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Dr. Susan E. Brown

What’s good for heart and bone health — including dark chocolate

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With February bringing us both Heart Health Month and Valentine’s Day boxes full of dark chocolate, this is a great time to talk about the bone and heart health link.

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In fact, osteoporosis can be described as calcium leaving the bones and going into the arteries. Research backs this up, as individuals with osteoporosis are more likely to develop heart disease as they age than are individuals without osteoporosis. Plus, a recent Canadian study showed that adults diagnosed with heart failure had double the risk of fracture as compared to those without heart failure.

I was recently fortunate enough to talk to Dr. Steven Masley, a Florida physician and author of The 30-Day Heart Tune Up: A Breakthrough Medical Plan to Prevent and Reverse Heart Disease. We talked about the powerful connection between bone health and heart health, and what we can do to keep calcium from shifting from our bones to our arteries to put us at greater risk of heart attacks, strokes and other serious health conditions.

As you’ll see in the video, Dr. Masley focuses on five food groups to benefit your bone health and heart health (for those of you who have been waiting, this is where the dark chocolate comes in!)

5 heart- and bone-friendly food groups from Dr. Masley

1. Fiber from fruits and vegetables provides alkalinity for our bones and helps dilate our arteries to increase circulation.

2. Healthy fat over “no fat.” Choose healthy fats like olive oil, avocado and seafood to reduce inflammation (good for both bone and cardiovascular health).

3. Lean protein is important for bone strength, metabolism and appetite suppression.

4. Beneficial beverages include a protein smoothie to start the day and pure, clean water to hydrate and flush out toxins. Dark chocolate cocoa is also a good treat!

5. Fabulous flavors keep healthy food delicious. Use herbs, spices, garlic in abundance. Dark chocolate is another option here.

 

Watch my video chat with Dr. Masley here

 

You can also preview chapter one of Dr Masley’s The 30-Day Heart Tune Up for free.

 

Better Bones Blog
Dr. Susan E. Brown

Put retesting your vitamin D level on your calendar

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With January slipping by faster than any of us can believe, here’s a reminder to put “getting your vitamin D tested or retested” on your calendar for late February.

bright sun above the cloud is lighting right to the cameraTiming really is everything, because by the end of winter your vitamin D level will be as low as it will be all year. Because of this, many women suffer more rapid bone loss by the end of winter— actually leading to an increase in springtime osteoporotic fractures.

Ideally we should strive for a 50 to 60 ng/ml level of vitamin D, all year round. To determine how much supplementation you need in each season, not only test your vitamin D level in late February but also toward the end of summer in late August. With this information, you can accurately adjust your vitamin D dose.

Helpful hints to remember

1. Keep track of how much of vitamin D you take during the different seasons, and note when you change doses. This way when you get your blood test you will know how much vitamin D you took to obtain that vitamin D level.

2. As a rule of thumb, for every 1,000 IU increase in vitamin D supplement, your vitamin D level increases by 10 ng/ml.

3. It takes two months to see the full effect of a change in vitamin D dose.

Vitamin D: how much is best?

• Lower than 32 ng/ml is deficient

• 33-49 is adequate

• 50-60 ng/ml is optimum

• Greater than 100 ng/ml is excessive

Experts now agree that a 32 ng/ml is the minimum adequate vitamin D level 25 necessary to protect bone. A level of 50-60 ng/ml is optimum for significant protection against many cancers, diabetes, multiple sclerosis and heart disease.

Why vitamin D is so important

At the Center for Better Bones we find good evidence that having an adequate vitamin D blood level reduces your risk of fracture by 50%, while at the same time significantly decreases your vulnerability to diabetes, cancer, heart disease, periodontal disease, high blood pressure and even cognitive decline! For the latest new research on vitamin D and a free chart depicting the degree to which various diseases can be prevented by adequate vitamin D supplementation take the time to visit my friends at www.grassroots health.net.  Or, learn more with my article Vitamin D: the benefits are more than ever imagined.

Dr. Susan E. Brown

It’s always the season for cinnamon’s bone building effects

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Special note: Here’s a reminder why you should try to include cinnamon in summer cooking with some new ideas, along with a popular blog I first posted in December.

