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Vitamin D Absorption
Dr. Susan E. Brown

Don’t sabotage your vitamin D intake

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So many women have become empowered to take action by joining the Better Bones Revolution. Like all of us, they’re busy with their families and work, so they’re focused on finding a simple way to incorporate bone health efforts into their lives. I usually recommend they make sure they’re getting enough vitamin D and vitamin D absorption. Supplementing with vitamin D is most often the first step that is going to have the greatest impact. Three major vitamin D researchers now suggest that with adequate vitamin D supplementation, we could prevent 50-60% of all osteoporotic fractures. And vitamin D is shown to have multiple benefits for your bones, as well as your whole body.

My experience and newer research show that nearly all healthy individuals can safely supplement with 2,000 IU of vitamin D every day. I recommend you take that amount for 2 months and then obtain a 25(OH)D vitamin D blood level test to see how close you are to the optimum 50-60 ng /ml level.

A side but important note is that vitamin D use is contraindicated for people with disorders such as sarcoidosis, high blood calcium and metastatic calcification. It should be used under a physician’s guidance in other cases such as primary hyperparathyroidism, kidney stones and high urinary calcium.

Make sure enough is enough what you need to know about vitamin D absorption

When it comes to vitamin D, there’s a difference between “taking enough” and “getting enough.” That’s because even if you are taking the right amount of vitamin D supplements, your body needs to absorb it so that your body can use it for better bone health. And your body may need some help for optimal absorption.

One simple example: it’s most effective to take vitamin D with your largest meal. Vitamin D is a fat-soluble vitamin and is for bets vitamin D absorption take it with with fats. So give your body a head start by including it with a meal — especially one that contains some fat — rather than taking it on an empty stomach or with an on-the-go breakfast in the morning. A recent study showed that taking vitamin D with your biggest meal ups the rate of absorption with a 50% increase in serum levels of 25(OH)D levels (compared to taking vitamin D without food or with a smaller meal.)

Learn more about vitamin D and how it affects your heart health, immune system and blood sugar control with my article “Vitamin D: its benefits are more than ever imagined.”

It is now possible to test your own vitamin D levels at home. Order your own vitamin D test online today — for only $59 (compared to the $232 price you’d pay without this special opportunity for Better Bones Blog readers). There is no reason to suffer the consequences of unknown vitamin D inadequacy any longer. Now you are empowered to know your vitamin D levels whenever you want. Visit the special Better Bones Foundation Direct Labs page for more information (you may need to scroll to the right to see the complete description, price and “add to cart” icon).  Get started now!

 

Reference:

Mulligan GB, Licata A. 2010. Taking vitamin D with the largest meal improves absorption and results in higher serum levels of 25-hydroxyvitamin D. J Bone Miner Res. 25(4):928-30. doi: 10.1002/jbmr.67. (http://www.ncbi.nlm.nih.gov/pubmed/20200983) (accessed 01.20.13)

 

paleo diet
Dr. Susan E. Brown

Paleo diet: one good reason our ancestors had stronger bones than we do

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The news of the recent Hostess Bakery bankruptcy reminds me of the old rumor that went around claiming Twinkies (definitely not part of the paleo diet) could even survive the apocalypse. While that is no doubt an exaggeration, our contemporary shopping basket is brimming with denatured, processed, preservative-filled and even synthetic foodstuffs — all very different from what our ancestors ate.

And while you may think that everything changes — technology for example — today we have almost exactly the same genetic machinery and the same physiological requirements of our early human, late Paleolithic, ancestors 90,000 years ago.

This nutritional discord between our evolutionary diet and today’s eating patterns create problems for bone health and wellness in general.

A quick comparison: Paleo diet vs. Contemporary Nutrition

Minerals: Mineral intake was 2 to 8 times higher for most minerals except sodium. Sodium intake was at least 5 times lower than today, at 768 mg/day, while potassium intake was 4 times higher than ours at 10,500 mg/day. Iron intake was 8 times higher and manganese 4 times higher than ours.

Vitamins: Vitamin intake was estimated to be 2 to 6 times higher than ours. For example, vitamin C intake was more than 6 times as much, and vitamin E nearly four-fold higher. Folate and vitamin A intakes were twice as high.

