal origin?

A whole-foods, plant-centered diet helps protect us from the plague of modern degenerative disease, this is clear. In addition, as far as bone goes, both vegetarian and vegan diets exhibit a reduced acid load which favors bone. But, as we evolved eating all sorts of plants and animals it is only logical to ask if a diet limited only to plant food sources supports lifelong bone strength?

For some time, scientists have tried to tease apart the impact on bone health of both vegetarian and vegan diets. This is not an easy task as there are many types of vegetarian diets. A lacto-ovo vegetarian diet can vary substantially from an “ovo” or “no ovo” vegetarian diet, etc. The research we have looks at how individuals identify themselves (vegetarian, vegan, or omnivore) and this is what we see:

Vegetarian diets and bone density

  • Vegetarians are found to have lower bone mineral density than their omnivore companions (8). One study (9) calculated vegetarians to have a 4% lower bone mineral density than meat eaters.
  • The study mentioned above (6) from Taiwan found that although bone density may be lower, aging bone loss among long-term ovo-lacto vegetarians was not affected significantly.

Vegetarian diets and fracture risk

  • Data (6) suggest vegetarians likely have a slightly increased risk of fracture.
  • Specifically, a large British study (10) calculated that vegetarians had a 25% increased risk of hip fracture.
  • Most researchers consider this increased risk fracture among vegetarians to be slight, and likely reduced by higher intakes of protein, vitamin/minerals, and omega-3 fats.

Veganism and bone

A vegan diet can be quite a different animal than the vegetarian diet (forgive the pun) and tends to be less nutrient dense. In Western societies, the vegan dietary pattern is associated with lower bone density and higher fracture risk, as reported below. But this may not be true for Eastern cultures where this dietary pattern evolved. Historically veganism was practiced amongst Buddhist nuns following the doctrine of “ahimsa,” which exhorts followers to “do no harm” to any living creature. Recent small studies (11, 12) suggest that these isolated and peaceful long-term vegan nuns did not experience an elevated risk of low bone density or fracture as compared to their omnivore counterparts.

Veganism and bone density in Western societies

  • Vegans as a group exhibit a lower bone density in the spine, hip, and total body than do vegetarians, and certainly substantially lower than that found in omnivores. (9, 10)
  • A recent in-depth German study (13) compared 36 vegans to 36 omnivores and found that the vegans had markers of lower bone density and a lower concentration of nutrients important to bone health. Vegans have lower levels of vitamins A and B2, lysine, zinc, selenium, omega-3 fats, iodine, and calcium.
  • Vegans experience substantially more fractures than either vegetarians or omnivores. (12, 14)
  • The large British EPIC-Ox study (10) found vegans to have nearly three times the risk of hip fracture as non-vegans.
  • Additionally, vegans exhibited a 50 to 100% increase in total fractures as compared to meat eaters.

Bone-enhancing nutrient suggestions for vegans and vegetarians

My clinical observations confirm the research finding that vegans and many vegetarians would do well to fortify their diet to support bone. Specifically, think of the following nutrients:

  • Calcium

Calcium intake is low in vegans, putting them at a higher risk for fracture. One study showed that calcium levels below 525 mg a day put women at a 75% higher risk of fracture. (15) Ensure a calcium intake of at least 600 to 800 mg (from diet and supplements together).

  • Vitamin D

Vitamin D deficiency has been commonly noted in vegans and increases the risk of fracture. (15). Test your vitamin D level and supplement with sufficient vitamin D to reach a 40 to 60 ng/mL level. (An at-home test for vitamin D is now available in our Shop.)

  • Vitamin B-12

Vitamin B-12 is essential for bone health. Unfortunately, it is one of the vitamins that is most difficult for vegetarians and vegans to obtain because it is mainly found in animal products. One study showed that low vitamin B-12 levels were detected in 11% of omnivores, 77% of vegetarians, and 92% of vegans. Prevalence of osteoporosis was seven times higher in vegan and vegetarian women with low B-12 concentrations. Low B-12 also leads to an elevation in homocysteine, which increases the risk for fracture. A meta-analysis study showed that vegans and vegetarians were at a 4% greater fracture risk for every µmol/L increase in homocysteine. (15)

Supplement with methylated B12, at a dose of 1,000 mcg once or twice a day (have your B-12 level tested if necessary).