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Cinnamon has been used for thousands of years as a healing agent by wisdom-driven cultures. It’s a highly prized food item for not only for flavoring, but for its antioxidant and digestion-enhancing effects, as well as for its ability to lower blood sugar and reduce insulin resistance. Of specific importance to us is the fact that cinnamon reduces bone breakdown and can help prevent osteoporotic bone loss.

While best known as a holiday treat, there are plenty of delicious reasons to choose cinnamon to spice up your summer. Here are just a few of my favorites:

•    Cut up apples and sprinkle them with cinnamon. A staff member reports that cinnamon on watermelon is excellent summer treat.
•    Include in your favorite chai tea recipe
•    Try adding cinnamon to fried rice
•    Use as a topping on frozen bananas
•    Try with all cereals – not just oatmeal – along with fruits and nuts.

As you shop for cinnamon, you may notice several alternatives. I do recommend you look for Ceylon cinnamon (Cinnamomum zeylanicum) also called “true cinnamon.” While it can be more expensive than the alternatives such as Cassia cinnamon, I believe the potential building effects are worth it year-round!

Finally, you may want to try one of my favorite recipes for Chai Tea, delicious hot or cold:

Traditional Chai Tea  

Recipe courtesy of Gina Galli

(makes 4 cups of tea)
•    2 cups of boiling water
•    Black tea – Either 2 tea bags or loose tea in a tea ball or disposable tea filters
•    1 teaspoon of whole Cardamom pods (crush and just use the seeds)
•    3 whole Star of Anise
•    2 whole Cinnamon Sticks
•    ½ of whole Nutmeg
•    2 cups of Milk or Almond Milk
•    Sweeten to taste with sweetener of choice (Stevia, Agave, or honey)
•    Other spices you can add are ginger, whole black peppercorns, or a Masala Spice Mix

1)    Boil water in a sauce pan, remove from heat and add tea to steep for 5-10 minutes—longer if you like it stronger.
2)    Add the spices whole to the tea (or you can put them in a small strainer or tea ball) and simmer for 10 minutes more until the tea becomes fragrant.
3)    Strain the tea or remove strainer and add 2 cups of milk. Bring the liquid back to a simmer just for just 2 to 3 minutes to blend flavors.
4)    You can add sweetener to taste if you like. In India they sometimes will add a teaspoon per serving of sweetened condensed milk.

 

References:

Tsuji-Naito K. Aldehydic components of cinnamon bark extract suppresses RANKL-induced osteoclastogenesis through NFATc1 downregulation. Bioorg Med Chem. 2008 Oct 15;16(20):9176-83. doi: 10.1016/j.bmc.2008.09.036. Epub 2008 Sep 14. http://www.ncbi.nlm.nih.gov/pubmed/18823786 (accessed 12.05.13)

 

Better Bones Blog
Dr. Susan E. Brown

Adding years to your life is as easy as 1-2-3 servings of vegetables

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We all know that eating fruits and vegetables is good for us – but new research results couldn’t make the point much clearer: including fruits and vegetables in your daily diet helps you live longer.

Three colored peppers stacked in a triangle, isolated on white.

  1. Those who consumed 3 vegetables a day lived 32 months longer than those who reported never consuming vegetables.
  2. Those who consumed 5 servings of fruits and vegetables each day lived 3 years longer than those who never ate fruit or vegetables.
  3. Those never consuming vegetables had a 53% higher mortality rate within the 13-year study period.

Simply put, the lower your fruit and vegetable intake, the greater the likelihood of a shorter lifespan and death.

What’s also interesting is that while we have known about the overwhelmingly positive effects of fruit and vegetable consumption for specific health issues – everything from cardiovascular disease to cancer to bone health – this is one of the first large-scale studies to look at the impact on overall lifespan.

