1 minute with Dr. Brown: Vitamin D

Got a minute? Every week I receive dozens of questions from women like you with concerns about their bone health. In my new series, “1 Minute with Dr. Brown,” I will try to answer your most pressing questions. If you have a question, send it in to us at center@betterbones.com
 

Question 1: Dr. Brown answers Gina’s question about how much vitamin D she should be taking

Low vitamin D means more flu

woman-sneezing

Did you ever wonder why you end up suffering from the flu nearly every winter? You may not be getting enough vitamin D.

The darker winter months are when our sun-dependent vitamin D levels are at their lowest.

Among its many other actions, vitamin D stimulates and supports immune function. And in temperate latitudes, researchers find that pandemic influenzas generally show clear seasonality.

In other words: More cold dark days, more flu.

Growing research connects vitamin D and influenza

  • Women given 800 IU of vitamin D daily were 3 times less likely to report cold and flu symptoms than those not given vitamin D. This study was a randomized controlled trial looking at bone loss in postmenopausal African American women.
  • A study with intake of 2,000 IU of vitamin D daily for one year efficiently protected women against typical winter colds and influenza.
  • A trial comparing vitamin D supplements with placebos in schoolchildren found that only 1,200 IU per day of vitamin D during winter and early spring reduced the incidence of seasonal influenza by a factor of two.

Protect yourself from winter flu related to low vitamin D

  • Maintain a 50 to 60 ng/ml vitamin D level all year round to get the fullest possible benefits from vitamin D.
  • Get your vitamin D tested now to prepare for the winter. To get your level to the optimal 50 to 60 ng/ml some may require the intake of 4,000 to 5,000 IU daily of vitamin D or even more. For others lesser doses are sufficient. Some people absorb vitamin D better than others, some seem to have a higher need and others have higher reserves from the summer.
  • Determine how much extra D you need. As a rule of thumb, for every 1,000 IU increase in vitamin D your vitamin D blood level will increase by 10 ng/ml. So if you measure your level in December and it is 30 ng/ml, you would add 2,000 IU more vitamin D to your daily supplement program to get to a 50 ng/ml.

Here’s to a happy, healthy winter season!

 

Reference:

Cauley JA, Chlebowski RT, Wactawski-Wende J, et al. Calcium plus vitamin D supplementation and health outcomes 5 years after active intervention ended: the Women’s Health Initiative. J Women’s Health (Larchmt). 2013;22:915-929.

Only 6 prunes a day decrease bone breakdown

Dried plums — or prunes — are among the highest antioxidant foods shown to help improve bone strength.  However, in early studies, the level of prune intake originally found to bone-enhancing was fairly high at 100 grams, or 9-10 prunes a day.

While researchers were happy with this first prune-positive finding, they did hear more than a few complaints about the number of prunes the women had to consume. So they decided to investigate if half that prune intake would still provide potent benefits.

How many prunes to reverse bone loss?

At the recent International Symposium on Nutrition and Osteoporosis I had the opportunity to meet two researchers studying the prune-bone link, including Dr. Shirin Hooshmand from San Diego State University.  Even though their clinical trial has been going only for six months, preliminary results are very positive.  Watch below as Dr. Hooshmand discusses more details about the study.

 

How Dr. Brown gets her 6 prunes a day

I stew up 42 prunes for a week’s supply and eat 2-3 a meal. I love them as a “sweet” ending to my meal or mixed into my hot cereal. I also eat them warmed up a bit and even drink the juice.

To stew prunes:

  • Put 42 dried prunes in pan and cover with water 1” above prunes, add a cut up lemon
  • Bring water to a boil then reduce heat to a simmer
  • Simmer for 20-30 minutes or until soft
  • Cool prunes and put in refrigerator

New research shows how lack of nutrients affects bone

young blond woman eating fresh salad close up

There’s a wide range of nutrients that affect bone.  And now I’m happy to say there’s a wide range of research as well that tells us how important these nutrients are for bone strength.