Fat: Fat intake was estimated at just 2/3 of ours at 21% total calories, including almost a 1 to 1 ratio of beneficial polyunsaturated omega-3 fats to omega-6 fats. Today we consume some 30% of calories from fat including 10 to 15 times more omega-6 than omega-3 fats, with 18% of our fats as refined vegetable oils including substantial amounts of harmful trans fats. Paleo diets had no processed oils or trans fats, nor any refined vegetable oils.

Protein: Protein intake was generally twice that of ours, estimated at 1/3 total calories. There were abundant sources of plant and animal protein, including wild animals, which have low body fat.

Fiber: Fiber intake was 5 to 8 times higher than ours at 100 to 150 grams/day as opposed to the current 15 grams/day.

Carbohydrates: Carbohydrate intake was similar to ours at 46% of calories, but all carbs were from whole, unprocessed, wild foods.

Refined Sugars: None or minimal intake of refined sugar (although some honey was available), as opposed to 15% of all calories in today’s diet. Today we average 20 teaspoons of added sugars a day, about 15% of total caloric intake, including 10% of our calories from fructose.

Grains and Cereals: None or minimal. Today refined grains comprise 32% of our diet.

Dairy: None beyond infancy. Today we average nearly 400 lbs of dairy products per year or 2 cups per day.

Acid-Alkaline Balance:  The paleo diet were largely alkaline-forming due to high potassium intake from vegetables, fruits, nuts, and seeds. On the other end of the scale, contemporary Westernized diets are low in vegetables and fruits yielding an average 50 meq of excess acid daily.

Alcohol: None or minimal, as opposed to 7-10% of contemporary diets.

Stay tuned, in a subsequent blog, I’ll provide you with 10 tips for regaining “The Paleo Edge.”

Watch Dr. Brown’s video on Paleo Diet:

 

 

References:

CDC (Centers for Disease Control and Prevention). National Health and Nutrition Examination Survey NHANES 2003-2004, Atlanta, Georgia.

Cordain, L., S. B. Eaton, A. Sebastian, N. Mann, S. Lindeberg, B. A. Watkins, J. H. O’Keefe, and J. Brand-Miller. 2005. Origins and evolution of the Western diet: health implications for the 21st century. American Journal of Clinical Nutrition 81:341–354.

Eaton, S. B., and S. B. Eaton III. 2000. Paleolithic vs. modern diets—selected pathophysiological implications. European Journal of Nutrition 39:67–70.

Eaton, S. B., and M. Konner. 1985. Paleolithic nutrition: a consideration of its nature and current implications. New England Journal of Medicine 312:283–289.

Eaton, S. B., and D. A. Nelson. 1991. Calcium in evolutionary perspective. American Journal of Clinical Nutrition 54:281S–287S.

 

Better Bones Blog
Dr. Susan E. Brown

Olive oil and Olive Oyl…

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Olive oyl_iStock_000019804004XSmallRecently I read a study that showed how a Mediterranean diet enriched with virgin olive oil supports bone health. The results are very interesting to me because researchers looked at three different types of diets:

• the Mediterranean diet including olive oil

• a low-fat diet

• the Mediterranean diet without olive oil but with nuts

Of these three diets (all of which might appear to be reasonably healthy to most people), the diet including substantial supplemental of 3.5 tablespoons of olive oil was associated with increased serum osteocalcin which suggests a protective effect on bone.

And what is the bone building magic of olive oil? It looks like that substance is Oleuropein, a polyphenol found in products from olive trees – including olive oil. Oleuropein stimulates the osteoblast cells responsible for bone formation to prevent age-related bone loss and osteoporosis.

And then, my mind couldn’t help but jump to another Olive Oyl – Popeye’s fickle girlfriend from the favorite cartoon. I’ve confessed in a previous blog that I have a “monkey mind” that tends to detour from one subject to another loosely making connections — I think they call it “stream of consciousness.” So where did my mind take the combo of olive oil, Olive Oyl and bone health?

In this case, I remembered — as you might too — that Olive Oyl has an extremely tall and thin build, and I couldn’t help but notice that she’s the kind of woman who is much more likely to be susceptible to bone loss. And the fact that she’s often angry or anxious about Popeye’s antics surely doesn’t help protect her bones. My mind then skipped to Popeye. While everyone knows he has impressive muscles because of his love for spinach, what else is he eating? Is he varying his diet enough to ensure he gets enough of the 20 key bone building nutrients?

As you can see, even with my “monkey mind,” I never stray too far from thinking about bone health!

