Is the keto diet good for your bones?

Why keto diets can be harmful to your health

So many people have asked me recently about the ketogenic “keto” diet and the benefits — and the drawbacks — of severe carbohydrate restriction.

Is the keto diet the “magic pill” for ending weight and health struggles, as a certain Netflix documentary would like us to believe?  As you’ll see, absolutely not. What’s more, keto diets can actually be quite harmful to your health.

What happens in your body when you’re on a ketogenic diet

A ketogenic diet is one that limits carbohydrate intake to the point at which the “starvation response” is triggered in the body. This starvation response mobilizes stored fat and breaks it down as a way to produce acetyl coenzyme A (CoA) — the body’s backup energy source in place of the glucose it isn’t getting when we don’t or can’t eat carbohydrates.

Most standard keto diets pair the low carbs with high fat and moderate protein intake, but when weight loss is the goal, there’s often a limit on fat intake as well to encourage reduced calorie intake (since fatty foods are typically higher in calories too).

The benefits of ketogenic diets

Keto diets do have legitimate benefits when it comes to weight loss, but as you’ll see below, the risks may outweigh the benefits.

Short-term weight loss. Reducing carbohydrate intake and monitoring caloric intake will offer the body only one place to turn for energy: body fat stores. A strict ketogenic regimen can produce steady and reliable weight loss in most otherwise healthy overweight adults in the course of a few months. (I’ll get to the “but…” in a moment.)

Short-term improvement in blood sugar. Individuals who eat a standard diet who do not have diabetes, prediabetes, or insulin resistance tend to have blood glucose levels in the range of 80–120 mg/dL. Those on a ketogenic diet, however, typically have blood glucose levels between 65–80 mg/dL. Before you say, “holy hypoglycemia!” keep in mind that the body adjusts to these levels in part by producing more CoA.  So for someone who might be on the borderline of diabetes and wants to better manage blood sugar levels, a keto diet can be a good place to start — although there’s a “but…” associated with this as well!

When keto diets become harmful to your health

While we evolved to use glucose as our primary energy source, our ancestors couldn’t always rely on carbohydrate-rich plant foods being available all the time. So the ability to use fats as a source of glucose (whether from animal foods they ate or by burning their own adipose tissue during times of famine) was an effective short-term backup plan. The operative phrase is “short-term.”

Because there are definitely harmful long-term effects of ketones in the body:

Keto diets acidify the body. Ketosis, which is the name for production of ketones in general, and its more dangerous, dysfunctional variant ketoacidosis (a life-threatening buildup of ketones that happens most often in diabetic individuals) results in lower blood pH — in other words, acidosis.

I’ve talked before about how acid-forming foods can be harmful to bones, but chronic low-grade acidosis has health impacts well beyond bone health. It can potentially increase risk of cancer development and progression; increases production of the stress hormone cortisol; and potentially causes the development of kidney disorders such as kidney stones (Robey, 2012; Pizzorno, 2015).

Keto diets can promote fatty liver disease and insulin resistance. This is where those two “but…” caveats from earlier come in… There is evidence in mice — and to a lesser extent in humans — that long-term use of keto diets promotes development of nonalcoholic fatty liver disease and (paradoxically) insulin resistance (Schugar & Crawford, 2012; Ellenbroek et al., 2014). The increase in insulin resistance is likely related to longer-term increases in cortisol.

So, while the short-term benefit for blood sugar and other cardiovascular makers exists with keto diets, in the long term, regulating blood sugar and other aspects of cardio health is better achieved through a balanced diet paired with regular exercise.

Keto diets are NOT the best choice for long-term weight loss

Although a keto diet may be a good starting point for shaving off pounds, it probably isn’t something you want to stick with over time — more than, say, a few months — especially if you have a family history or personal tendency toward diabetes, insulin resistance, kidney dysfunction or fatty liver disease.

This includes finding ways to gradually include a healthier set of carbs into your food choices. My favorites are nutrient-rich, alkalizing starchy vegetables like root vegetables and squash, which are full of complex carbohydrates, rather than the standards of bread and sweets.

