prunes for bones

How many prunes do you need to eat to start building bone?

Six is officially the new magic number when it comes to how many prunes a day provide bone-building benefit. The recently published clinical trial confirms the preliminary results I reported earlier — and makes getting enough prunes in our daily diet a real possibility!

Here is more about the study findings along with two great Thanksgiving side dish recipes that include prunes:

Clear findings: prunes are good for bones

Researchers ran a 6-month trial comprising 48 women in their late 60s/early 70s who were identified as having osteopenia, in which 16 participants ate 50 g, or roughly 6 prunes, 16 others ate 100 g, or 9-10 prunes, and the remaining 16 was a control group and ate dried apples instead. (Watch an interview I conducted with researcher Dr. Shirin Hooshmand while the study was ongoing.)

The researchers measured the participants’ bone mineral density in the hip, lumbar spine, and ulna (forearm) and examined specific bone health indicators in the blood at the start of the study and again 3 months and 6 months later. They also analyzed participants’ nutrient intake to account for all other potential factors affecting bone health, like vitamin D status, calcium intake, exercise, and overall nutrition.

In the apple-eating control group, BMD stayed unchanged or decreased. But in both groups of women who ate prunes, spine bone density increased, while forearm and hip BMD remained the same. Those who ate 100 g of prunes had a slightly greater increase in vertebral BMD than the 50-g group, but the difference between the two groups wasn’t significant — and in both groups (but not the control), a specific marker of bone resorption called tartrate-resistant acid phosphatase (TRAP-5b) was significantly lower at both 3 months and 6 months into the study, indicating that eating either amount of prunes had a positive, long-lasting impact on bone turnover.

Based on these findings, the researchers concluded that the lower prune intake — 50 g or 6 prunes — was adequate for most women to get the benefits.

Two hearty prune recipes to be thankful for

If you’re losing bone and want a simple way to improve your bone health, the message here is quite simple: aim to include 2 prunes at each meal.
There are many interesting recipes out there that incorporate prunes alongside alkalizing vegetables. Here are two of my favorites — and both just happen to be perfect additions to your Thanksgiving menu. You can even share with your guests that besides being tasty, these side dishes are also helping them build stronger bones!

Shredded butternut squash with prunes and pistachios

Ingredients
1 medium butternut squash (1 ½ pounds)
2 medium shallots, finally chopped
1/3 cup shelled natural pistachios, coarsely chopped
3 large prunes, coarsely chopped
2 tbsp preferred cooking oil
2 tsp mint (finely shredded fresh or dried)
1 to 1 ½ tbsp fresh lemon juice
Kosher/coarse salt
Cayenne pepper

Preparation
Peel and chop butternut squash (sized to fit in tube of food processor). Using the food processor shredding disc, shred squash (about 3 ½ cups). Heat cooking oil in a large skillet over medium heat until hot. Add shallots and cook for 1 minute, stirring. Add shredded squash, turn up the heat to medium high, and cook for 3 minutes, stirring, until the squash is tender, like a purée. Stir in the pistachios, prunes, mint, and lemon juice. Add salt and cayenne to taste. Serves 6.

– Recipe created by Sara Moulton, author, Home Cooking 101 via sunsweet.com.

Savory prune stuffing

Ingredients
2 tbsp olive oil
3 large leeks (white and pale green parts only), cut into 1-inch pieces (4 cups)
1 1/4 cups chopped celery
1 tablespoon minced garlic
2 Granny Smith apples, peeled and cut into 1/2-inch cubes
10 ounces pitted prunes, chopped into 1/2-inch pieces
1/2 cup sherry or vermouth (or warm water to avoid alcohol)
6 cups (1/2-inch) white bread cubes (soft Italian or French bread)
2 large eggs, beaten to blend
2 tsp crumbled dried sage
1 tsp chopped thyme
1/2 cup chopped flat-leaf parsley
Large pinch ground cloves
Large pinch grated nutmeg
1 cup (+/-) either beef, chicken or vegetable stock
Kosher salt to taste
Freshly ground black pepper to taste

Preparation
Toast bread cubes at 350 degrees for 15 minutes (or just leave out uncovered overnight to dry). Soak prunes overnight (or at least 2 hours) in sherry (or vermouth). Sauté leeks and celery until softened (approx. 10 minutes). Add garlic, saute for 2 more minutes. Add apples and continue to cook until softened (approx. 10 more minutes). Add prunes and the soaking liquid to the mixture
In large bowl combine eggs, sage, thyme, parsley, cloves and nutmeg, whisk until evenly combined. Add egg mixture to the leek and prune mixture, gently combine with the toasted bread cubes. Use broth to moisten the mixture if needed. Place the stuffing mixture into a large baking dish and bake in oven for approximately 40 minutes to 1 hour at 350 degrees.

Stuffing variations:
To make a heartier stuffing cook off ¾ pound of either ground pork or sweet Italian sausage (casings removed) and add it  to the stuffing mixture before the final baking.

Roasted chestnuts also make a great addition to this recipe (whether you roast your own or use prepared ones). I would suggest using approximately 10 oz and either halve or quarter the nuts.

Substituting corn bread for the bread cubes will give an interesting texture and depth to this recipe.

Gluten free is easy enough with the substitution of gluten free bread cubes.

Reference:
Hooshmand S, Kern M, Metti D, et al. The effect of two doses of dried plum on bone density and bone biomarkers in osteopenic postmenopausal women: a randomized, controlled trial. Osteoporos Int 2016;27:2271–2279.