 

References:

Fernández-Real JM, Bulló M, Moreno-Navarrete JM, Ricart W, Ros E, Estruch R, Salas-Salvadó J.(2012) A Mediterranean Diet Enriched with Olive Oil Is Associated with Higher Serum Total Osteocalcin Levels in Elderly Men at High Cardiovascular Risk. J Clin Endocrinol Metab. 2012 Aug 1.

Santiago-Mora R, Casado-Díaz A, De Castro MD, Quesada-Gómez JM. 2010. Oleuropein enhances osteoblastogenesis and inhibits adipogenesis: the effect on differentiation in stem cells derived from bone marrow. Osteoporos Int. 2011 Feb;22(2):675-84.

vitamin d
Dr. Susan E. Brown

Vitamin D level in tropical indigenous populations

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As an anthropologist I’ve often wondered just what level of vitamin D would be found among indigenous populations living traditional lifestyles. A new study provides insights on the natural vitamin D levels of tropical indigenous individuals. And the good news is that the vitamin D level found among these native populations is very similar to what I have held as the “optimum” vitamin D level.

 

Reference:

Luxwolda, M. F., R. S. Kuipers, I. P. Kema, D. A. Janneke Dijck¬Brouwer, and F. A. J. Muskiet. Traditionally living populations in East Africa have a mean serum 25 ¬hydroxyvitamin D concentration of 115 nmol/l. British Journal of Nutrition, 2012 Jan 23:1-5. [Epub ahead of print]. DOI :10.1017/S0007114511007161.

 

Better Bones Blog
Dr. Susan E. Brown

My green drink challenge

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Several women have been talking to me about how to change out acid-producing foods for alkaline-producing items by adding green drinks to their menu plans. They love being able to experiment with different combinations to find which ones suit their taste best. And they appreciate how simple it is to help them get my recommended 9-10 servings a day of vegetables and fruit.

As both a bone health nutritionist and someone who likes to test things, I welcomed the chance to break out the blender and try the tips and recipes that Better Bones readers have sent me.

Here is one tasty, fruity green drink developed by my client Maia:

The Green Monster

1 cup OJ

1/2 cup frozen pineapple

1/4 cup frozen mango

1/2 cup water

One BIG hand full of baby spinach or tender kale (depending on the size of your hand you may need two handfuls)

Mix in your blender until it’s nice and smooth.

I agree that Maia’s drink is delicious, but seeing that it largely fruit based, I challenged myself to see if I could develop a tasty, mostly vegetable green drink. To see my concoctions, check out my video and the recipe:

 

Dr. Brown’s “Veggie” Green Monster

1/2 cup mixed greens

1 1/2 stalks celery

1/4 cup diced cucumbers

1/8 cup fresh parsley

1 small apple, cored

2 tsp fresh lime juice

2 tsp fresh lemon juice

1/2 tsp grated fresh ginger

1/2 tsp lime zest

1 1/4 cup coconut water

Mix in blender.

If you have an even better, tastier, recipe for a green veggie drink post it here in the comments section below and you will be entered for a drawing to win a copy of my Acid-Alkaline Food Guide book. I’m eager to hear from you!

 

Dr. Susan E. Brown

Apple Benefits – Good Bone Health to the Core

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Apples_iStock_000019059160XSmall

In my part of the country, October means apple picking. I grew up with a variety of apple trees in my backyard. I couldn’t wait for the first frost, after which the Northern Spy apples got really crispy. Apple benefits the whole body, let’s learn more…

You may not realize that eating a fresh, crisp apple gives you a unique bone-building phytonutrient called phloridzin. This flavonoid antioxidant is only found in apples — especially in the peels — and can help improve bone density and reduce bone breakdown for women after menopause.

In addition to generous amounts of vitamin C, potassium, and fiber, apples also contain boron, a trace mineral needed to help our bodies metabolize and use other nutrients. A daily apple benefits your body in so many ways!

Picking apples and the natural approach over bone drugs

When you compare not just apples — but also other natural methods for building bone — with bone drugs, you see some compelling reasons to pick nature!

1. You’ll build permanent bone with a natural approach, rather than temporarily creating bone mass from drug molecules (which is how bisphosphonate drugs function).

2. You can truly have an apple — or strawberries, watermelon or other alkaline-forming foods — a day for the rest of your life, while the recommended limit to taking bone drugs safely is five years.