References

Ellenbroek JH, van Dijck L, Tons HA, Rabelink TJ, Carlotti F, Ballieux BE, de Koning EJ. Long-term ketogenic diet causes glucose intolerance and reduced β- and α-cell mass but no weight loss in mice. Am J Physiol Endocrinol Metab. 2014 Mar 1;306(5):E552-8. doi: 10.1152/ajpendo.00453.2013. Epub 2014 Jan 7.

Kosinski C, Jornayvaz FR. Effects of ketogenic diets on cardiovascular risk factors: Evidence from animal and human studies. Nutrients. 2017 May 19;9(5). pii: E517. doi: 10.3390/nu9050517.

Kosinski C, Jornayvaz FR. [Ketogenic diets: the miraculous solution?] Rev Med Suisse. 2017 May 31;13(565):1145-1147.

Nei M, Ngo L, Sirven JI, Sperling MR. Ketogenic diet in adolescents and adults with epilepsy.
Seizure. 2014 Jun;23(6):439-42. doi: 10.1016/j.seizure.2014.02.015. Epub 2014 Mar 12.

Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr. 2013 Aug;67(8):789-96. doi: 10.1038/ejcn.2013.116. Epub 2013 Jun 26.

Pizzorno J. Acidosis: An old idea validated by new research. Integr Med (Encinitas). 2015 Feb; 14(1): 8–12.

Robey, IF. Examining the relationship between diet-induced acidosis and cancer. Nutr Metab (Lond). 2012; 9: 72. Published online 2012 Aug 1. doi:  10.1186/1743-7075-9-72

Schugar RC, Crawford PA. Low-carbohydrate ketogenic diets, glucose homeostasis, and nonalcoholic fatty liver disease. Curr Opin Clin Nutr Metab Care. 2012 Jul;15(4):374-80. doi: 10.1097/MCO.0b013e3283547157.

Woman shopping at a summer farmer's market

Early summer superfoods for osteoporosis

There are so many reasons why we should eat fresh whole foods in season, and it’s even better if we select foods that strengthen and support our bones.

As we enter summer, I want to share with you some of my favorite seasonal foods that fit the criteria of “superfoods” for bones — and I also want to share exactly what these criteria are to help you identify even more foods on your own.

In developing my daily diet, I think in terms of 11 major food groups, which you’ll see below with my early summer superfood favorites. Why not add your own favorite summer foods to my list? Have fun with this; putting a little of your attention on the food groups and their ideal daily servings will likely result in more diverse and wholesome summer eating.  Notice the abundance of fresh greens in your market and pick the ones that you enjoy.

Early summer superfoods for bone health

Vegetables
4.5 cups/day
– Green leafy vegetables
– Asparagus
– Snow peas
– Watercress
– Lettuce
– Dandelion greens

Protein
60-80 g/day (as tolerated)
– Fresh salmon
– Lentils
– Lean meats

Nuts and seeds
2-3 servings/day
– Almonds (1st nut of the summer)
– Sesame seeds

Water
8 glasses/day
– Pure water
– Lemon water
– Iced green tea with mint

Fermented foods
1-2 servings/day
– Kombucha
– Lacto-fermented pickles

Root crops & squashes
1-2 servings/day
– Scallions
– Summer squash

Fruits
2-3 servings/day
– Strawberries
– Raspberries
– Blueberries

Dairy
0-2 servings/day
– Kefir
– Yogurt

Oils & fats
1-2 tbsp/day
– Olive oil
– Coconut oil
– Avocado

Whole Grains
1-2 servings/day
– Quinoa
– Whole grain rice

Herbs & spices
1-2 tsp/day
– Parsley
– Mint
– Cilantro

What makes a food a “superfood” for bone health?

Here are the key qualities of food that in my book earn them the title of “bone superfood.”  Think about the foods that you like to eat. How many of them meet these qualifications?

Early summer is a time when Nature wakes from her winter rest and growth abounds. I send each of you my best wishes for a joyous early summer, full of the season’s growth and great tastes and flavors!

Pin our easy reference chart!

Mediterranean diet

Is the Mediterranean diet good for bones?

There is an amazing amount of research on the Mediterranean diet and its benefits for health, so naturally I get some questions about whether it’s good for bone health, too.