Share these recipes with a friend! 

99 ways to eat more fruits and vegetables

99 ways to get 9 daily servings of alkalizing vegetables, fruits and spices

There is an ever-growing body of scientific studies showing that the more colorful vegetable, fruits, nuts and seeds you eat, the healthier you are!  Your risks for needless fracture, heart disease, cancer, stroke, autoimmune disease, depression, inflammation, and many other disorders are dramatically reduced for those consuming abundant vegetable foods.

Given this evidence, we recommend aiming for 9 to 13 servings a day of life-supporting vegetables, fruits nuts, seeds, herbs and spices. While tweaking our diet a bit may sound daunting, it is really within our reach. Here are our favorite 99 ways to consume more alkalizing, wholesome vegetable foods — feel free to add your own to the list!

1. Fermented veggies (think sauerkraut or kimchi) are the BEST — not only do you get the veggies but you get additional probiotics, and they last for a LONG time!

2. Prunes are where its at! Two prunes after dinner can curb your sweet tooth or make them into a jam with warming spices.  (And prunes help build bone!)

3. Try baking apples with a dusting of cinnamon as a tasty dessert.

4. Make a trail mix for a snack using dried fruits, nuts, and seeds.

5. Leave the skin on your fruits & vegetables, as they often are the most nutrient-dense portion of the food.

6. Bake your fruits and vegetables into healthy bread alternatives — recipes for zucchini bread and banana bread abound online.

7. Add lemon, lime, cucumbers, or other tasty fruits to seltzer or plain water for additional flavor —and then eat them once they’ve infused into the liquid.

8. Bake kale or other greens into tasty chips for snacking.

9. Try freezing bananas and using a blender/emulsifier to make homemade frozen “milkshake” treats.

10. Start your meal with fruits and vegetables first before you eat things like bread and other carbs—you’ll eat more of the veggies and less of the carbs.

11. Dice a mixture of assorted vegetables into your breakfast omelet.

12. Eat fresh fruit as your dessert instead of unhealthy dessert options.

13. Power up your lunch wrap or sandwich by doubling the amount of veggies to proteins/meats.

14. Steam up enough of your favorite veggies for 2-3 days and keep them in a container in the fridge so that you can grab and go.

15. Set out a bowl of fruit so that during the day as you walk by you might be more likely to grab a piece of fruit.

16. Load up one meal with 5–6 serving of veggies using this veggie Buddha Bowl recipe

17. Try making homemade veggie packed soups and stews. These are great warming foods for the winter and your digestion. Plus they can last all week and are easy to grab when time is limited!

18. Make one night a week a meatless meal. This will encourage you to see what new recipes you can try that are more plant-based!

19. Follow a few plant-based cooking pages on social media like Facebook, Pinterest, or Instagram. These pages are constantly sharing new recipe ideas that can help you get out of the same old cooking slump!

20. Farmers’ markets are your friend! See if your area has a farmers’ market and make it a point to go there before the grocery store. You will leave with more fruits and vegetables that are a better quality and more nutrient dense!

21. Add a salad to any meal for an instant 2–3 servings of veggies

22. Always add some sort of vegetable to your sandwich, such as dark leafy greens, tomatoes, cucumbers, or slivers of jalapeño pepper for a little kick.

23. Bring pre-cut vegetables to work to snack on throughout the day.

24. Try baking pears with peaches with a pinch of cinnamon for a healthy dessert!

25. Make a cauliflower crust pizza with fresh tomato sauce, basil leaves, and a healthy cheese!

26. Try juicing! Carrot juice is delicious and easy to incorporate into daily life.

27. Spiralizers for thin-slicing veggies are widely available at grocery stores now. These veggies act as a great substitute for pastas and are very filling. So instead of pasta, make “zoodles” out of zucchini and serve with tomato sauce or pesto (and drop in a few mixed veggies for still more servings!)

28. Olive oil counts! 1 Tablespoon of olive oil counts as a serving and also packs additional bone building benefits! Put some in a jar with herbs like garlic, oregano, rosemary, and thyme to add flavor to spiralized veggie pasta.

29. Add blueberries or fruit to your morning yogurt.

30. Blend vegetables and fruit into a smoothie.

31. Using lettuce or greens instead of bread can help alkalize your meal as well get you additional servings of veggies!

32. Warming peppermint, ginger, or spiced teas are great for your bones, and the aromatic qualities aid in the digestion of your food which help with absorption of your vitamins and minerals.

33. Bok choy is a great filler and leafy green it has little flavor so you can add it to almost anything as a way to pump up your serving count

34. Add true pickles as a flavorful snack or addition to any sandwich or wrap.

35. Buy local veggies in season and freeze. Locally sourced organics veggies are the best; however, they have a short window. Buy in bulk and freeze your veggies for use all year long if canning is not an option. Most veggeis freeze well; if you’re not sure whether you should freeze a certain type of veggies, here is a quick guide.

36. Purge your fridge of store-bought salad dressings. Making your own homemade dressing is simple and effective for getting more fresh herbs and spices in your diet. Plus you’re going to need something to put that new lovely dressing on!

37. Skip the dips and be the person who brings the veggie dish to the next party. You will be looked on as an innovator as many people look for the healthful options at the party yet always get the same old appetizers!

