Category Archives: bone

Beating Osteoporosis

Osteoporosis: Is Calcium the Key?

Is Calcium the Key to Preventing Osteoporosis?

World Osteoporosis Day takes place every year on October 20. The campaign, organised by the International Osteoporosis Foundation (IOF), aims to raise global awareness of the prevention, diagnosis and treatment of osteoporosis and metabolic bone disease.

Our bones are constantly being broken down and rebuilt in a process known as ‘bone turnover’. In our early years, bone is built faster than it is broken down, and we reach our ‘peak bone mass’ at some point during our 20s. After this time, preserving healthy bones becomes a vital health concern. If bone is broken down more quickly than it is remade, then osteoporosis may occur.

This condition is of particular concern to postmenopausal women who produce less of the bone-protecting hormone oestrogen. Women lose more bone during their menopausal years than at any other time in their life [1]. However, men are under-diagnosed when it comes to osteoporosis and are more likely to go untreated.

The Key Three: Calcium, Magnesium and Vitamin D

Calcium is widely understood to play a key role in bone health and in preventing osteoporosis. After all, 99% of the body’s calcium is stored in bone. However, a calcium-rich diet in the absence of other bone-building nutrients is not effective in building healthy bones. Good quality studies have even linked high calcium intake with increased risk of bone fracture. This is most likely because calcium must work alongside other nutrients to build and maintain healthy bones.

Calcium must be absorbed and retained effectively to benefit bones. This requires two more nutritional helpers: magnesium and vitamin D. These three nutrients work synergistically – none is effective without the others.

60% of the magnesium in our body is stored in our bones. Magnesium works hand in hand with calcium by stimulating the hormone calcitonin which helps to draw calcium into bone and keep it there. Magnesium is also required in order to convert vitamin D to its active form.

Unfortunately many of us fail to meet the recommended daily intake of magnesium. Deficiency in this mineral is a particular concern for girls. In a recent national survey, more than 50% of girls between the ages of 11 and 18 had inadequate magnesium intake, putting them at risk of osteoporosis in later years.

Vitamin D is also essential for calcium absorption, helping to transport calcium out of the intestine and into the bloodstream. An estimated 60-70% of the UK population are low in Vitamin D. Elderly people and darker skinned populations are at particular risk of osteoporosis due to this. It is difficult to obtain sufficient Vitamin D from diet alone. Supplements or sun exposure (around 15 minutes each day) are the best ways to obtain the daily requirement of this vitamin to support healthy bones and prevent osteoporosis from occurring.

Nutrients for Bone Retention

Building healthy bone is only one part of the picture. Once healthy bone has been built, it is important to ensure that it is retained. Preventing bone from being broken down is essential in warding off osteoporosis. Special compounds in plant foods play a key role in preventing bone from being broken down. These compounds have ‘bone resorption inhibiting properties’. They support bone health by ‘turning off’ osteoclasts, the cells that break down bone tissue.

Dried plums, a source of phenols, have been shown in human studies to improve bone density by preventing bone breakdown. Other phytonutrients such as quercetin and hesperidin, present in fruits and vegetables such as onions, broccoli and citrus fruits, show similar benefits. Including these fruits and vegetables regularly alongside sources of calcium, magnesium and Vitamin D is the key to nourishing strong and healthy bones, therefore preventing osteoporosis in later life [2].

Bone Boosting Recipes

Dried Plum ‘Bone Booster’ Snack Bars

Prep Time: 10 minutes Cook Time: 30 minutes Serves: 8

Special phenolic compounds in dried plums increase levels of a hormone linked to bone formation. These compounds also help to prevent bone from being broken down. Dried plums, or prunes, are also high in antioxidants and provide an excellent source of potassium, boron and copper – essential nutrients for bone health. Soy flour provides a source of ‘bone boosting’ phytoestrogens, while almonds, pumpkin seeds and sunflower seeds are useful sources of calcium and magnesium. [3]