A brand new meta-analysis suggests that we can emphatically say it’s molto buoni [very good] for bones as well as the rest of the body (Benetou et al., 2018). The study looked at the relationship between adherence to a Mediterranean diet and hip fracture in over 140,000 US and European adults over age 60 (82% of whom were women). It found that those who have moderate to high adherence to a Mediterranean diet had a significant decrease in hip fracture risk compared to those with low adherence.

Mediterranean diet = Alkaline for Life® Diet

This finding is no surprise, because the Mediterranean diet is based on very similar principles as the Alkaline Diet — a focus on alkalizing plant foods and healthy fats, with limits on meat intake and simple carbohydrates. In many ways, the Mediterranean diet is simply one interpretation of Alkaline eating based on foods and meal patterns common to a certain part of the world.

A look at the extensive literature on Mediterranean diet and health highlights just a few important features:

• As a largely plant-based diet, it’s not only an alkaline option, it also offers health-supporting polyphenols that many studies agree are valuable in fighting cancer, inflammation, and oxidative stress — all factors that contribute to poor bone health (Estruch et al. 2013; Medina-Remon et al. 2017; Terra et al. 2009; Anderson & Nieman 2016; Martinez-Gonzalez et al. 2015).

• It contributes to maintenance of healthy weight and — important for bone health — muscle mass. One recent meta-analysis found that older adults who closely follow a Mediterranean diet had a lower risk of becoming frail and were better able to maintain muscle strength, activity, weight and energy levels (Kojima et al., 2018).

• A key component of the Mediterranean diet, olive oil, is associated with increased serum osteocalcin and P1NP concentrations, suggesting a protective effect on bone (Fernandez-Real et al., 2012) — and recent studies found higher consumption of olive oil corresponds to higher bone density (Savanelli et al., 2017).

More benefits to Mediterranean-style eating

It’s pretty clear that the Mediterranean diet is beneficial to bones. So what other health benefits does it offer? Here are just a few:

• The Mediterranean Diet is specifically associated with improvements in blood pressure, insulin sensitivity, lipid profiles, inflammation, oxidative stress, and atherosclerosis (Martinez-Gonzalez et al. 2015).

• Researchers have found repeatedly that those eating a Mediterranean diet experienced about a 30–60% reduction in cardiovascular risk (Estruch et al. 2013; Bonaccio et al., 2017; Carlos et al. 2018).

• Individuals following the Mediterranean diet experienced half as much age-related brain shrinkage as those who did not (Luciano et al. 2017).

• A recent study of over 22,000 Spanish men and women noted benefits in terms of type 2 diabetes, weight gain, metabolic syndrome, depression, cognitive decline, and nephrolithiasis (Carlos et al., 2018).

So if you’ve been wondering if infusing your alkaline diet with more Mediterranean flavor and flair would help you support your bone health, wonder no more — it will do that and more!

Vitamin D reduces breast cancer risk

How much vitamin D do you need to reduce breast cancer risk?

It has been recognized for over a decade that vitamin D has a protective effect against a variety of cancers, including breast cancer (Garland et al., 2006; Krishnan et al., 2010). But new research from our friends at GrassrootsHealth on vitamin D and breast cancer has me really excited. The group has found that maintaining a higher vitamin D level can reduce breast cancer risk by — are you ready for it? — a whopping 80 percent.

Higher vitamin D levels reduce breast cancer risk AND reduce bone loss

GrassrootsHealth recently combined two randomized clinical trials from Dr. Joan Lappe (Lappe et al., 2007; McDonnell et al, 2016) looking at women over four years. What they found was that was that those women who had vitamin D blood levels equal or greater then 60 ng/mL — the same levels helpful in preventing bone loss — had an 80% lower risk of breast cancer than women with concentrations less than 20 ng/mL (a very deficient level indeed).

Meanwhile, a similar study conducted recently showed that women with a vitamin D level above 38 ng/mL (about the level conventionally regarded as “adequate) had a 21% lower risk of breast cancer than women with levels at or below 24.6 (O’Brien et al., 2017).

You can’t help but notice the difference in risk reduction at 60 ng/mL versus 38 ng/mL is rather large. It reinforces what I’ve maintained all along — that current serum vitamin D recommendations are too low for women to get the best protective effects. But it also strongly supports the need for everyone to keep tabs on their vitamin D levels to ensure they don’t fall below the minimum level for bone health (and overall health).