38. Plant-based chili is a filling, warming dish and a great opportunity to add more veggies and fresh spices in! If you have a slow-cooker, it’s super easy and you can freeze half of it for later.

39. Don’t forget the sweet potatoes on your grocery list! An alkalizing root crop sweet potatoes are not just for Thanksgiving. Kids love them too!

40. Ever see a veggie you don’t recognize at the store? Buy one and challenge yourself to find a recipe for it for the weekend.

41. Don’t ever see anything you’re unfamiliar with at your store? Consumer Supported Agriculture (CSA) Boxes are great ways to try new veggies! Ask around at the farmers’ market for local CSA opportunities.

42. Add avocado to toast with a slice of tomato.

43. Make apple chips in the oven for a great snack

44. Swap your white rice for cauliflower rice. The recipe is easy and it actually tastes better and is better for you too!

45. Cauliflower can also act as a bread substitute! Swap bread for cauliflower in your grilled cheese or pizza crusts

46. Don’t forget veggies from the sea! Spread chopped avocado and grated carrot on a sheet of nori seaweed. Roll up and slice for an easy veggie “sushi” roll.

47. Make veggie shots—a quick and dirty way to get the veggies in!

48. Swap the fries for the veggie of the day when out at restaurants.

49. Start a veggie garden—even a planter with a small collection of vegetables or herbs will inspire you to eat more veggies. And if you worry about vegetable plants taking over your tiny window ledge, keep in mind the dwarf varieties have been developed specifically for people like you who have limited space.

50. Keep bone broth handy in the pantry, it is a great bone builder and you can add any type of veggie for an instant warming soup.

51. Don’t skip the pizza — just add lots of veggies! Also, lots of new gluten-free crusts are available and are very tasty!

52. Eating out? Explore your taste buds and order a veggie entree.

53. Prep is key if you want to ensure success! Plan your meals for the week, buy what is needed, and pre-prep anything that might take time.

54. Avocado deviled eggs are a great mix of proteins and good fats!

55. If you crave fries, try making you own with sweet potatoes or zucchini. Air fryers are a more heathful alternative to regular deep frying.

56. Have the right tools for the job! Sharp knives, dicers, and graters can take the “labor” out of chopping & prepping veggies!

57. Invest in your kitchen! It will save you money in the long run and boost your health. Crockpots, food processors, steamers, pressure cookers, and spiralizers are all kitchen must haves that will make your meals easier to manifest.

58. It is easier to stay motivated when you have support! Find like-minded family & friends to go on this plant-based journey with.

59. Snack on veggies as you cook.

60. Find a great motivational food blog and subscribe. This will give you a weekly or daily dash of inspiration.

61. Measure your pH first thing in the morning. Based on the results, reflect on what you ate the previous day — and plan the alkalizing veggies you can eat today. Stay motivated by using the Alkaline for Life Diet Starter Kit.

62. Try this easy recipe for veggie breakfast hash.

63. Make a frittata for breakfast!  A frittata mixes eggs with lots of veggies!

64. Mix minced broccoli or cauliflower into scrambled eggs; they don’t change the texture.

65. Make avocado-based pudding.

66. Use veggie-based salad dressings.

67. Add carrot or sweet potato puree to cookie dough — it doesn’t really change the taste.

68. Add olives to all salads and as a side dish.

69. Add raw sunchoke to salads for great alkalizing prebiotic. Grate or thinly slice for an easy topping.

70. Add 1 Tbsp chia seeds and 1 Tbsp pine nuts to cooking oatmeal for texture.

71. For a healthy snack, cover canned chickpeas in a little olive oil and sprinkle with Adobo seasoning, then roast them.

72. Make spicy hot lemon water with a bit of cayenne and maple syrup.

73. Put fresh lemon juice in your hot cider (great for sweet cravings).

74. Slow-cook odds and ends of veggies with veggie broth for a great soup.

75. Explore different flavors and spices with this easy recipe for Thai veggie curry.

76. Add pumpkin or butternut squash to smoothies, pancakes, or soup

77. Dehydrate veggies and make a great snack or trail mix.

78. Plant an indoor herb garden on your kitchen counter.

79. Add cucumbers and mint to water.

80. Instead of mayo, add avocado to your tuna fish.

81. Try making sweet potato brownies

82. Baking a cake? Substitute a cup of cooked, mashed butternut squash for the oil. The cake will be amazingly moist and no one will know the difference (and if the squash is particularly sweet, you can cut back on the refined sugar by 1/3 while you’re at it!)

83. Eat more turmeric root to harness its anti-inflammatory superpowers — like this easy recipe for soothing golden milk.

84. Try butternut squash ravioli!

85. Instead of potato chips, try sliced bell peppers with hummus to achieve the same crunch!

86. Used chopped parsley as a final touch in many dishes.

87. Remember that a serving is only 1/2 a cup — so you can get 2 or 3 or more servings by loading up your plate with one vegetable

88. Change it up this holiday season and make pumpkin pie — without the crust! Or take it one step further by subbing in sweet potato.

89. Slice a cucumber lengthwise and hollow out. Load with sandwich fixings and enjoy this bread-free treat.

90. Try this recipe for a easy alkalizing & filling lunch or dinner

91. Instead of nut butter and crackers, revisit that childhood favorite of “bumps on a log”: half a stalk of celery slathered with peanut butter, with a few raisins sprinkled on top. Crunchy and filling!