The really good news is that just 3 servings of fruits and vegetables daily give huge benefits! To help you get started, here’s one of my favorite veggie-filled recipes that can be served as a side dish, tossed with pasta or used with a wrap:

Indian-Style Roasted Vegetable Medley

(10 servings)

6 large cloves garlic, coarsely chopped
4 medium-sized potatoes, unpeeled and diced into 1-inch cubes
2 large sweet potatoes, unpeeled and diced into 1-inch cubes
2 large onions, sliced lengthwise
1 medium-sized eggplant, diced into 1-inch cubes
1 medium-sized cauliflower, diced into 1-inch cubes
¼ C melted clarified butter
1 Tbsp ground coriander
2 tsp ground turmeric
1 tsp ground cumin
1 tsp sea salt
½ tsp black cumin seed (optional)
Chili powder to taste
Finely chopped fresh cilantro as a garnish

1. Preheat the oven to 400ᴼF. Lightly coat two 9-x-13-inch baking dishes with vegetable oil and set aside.
2. In a large bowl, combine the garlic, potatoes, onions, eggplant, cauliflower and butter. Toss well.
3. Add the coriander, onion powder, turmeric, ground cumin, salt, cumin seed and chili powder to the vegetables and toss well.
4. Transfer the vegetables to the prepared baking sheets, spreading them out in a single layer.
5. Roast the vegetables for 35 minutes, or until lightly browned and fork-tender. Top with a handful of cilantro and serve.

Recipe courtesy of The Amazing Acid Alkaline Cookbook by Bonnie Ross

 

Reference:

Bellavia, Andea, et. al. 2013. Fruit and vegetable consumption and all-cause mortality: a dose-response analysis. Am J Clin Nutr, vol 98. Pp. 454-9.

 

Dr. Susan E. Brown

Questions about vitamin K? Here are some answers

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As more and more people discover that vitamin K helps naturally strengthen our bones and protect our hearts, I’m frequently asked how to get the optimal benefit from this key nutrient. Here are answers to the most common questions I hear:

1. Why do I so strongly recommend supplementation of vitamin K?

For most of us, our current dietary intake of vitamin K is too low to have the proper calcium utilization that keeps calcium in the bones and out of our arteries. Vitamin K facilitates the transport of calcium from the bloodstream into the bone and is essential for the proper formation of “osteocalcin,” a bone-formation protein. It also prevents arterial calcification.

2. What is the difference between the various forms of vitamin K and which form do I prefer?

The two main forms of vitamin K are K1 and K2:

•    K1 (phylloquinone) is abundant in green leafy vegetables. This form of vitamin K has a short half-life within the body, being rapidly cleared by the liver. A small amount of K1 is commonly used in multivitamin formulations and a deficiency of vitamin K1 leads to defective blood clotting.
•    K2 (menaquinone) is found in meat, eggs, and some dairy products. Vitamin K2 is produced by bacteria found in aged or fermented foods such as natto, aged cheese, and sauerkraut. Certain forms of vitamin K2 are now being introduced into selected nutritional supplements.

The subtypes of vitamin K2 are known as MK-7 and MK-4. More and more, these are being incorporated into nutritional supplements, so let me explain a bit about the vitamin K2 family.

•    Vitamin K2, in the form of MK-7 (menaquinone-7) has a long half-life within the body, being evident even 72 hours after ingestion. Small supplemental or dietary doses of the potent MK-7 (180 mcg) have been found effective in reducing menopausal bone loss, strengthening bone, and reversing arterial calcification. To date no fracture trials have been done with MK-7, but the Japanese populations that consume this nutrient through a high intake of fermented soy called “natto” exhibit a reduced incidence of both fracture and heart disease.
•    Vitamin K 2 as MK-4 (menaquinone-4) is found in small amounts in foods such as butter, egg yolks, and meat, and it has a short half-life within the body. A form of very high-dose synthetic MK-4 has been developed as an osteoporosis drug by the Japanese. When used as a bone drug, MK-4 must be taken in the high dose of 15 mg, three times a day. Studies suggest this K2 supplementation effectively reduces fracture risk.

With the Better Bones approach, we encourage everyone to eat at least two cups of green leafy vegetables per day. These vegetables will provide a good amount of the plant-based K1. While vitamin K1 is important, research supports the special value of vitamin K2 as MK-7. We use MK-7 supplements that are naturally derived from fermented foods such as soy (“natto”) in the dose of 90 to 300 mcg per day.

The synthetic vitamin K2 as MK-4 mentioned above is given in high pharmacological, not physiological doses (45 mg/day). At the Center for Better Bones, we have great success with small dietary level doses of MK-7 and rarely find the need to use this high dose MK-4 bone drug.