  • Zinc

Zinc is important for bone health. The RDA is 6.8 mg/day for women and 9.4 mg/day for men. The USDA suggests that 17% of women and 11% of men are not meeting these recommended daily intakes on zinc. (16)

Zinc from plant sources is harder for the body to break down and use because of phytates, which make the zinc less bioavailable. The Food and Nutrition Board recommends that vegetarians and vegans should consume 50% more zinc than the recommended daily amount. (15)

  • Other bone building minerals

A dozen minerals are essential to support life-long bone strength. Assess your intake of the key bone-building minerals. While vegan and vegetarian diets may well be high in potassium, are you consuming enough bone-essential micro-nutrients minerals like zinc, manganese, copper, and boron?

Consider testing for your personal mineral adequacy with the Alkaline for Life Diet Starter Kit. Low pH readings suggest mineral inadequacy.

  • Protein

Protein is another key nutrient in bone health. Low protein levels may increase the risk of fracture. One study showed that vegans and vegetarians in the lowest quartile of protein consumption were at a significantly increased risk of hip fracture when compared to those who ate adequate amounts. (15)

Another study looking only at wrist fractures showed that when vegetarians ate adequate amounts of protein, the risk of wrist fracture was reduced by 68%. The same study showed that vegetarians who did not consume enough plant protein were at a higher risk for wrist fracture. (17)

Consume adequate protein. At the Center for Better Bones, we suggest 50 to 70 g of protein for the average person with 1 g of protein per kilogram of body weight as optimal.

  • Omega-3 fats

Vegetarians and vegans typically underconsume EPA and DHA, the Omega-3 fats that support bone health. In a vegetarian or vegan diet the main source of these fats (fish) is not consumed. The body can convert ALA (which comes from sources like flax, hemp, and chia) to EPA and DHA, however the conversion is limited. Therefore, ALA is not a significant source of EPA and DHA.

Research documents that those who consume omega-3 fats have a lower risk of hip fracture. Seaweed, algae, and algae oil with EPA/DHA supplements are good ways to obtain these essential fatty acids. An optimum omega-3 EPA/DHA intake is 2,000 to 3,000 mg/day.

  • Last, but not least, consume adequate calories

Bone is very metabolically active tissue requiring a high energy intake to build and maintain bone. Being underweight and losing weight is generally associated with low bone density and increased fracture risk.

References:

Click for References

  1. Shahinfar, H., et al. 2021. The link between plant-based diet indices with biochemical markers of bone turn over, inflammation, and insulin in Iranian older adults. Food Science & Nutrition 9(6):3000-3014.
  2. Alonso, A., et al. 2004. Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: The Seguimiento Universidad de Navarra (SUN) Study. British Journal of Nutrition 92(2):311-319.
  3. Corley, J., et al. 2020. Dietary patterns, cognitive function, and structural neuroimaging measures of brain aging. Experimental Gerontology 142:111117.
  4. Bhupathiraju, S. N., et al. 2013. Quantity and variety in fruit and vegetable intake and risk of coronary heart disease. American Journal of Clinical Nutrition 98(6):1514-1523.
  5. Banerjee, T., et al. 2015. High dietary acid load predicts ESRD among adults with CKD. Journal of the American Society of Nephrology 26(7):1693-1700.
  6. Chuang, T. L., et al. 2021. Effects of vegetarian diet on bone mineral density. Tzu Chi Medical Journal 33(2):128-13
  7. New, S. A., et al. 2000. Dietary influences on bone mass and bone metabolism: Further evidence of a positive link between fruit and vegetable consumption and bone health? American Journal of Clinical Nutrition 71(1):142-151.
  8. Veronese, N., and J. Y. Reginster. 2019. The effects of calorie restriction, intermittent fasting and vegetarian diets on bone health. Aging Clinical and Experimental Research 31:753-758.
  9. Iguacel, I., et al. 2019. Veganism, vegetarianism, bone mineral density, and fracture risk: A systematic review and meta-analysis. Nutrition Reviews 77(1):1-18.
  10. Tong, T. Y. N., et al. 2020. Vegetarian and vegan diets and risks of total and site-specific fractures: Results from the prospective EPIC-Oxford study. BMC Medicine 18:353.
  11. Garvan Institute. 2009. Vegan Buddhist nuns have same bone density as non-vegetarians. ScienceDaily, 17 April.
  12. Ho-Pham, L., et al. 2012. Vegetarianism, bone loss, fracture and vitamin D: A longitudinal study in Asian vegans and non-vegans. European Journal of Clinical Nutrition 66:75–82.
  13. Menzel, J., et al. 2021. Vegan diet and bone health—Results from the cross-sectional RBVD Study. Nutrients 13(2):68
  14. Burckhardt, P. 2016. The role of low acid load in vegetarian diet on bone health: A narrative review. Swiss Medical Weekly 146:w14277.
  15. Tucker, K. L. 2014. Vegetarian diets and bone status. American Journal of Clinical Nutrition 100(Suppl. 1):329S-335S.
  16. Moshfegh, A., et al. 2005. What we eat in America, NHANES 2001-2002: Usual nutrient intakes from food compared to dietary reference intakes. S. Department of Agriculture, Agricultural Research Service.
  17. Thorpe, D. L., et al. 2008. Effects of meat consumption and vegetarian diet on risk of wrist fracture over 25 years in a cohort of peri- and postmenopausal women. Public Health Nutrition 11(6):564–572.