Ingredients

  • Olive oil cooking spray
  • ¼ cup Dried Plum (Prune) purée
  • ¼ cup honey
  • ¼ cup orange juice
  • 1 egg white
  • 2 tsp grated orange zest
  • ¼ cup soy flour
  • ½ tsp cinnamon
  • ½ teaspoon baking powder
  • ½ cup rolled oats
  • ½ cup whole almonds
  • ½ cup unsweetened shredded coconut
  • ¼ cup raw pumpkin seeds
  • ¼ cup raw sunflower seeds

Directions

Heat oven to 160°C. Spray an 8×8” baking pan with cooking spray and line with parchment paper, leaving the paper overhanging on 2 sides. In a large mixing bowl, whisk together dried plum purée, honey, orange juice, egg white and orange zest. In small bowl, whisk together flour, cinnamon and baking powder. Fold flour mixture, oats, almonds, coconut, pumpkin seeds and sunflower seeds into dried plum mixture.

Press mixture evenly into prepared pan. Bake about 30 minutes or until firm to the touch. Cool on rack; remove from pan, using paper to lift it out. Cut in four, then cut across in half to make 8 bars.

Nutrition Facts

Calories: 212
Cholesterol: 0mg
Total Fat: 12g
Saturated Fat: 4g
Sodium: 41mg
Carbohydrate: 22g
Protein: 6g
Fibre: 3g
Potassium: 159mg

‘Better Bones’ Banana Oat Bars

Makes one 9×9-inch pan. 6 Servings.

Oats and flaxseed provide lignans which support bone and hormonal health after menopause. Bananas provide potassium which helps to prevent loss of calcium from the body. Anti-inflammatory omega 3, in the ground flaxseed and walnuts, is linked with improved bone density. Special phenolic compounds in dried plums increase levels of a hormone linked to bone formation. These compounds also help to prevent bone from being broken down. Dried plums, or prunes, are also high in antioxidants and provide essential nutrients for bone health such as potassium, boron and copper.

Ingredients

  • 2 large, very ripe bananas
  • 1 teaspoon vanilla (optional)
  • 2 cups rolled oats
  • 1/4 cup pitted, chopped prunes
  • 1/4 cup chopped walnuts
  • 2 tbsp ground flaxseed
  • Grated nutmeg or cinnamon (optional)

Directions

Heat the oven to 180°C and lightly grease a 9×9-inch square baking dish with olive oil.

Peel the bananas and mash their flesh in a medium mixing bowl until no large chunks remain. Stir in the vanilla, if using. Add the oats and stir them in. Stir in the prunes and nuts.

Pat the thick mixture evenly into the baking pan. Sprinkle the top lightly with cinnamon. Bake for 30 minutes or until the edges just begin to crisp up.

Per serving:

Calories: 200
Fat: 4.9g
Fibre: 5.6g
Sugar: 10.7g
Protein: 5.5g

Written by Nadia Mason

References
1. Feskanich D, Willett WC, Colditz GA. Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr. 2003;77:504-511.
2. Hooshmand et al (2011) Comparative effects of dried plum and dried apple on bone in postmenopausal women. Brr J Nutr 106(6):923-30.
3. Gunn et al (2015) Nutrients Increased Intake of Selected Vegetables, Herbs and Fruit may Reduce Bone Turnover in Post-Menopausal Women 7(4): 2499–2517.

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New research links FOS and Bone Health

A recent study published in the Journal of Nutrition suggests a link between fructooligosaccharides (FOS) and bone health. It indicates that combining a calcium supplement with FOS is more effective than taking a calcium supplement alone (1).

The two-year study followed 300 post-menopausal women and measured markers of bone health. The women were randomly divided into three groups. One group of women were given a daily calcium supplement, while a second group were given a combination of calcium and FOS . The third group were given a placebo supplement. At the end of the study, measures of bone turnover and bone density were taken.

At the end of the study, there were no significant differences in bone density between any of the three groups. However, the results showed that the combination of FOS and calcium had the greatest effect on bone turnover.

Bone is constantly being broken down and rebuilt. The rate at which this happens is known as ‘bone turnover’ and is a known indicator of bone quality. The change in bone turnover markers in the women taking both FOS and calcium indicates ‘a more favourable bone health profile’ according to the researchers in this study.