92. Save time by chopping and peeling all your veggies for the week on Sunday evenings (or a day of the week when you have time). Wrap and store in the fridge crisper until ready to use.

93. Easy roasted garlic! Cut the very top off a head of garlic and bake in a small separate baking dish the next time you make a casserole. Roasted garlic is soft, creamy and flavorful.

94. Add pureed carrots or finely chopped broccoli to mac and cheese for a healthier spin on this hearty favorite.

95. Instead of fries, chop fresh veggies and serve with a creamy dressing for easy dipping.

96. Remember stuffed peppers? For a change from taco night, mix browned and drained ground beef with onion, garlic and stewed diced tomatoes and rice, stuff peppers and top with cheese.

97. Herbs! Sprinkle fresh cut herbs over omelets and casseroles for an instant flavor pop.

98. Challenge yourself to double the vegetables in any recipe. Making quiche? In addition to broccoli and onions, add some chopped peppers or carrots!

99. Substitute pureed broccoli or cauliflower for cream in soup recipes. Steam veggies, then blend with an infusion blender until smooth. Thin with broth as needed. Easy!

What’s your favorite way to work in more servings of fruits and veggies? 

Check out these great reader submitted tips! Add yours above.

100.  Don’t just spiralize zucchini! Daikon, fat carrots, turnips, rutabagas, sweet potatoes, potatoes, and the neck part of butternut squash work great, too! Toss with a little olive oil and spread out on a cookie sheet in the oven at 350 or higher. Toss once or twice while baking. Bake until al dente. Wonderful pasta substitute! Check out inspiralized.com for some great recipe ideas! – Deborah

101. Add extra onions and grate a carrot into your pasta sauce. an extra grated garlic clove is always good. – Diane Reich

102.  I add fruit and nuts to my hot cereal: Blueberries and walnuts to oatmeal; apples, raisins, and walnuts, plus cinnamon, ginger, and turmeric to steel cut oats; cut up pears and blueberries with walnuts and nutmeg and ginger to brown rice farina/amaranth cereal; and perhaps my favorite, unsweetened shredded coconut, cut up date, walnuts, and half a banana, plus some coconut oil with brown rice farina/amaranth cereal. – Janet

 

Magnesium

Take the Better Bones magnesium challenge!

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 over 300 enzymes 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 magnesium intake confers protection not only against fractures, but also type 2 diabetes, metabolic syndrome, hypertension, and cardiovascular disease (Bo et al., 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 & 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) for magnesium — 320 mg/day for women, 420 mg/day for men — and even that, in my opinion, is below the optimal.

My magnesium 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’ magnesium content (below), 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 600 mg of magnesium in alkalzing 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, Pisu E. Role of dietary magnesium in cardiovascular disease prevention, insulin sensitivity and diabetes. Curr Opin Lipidol. 2008 Feb;19(1):50–56.

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

Ismail Y, Ismail AA, Ismail AAA. 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 2010;48:323–327.

Moshfegh A, Goldman J, Ahuja J, Rhodes D, LaComb R. 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., Mineral content of foods and total diets: The Selected minerals in Foods Survey, 1982 to 1984 J Am Diet Assoc 1986;86:876-91.

Rajizadeh A, Mozaffari-Khosravi H, Yassini-Ardakani M, Dehghani A. Effect of magnesium supplementation on depression status in depressed patients with magnesium deficiency: A randomized, double-blind, placebo-controlled trial. Nutrition 2017;35:56–60.

Are you eating these bone health superfoods?

7 superfoods that help decrease bone breakdown

Women with osteopenia may be able to reduce their bone breakdown by consuming a daily amount of 9 or more servings of vegetables and fruits. But not just any vegetables and fruits, as reported by a recent New Zealand study that highlighted which bone superfoods can make the biggest difference.

Here’s what these researchers found when they tested the effects of known bone super foods on women’s ability to build bone.

How the study tested bone superfoods

The study group of 142 postmenopausal women (mean age 60 years) was divided into three groups: a control group, which had no change to their existing diets, and two intervention groups of 50 women each, both of which were instructed to increase their consumption of vegetables and fruits to 9 or more servings (1/2 cup cooked or 1 cup raw) each day and to add some aromatic culinary herbs to each meal. Participants in one group chose from foods that emphasized specific vegetables/herbs/fruit known to reduce bone breakdown (aka bone superfoods). The other group was left to choose their 9 servings per day, but could not consume any of the bone superfoods.

Most of the women in the intervention groups (52%) had osteopenia; the rest mainly had normal bone density, although a few had osteoporosis.

No surprise: More plant foods lead to better bone health

The study found that:

  • Both intervention groups consuming the 9 servings of vegetables experienced significantly reduced loss of calcium and a rise in urinary pH compared to the control group.
  • Women in the group that ate the bone superfoods were the only ones to reach the daily internationally recommended level of 4700 mg of the key bone nutrient, potassium.
  • A significant reduction in bone breakdown was seen in women with osteopenia whose 9 or more servings of vegetables and fruits included the bone superfoods. This is a very positive marker, as excessive bone breakdown leads to further osteopenia and even osteoporosis.

Are you eating these superfoods?

Here are the foods that are so effective at building bone. Some of them may surprise you!