Dr. Susan E. Brown

Silicon: Important Bone Nutrient and Worthy of Greater Study 

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Key Points In This Blog

  • Silicon Is Abundant in the Natural Environment 
  • It Is An Important Yet Overlooked Key Trace Mineral 
  • Silicon is More Bioavailable as Choline-Stabilized Orthosilicic Acid  
  • Key to Healthy Bone, Skin, Hair, Nails, Joints, Arteries 
  • Promotes Aluminum Detoxification 

Abundant in the Natural Environment: 

When you hear the word “silicon,” your first thought is probably not of “silicon” as a nutrient, but rather “Silicon Valley” pops into your mind. Silicon is a hard and brittle crystalline solid needed in the computer industry for the production of semiconductor chips. The properties of silicon allow millions of bits of information to be processed and stored in computers, thus the term “Silicon Valley.” 

Silicon is the seventh most abundant element in the universe and the second most abundant element on this planet after oxygen. About 25% of the earth’s crust is silicon. (1) Quartz is a form of silicon combined with oxygen. 

Abundant on earth, it is logical that silicon would be found in and important to the human body. Here is what we know so far. 

Silicon Is an Important Trace Mineral for Human Health 

Nutrient-wise, silicon is the third most abundant trace mineral in the human body. The highest concentration of silicon is found in connective tissues, especially in the aorta, trachea, bone and skin. With age there is an observed decrease of silicon concentration, which may be linked to several  degenerative disorders including atherosclerosis, osteoporosis, arthritis, excessive skin aging and even Alzheimer’s disease. (2) 

Silicon can be found in whole grains, vegetables, fruit, sea water, mineral water and beer. Even though plant foods contain high levels of silicon, its bioavailability from these sources is questionable due to poor solubility of actual silicon forms in these foods. Beer is an exception as the processing of beer leads to the formation of orthosilicic acid, the readily bioavailable source of silicon. 

In the U.S. and Europe silicon intakes range from 25 to 50 mg of silicon per day, with intake decreasing amongst the elderly who likely consume less whole plant food. (3) 

Bioavailable as Choline-Stabilized Orthosilicic Acid  

The crystalline silicon as seen in quartz is insoluble and not bioavailable to humans. Rather, orthosilicic acid, sometimes referred to as soluble silica, is the form that is bioavailable to the human body.  

The most highly studied form of silicon supplementation is “choline-stabilized orthosilicic acid” (ch-OSA). Adding choline, a Vitamin-B-like nutrient that is commonly deficient in the U.S. diet, stabilizes the orthosilicic acid and gives the supplement lasting biological value. Ch-OSA has been approved for human consumption and is known to be non-toxic. 

Key to Healthy Bone, Skin, Hair, Nails, Joints and Arteries

Research over the years has shown that a daily supplement of choline-stabilized orthosilicic acid offers varieties of health benefits. These clinically documented health benefits include: 

  • Bone Health 

Silicon stimulates collagen production and connective tissue formation and appears to help trigger the deposition of calcium and phosphate in bone tissue. (4) Early on there was established a direct relationship between silicon content and bone formation, and a 1993 European study showed silicon administration to increase bone density in osteoporotic women. (5) Overall, higher dietary silicon intake has been associated with greater bone mineral density. (6) 
I first learned about the bone-strengthening effects of choline-stabilized orthosilicic acid more than 10 years ago when I met with a group of European researchers investigating the topic.  These researchers documented that 6 mg of liquid choline-stabilized orthosilicic acid promoted bone mineralization as measured by the bone formation pro-collagen marker known as P1NP. Study participants given 6 to 12 mg of orthosilicic acid showed greater improvements in bone formation. (7)  