3. Is it safe to use doses of vitamin K that are well above the RDA?

The RDA for vitamin K, as in all nutrients, is the established level which will prevent deficiency disease in a majority of the population. Unfortunately, the RDA tells us nothing about the level that will promote optimal health. Happily, vitamin K is extremely safe when consumed in levels many, many times its RDA. The only exception is for those on the blood thinner Coumadin because supplementing with vitamin K will reduce the effectiveness of Coumadin.

For more information on the benefits and safety of vitamin K, I suggest you review any of the 261 articles by world-renowned vitamin K researcher, Dr. Cees Vermeer here.

 

Dr. Susan E. Brown

Can Vitamin C Speed Up Fracture Healing and Reduce Fracture Risk?

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You know vitamin C is an important nutrient, but do you know how valuable it is for bone health? I first learned about the importance of vitamin C in high school history when we read about its use by European seafaring explorers to fight the dangers of “scurvy.” Of course, at that point in my life I was more interested in getting to my after-school activities on time than I was in learning more about the health benefits of vitamin C.

Several pieces of fresh oranges in the form of letter C. Isolated on white.

Building bone density

• Higher intake of vitamin C has been associated with a lower rate of bone loss as we age. Equally, many studies report that individuals with osteoporosis have lower levels of vitamin C.

• The bone benefits of vitamin C appear to be particularly striking for women who smoke or are on hormone replacement therapy.

• In animal studies, vitamin C helped prevent the bone loss associated with ovary removal. What’s most interesting about this finding is that the researchers suggest that vitamin C could prevent “low turnover osteoporosis” — the type of bone loss associated with ovary removal. Bone turnover involves the on-going process by which old bone is broken and new bone formed. Low bone turnover, means low bone renewal.

Reducing fracture risk

Higher intake of vitamin C is also associated with a reduced risk of fracture, while low levels of ascorbic acid have been reported in patients experiencing hip fracture. For example, in the 15-year Framingham Osteoporosis Study, participants with the highest intake of total vitamin C from diet and/ or supplements had significantly fewer fractures compared to those with the lowest vitamin C intake.

Speeding fracture healing

As an antioxidant, anti-inflammatory nutrient, vitamin C aids in fracture healing. In both human and animal studies, vitamin C supplementation is consistently found to speed fracture healing. It also improves the mechanical resistance of the new tissue that grows for bone healing, called the fracture callus. In the case of wrist fracture, supplementing with vitamin C helps prevent the post-fracture condition known as complex regional pain syndrome (CRPS). CRPS is an extremely painful inflammatory process associated with suboptimal fracture healing.

With all of these benefits, I recommend that you use vitamin C daily, along with other key antioxidants found in my Better Bones products. You can learn more about vitamin C and other essential nutrients for optimal bone health in my article 20 key bone-building nutrients.

 

References:

Vitamin C and Bone Mineral Density

Sugiura M. “Dietary patterns of antioxidant vitamin and carotenoid intake associated with bone mineral density: findings from post-menopausal Japanese female subjects” Osteoporosis Int. 2011.

Sahni S., Hannan M., Gagnon D et al. “High vitamin C intake is associated with lower 4-year bone loss in elderly men” Journal of Nutrition 2008.

Wolf RL, Cauley JA, Pettinger M, Jackson R, Lecroix A, et al. Lack of a relation between vitamin and mineral anti-oxidants and bone mineral density: results from the Women’s Health Initiative. Am J Clin Ntr 2005. Vol 82. Pp. 581-588.

Zhu LL., Cao J, Sun M, et al. “Vitamin C prevents hypogonadal bone loss” PLos One. 2012. Vol. 10. Doi:10.1371/journal.pone.0047058 Chuin, A. et al., “Effects of antioxidants combined to resistance training on BMD in elderly women: a pilot study,” Osteoporosis International, published online: 20 Nov., 2008. http://www.ncbi.nlm.nih.gov/pubmed/19020919.

Vitamin C Fracture Risk

Sahanis S., et al. “Protective effect of total and supplemental vitamin C intake on the risk of hip fracture” Osteoporosis Int. 2009. Vol 20. Pp 1853-1861.

Falch JA, Mowe M, Bohmer T. “Low levels of serum ascorbic acid in elderly patients with hip fracture” Scand J Clin Lab Invest. May 1998. Vol 58. No. 3. Pp. 225-228.