  • Green, leafy vegetables like kale, bok choy or red cabbage
  • Citrus fruits
  • Prunes
  • Onions
  • Broccoli
  • Tomatoes
  • Green beans

Here at the Center for Better Bones, we’ve long championed our Alkaline for Life Diet® — high in vegetables, fruits, nuts, seeds, pulses and spices — as the ideal bone-enhancing eating program. Our helpful graphic shows you what a bone-superfood Alkaline Diet looks like. How close is your current diet to this ideal?

superfoods for bones

Reference
Gunn CA, Weber JL, McGill A-T, Kruger MC. Increased intake of selected vegetables, herbs and fruit may reduce bone turnover in post-menopausal women. Nutrients 2015; 7(4): 2499–2517.

5 diet changes that may increase lifespan

5 diet changes that add years to your life

Improving your diet quality by 20% can lead to a longer life — and it’s surprising how small the changes are to get you there.

A recent study in the New England Journal of Medicine shared how making a few minor tweaks to your eating habits can produce a noticeable increase in your lifespan. I find it fascinating that this was the first time researchers actually looked at whether changing your eating habits for the better would have any effect on how long you live. It seems so obvious that the answer would be yes — but no one had ever actually done research to see if it’s really true.

And boy, is it true.

What the study looked at

Researchers analyzed data from almost 48,000 women who participated over a total of 16 years in the Nurses Health Study and 26,000 men who took part in the Healthy Professionals Follow-Up Study. What they found is that those whose diets scored consistently high on three separate measures of diet quality had between 11 and 14% lower risk of death from any cause than those whose diet quality scored consistently low.

That’s pretty impressive by itself, but the part that really caught my attention was what the study found when people made the commitment to healthier eating. Those participants whose diet quality scores improved by 20% over time had a reduction of between 8 to 17% in their risk of death by any cause—regardless of whether those improvements took 8, 12, or 16 years to accomplish. The association was stronger when cardiovascular causes of death were considered in isolation. And the reverse was also true: If the participants’ diet quality got worse over time, their risk of dying during the study period grew by 6–12%.

5 diet changes that may just save your life

Something else that I noticed about this study — so many of the diet changes researchers note can lengthen your lifespan are the same eating habits that do so much to protect your bones!

1. Less meat, more lentils. The authors noted that “…increase in consumption of nuts and legumes from no servings to 1 serving per day and a reduction in consumption of red and processed meats from 1.5 servings per day to little consumption will result in an improvement of 20 points in the score.” So if you are thinking of beef stew for dinner, you might want to skip the red meat and eat a bean-based chili instead — with plenty of veggies!

2. Use high-fiber whole grains instead of their processed counterparts. In place of pasta or white rice, why not try wild rice instead? It’s higher in fiber and lower in carbohydrate — and less acidifying. (Throw in a handful of chopped walnuts or cashews for additional anti-inflammatory benefits.)

3. Skip the soda and drink water with a splash of lemon or lime juice instead. Citrus fruits are especially alkalizing additions — and it’s almost universally true that most of us aren’t well hydrated so drink up!

4. Eat more leafy greens. Commit to adding at least one leafy green vegetable — even just one! — to your plate at one meal each day. You’d be amazed at how easy it is — and you’ll get more out of it if you substitute it for something less beneficial, like pasta or potatoes. Whether cooked or in a fresh salad, the benefits of leafy greens are unmistakable.

5. Experiment with spices. There are a number of spices with bone-supporting properties, and it’s a simple matter to include them to your recipes. I’ve offered some suggestions for using one of them, turmeric, in an earlier post.

I know many people think that making changes to improve health is an arduous uphill climb. It isn’t! If there’s one thing I hope all my readers will share with their family and friends, it’s this: You can make a big difference by making a few small changes.

Have a friend who could use this information? Please share this blog — and save a life!

Reference:
Sotos-Prieto M., Bhupathiraju S.N., Mattei J., et al. Association of changes in diet quality with total and cause-specific mortality. N Engl J Med 2017;377(2):143–153.

How much magnesium do you need to prevent fracture?

Is magnesium the missing ingredient for preventing bone fracture?

Are you getting enough magnesium? The mineral may not immediately spring to mind when you think about important nutrients for your bones — but two new studies that found a strong relationship between insufficient magnesium and fracture risk could change this.

Low magnesium and hip fracture are connected

The first study (Kunutsor et al, 2017) found that having low magnesium levels in the blood correlated to a 44% higher risk of bone fractures, particularly hip fractures. This was done by looking at serum magnesium levels of 2,245 middle-aged men (age 43-61 years old).

The study noted that none of the men with what they regarded as “high” magnesium levels (more than 2.3 mg/dL) fractured at all. I should mention that the FDA sets the serum magnesium reference range at 1.8-3.6 mg/dL, so 2.3 mg/dL hardly qualifies as a “high” level of magnesium. It’s not even in the middle of the range! And that raises the possibility that chronic, latent magnesium deficiency may have been depleting the study participants’ bones of this needed mineral (Elin, 2011).

How much magnesium do you need to lower fracture risk?

Researchers also continue to reveal the importance of dietary intake of magnesium — especially for women. The second study (Veronese et al, 2017) included 1,577 and 2,071 women with an average age of 60 years. During the 8 year study, 560 participants — almost 15% — had a fracture. The risk of fracture also decreased significantly in the people who had the highest magnesium intake — 53% in the men, and 62% in the women.

One of the important findings was that in women, the effects were only seen to a significant degree in the ones who achieved the recommended daily allowance (RDA) of dietary magnesium, which was 320 mg/day (for men, it was 420 mg/day).