  • Skin  

Silicon is an essential component of collagen and appears to stimulate collagen production and connective tissue formation. Skin aging is associated with a decrease in silicon and hyaluronic acid levels in connective tissue that results in a loss of moisture and elasticity. Research suggests that choline-stabilized orthosilicic acid can help restore elasticity to sun-damaged skin and reduce the appearance of wrinkles. An often-cited study of middle-aged women with photo-aging of facial skin found that supplementation with ch-OSH reduced signs of wrinkling. (8) 

  • Hair and Nails 

Supplementation with choline-stabilized orthosilicic acid has been reported to help improve the strength of both hair and nails and may help improve hair quality. In a randomized, placebo-controlled study, oral supplementation with ch-OSA was shown to have positive effects on hair morphology and tensile strength. (9) In the same study on skin mentioned above, supplementation with choline-stabilized orthosilicic acid was shown to decrease the brittleness of nails as well. 

  • Joints  

Early research with animals suggests that orthosilicic acid leads to an increase in cartilage collagen concentration, although this role of silicon has not been highly researched. (10)  

  • Arterial Health 

Given that the highest concentration of silicon is found in connective tissues such as the aorta, trachea, bones and skin, some researchers suggest a role for silicon in arterial health. Indeed, animal studies report that supplementation with soluble silica lowered blood pressure. (See Reference 2.) Further, a study in Finland showed an inverse relationship between silicon in the drinking water and atherosclerosis. (11) 

Promotes Aluminum Detoxification, Possibly Reducing Risk of Alzheimer’s Disease 

Aluminum is a known neurotoxin that has been implicated in the development of Alzheimer’s disease. Research suggests that silicon reduces the bioavailability of aluminum. Consumption of moderately high amounts of beer in humans and orthosilicic acid in animals has been shown to reduce aluminum uptake from the digestive tract and slow down the accumulation of aluminum in brain tissue. (12) 

Further, it has been found that drinking silica-rich mineral waters significantly reduces the body burden of aluminum. (13)  

 

References: 

  1. Pappas, S. 2018. Facts about silicon. Live Science website. Accessed 4-2-21. 
  2. Jurkić, L. M., et al. 2013. Biological and therapeutic effects of ortho-silicic acid and some ortho-silicic acid-releasing compounds: New perspectives for therapy. Nutrition & Metabolism 10(1):2. 
  3. Jugdaohsingh, R., et al. 2002. Dietary silicon intake and absorption. American Journal of Clinical Nutrition 75(5):887-893. 
  4. Reffitt, D. M., et al. 2003. Orthosilicic acid stimulates collagen type 1 synthesis and osteoblastic differentiation in human osteoblast-like cells in vitro. Bone 32(2):127-135. 
  5. Eisinger, J., and D. Clairet. 1993. Effects of silicon, fluoride, etidronate and magnesium on bone mineral density: A retrospective study. Magnesium Research 6(3):247-249. 
  6. Jugdaohsingh, R., et al. 2004. Dietary silicon intake is positively associated with bone mineral density in men and premenopausal women of the Framingham offspring cohort. Journal of Bone and Mineral Research 19(2):297-307. 
  7. Spector, T. D., et al. 2008. Choline-stabilized orthosilicic acid supplementation as an adjunct to calcium/Vitamin D3 stimulates markers of bone formation in osteopenic females: A randomized, placebo-controlled trial. BMC Musculoskeletal Disorders 9:article 85. 
  8. Barel, A., et al. 2005. Effect of oral intake of choline-stabilized orthosilicic acid on skin, nails and hair in women with photodamaged skin. Archives of Dermatological Research 297:147-153. 
  9. Wickett, R. R., et al. 2007. Effect of oral intake of choline-stabilized orthosilicic acid on hair tensile strength and morphology in women with fine hair. Archives of Dermatological Research 299:499-505. 
  10. Calomme, M. R., et al. 1997. Supplementation of calves with stabilized orthosilicic acid: Effect on the Si, Ca, Mg, and P concentrations in serum and the collagen concentration in skin and cartilage. Biological Trace Element Research 56(2):153-165. 
  11. Schwarz, K., et al. 1977. Inverse relation of silicon in drinking water and atherosclerosis in Finland. Lancet 1(8010):538-539. 
  12. González-Muñoz, M. J., et al. 2008. Role of beer as a possible protective factor in preventing Alzheimer’s disease. Food and Chemical Toxicology 46(1):49-56. 
  13. Exley, C., et al. 2006. Non-invasive therapy to reduce the body burden of aluminum in Alzheimer’s disease. Journal of Alzheimer’s Disease 10(1):17-24. 
magnesium osteoporosis
Dr. Susan E. Brown

Why You Need More Magnesium

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Did you know?