FOS seems to enhance calcium absorption in the large intestine, and the researchers suggest that this is the reason for its effect on bone health. These findings certainly support the need for more research in this area, particularly for vulnerable groups such as postmenopausal women.

More about FOS

FOS or prebiotics are found in chicory root, jerusalem artichoke, asparagus, leeks, onion, beans, peas and lentils.
FOS or prebiotics are found in chicory root, jerusalem artichoke, asparagus, leeks, onion, beans, peas and lentils.

FOS is a prebiotic nutrient found in plant foods. Prebiotics are not digested, and simply pass through the body. In doing so, they act as ‘food’ for healthy bacteria in the bowel, boosting numbers of health-promoting acidophilus and bifidobacteria, and crowding out disease-causing bacteria. As well as improving calcium absorption, FOS also supports both digestive and immune health.

High concentrations of FOS or prebiotics are found in chicory root, jerusalem artichoke, asparagus, leeks, onion, beans, peas and lentils. FOS can also be taken in supplement form, and its sweet taste means that it works well mixed into oatmeal, yoghurt or smoothies, or simply used as a low-calorie sweetener to enhance flavour.

In the UK, most of us average an intake of around 12g of fibre each day – only half of the recommended amount. More research is still needed in the area of FOS and bone health. In the meantime, increasing fibre intake, and prebiotic foods in particular, seems a sensible measure to ensure the recommended intake for optimal health.

References

Slevin, M, Allsopp P, Magee M, Bonham V, Naughton J, Strain M, Duffy J, Wallace E, McSorley E. 2014. “Supplementation with Calcium and Short-Chain Fructo-Oligosaccharides Affects Markers of Bone Turnover But Not Bone Mineral Density in Postmenopausal Women”. Journal of Nutrition Jan 2014

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Potassium boosts bone health

A randomised, double-blind placebo-controlled trial has suggested that potassium citrate may have significant benefits for bone health (1).

The research involved 201 healthy elderly men and women who received supplements each day for 24 months. All of the adults received a calcium and vitamin D supplement each day. In addition, the adults were given either a daily potassium citrate supplement or a placebo pill.

After 24 months, bone mineral density was measured by x-ray. A special tool was also used to calculate the risk of fracture for each participant.

Potassium Citrate is strongly linked with bone health
Potassium Citrate is strongly linked with bone health

The researchers suggested that the benefits of the potassium citrate are a result of its alkalinity which helps to prevent calcium loss from bones. The food that we eat determines the pH balance in our bodies. If our diet is acid-forming, then the alkaline mineral calcium is leeched from our bones to restore pH balance. This calcium loss decreases bone mineral density, making bones very vulnerable. Potassium citrate gives the body the resource it needs to keep pH levels balanced without placing stress of the bones. It ensures that the bones are provided with sufficient back-up alkaline which can be stored by the bone ready to be used when alkaline compounds in the blood run short.

The modern diet is believed to have an increasingly acidic load owing to poor food choices. Potassium-rich fruits and vegetables are often overlooked in favour of acid-forming processed red meats, cheddar cheese, sodium, white flour and sugar. Over time, eating an imbalanced diet of excess animal protein, refined grains, sugar, alcohol and salt can cause your body to slip into a state of mild acidosis.

By making small adjustments to your diet, your body can use its mineral stores for building bone, rather than for fighting acidosis. You can shift to a more alkaline diet by making a few simple dietary changes:

  • Eat more than 5 servings of fruit and vegetables each day
  • Reduce intake of processed animal products
  • Replace grains such as wheat and white rice with more alkaline quinoa, millet and buckwheat
  • Drink water with a little freshly squeezed lemon or lime
  • Use potatoes, squash and other root vegetables as your energy-giving carbohydrate sources
  • Eat plenty of spices such as ginger, cinnamon and mustard
  • Try alkaline-forming supplements such as a good quality multivitamin and mineral formula, or a greens powder each day