I generally recommend a daily magnesium intake of: 400-800 mg/day (which is somewhat higher than the RDA).

Here’s how to get the magnesium you need

I get two messages from these studies. One is obvious: We need to pay more attention to magnesium for healthy bones! Both studies show that people who lacked adequate magnesium would have benefited from having more, either through changes to their diet or by taking a magnesium supplement. They also show that even a small increase in daily magnesium intake can produce a significant effect. Ideally, though, we want to get enough to keep our bones healthy — and current ideas of what constitutes “enough” are probably too low.

The other message is perhaps less obvious, but no less important: chronic, latent magnesium deficiency is something you can probably fix pretty easily, assuming there’s no hidden disease process that prevents absorption. A good way to start is to try adding more magnesium-rich foods to your diet, like this easy salad recipe that gives you 350 mg of magnesium. You can also learn more about supplementing for magnesium with my Better Bones Basics.

Magnesium rich salad recipe

Try this magnesium-rich warm salad

In a bowl, toss:
1 cup steamed or sautéed spinach (157 mg of magnesium)
1 avocado, sliced (58 mg of magnesium)
1/4 cup almonds (105 mg of magnesium)
3.5 ounces of sautéed tofu (30 of magnesium)
Sea salt and pepper to taste (optional)

Hear Dr. Susan Brown talk about the importance of magnesium for bone health

References:

Elin RJ. Re-evaluation of the concept of chronic, latent, magnesium deficiency. Magnes Res 2011;24(4):225-227.

Food and Drug Administration. Investigations Operations Manual 2017: Appendix C. Silver Spring, MD: US FDA. Available at https://www.fda.gov/ICECI/inspections/IOM/ (accessed August 7, 2017).

Kunutsor SK, Whitehouse MR, Blom AW, et al. Low serum magnesium levels are associated with increased risk of fractures: a long-term prospective cohort. Eur J Epidemiol 2017; doi: 10.1007/S10654-017-0242-2.

Veronese N, Stubbs B, Solmi M, et al. Dietary magnesium intake and fracture risk: data from a large prospective study. Br J Nutr 2017; doi: 10.1017/S0007114517001350.

Can Strontium Build Bone?

Strontium: bone drug or nutrient?

Quite frequently women write me to ask: What is strontium and why do you include it in your Better Bones Builder?

Well, there’s a short answer and a long answer to that question. Here’s the short answer: Strontium is an element very much like calcium and naturally present in our food and water. If you are eating a typical diet, you might getting anywhere from 1 mg to more than 10 mg of strontium per day. The reason it’s in the Better Bones Builder is that the elemental form (that is to say, the non-radioactive version found in nature) has been shown to promote formation of healthy teeth and bones. So it makes sense to include dietary doses of strontium in comprehensive bone-building formulas such as our Better Bones Builder because low-dose strontium is a companion nutrient that works with calcium and other minerals to promote bone health.

Low-dose vs. high-dose strontium

Now let’s get to the long answer. Where confusion sets in is when people hear about strontium being used by itself to build bone. What most people don’t realize when they read about strontium as “the solution” for bone health is that such talk isn’t referring to dietary doses of elemental strontium — rather, it’s referring to the extremely high-dose strontium that has been developed and patented as a drug therapy for osteoporosis in Europe. This drug, known as Protelos®, contains 680 mg of elemental strontium and two grams of strontium ranelate, a synthetic salt that combines strontium with ranelic acid.

Risks of high-dose strontium

Elemental strontium is different

Elemental strontium is a natural part of the earth’s crust and is very different from “strontium 90” which is a hazardous radioactive nuclear fallout product from aboveground nuclear testing. All strontium used in bone-building health products is elemental strontium.

One goal of Protelos® is for a small number of strontium atoms to displace calcium atoms in bone. For this effect it is necessary that the strontium drug be taken at least two hours apart from calcium. This separation of calcium from strontium is not necessary for low-dose strontium (22 mg) like that in my bone-building formula, which is used as a nutrient to aid the development of healthy bones. Unlike dietary strontium, the strontium drug has been found to have various adverse side effects including nausea, diarrhea, and, more rarely, memory problems, serious skin rashes, and venous clots. For the first 10 years of its use as an osteoporosis drug, however, more serious drug-induced problems were detected as the strontium drug (Protelos®) was found to substantially increase the risk of heart problems, including heart attack. In 2014, the European Medicines Agency Pharmacovigilance Risk Assessment Committee (PRAC) concluded that the risks of the strontium drug outweighed the benefits and they recommended suspension of its use.

Specifically, PRAC reported in 2014 that:

  • For every 1,000 patient years of use of the strontium drug (Protelos®) there were 4 more cases of serious heart problems and 4 more cases of blood clots or blockages of blood vessels than there were with the placebo.
  • As for benefits, the strontium drug had only a modest effect in osteoporosis, preventing 5 non-spinal fractures, 15 new spinal fractures, and 0.4 hip fractures for every 1,000 patient years.

Later in 2014 this same European committee revised its recommendation allowing the strontium drug to be used by patients who could not be treated for osteoporosis by other bone medicines, but requiring that patients using the strontium drug be carefully monitored. In addition, those with a history of heart or circulatory problems were not allowed to use this medication.

The high-dose strontium drug is not available in the U.S.