The majority of the magnesium stored in your body is in bone, accounting for approximately 60% of total body magnesium. This magnesium is present on the surface of bone, and is available for the body to exchange into the blood as needed (1). It is very important for our bone health to make sure that we have adequate magnesium. Not only does magnesium have a structural role in bone maintenance, but it also influences bone-building cells and it modulates potential bone-damaging inflammation.

Low magnesium levels can jeopardize bone in many ways, including making the body resistant to the effects of vitamin D and the parathyroid hormone.

function of magnesium for bone

Magnesium and bone density

  • Magnesium intake was positively associated with whole-body bone mineral density in a study of more than 2,000 people. (2)
  • A large study found that women who consumed 422 mg or more of magnesium per day had significantly higher hip and whole-body BMD than those who consumed less than 206 mg daily. (3)
  • In the Framingham study, higher intake of magnesium was associated with greater BMD in the hip for both men and women, and in the forearm for men. (4)
  • Cheng et al. reported that for every 0.16 mmol/L increase in serum magnesium, bone density increased 8.78-fold. (5)

A large-scale study found that higher intakes of magnesium were associated with higher BMD, as shown in the graphs below. (6)

female magnesium and bone density

male magnesium and bone density

Magnesium and fracture

  • Having low magnesium levels in the blood correlated to a 44% higher risk of bone fractures, particularly hip fractures, as reported in a 2017 study that looked at serum magnesium levels of 2,245 middle-aged men. Interestingly, none of the men with what they regarded as “high” magnesium levels (more than 2.3 mg/dL) fractured at all. (7)
  • A 2018 study of more than 113,000 participants reported that hemodialysis patients with the highest serum magnesium levels had a 23% lower risk of hip fracture than those with the lowest serum magnesium (highest quartile vs. lowest). (8)
  • Another study reported that the risk of fracture decreased significantly in those who had the highest magnesium intake: (9)
    • 53% decreased risk of fracture in men
    • 62% decreased risk of fracture in women

Magnesium supplementation and bone

  • In one study, postmenopausal women on estrogen replacement therapy took a multivitamin and supplemented with an additional 400 mg/day of magnesium and 600 mg/day of calcium. In one year, they saw increased BMD at the heel compared with those who were only receiving estrogen replacement therapy. (10)
  • Another study reported that postmenopausal women who supplemented daily with 1,830 mg magnesium citrate for 30 days saw decreased serum iPTH levels (a bone breakdown marker), increased osteocalcin (bone-building), and decreased urinary DPD (a bone breakdown marker), indicating that they had increased bone buildup while decreasing bone resorption or breakdown. (11)
  • Healthy 8- to 14-year-old girls who supplemented with 300 mg magnesium per day for 12 months saw a significantly increased accrual of bone mineral content in the hip, compared with their peers in the placebo group. (12)

 

References:

  1. Vormann, J. 2016. Magnesium: Nutrition and homoeostasis. AIMS Public Health 3(2):329–340. doi:10.3934/publichealth.2016.2.329.
  2. Ryder, K. M., et al. 2005. Magnesium intake from food and supplements is associated with bone mineral density in healthy older white subjects. Journal of the American Geriatrics Society 53(11):1875–1880. doi:10.1111/j.1532-5415.2005.53561.x.
  3. Orchard, T. S., et al. 2014. Magnesium intake, bone mineral density, and fractures: Results from the women’s health initiative observational study. The American Journal of Clinical Nutrition 99(4):926–933. doi:10.3945/ajcn.113.067488.
  4. Tucker, K. L., et al. 1999. Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. The American Journal of Clinical Nutrition 69(4):727–736. doi:10.1093/ajcn/69.4.727.
  5. Cheng, W. W., et al. 2019. Mineral nutrition and the risk of chronic diseases: A Mendelian randomization study. Nutrients 11(2):378. doi:10.3390/nu11020378.
  6. Welch, A. A., et al. 2017. Dietary magnesium may be protective for aging of bone and skeletal muscle in middle and younger older age men and women: Cross-sectional findings from the UK Biobank Cohort. Nutrients 9(11):1189. doi:10.3390/nu9111189.
  7. Kunutsor, S. K., et al. 2017. Low serum magnesium levels are associated with increased risk of fractures: A long-term prospective cohort. European Journal of Epidemiology 32(7):593-603. doi: 10.1007/S10654-017-0242-2.
  8. Sakaguchi, Y., et al. 2018. Magnesium and risk of hip fracture among patients undergoing hemodialysis. Journal of the American Society of Nephrology: JASN 29(3):991–999. doi:10.1681/ASN.2017080849.
  9. Veronese, N., et al. 2017. Dietary magnesium intake and fracture risk: Data from a large prospective study. British Journal of Nutrition 117(11):1570-1576. doi:10.1017/S0007114517001350.
  10. Abraham, G. E., and H. Grewal. 1990. A total dietary program emphasizing magnesium instead of calcium. Effect on the mineral density of calcaneous bone in postmenopausal women on hormonal therapy. The Journal of Reproductive Medicine 35(5):503–507.
  11. Aydin, H., et al. 2010. Short-term oral magnesium supplementation suppresses bone turnover in postmenopausal osteoporotic women. Biological Trace Element Research 133(2):136–143. doi:10.1007/s12011-009-8416-8.
  12. Carpenter, T. O., et al. 2006. A randomized controlled study of effects of dietary magnesium oxide supplementation on bone mineral content in healthy girls. The Journal of Clinical Endocrinology and Metabolism 91(12):4866–4872. doi:10.1210/jc.2006-1391.
Collagen supplementation benefits
Dr. Susan E. Brown