3. You’ll be building a better body overall with natural steps like the alkaline diet, exercise and stress reduction — including strengthening muscles, keeping your blood pressure optimal, and protecting your heart health.

Of course, one specific difference to note between apples and bone drugs — one of my favorite recipes found below wouldn’t work with a bone drug!

Baked apples with tahini and cinnamon

4 apples, baking variety

½ cup apple cider or juice

2 tablespoons tahini

2 tablespoons maple syrup

¼ teaspoon cinnamon

1 tablespoon chopped pecans or walnuts

Wash and core apples, taking care not to cut through to the bottom. Place them in a baking dish in 1/2-inch of water. Mix the remainder of the ingredients together and spoon into the cavities of the apples.

Cover and bake at 350°F for 35 minutes. Uncover and bake another 15 minutes. Serve just like this or cover with your favorite topping. Serves 4.

Enjoy apple benefits for your body and taste buds!

 

References:

Puel, C., A. Quintin, J. Mathey, C. Obled, M. J. Davicco, P. Lebecque, S. Kati-Coulibaly, M. N. Horcajada, and V. Coxam. 2005. Prevention of bone loss by phloridzin, an apple polyphenol, in ovariectomized rats under inflammation conditions. Calcified Tissue International 77(5):311–318.

Nielsen, F. H., C. D. Hunt, L. M. Mullen, and J. R. Hunt. 1987. Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. FASEB Journal 1(5):394–397.

 

Better Bones Blog
Dr. Susan E. Brown

If we could reset research…Part 1

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Here it is, Sunday night and I sit at my computer diligently parsing 268 new research abstracts looking for breakthroughs and gems of knowledge to share with you.

As I consider studies from Sweden, Lebanon, Canada and Spain, it seems that, more than ever, new studies — wherever they come from — focus less on natural approaches and prevention than they do on the latest bone drugs.

Now, this isn’t exactly news given that much of the research activity is supported by pharmaceutical companies. And much of what we know about vitamin D, calcium and other bone-building nutrients has come from this support.

But I can’t help but think of all the research questions out there that aren’t getting much attention. If I had the chance to “reset” research priorities with a focus on the issues I think deserve more attention, these are the topics I would choose:

• The role played by emotions in our bone health – from the way that calming meditation and inner peace promote overall wellbeing, to the effects of fear, worry, and bouts of anxiety

• The importance of exercise — mindful tai chi, yoga and qi gong

• The development of affordable functional test for assessing mineral adequacy. If we can send a man to the moon, can’t we figure out if a person has enough manganese or zinc to maintain bone health?

• Practical ways to measure real bone strength, not just density as measured today

• Focus on natural healing for auto-immune diseases, allergies and other inflammatory conditions which are treated with steroid medications (some 20% of osteoporosis is cause by steroid use)

What about you? If you could talk to the top bone health scientists around the world, what areas would you ask them to study? Share your ideas with me in the comments section below.

 

blueberries superfood
Dr. Susan E. Brown

Blueberries top my list of super fruits

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A summer favorite returns! As part of my most popular blog series, this look at the bone-strengthening power of blueberries includes a delicious smoothie recipe with not only blueberries, but also green tea!

When I’m traveling, I make it a point to avoid the fast food restaurants and other convenience “food” found along the road by packing my cooler with snacks.

I make an exception to my roadside rule when I’m on one of my drives in Maine. I know I can look forward to farm stands filled with all varieties of fresh fruits and vegetables. Especially those carrying wild blueberries — one of my bone-building super foods!

Blueberries have become a regular fixture on super food lists because they’ve been shown to help prevent cardiovascular issues, diabetes and cancer due to their high concentration of antioxidants and other health-promoting compounds.

BlueberriesWe’ve also learned blueberries may help prevent osteoporosis in postmenopausal women. Using animal models designed to represent menopausal osteoporosis, researchers found that when animals were given blueberries, the blueberry “treatment” was able to prevent the loss of bone mineral density throughout the whole body. Those who were not given blueberries suffered a 6% loss of bone density throughout their bodies.

What’s most interesting to me is that researchers report the mechanism by which blueberries prevent bone loss is different than other fruits studied. Blueberries appear to reduce bone breakdown (resorption) rather than by increasing bone formation as do dried plums, for example.

I’m looking forward to finding out more about the many different ways the foods we eat contribute to our bone health. Remember, our bodies are capable of building bone strength if we give them the consistent support they need. You can do just that with some delicious blueberries for dessert.