Keeping strontium in perspective

To avoid any confusion, let me be perfectly clear: In the U.S. the strontium drug Protelos® is not approved for use as a bone drug, and it is not available here for purchase. In the U.S. and Canada, however, one can purchase equally high dose natural forms of strontium as strontium citrate or strontium carbonate and some companies promote bone support formulas with 680 mg elemental strontium (the same strontium dose as in the Protelos® strontium drug formula). Keep in mind that this high-dose strontium, be it natural strontium as sold in the U.S. or synthetic as in Protelos®, is best viewed as a “bone drug,” and, as with all bone drugs, it should be used with great caution. While the synthetic strontium drug (Protelos®) has been shown to carry serious adverse effects, to date there have been no studies on the safety or efficacy of high-dose (680 mg) natural strontium as sold here in the U.S.

Here at the Center for Better Bones our mission is to explore the full human potential for natural, life-long bone health. We strive to work with nature and in accord with nature when at all possible. The Better Bones, Better Body program includes small low doses of supplemental strontium, while not generally recommending the use of high-dose strontium (680 mg) or conventional bone drugs.

I hope this helps clear up the confusion when it comes to strontium. I will be writing more on strontium in the future, so stay tuned!

Best wishes to everyone.

References: 

2014 European Medicines Agency. PRAC recommends suspending use of Protelos/Osseor (strontium ranelate),Jan 10. EMA/10206/2014  http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2014/01/news_detail_002005.jsp&mid=WC0b01ac058004d5c1

2014 European Medicines Agency. PRAC. Protelos/Osseor to remain available but with further restrictions. April 14, EMA 235924/2014 http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2014/02/news_detail_002031.jsp&mid=WC0b01ac058004d5c1

 

Strontium Ranelate

Strontium Ranelate

5 recipes to use turmeric for Better Bones 

I love cooking with turmeric because it adds a brilliant yellow color and pungent taste to so many foods. Plus, its active compound, curcumin, has been extensively studied and displays an impressive list of benefits, including anti-inflammatory and antioxidant effects that are important to bone health.

Used in foods, turmeric can deliver a significant amount of curcumin. You may be most familiar with turmeric as a key ingredient in curry powder and other savory dishes. I like to use it whenever I can. Here are some of my favorite recipes using turmeric:

1. Turmeric-spiked ghee

Turmeric is fat-soluble, and in traditional Indian cuisine, it’s generally cooked in ghee (clarified butter) or oil. Heat 1 Tbsp of ghee, add ½ tsp of turmeric powder and lightly sauté it for a few minutes. Store your “turmeric ghee” refrigerated in a jar and use it as a colorful and healthy oil for sautéing vegetables, nuts and seeds.

2. Beautiful yellow rice

Use the same turmeric ghee as nutritious condiment when cooking rice. Put 1 Tbsp turmeric ghee in a saucepan, along with ¼ tsp cumin seeds and a pinch of black pepper and salt. Sauté this spice mix a few moments before adding to the rice cooking water.

3. Turmeric-ginger tea

Bring 2 cups of water to boil in a saucepan. Put in ½ to 1 tsp turmeric powder, 1/4 tsp ginger powder, 1/8 tsp ground cinnamon, and a pinch of pepper. Simmer this for 15 minutes, then let settle, strain, and drink hot or cold with sweetener if desired.

4. Golden milk 

In a saucepan, mix and bring to a light boil the following:

  • 2 cups of any “milk” you choose (dairy, soy, rice, almond, or ½ almond and ½ coconut milk)
  • 1 Tbsp of ground turmeric (feel free to start with less)
  • 1 tsp powdered or fresh ginger
  • ½ tsp ground cinnamon
  • ¼ tsp ground cardamom
  • ¼ tsp nutmeg
  • 1 Tbsp sweetener (maple syrup, sucanat, etc.)
  • Pinch of black pepper

5. Chicken curry salad

  • Dress shredded chicken or chopped tofu with a mixture of turmeric, curry powder, cumin, mayonnaise, salt and pepper.
  • Add chopped celery or red pepper, raisins, chopped walnuts, minced garlic and a pinch of cayenne pepper and black pepper to taste.
  • Drizzle with a bit of lemon or lime juice, and serve over salad greens, rice, or use as a colorful sandwich filling.

More ways to use turmeric powder:

  • In deviled eggs or chicken soup
  • As a natural coloring for bland foods such as mashed potatoes, rice or quinoa
  • Sprinkled on avocado or salads

How much turmeric powder to aim for?

To gain health benefits from the spice, the University of Maryland Medical Center recommends taking 1 to 3 grams of dried, powdered turmeric root per day, which is about 1/2 to 11/2 tsp. A small amount of black pepper enhances the bioavailability of curcumin, as does boiling.

With so many ways to use turmeric, no wonder it is one of the most widely used culinary spices worldwide! If you would like to learn more about the benefits of turmeric and curcumin, see my recent blog “New study suggests curcumin helps build bone.”

Turmeric Recipes

Turmeric Recipes

Curcumin build bones

New study suggests curcumin helps build bone

A recent study shows that use of a new bioavailable derivative of curcumin significantly increased the bone density in the heel, upper jaw and little finger bones in older men. While the study looks at men — more about that below — I think it has some very interesting implications for us all!

What did the study look at?