Research Updates: The Latest and Greatest on Collagen

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Here at the Center for Better Bones, we try to keep up with the latest research and developments on all of our favorite nutrients. Today, we are going to report on two exciting studies on collagen!  

Collagen Supplementation Improves Body Composition and Muscle Strength 

A randomized controlled trial investigated the impacts of collagen supplementation in men with sarcopenia (low muscle mass), in combination with a 12-week resistance training program. Participants were either given 15 grams of collagen peptides per day or a placebo, and were instructed to drink the solution as soon as possible after their resistance training session, or at least within one hour.  

After 12 weeks, both groups gained muscle mass while decreasing fat mass. However, the collagen-supplemented group fared much better. The collagen-supplemented group: 

  • Had significantly more gains in muscle mass than the placebo group, 
  • Saw a more profound increase in muscle strength than the placebo group, and 
  • Had a higher loss of fat mass than the placebo group. 

Reference: https://pubmed.ncbi.nlm.nih.gov/26353786/ 

Collagen Peptides Improve Intestinal Epithelial Barrier Dysfunction  

For context, our intestinal barrier is a protective membrane that prevents toxins and undigested proteins from leaking from the gut into the bloodstream, while allowing nutrients to pass through into the blood. It is responsible for nutrient absorption, and defense against antigens and foreign organisms. In fact, almost 70% of the entire human immune system is found in our gut, making sure that unwanted foreign elements do not get into the blood. The intestinal epithelial barrier can be damaged from stress, infection, severe inflammation, or repair deficit. This damage is associated with several conditions including food allergies, celiac disease, and autoimmune diseases like irritable bowel syndrome (IBS) and inflammatory bowel disease. 

Inflammation can induce damage to this delicate, protective intestinal barrier. Specifically, TNF-alpha, a common inflammatory cytokine, increases permeability of the intestine and can cause defects in the tight junctions that form the barrier. This can allow molecules and organisms to “leak” through the intestinal wall and stimulate a more intense immune response (commonly known as “leaky gut”). 

This specific study looked at the use of Alaska pollock-skin-derived collagen (fish) peptides on tight-junction (intestinal epithelial wall) permeability in the presence of inflammatory marker TNF-alpha. 

What the researchers found was that this fish collagen might well have the potential to fortify the protective intestinal barrier.  

Specifically, cells treated with fish collagen had significantly decreased intestinal barrier dysfunction when challenged with an inflammatory force (TNF-alpha) over those who were not treated with fish collagen.  

Although this study was done in a cell model, it shows promising evidence that collagen peptides may decrease inflammation-induced damage to our intestinal epithelial barrier!  

https://pubmed.ncbi.nlm.nih.gov/28174772/ 

To learn more about collagen and bone health read my comprehensive report: Should I take Collagen for Osteoporosis?