Here are some highlights from the findings from the 9th International Symposium on Nutritional Aspects of Osteoporosis which I attended:

  • Multi-nutrient inadequacy and osteoporosis: A Brazilian study looking at individuals with and without osteoporosis found that those with osteoporosis had significantly lower intake of many nutrients including protein, calcium, potassium, vitamin K, magnesium, zinc and vitamin D. (Põlluste et al. 2015)
  • Vitamin A and beta-carotene: Higher blood levels of both vitamin A and beta-carotene were associated with higher bone mineral density amongst Chinese adults. (Zhang et al. 2015)
  • Magnesium in bone density: Among Brazilian women bone mineral density was found to be greater in women who with the highest magnesium intake, as compared to those with an official deemed “adequate’ intake. (Peters et al. 2015)
  • Vitamin E and bone density: A large Chinese study found that higher vitamin E intake was positively associated with higher bone mineral density and a lowered risk of osteoporosis among older women. (Chen et al. 2015)
  • Vitamins K, D and fracture risk: A very large Norwegian study found that participants with both low circulating vitamin K1 and vitamin D had a 50 percent increased risk of hip fracture as compared to those with higher levels of these nutrients. (Finnes et al. 2015)

For three decades, we’ve championed adequate intake of all key bone building nutrients. So you can imagine our delight to see medical researchers are studying how intake of key bone nutrients beyond just calcium and vitamin D benefit skeletal health.

 

References:

Chen, Y. M., W. Q. Shi, J. Liu, Y. Cao, Y. Y. Zhu, and K. Guan. 2015.  Association of dietary and serum vitamin E with bone mineral density in middle-aged and elderly Chinese: A cross-sectional study. Presentation at 9th International Symposium on Nutritional Aspects of Osteoporosis. 17-20 June 2015, Montreal, Canada.

Finnes, T. E., C. M. Lofthus, A. J. Søgaard, G. S. Tell, E. M. Apalset, C. Gjesdal, G. Grimnes, B. Schei, R. Blomhoff, S. O. Samuelsen, K. Holvik, and H. E.

Meyer.2015. Increased risk of hip fracture in older Norwegians low in both circulating vitamin K1 and 25-hydroxyvitamin D: A NOREPOS study. Presentation at 9th International Symposium on Nutritional Aspects of Osteoporosis. 17-20 June 2015, Montreal, Canada.

Peters, B. S. E., M. B. R. Camargo, M. Lazaretti-Castro, N. A. G. de França, and L. A. Martini. 2015. Relationship between magnesium intake and bone mass density in Brazilian postmenopausal women. Presentation at 9th International Symposium on Nutritional Aspects of Osteoporosis. 17-20 June 2015, Montreal, Canada.

Põlluste, K., M. Kull, R. Müller, A. Aart, R. Kallikorm, and M. Lember. 2015. Nutritional deficiencies and bone mineral density in a cohort of patients referred to osteoporosis clinic. Presentation at 9th International Symposium on Nutritional Aspects of Osteoporosis. 17-20 June 2015, Montreal, Canada.

Zhang, C. X., G. D. Chen, Y. Cao, Y. Y. Zhu, and Y. M. Chen. 2015. Association of dietary consumption and serum levels of vitamin A and β-carotene with bone mineral density in Chinese adults. Presentation at 9th International Symposium on Nutritional Aspects of Osteoporosis. 17-20 June 2015, Montreal, Canada.

7 top nutrients for bone health

What’s the one nutrient you need for bone health? I’m asked that question quite often. Of course, while calcium, magnesium and vitamin D are high on the list, I can’t really choose just one because of the way the various key nutrients rely on each other to get the job done.

But if you do need to narrow the list down from more than 20 important nutrients, here’s my choice for the 7 top nutrients. You should aim to get these every day to build bone strength, reduce bone loss and help keep you from fracturing.

 

If you want to read more about these nutrients and more, you see my article here.  And, because so many of you have asked for a supplement with extra calcium and magnesium, I’ve reformulated my Better Bones Basics with more of each, plus optimal amounts of the other key nutrients.

 

Top References:

Heaney, R., & Weaver, C. 2003. Calcium and vitamin D. Endocrinol. Metab. Clin. N. Am., 32 (1), 181–194, vii–viii. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/12699298 (accessed 05.20.2008).

Brown, S. 2008. Vitamin D and fracture reduction: An evaluation of the existing research. Alt. Med. Rev., 13 (1), 21–33. URL (PDF): http://www.thorne.com/altmedrev/.fulltext/13/1/21.pdf (accessed 05.22.2008).

Holick, M. 2006. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin. Proc., 81 (3), 353–373. URL: http://www.ncbi.nlm.nih.gov/pubmed/16529140 (accessed 05.13.2008).

Hanley, D., & Davison, K. 2005. Vitamin D insufficiency in North America. Symposium: Vitamin D Insufficiency: A Significant Risk Factor in Chronic Diseases and Potential Disease-Specific Biomarkers of Vitamin D Sufficiency. J. Nutr., 135 (2), 332-337. URL: http://jn.nutrition.org/cgi/content/full/135/2/332 (accessed 05.13.2008).