Vitamin C and Fracture Healing

Sheweita S.A. and Khoshhal K.I. “Calcium metabolism and oxidative stress in bone fractures: role of antioxidants” Current Drug Metabolism. August 2007. Pp. 519-525.

Alcantara-Martos T. et al. “Effect of vitamin C on fracture healing in elderly osteogenic disorder Shionogi Rats” J Bone and Joint Surg. December 2007. Vol 89-B. No. 3. Pp. 402-407.

Shah As, et al. “Use of oral vitamin C after fractures of the distal radius” J Hand Surg. November 2009. Vol 34A. No. 9. Pp. 1736-1738.

 

Better Bones Blog
Dr. Susan E. Brown

My second annual green drink challenge

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What a difference a year makes! Last October, I was inspired but more than a little skeptical that I would be able to mix up a tasty, mostly vegetable green drink.

Green smoothies made of fresh vegetables and fruits

Keeping this in mind, it’s time for my Second Annual Green Drink Challenge, so that I can see your latest ideas. Post your favorite recipe here in the comments section below and you’ll automatically be entered for a drawing to win a copy of the second edition (just published) of my Acid-Alkaline Food Guide. To help you get started, here’s a recipe from a coworker who has finally agreed to share! I like this one because it features bone-building super foods: blueberries, kale and Matcha (or maccha) green tea powder.

Richard’s Super-Food Smoothie

½ C filtered water

½ C coconut water (good source of potassium and magnesium)

½ C organic cherries (frozen)

½ C organic blueberries

1 C organic kale (I prefer baby kale)

1 C organic 50/50 romaine/spinach mix

1 tsp Matcha green tea powder 3-5 dashes of cinnamon (I prefer Ceylon cinnamon — it’s easier on the liver if you’re consuming it every day)

½ cup coconut kefir (or Greek yogurt if you can tolerate dairy)

Blend in blender until smooth.

Enjoy!

 

Better Bones Blog
Dr. Susan E. Brown

High blood pressure? Hardening of the arteries? Heart disease risk? Keep vitamin K in mind

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We’ve recently seen a positive new twist on the heart-health benefits of vitamin K. For the first time, researchers found that low serum levels of vitamin K1 (phylloquinone) were significantly associated with the progression of coronary artery calcium in people taking anti-hypertension medication.

The importance of vitamin K2

While the study above looked at K1 (the vitamin K from plants), I’ve also written extensively about vitamin K2 as MK-7 K2 (menaquinone) and the important role it plays in keeping calcium out of the arteries to help prevent heart issues. In fact, vitamin K2 (produced by bacteria) is a more bioavailable, longer lasting form of vitamin K which provides greater support for both bone and cardiovascular health than does plant-based K1. Here’s just some of what we know about the more potent K2:

• People with more dietary intake of K-2 have less of a risk for cardiac events. Aortic calcification, myocardial infarction risk and cardiovascular mortality are shown to be inversely associated with intake of vitamin K, notably K2.

• People who consume the most vitamin K2 have a 50% reduced risk of arterial calcification, according to a study of 4,800 people. During the 10-year study, those taking the most K2 also exhibited a 50% reduced risk for cardiovascular events.

• For every 10 mcg of vitamin K2 consumed, the risk of coronary heart disease was reduced by 9% in a 16,000-person study looking at how high intakes of natural vitamin K2 protect from cardiovascular disease.

Get more vitamin K

Foods high in vitamin K1
Kale, cooked
Collard greens, cooked
Spinach, cooked
Turnip greens, cooked
Beet greens, cooked
Mustard greens, cooked
 
Foods high in vitamin K2
Ripe cheese
Yogurt
Natto
Fermented foods

These studies and more are proving the many health benefits of getting enough vitamin K. To make sure you’re getting plenty of both vitamins K1 and K2 as MK-7, try to eat more of foods high in each (see above).

 

References:

Shea, M Kyla, et.al. 2013. Association between circulating vitamin K1 and coronary calcium progression in community-dwelling adults: the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr, doi: 10.3945/ajcn.112.056101. URL: http://ajcn.nutrition.org/content/early/2013/05/29/ajcn.112.056101.abstract (accessed 08.01.2013)

Geleijnse, JM et al., Dietary intake of K-2 reduces the risk of cardiac events and aortic atherosclerosis: The Rotterdam Study. J Nutr.2004;134;3100-3105.

protein recommendations
Dr. Susan E. Brown

Protein recommendations – is it good or bad for bone?