 

My favorite blueberry smoothie

½ cup coconut milk

½ cup coconut water

½ cup blueberries

1 teaspoon matcha green tea

(You may also add ¼ to ½ of an avocado to boost healthy fat and potassium, as well as create a creamy texture)

Blend. Enjoy!

 

Reference:

Devareddy, L., et al. 2007. Blueberry prevents bone loss in ovariectomized rat model of postmenopausal osteoporosis. J. Nutr Biochem; 19 (2008) 694-699

 

Better Bones Blog
Dr. Susan E. Brown

Green tea: my #1 bone-building super food

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Special note: This summer I’m featuring some of the most popular reader blogs. This blog on green tea generated a lot of good discussion. Make sure you read the many comments too.

Many of my blogs focus on food. One reason may be that there are so many good things to eat —almond butter is a current favorite. But more important, we’re constantly learning so much about the powerful bone-building effects of food.

Green tea with leavesMaking good nutritional choices is one of the simplest and most immediate ways to take action for strengthening bone. So expect a few more blogs about food with a focus on the “super foods” that you should think about adding to your meals and snacks.

Green tea is full of antioxidant compounds and multiple studies suggest it protects against bone loss and osteoporosis. Specifically, drinking green tea appears to stimulate mineralization to generate bone formation, while at the same time inhibiting the formation of cells that remove bone tissue. And there are literally hundreds of studies that connect green tea to improved health in addition to its bone-building benefits.

Here are some tips to get the best cup of green tea

• Use a teapot rather than a tea ball. Green tea needs room to expand as it steeps.

• Take care with water temperature. I suggest heating water to almost boiling (about 180 degrees). If the water is too hot, the leaves will cook the tea and it will be too bitter. Warm your cup with hot water first so that the temperature of the brewing water won’t cool too quickly.

• Pay attention to water quality. If your water tastes bad, your tea will taste bad.

• Steep from 1-3 minutes. The smaller the leaf size, the more quickly the tea will infuse. However, if you steep the tea too long, the tea will again be too bitter. You can experiment a bit to find the taste that you like best.

• Store tea in a cool, dry place.

• For those who want to avoid caffeine (as I do), put the tea in the near boiling water for 30 seconds, pour off this water and then make the tea. This removes most of the caffeine.

A Chinese proverb says “better to be deprived of food for three days than tea for one.” I’m not going to suggest you skip meals, but I do recommend you make drinking green tea a priority for bone health!

 

References:

Chen, Z., et al. 2003. Habitual tea consumption and risk of osteoporosis: A prospective study in the women’s health initiative observational cohort. Am. J. Epidemiol., 158 (8), 772–781. URL (accessed 11.11.2009).

Daniells, S. 2009. Green tea extracts linked to healthier bones: Study.  (accessed 11.10.2009).

Better Bones Blog
Dr. Susan E. Brown

Weight gain linked to lower vitamin D

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Feet on scaleLower levels of vitamin D may mean higher numbers on the scale, according to new research.

This study linking lack of vitamin D with weight gain in postmenopausal women is one of the first to show this correlation, and I expect it will cause other researchers to take an even closer look at how vitamin D can influence body weight.

 

It’s also another example of how everything we do for our bone health should be good for the entire body.

Here are the highlights of the study, funded by the National Institutes of Health and published online in the Journal of Women’s Health. It looked at nearly 4,600 women over the age of 65 for five years:

• Women with insufficient blood levels of vitamin D gained more weight than those with adequate levels of the vitamin.

• The difference in weight gain was about two pounds. In the group of 571 women who gained weight, those with insufficient Vitamin D levels gained 18.5 pounds over five years. Women who had sufficient vitamin D gained 16.4 pounds.

• Nearly 80% of women in the study had insufficient vitamin D (less than 30 ng/mL).

I know that the weight aspect of the study will be interesting to a lot of people — after all, we all want to know what contributes to extra pounds — but it’s just as important that almost 80% of the women in the study have vitamin D levels so low they will limit calcium absorption.

I recommend an ideal level of 50-60 ng/mL for better bones and a better body. For more information about the whole body benefits of vitamin D, read my article “Vitamin D: its benefits are more than ever imagined.”

 

Reference:

Kaiser Permanente (2012, June 25). Low vitamin D levels linked to weight gain in some older women. ScienceDaily. (accessed 07.05.12)