Watch my interview with Carol Baggerly, the founder of GrassrootsHealth, to learn more about this groundbreaking research and Grassroots Heath’s new D-Action Cancer Prevention Society!

References

Garland CF, Garland FC, Gorham ED, Lipkin M, Newmark H, Mohr SB, Holick MF. The role of vitamin D in cancer prevention. Am J Public Health. 2006 February; 96(2): 252–261.

Krishnan AV, Trump DL, Johnson CS, Feldman D. The role of vitamin D in cancer prevention and treatment. Endocrinol Metab Clin North Am. 2010 Jun;39(2):401–418.

Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007 Jun;85(6):1586–1691.

McDonnell SL, Baggerly C, French CB, Baggerly LL, Garland CF, Gorham ED, Lappe JM, Heaney RP. Serum 25-hydroxyvitamin D concentrations ≥40 ng/ml are associated with >65% lower cancer risk: pooled analysis of randomized trial and prospective cohort study. PLoS One. 2016; 11(4): e0152441.

O’Brien KM, Sandler DP, Taylor JA, Weinberg CR. Serum vitamin D and risk of breast cancer within five years. Environ Health Perspect. 2017; DOI:10.1289/EHP943.

Root vegetables for bone building

Root vegetables are winter’s gift to bones

How many of you recognize the root cellar depicted below? That cold-weather storage area actually looks just like the well-used root cellar in my parents’ house.

As our ancestors knew in the days before refrigeration, hardy, storable root vegetables like potatoes, carrots, parsnips, sweet potatoes, and so forth make for delicious, warming, winter foods — and as an added bonus, they have tremendous value for bone health. They are highly alkalizing and packed with important bone-building nutrients, and as an extra benefit, root veggies can satisfy our sweet tooth if cooked at length.

Root vegetables: plentiful and versatile

At a time of year when field-fresh, organic vegetables may be harder to find in cold northern latitudes, you can almost always count on roots being readily available.

In our Better Bones Better Body Program, we suggest everyone consume at least one root vegetable daily in summer and perhaps two in winter. Root vegetables can easily substitute for bread, pasta, and grains in supplying carbohydrates for energy, yet their high potassium content means they help alkalize the body, unlike acid-forming grains.

I enjoy most root crops, but my favorite is the potato — maybe because of my Irish grandmother, who ate her own “home fried” potatoes every morning, or perhaps because one large baked potato eaten with skin offers a whopping 1626 grams of potassium!

Winter root crops pack a lot of bone-building nutrients

Potassium isn’t all roots have to offer. The table below details the amount of various key bone-building nutrients found in popular root crops. We have standardized these to 100 g of each of vegetable (just so you know, a large baked potato weighs about 229 g).

An easy root vegetable recipe to savor

While I love baked potatoes all year around, one of my favorite winter recipes is roasted root vegetables. I use a number of different roots together with onion, some olive oil, and seasoning. Maybe you want to try out the recipe below; I’d love to hear of your personal warming winter root vegetable recipes.

Roasted Root Vegetables

This dish is so versatile that I have actually eaten it for breakfast alongside cooked quinoa and a poached egg. It is a great addition to almost any meal.

Ingredients:

6 large cloves of garlic, whole

5 medium-sized parsnips, diced into 1-inch cubes

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-size butternut squash, diced into 1-inch cubes

¼ cup light olive oil

1 teaspoon sea salt

Optional herbs: parsley, oregano, or rosemary

  1. Preheat oven to 400°F. Lightly coat two 9 × 13 inch baking dishes with vegetable oil and set aside.
  2. In a large bowl, combine garlic, parsnips, potatoes, onions, squash, and olive oil. Toss well.
  3. Add sea salt (and any herbs you desire) to the vegetables and toss again.
  4. Transfer the vegetables to the prepared baking dishes, spreading them out in a single layer.
  5. Roast the vegetables for 35 minutes or until lightly browned and fork tender, and serve.

Yields 8 servings.

Timesaver tip: The first time you make this dish, cut up more than you need of everything except the onions and freeze the extra in a gallon-size freezer bag. Then the next time you want it, all you have to do is thaw it, cut the onions, season, and bake!

 

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.

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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.