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Special note:  Recently I saw a review of various studies that said getting more protein from non-red meat sources may reduce your risk for a stroke.  Here’s a blog I posted earlier showing that protein is essential for bone health and can be a part of the alkaline diet.

variety of legumes in bowls and glasses, arranged on kitchen tableAs I was updating my Acid Alkaline Food Guide, I decided it’s time to dispel some of the most common misconceptions about an alkaline diet. These inaccuracies may actually be keeping you from enjoying the widest variety of foods possible while still keeping your pH in optimal range.

Take protein for example. I’m often asked if it’s true that a special diet that promotes pH balance can include the amount of protein that is required for good health. The answer is an absolute “yes!” — adequate protein is essential for bone growth, maintenance and renewal as well as overall health.

Read on for protein recommendations

It’s only excessive intake of protein that’s acid forming. The key with protein, as it is for many things, is moderation. A healthy, balanced diet should include at least 50 to 63 grams of total protein a day, as well as plenty of alkalizing fruits and vegetables. In fact, even higher amounts of protein can be beneficial if they are balanced by alkalizing foods or supplements.

My protein recommendations – keep these in mind when it comes to intake 

• Many of us living in the U.S. do get too much protein, especially since most of our protein intake comes from animal protein, which robs more nutrients from bone than plant protein. Many of us consume over 100 grams of protein per day — way more than necessary!

• A 4 ounce serving of turkey, beef or chicken has, on average, 33 grams of protein. Think about how many servings of these meats you eat a day to estimate your own protein intake. Then if necessary, think of some ways you can reduce the amount.

• Dried beans and combinations of beans and grains make excellent protein-rich meat substitutes.

• If you like to include meat in your main meal, consider options where meat is just one ingredient of many – such as a stir fry.

Finally, when considering protein intake, we should look at the habits of our ancestors during the Paleo age. While they certainly were big game hunters, they also ate a wide variety of alkalizing foods including roots, plants, nuts, seeds and fruits. As I note in my book, the careful reconstruction of 159 ancestral Upper Paleolithic diets by researchers has led them to conclude that 87% of the pre-agricultural diets were alkaline-forming. What worked for them can certainly work for us!

Learn more about the Paleo approach to bone health or about getting just the right amount of protein.

 

Better Bones Blog
Dr. Susan E. Brown

Why eating and driving is bad for your bones

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Be honest: how often do you eat while doing something else? I recently discovered a report that looks at the things Americans do while they are eating and drinking. Out of 400 different activities tracked, we ate or drank while doing nearly all of them — including working, driving, emailing, volunteering and getting ready in front of the mirror.

And as a bone health expert, this concerns me. I’m very aware that American eating habits differ from those of more traditional cultures around the world, who pay attention when eating and share meals as families. In fact, I’ll always recall the Dominican peasant who scolded me for reading while eating saying, “El que come, come”—(that is, “He who eats, eats). But I’ve seen how our constant rush to multi-task can have a disruptive effect on digestion — which has a huge negative impact on our bone health.

That’s because when the body is stressed — either emotionally or physically — it makes less hydrochloric acid and fewer digestive enzymes, and sends less blood to the GI tract. Living like this can also upset your immune system and alter the balance of your gut flora. All of these changes can make it difficult for your body to digest food and absorb the nutrients that are so critical for better bone health and staying well.

Strong digestion = strong bones

To strengthen your digestion, I encourage you to plan at least one meal each day with others, where you prepare your food with mindfulness, then sit and spend some time enjoying the food and your company. Engaging in this practice just once a day will help calm the nervous system and remind it that eating and digesting are priorities. And I’m sure you’ll enjoy your meal much more too!

If you’re interested in learning more about promoting good digestion, see my article Ten steps to better digestion.

 

Reference: 

Hamrick, K. et.al. 2011. United States Department of Agriculture, How Much Time Do Americans Spend on Food?  Economic Information Bulletin Number 86. http://www.ers.usda.gov/media/149404/eib86.pdf