Holick, M. 2005. The vitamin D epidemic and its health consequences. J. Nutr., 135 (11),2739S–2748S. URL: http://jn.nutrition.org/cgi/content/full/135/11/2739S (accessed 05.13.2008).

Bischoff–Ferrari, H., et al. 2007. Calcium intake and hip fracture risk in men and women: A meta-analysis of prospective cohort studies and randomized controlled trials. Am. J. Clin. Nutr., 86 (6), 1780–1790. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/18065599 (accessed 06.17.2008).

Steingrimsdottir, L., et al. 2005. Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake. JAMA, 294 (18), 2336-2341. URL: http://jama.ama-assn.org/cgi/content/full/294/18/2336 (accessed 06.17.2008).

Dawson–Hughes, B., et al. 1997. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. NEJM, 337 (10), 670-676. URL: http://content.nejm.org/cgi/content/full/337/10/670 (accessed 06.17.2008).

Dawson–Hughes, B., et al. 1990. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. NEJM, 323 (13), 878–883. URL: http://www.ncbi.nlm.nih.gov/pubmed/2203964 (accessed 05.13.2008).

Brown, S. 2006. “Bone nutrition.” In Scientific Evidence for Musculoskeletal, Bariatric, and Sports Nutrition, ed. I. Kohlstadt, p. 458. Boca Raton, FL: CRC Press.

Knapen, M., et al. 2007. Vitamin K2 supplementation improves hip bone geometry and bone strength indices in postmenopausal women. Osteoporos. Int., 18 (78), 963–972. URL: http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17287908 (accessed 05.14.2008).

The benefits of protein for bone health

When many women start following an alkaline diet, their first change is to cut out acid-forming proteins completely. Such a severe restriction of protein is definitely too much of a good thing.

That’s because research suggests that a higher protein intake can reduce aging bone loss and actually decrease fracture risk when combined with a higher intake of key bone nutrients like calcium. Let’s take a closer at look at the benefits of protein for bone health.

How much protein should you be getting?

1. Dietary protein is acid forming, but only if consumed in excess of what the body needs. And even excess protein intake can be compensated for by increasing your intake of alkalizing foods and supplemental alkalizing mineral compounds.

2. The RDA for protein is 0.8 grams of protein/day per kilo of weight (a kilo is 2.2 pounds). For a 140 lb woman this would be 51 grams of protein, the bulk of which is easily obtained from a 4 ounce serving of meat or fish, or a cup serving of beans, grains and vegetarian protein sources. The Recommended Daily Allowance (RDA) is the official standard for an adequate intake, although as you’ll see below, we probably should get more.

3. New research suggests a more bone-optimizing protein intake would be higher, at 1.2 to 1.3 grams per kilo. For example, a woman weighing 140 pounds would get more bone-benefit from 76 grams of protein then from the current RDA of 51 grams protein/day. Here one might consume complete vegetarian protein combinations (grains and beans or beans and seeds) along with perhaps some eggs, dairy or meat. Details on this research by Christian Wright of Purdue University are in the video below.

4. We’ve seen a higher protein intake does help build bone mass at the Center for Better Bones. The one caveat, however, is that for long-term success we need to provide our body with enough alkalizing mineral compounds from diet and alkalizing supplements to buffer any excess metabolic acids produced.

Bone is nearly one-half protein by volume and body-wide protein is constantly needed to repair and build all tissues. While higher protein can benefit bone, it’s always important to monitor your pH balance to make sure you’re buffering any excess metabolic acids produced by the increased protein intake.

How much protein do you need for your bones? Interview with Dr. Wright.

Vitamin C reduces fracture risk

High amounts of vitamin C led to a nearly 44% reduction in risk of fracture, according to new research on the effects of vitamin C on bone health.  The study suggests that women and men with higher levels of vitamin C intake experience significantly less aging bone loss than those with lower vitamin C intakes along with the significant reduction in fracture incidence.  The 25% with the highest vitamin C intake had nearly a 44% reduction in risk of fracture.

What surprises me about this research is the “high” level of vitamin C intake was only 200 to 300 mg/day (and that is from diet and supplements together). At The Center for Better Bones we find that for complete health and detoxification, many people require much higher dose of this key vitamin — up to 1,000-3,000 mg a day. This makes sense because vitamin C plays several important roles within every cell — including dozens of important functions related to cell repair and division, energy production, toxin neutralization.