Reference

1.Jehle S, Hulter HN, Krapf R (2012) Effect of Potassium Citrate on Bone Density, Microarchitecture, and Fracture Risk in Healthy Older Adults without Osteoporosis: A Randomised Controlled Trial. Journal of Clinical Endocrinology and Metabolism. Nov 15 (Epub ahead of print)

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Lack of Vitamin D a worry for the frail

Vitamin D has received a lot of attention both in research and in the media recently, and I recently wrote about the importance of this vitamin for expectant mothers and their children. It is becoming clear that adequate levels of vitamin D are critical at all stages of life. A new study published in the European Journal of Clinical Nutrition suggests that low levels of Vitamin D can increase the risk of death in frail, older adults (1).

Sunshine
Sunshine is one of the best sources of Vitamin D

The study, which analysed data on 4300 adults over the age of 60, found that inadequate Vitamin D levels increased risk of death from all causes by 30 percent.

‘Frailty’ is defined as a decrease in physical function, marked by symptoms such as slow walking, muscle weakness, low physical activity and unintentional weight loss.

The study found that those who had lower vitamin D levels were more likely to be frail. It also found that frail adults with low levels of vitamin D also had triple the risk of death over people who were not frail and who had higher levels of vitamin D.

The effect of Vitamin D on muscles and bones has indeed been known for some time. When Vitamin D receptors are activated within the cell, this stimulates new protein synthesis which affects muscle growth (2). In fact a prospective study found that Vitamin D supplementation increased the number of fast-twitch muscle fibres and improved muscle function in elderly women with osteoporosis (3). This is particularly interesting as it suggests that the protective effect of Vitamin D on fracture risk is not solely a result of its effect on bone mineral density. It may also be a result of improved muscle strength leading to better physical function and lower numbers of falls.

The study does not prove whether Vitamin D plays a causative role. In other words, it is not clear whether Vitamin D deficiency contributed to frailty, or whether frail adults were more likely to develop the vitamin deficiency because of health problems.

“If you have both, it may not really matter which came first because you are worse off and at greater risk of dying than other older people who are frail and who don’t have low vitamin D,” says study leader Ellen Smit. “This is an important finding because we already know there is a biological basis for this. Vitamin D impacts muscle function and bones, so it makes sense that it plays a big role in frailty.”

The researchers suggest that older adults should be screened for Vitamin D levels, and that they should spend more active time in the sun. A carefully managed diet can also help to boost levels. For example, oily fish such as salmon or mackerel can provide 350iu per serving, so try to include this a couple of times each week. Eggs can help too, with a single egg supplying 20iu of Vitamin D. For elderly people who spend little time outdoors it may be wise to supplement Vitamin D in order to ensure adequate levels, especially during the winter months. Sunlight is of course the best source, and just 20 minutes outdoors between the hours of 10am and 2pm will provide around 400iu of the vitamin.

Written by Nadia Mason, BSc MBANT NTCC CNHC

 References

1. E Smit, C J Crespo, Y Michael, F A Ramirez-Marrero, G R Brodowicz, S Bartlett, R E Andersen (2012) The effect of vitamin D and frailty on mortality among non-institutionalized US older adults. European Journal of Clinical Nutrition

2. Boland R. (1986) Role of vitamin D in skeletal muscle function. Endocr Rev 7:434-48.

3. Sorensen OH, Lund B, Saltin B, et al. (1979) Myopathy in bone loss of ageing: Improvement by treatment with 1 alpha-hydroxycholecalciferol and calcium. Clin Sci (Lond) 56:157-61.

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The importance of bone health

Bone health is an issue which is becoming increasingly more prominent in today’s society. According to the National Osteoporosis Society (1), one in two women and one in five men over the age of 50 in the UK will suffer with a bone fracture. This is mainly due to poor bone health which means that we all need to know how important it is to build and maintain strong bones.

In addition to weight baring exercise, nutrition is absolutely vital for establishing strong bones in childhood and adolescence as this is when the body passes through the bone growth stages to create individual peak bone mass. Within the 4 years surrounding an adolescent’s peak height, around 39% of their total body bone mineral is gained. This highlights how crucial this time is for building strong bones for the future as we go in to adulthood, as low bone mineral growth during youth is linked to the risk of developing brittle bones and osteoporosis in older age.