  • The trial population consisted of 57 older Italian men — all between 68 and 73 years old — described by study authors as “reasonably fit” with a BMI below 25.
  • All study participants began a standardized bone health management program that included regular exercise, nutritional evaluation and dietary modifications, with particular focus on vitamin D, vitamin C and calcium.
  • 29 of them spent 24 weeks supplementing their program with the curcumin supplement, while the remaining 28 did not.

Now, it’s important to note that this is a small, preliminary study, and some of the choices the researchers made limit its usefulness. Men have fewer risk factors for bone loss than women in the same age group, and it’s unclear how “low” the subjects’ bone mass was (relative to their overall body size) to begin with. Plus, given that the individuals were “reasonably fit” Italian seniors (who likely had eaten an alkalizing Mediterranean diet most of their lives), we can infer that their initial risk of osteoporosis and fracture wasn’t high.

The powerful effects of curcumin

But as a starting point, it has some interesting implications. Curcumin has long been known to have antioxidant and anti-inflammatory properties. And there’s evidence suggesting it inhibits an important biochemical mechanism for osteoclast development know as the RANKL pathway (Bharti et al., 2004) — which is the same process targeted by the powerful bone drug denosumab (Prolia; Hanley et al., 2012).

That’s why it makes sense that a bioavailable curcumin could have such powerful effects to build bone when combined with common-sense healthy diet and exercise habits.

Obviously, the researchers have much more work to do, but I am encouraged to see scientists turning to nature to find the best ways to build bone health!

 

References

Bharti AC, Takada Y, Aggarwal BB. Curcumin (diferuloylmethane) inhibits receptor activator of NF-kappa B ligand-induced NF-kappa B activation in osteoclast precursors and suppresses osteoclastogenesis. J Immunol. 2004;172(10):5940–5947.

Hanley DA, Adachi JD, Bell A, Brown V. Denosumab: mechanism of action and clinical outcomes. Int J Clin Pract. 2012 Dec;66(12):1139–1146.

Riva A, Togni S, Giacomelli L, et al. Effects of a cucurmin-based supplementation in asymptomatic subjects with low bone density: A preliminary 24-week supplement study. Eur Rev Med Pharmacol Stud. 2017;21:1684–1689.

yogurt for osteoporosis

New study shows yogurt reduces osteoporosis risk

I know sometimes it’s not easy to change lifetime eating habits! But again and again, studies document the bone-building benefits of consuming nutrient-dense foods — such as yogurt.

In a large Irish study, one serving of yogurt daily was linked to a substantially lower risk of osteoporosis and osteopenia.

The researchers measured total hip, femoral neck, and vertebral BMD and bone biochemical markers in 1,057 women and 763 men and conducted separate measurements of physical function in 2,624 women and 1,290 men. Then they accounted for a wide range of factors that affect the risk of osteoporosis: body weight, kidney function, physical activity, servings of milk or cheese, and calcium or vitamin D supplements, smoking, alcohol use, and so forth.

Two things make this study especially interesting

First, the bone-strengthening effect of yogurt was not seen in people who drank milk or ate cheese — it was the yogurt, specifically, not any dairy product. This supports the suggestion that yogurt’s bone-building punch lies in its contribution to our all-important gut microbiome.

Second, the study included over 4,000 adults in the over-60 age group and looked at both physiological measures of bone quality as well as physical function measures like the ability to complete common movements (standing up). This strategy provides a more holistic portrait not just the bones, but the body as a whole. I’m always in favor of that!

It’s not the first time we’ve seen the suggestion that probiotics support bone health. Another study from Sweden reported fermented dairy was associated with a lower risk of fracture, and the US Framingham Offspring Study found a similar association between yogurt consumption and hip bone density. I’ve noted before that probiotics can strongly inhibit inflammation and likely enhance bone strength for this reason.

What does this study mean?

While the study found a strong link between yogurt and bone health, that doesn’t mean eating multiple servings of yogurt daily will eliminate your risk osteopenia or osteoporosis. But it does support the idea that nutrient-dense foods, like a low-sugar, high probiotic yogurt, benefit bone by delivering calcium, protein, phosphorus, potassium and other nutrients.

All yogurts are not created equal

yogurt-with-berriesThe most successful studies were done with European yogurts, which are high in probiotic organisms and low in sugar. If you want to see what yogurt can do for you, choose brands high in beneficial bacteria with no added sugar or additives (which unfortunately can counteract the benefits). Best bet: start with plain, organic, whole-milk yogurt and add fresh berries and alkalizing nuts and seeds for a creamy bone-supporting treat. Or whip up a yogurt smoothie! The possibilities are endless.

No dairy? No worries! If you avoid dairy remember there any many wholesome non-dairy fermented foods such as sauerkraut, olives, kimchi, tempeh, miso and true (fermented) pickles of all sorts.

 

 

 

References:

Laird E., Molloy A.M., McNulty H. et al. Greater yogurt consumption is associated with increased bone mineral density and physical function in older adults. Osteoporos Int (2017). doi:10.1007/s00198-017-4049-5

Michaelsson K., Wolk A., Langenskiöld S., et al. Milk intake and risk of mortality and fractures in women and men: cohort studies. BMJ 2014;349:g6015.

Martín Jiménez JA, Consuegra Moya B, Martín Jiménez MT. [Nutritional factors in preventing osteoporosis]. Nutr Hosp. 2015 Jul 18;32 Suppl 1:49-55. doi: 10.3305/nh.2015.32.sup1.9480.