I’m always uplifted when physicians take into account the nutrient factors that benefit bone. I encourage you to take a few minutes and watch my recent conversation with Dr. Sahni, from Beth Israel Deaconess Medical Center, Boston, about her research on vitamin C and broadening the scope of research about the many roles of nutrients.  I congratulate Dr. Sahni on her study!

Learn more with my interview with Dr. Sahni

 

Reference:

Author; S. Sahni. Vitamin C and Bone Health, Presentation at 9th International Symposium on Nutritional Aspects of Osteoporosis, Montreal Canada, June 17-20, 2015.

Is a hidden food allergy harming your bones?

chocolate-chip-cookie-food-allergyDo you suffer from food allergies?  Knowing the answer is simple enough if you notice that you become congested or have headaches every time you eat dairy products.  The solution is simple too — avoiding the foods that cause immediate reactions to find symptom relief.

But did you know that 80% of all food reactions are delayed — making it difficult to know when you’re allergic or sensitive to what you eat? Hours — or even days — after enjoying a particular food, you might experience a reaction, which can be associated with a wide range of symptoms, including:

•    Fatigue
•    Arthritis and  joint pain
•    Asthma
•    Sinus issues
•    Irritable bowel
•    Autoimmune disease and poor nutrient absorption to fibromyalgia and systemic inflammation. These powerful, yet hidden, reactions turn our white blood cells into virtual Pac-Men looking for something to attack and spreading inflammatory chemicals throughout the body.

Inflammation and its effects on bone

Hidden allergies not only contribute to an array of health problems and increase systemic inflammation, but they also waste the immune system and end up producing serious “repair deficit.” Within bone the combo of tear-down inflammation from an over-active immune system and the ensuing long-term bone repair deficit contributes to skeletal fragility and sets the stage for needless fracture.

5 ways food allergies can damage bone

•    Cause inflammation capable of tearing down bone
•    Increase bone-damaging cortisol and metabolic acidity
•    Weaken immune-system-directed bone repair
•    Reduce digestion and assimilation of nutrients
•    Signal a nervous system that is jittery and worried

A self-help test for delayed allergies/hypersensitivities can be done by eliminating any and all foods you are suspicious of for four days, watching to see if symptoms change, and then reintroducing these foods. Often this simple elimination/challenge test yields symptom improvement. Even better, a simple at-home test for 95 possible delayed food allergies, The Food Safe™ Allergy Test, is now available. This test requires no blood draw at a lab and each food allergy report will include a rotation diet.

Big news on benefits of vitamin K2 as MK-7

I like to keep my eye on vitamin K2 as MK-7 (menaquinone-7). I haven’t quite figured out why it doesn’t get as much attention as calcium, magnesium or vitamin D.

Especially when you realize the power of vitamin K2 as MK-7 for building bone strength, helping to prevent osteoporosis, protecting the heart and even reducing overall mortality.

Here are the latest reasons why you should get optimal amounts of vitamin K2 as MK-7:

  • Vitamin K as MK-7 improves cardiovascular health in healthy postmenopausal women. Noted vitamin K expert Dr. Cees Vermeer recently led a study that showed long-term use of vitamin K2 in the form of MK-7 has a positive impact on heart health. Vitamin K helped reduce the amount stiffening of the artery walls related to aging, as well as improved vascular elasticity. The study monitored 244 healthy post-menopausal women for three years.
  • As dietary intake of vitamin K goes up, mortality risk goes down.  In a recent diet analysis of 7,216 participants, dietary intake of vitamin K was inversely associated with mortality risk. Those who increased their vitamin K1 and K2 dietary intakes over the nearly five year follow-up period had a 43% and 45% reduced risk of overall mortality compared to those whose intakes were unchanged or reduced. Those with increased vitamin K2 intakes during follow-up had a 59% lower risk of death from cancer.
  • K2 plays a role in preventing fractures in postmenopausal women with osteoporosis.  An analysis of the results of 19 different studies focused on postmenopausal women with osteoporosis showed that vitamin K2 plays a role in improvement of the vertebral bone mineral density and the prevention of fractures.

So you see why it’s important not to overlook vitamin K2 as MK-7 in your diet!

How much vitamin K2 as MK-7 should you get every day?

Would you believe that there is no actual recommended daily allowance (RDA) for vitamin K2?  For most people, I recommend a therapeutic dose of 90-200 mcg of vitamin K as MK-7 on a daily basis.  Important note: The only exception is for those on the blood thinner Coumadin because supplementing with vitamin K will reduce the effectiveness of Coumadin.

Unfortunately, the average U.S. intake is only 9-12 mcg, if any at all!  For more information on vitamin K2 as MK-7, read my in-depth article about the many benefits of vitamin K.