 

References: 

  1. Zdzieblik, D., et al. 2015. Collagen peptide supplementation in combination with resistance training improves body composition and increases muscle strength in elderly sarcopenic men: A randomised controlled trial. The British Journal of Nutrition 114(8):1237–1245. doi:10.1017/S0007114515002810. 
  1. Chen, Q. et al. 2017. Collagen peptides ameliorate intestinal epithelial barrier dysfunction in immunostimulatory caco-2 cell monolayers via enhancing tight junctions. Food & Function 8(3):1144–1151. doi:10.1039/c6fo01347c. 
Dr. Susan E. Brown

Basic Steps to Support Immunity in Today’s Environment

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  • Stay well hydrated. Pure water, ginger, and herbal tea are good. (How to Make Fresh Ginger Tea)
  • Alkalize. Consume daily 2 cups of vegetables for lunch and 2 for dinner, 2 to 3 servings of fruit, nuts and seeds, and use plenty of herbs and spices. (10 Tips for an Alkaline Diet)
  • Maintain a first-morning urine pH of 6.5 to 7.5. Test your pH using our Alkaline Diet Starter Kit.
  • Spend time outdoors in nature (in open spaces, at least 6 feet away from others).
  • Worry less. Meditate, rest, get enough sleep.
  • Follow the general CDC sanitary precautions and maintain social distancing.
  • Seek medical help if you get ill.

Alkaline for Life® Immune-Support Nutrient Supplement Suggestions:

  • L-Ascorbate/Vitamin C. Begin by taking 3,000 to 5,000 mg of vitamin C spread throughout the day. Increase dose to bowel tolerance as necessary for optimum immune enhancement. Vitamin C is a highly documented and powerful natural anti-oxidant and anti-viral, especially powerful when it is taken in adequate amounts on a regular basis. At the Center for Better Bones and Alkaline for Life we use a professional grade, fully buffered, fully reduced L-ascorbate vitamin C powder, designed for therapeutic high-dose use (Alkalini-C). Each ½ teaspoon of Alkalini-C provides 1.5 grams of this high-quality, fully buffered, fully reduced L-ascorbate form of vitamin C. Alkalini-C is a premier anti-oxidant, a potent natural anti-viral, and a powerful alkalizing agent. Read our blogs on the benefits of vitamin C here.
  • Vitamin D. Ideally you want to take enough vitamin D to reach a 50 to 60 ng/mL blood level. Those not yet taking vitamin D might start with 4,000 IU a day for two weeks and then reduce to 2,000 IU per day. If you are testing your vitamin D level, adjust your dose accordingly to achieve a level of 50 to 60 ng/mL blood level of vitamin D. Generally, each 1,000 IU of additional vitamin D increases blood level vitamin D by 10 points (ng/mL). A simple blood spot test for vitamin D is available from Grassroots Health and a self-order blood test is available from Direct Labs. Vitamin D strengthens the immune system and thus helps the body fight viral infections. Numerous studies have documented that vitamin D reduces rates of respiratory infections.
  • Quercetin Flavonoid/Flavonol Combination (500 to 4,000 mg). At the Center for Better Bones and Alkaline for Life we use high-dose water-soluble quercetin dehydrate enhanced with pomegranate extract and OPC (1,000 to 4,000 mg/day). Quercetin is a powerful, broad-spectrum anti-viral and a potent anti-oxidant, which also inhibits release of pro-inflammatory cytokines and stabilizes mast cells. It works synergistically with L-ascorbate (vitamin C) to activate cells responsible for repair. A quercetin derivative is currently being tested in China for COVID-19.
  • Zinc and Selenium. Supplement daily with zinc (20 to 30 mg) and selenium (150 to 250 mcg). These can be found in a professional grade multivitamin or as single supplements. Both zinc and selenium are essential for optimum immune functioning and display important anti-viral activities.
  • Magnesium. Supplement with a total of at least 400 mg magnesium in alkalizing form (such as magnesium citrate, glycinate, ascorbate). Magnesium is an important mineral that participates in many immune responses. Also, abundant magnesium is essential for maintaining optimum pH balance (which itself helps protect cells from viral invasion). The intake of magnesium is suboptimal to deficient in the average diet. If magnesium gives you a loose stool, it is due to a cellular block to magnesium uptake. This can be corrected by taking 1 teaspoon of liquid choline citrate 2x per day with the magnesium. This liquid choline citrate will enhance magnesium uptake and help alkalize your chemistry. Watch Dr. Brown’s video about magnesium uptake problems here.
  • Multivitamin/mineral. Consider using daily a professional grade multivitamin/mineral high in B vitamins, bioavailable anti-oxidants, and other cofactors helpful for boosting immunity. Generally this should be at least a 2-servings-per-day product to deliver adequate doses of the nutrients.

These statements have not been reviewed by the FDA. Those with health concerns and/or taking pharmacological drug medications should consult with their health care provider on the appropriateness of nutrient supplements for their individual situation. Large doses of vitamin C have been questioned for those with diabetic ketoacidosis or glucose-6-phosphate dehydrogenase deficiency (G6PD) and perhaps in pregnancy/lactation, so discuss with your healthcare professional first.  Some, but not all, authorities suggest high-dose vitamin C should not be used in people with hemochromatosis or active oxalate kidney stones.

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Selected Support Materials:

Alkaline for Life website

Vitamin C Questions: Answered, Helen Saul Case, March 27, 2018

Dr. Robert Cathcart 1980 lecture about treating 20,000 patients with high-dose vitamin C 

Orthomolecular Medicine News Service Releases on Vitamin C for COVID-19.

Nutritional Treatment of Coronavirus, Andrew W. Saul, January 30, 2020

How to Protect Yourself from COVID-19, Mark Hyman, MD, 2020

Magnesium Uptake with Choline Citrate. Russell Jaffe, MD, PhD, CCN, Director, PERQUE, LLC

Dr. Susan E. Brown

Take the Better Bones magnesium challenge!

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Magnesium is the fourth most common mineral in our body, and over half of it is stored in the skeleton, where it works with other minerals to strengthen bone.

Magnesium is mostly lost in modern food processing, so it’s common for people to take in too little — and even in people with supposedly “normal” serum magnesium levels, there can be cause for concern, as levels may simply reflect low intake that has been offset by removal of this key mineral from bone (Ismail et al. 2010).

And as I mentioned in an earlier post, higher levels of magnesium in the body are associated with a reduced fracture rate — so making sure we get enough in the diet really warrants more attention, especially for those at risk of osteoporotic fractures.

Beyond that, magnesium is involved in more than 300 enzyme systems and is extremely important not only to our skeletal system, but also to every other system within the body, including the muscles, cardiovascular system, blood glucose regulation, and the nervous system. A few things you might not know:

  • Research has found that increased dietary intake confers protection not only against fractures, but also type 2 diabetes, metabolic syndrome, hypertension, and cardiovascular disease (Bo and Pisu 2008). Taking large amounts of calcium in the face of magnesium deficiency can cause calcium to precipitate out, contributing to kidney stones and hardening of the arteries.
  • A recent 20-year study has found that serum magnesium levels often are below normal in depressed adults. Depression that resists treatment by other means has been found to response to magnesium supplementation (Rajizadeh et al. 2017) — which makes sense, given that many commonly used antidepressants raise serum magnesium as a side effect (Eby and Eby 2010).
  • Except for children under the age of 5, all individuals studied, regardless of age, gender, or race, failed to consume even the recommended daily allowance (RDA) of 320 mg/day for women, 420 mg/day for men — and even that, in my opinion, is below the optimal.

My challenge for you 

Can we get enough magnesium in our diets without using supplements? I’m a big believer in getting the nutrients we need through food, but I’m not sure the average person can do it — because looking at a chart of foods high in magnesium, it’s pretty clear to me that the task of getting upward of 400—800 mg/day to restore bone stores and maintain adequate serum levels is a Herculean one. (This is an important reason why Better Bones Builder contains a daily dose 300 mg of magnesium in alkalizing form.)

How are you at making the most out of magnesium-rich foods? I’d love to hear input from readers on recipes that offer up a full day’s supply — at least 400 mg — of this vital nutrient!

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Click here for the printable Better Bones, Better Body® list of magnesium-rich foods

Resources:

Bo, S., and E. Pisu. 2008. Role of dietary magnesium in cardiovascular disease prevention, insulin sensitivity and diabetes. Curr Opin Lipidol. 19(1):50–56.

Eby, G. A., and K. L.  Eby. 2010.  Magnesium for treatment-resistant depression: A review and hypothesis. Med Hypotheses 74(4):649–660.

Ismail, Y., et al. 2010. The underestimated problem of using serum magnesium measurements to exclude magnesium deficiency in adults; a health warning is needed for “normal” results. Clin Chem Lab Med 48:323–327.

Moshfegh, A., et al. 2009. What we eat in America, NHANES 2005-2006: Usual nutrient intakes from food and water compared to 1997 dietary reference intakes for vitamin D, calcium, phosphorus, and magnesium. U.S. Department of Agriculture, Agricultural Research Service.

Pennington, J., et al. 1986.  Mineral content of foods and total diets: The Selected minerals in Foods Survey, 1982 to 1984 J Am Diet Assoc 86:876-91.

Rajizadeh, A., et al. 2017. Effect of magnesium supplementation on depression status in depressed patients with magnesium deficiency: A randomized, double-blind, placebo-controlled trial. Nutrition 35:56–60.