 

References:

Huang ZB, Wan SL, Lu YJ, Ning L, Liu C, Fan SW. Does vitamin K2 play a role in the prevention and treatment of osteoporosis for postmenopausal women: a meta-analysis of randomized controlled trials. Osteoporos Int. 2014 Dec 17. http://www.ncbi.nlm.nih.gov/pubmed/25516361 (accessed 04-29-2015)

Knapen MH, Braam LA, Drummen NE, Bekers O, Hoeks AP, Vermeer C. Menaquinone-7 supplementation improves arterial stiffness in healthy postmenopausal women: double-blind randomised clinical trial. Thromb Haemost. 2015, Feb. 19 (Epub ahead of print) http://www.ncbi.nlm.nih.gov/pubmed/25694037 (accessed 4-29-2015)

Martí Juanola-Falgarona et al. Dietary Intake of Vitamin K Is Inversely Associated with Mortality Risk. J Nutr
2014;144(5):743-750. http://jn.nutrition.org/content/early/2014/03/19/jn.113.187740 (accessed 04-29-2015)

10 steps to better digestion

When it comes to getting the most from your digestion, it’s more than “you are what you eat” — it’s “you are what you absorb.”

That’s because even if you eat the highest quality foods, you need to digest and absorb their nutrients to get the benefits. Digestive problems keep you from doing this, plus lead to distressing symptoms like gas, diarrhea, bloating, constipation, weight gain and more.

You can take simple and practical changes to improve digestion and get the nutrients you need. Here are my top 10 steps for better digestion:

meal1. Drink hot water and hot herbal teas.

Both help detoxify the body and build digestive strength. Simmering a few slices of ginger root in boiling water makes a ginger root tea that stimulates digestion. Ginger in food has the same effect, as does candied ginger root eaten after meals. Other herbs that promote good digestion and make excellent herbal teas are chamomile, peppermint, and cinnamon.

2. Eat freshly cooked foods.

Freshly cooked foods are the most nourishing and are free of molds or staleness. It’s better to eat a simple, freshly cooked meal than a complicated one made of leftovers.

3. Chew your food well and eat at a moderate pace.

Ideally, you should chew each mouthful some 30 times, breaking the food into small particles and allowing the salivary enzymes to begin their work digesting the food. Try putting the fork down between each mouthful and swallowing one bite before taking another as a way to slow down if you’re accustomed to “bolting” your food.

4. Eat simply.

Mixing many different types of foods taxes the digestive system. Experiment with simple meals of just two or three different foods.

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teacup5. Eat cooked foods instead of cold or raw foods.

As traditional Eastern medicine explains, food must be “burned” in the “fire” of digestion. Cold and raw foods must be “heated up” more than cooked foods and as such they dampen and weaken the fire of digestion. People with weak digestion would do well to eat no or little raw or cold food or drinks. This means favoring cooked vegetables and fruits over raw produce, and using hot soups, casseroles, or grain and bean dishes in place of sandwiches or snack-type meals. Avoid cooling the “fire” with cold drinks or ice water during meals.

6. Eat in a peaceful and relaxed environment.

If you do a little comparative test, you will note that you feel better and your digestion is smoother when you eat in a quiet, peaceful environment. Avoid watching television, reading, working, or arguing with others when you eat. You will see the difference.

7. Eat fruit between meals, not with meals, and choose cooked fruit.

Raw fruit dampens the digestive fire, especially during the winter when we are already cold. As such, those with weak digestion might find that eating raw fruit with meals causes intestinal gas and bloating. Cooked fruit is a fine dessert, and you can still use raw fruit for snacks — but know that even as an occasional snack, fruit might be a problem if your digestive fire is smoldering rather than blazing.

8. Avoid overeating.

Excessive intake of food greatly burdens the entire digestive system. Ancient Ayurvedic medicine recommends consuming the amount of food that will fit into two cupped hands at any meal. Practice moving away from the table while you are still a bit hungry.

9. Sit still and relax a few minutes after eating.

Digestion is an amazing process — it turns tofu enchiladas into blood and tissue cells. Resting a few minutes after eating gets this very complicated process off to a good start by allowing your body’s resources to focus fully on the digestive engine.

10. If all else fails, seek professional help to determine the source of the problem.

If these simple self-help steps do not resolve your digestive problems, you should consider consulting both a physician and a nutritionist. A nutritionist can help you figure out if probiotics and other nutritional digestive aids would be useful. Your physician can investigate the possibility that a medical problem is affecting your digestion.