Fresh Orange Juice
Many Fresh Orange Juice's can be bought fortified with Calcium, Magnesium or Vitamin D.

Nutrients such as calcium, vitamins D and K and magnesium have all been specifically identified for bone health and having an influence on bone mineral density. A recent review (2) published in the journal Clinical Biochemistry focuses in particular on calcium’s effect on bone health. They reviewed numerous research papers looking into the effects of certain calcium rich foods on bone density.

For example, one study reported that women who had a lower intake of milk in childhood and adolescence had low bone density in adulthood and as a result they had a much greater risk of fractures later in life. Additionally, the authors reported on findings that with low intake of cow’s milk, even pre-pubertal children can have a higher risk of fractures which shows how important calcium intake is in early life.

As well as dietary calcium intake, calcium supplementation has also been found to be a fantastic contributor to bone mineral accretion. So be sure you add calcium to your family’s supplement regime to ensure all your bones are as strong as they can be to help prevent breakages.

Once peak bone mass is achieved around the age of 20 it needs to be maintained in the bone maintenance stage which lasts around 10-20 years. Then as we reach middle age our bone density starts to reduce by approximately 0.5–1.0% per year. However, it is important to note that female bone losses can be considerably more around the time of the menopause, at around 2–3% per year due to decreases in oestrogen levels. This represents a crucial time for maintaining bone density through our food and nutrition choices. Not surprisingly, calcium intake has been linked to the prevention of bone loss around this time.

Within the review paper, the research indicates that baseline calcium intakes of 500–1000 mg/day (meeting the recommended intake of 700mg a day) which were increased by 500–1200 mg/day prevented bone loss.

In order to be within this calcium intake, try to include the following foods into your typical day’s food intake, which combined equates to around 1578mg of calcium:

Typical servings: plain low fat yoghurt, 225g (415 mg of calcium), cheddar cheese, 40g (307mg), milk (around 300mg), pink salmon, 85g (181mg), Orange juice, calcium-fortified, 170ml (375mg). Dietary calcium is also available from sources such as other dairy products, bony fish, legumes, certain nuts (such as almonds and Brazil nuts), fortified soya milk and some fortified breakfast cereals also contain smaller amounts of calcium.

However, the report noted that most people’s calcium intake from dietary sources is often not sufficient especially for those that do not drink milk e.g. Chinese cultures. They therefore recommended calcium supplementation to meet the requirement. Vitamin D is also a great contributor to healthy bones on its own however when combined with calcium it has a much greater effect and the review noted that supplemental vitamin D combined with supplemental calcium can help to slow bone loss. This study included 1200 mg/day calcium and 1000 IU/day vitamin D supplementation and found that the two nutrients used together had a greater effect on maintaining bone density than when used individually.

It was also noted that calcium and vitamin D supplementation, at an intake of around 1000–1200mg calcium (depending on dietary calcium intake) and 800 IU vitamin D daily, is particularly important for those with osteoporosis or those at risk of its development. However, make sure that you are not exceeding the recommended upper limit of calcium which is 3,000 mg/day for children and adolescents aged 9–18 years, 2,500 mg/day for 19–50 year olds and 2,000mg/day for those aged> 50 years.

What all of this means it that it is really important to get enough calcium and vitamin D in both food and supplement forms to help keep bones healthy and strong, and also that your kids are getting enough to help build their bones for the future.

Written by Lauren Foster

(1) National Osteoporosis Society

(2) Zhu, K. & Prince, R.L. (2012) Calcium and bone. Clinical Biochemistry, p7.

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Why magnesium is important for health

In our efforts to remain healthy and youthful there is a lot of talk about antioxidants, omega oils, calcium and several other nutrients and yet we may have overlooked the missing link in our diets, the mineral magnesium.

Magnesium is the fourth most abundant mineral in the body and can be found in the teeth, bones and red blood cells.  In fact half is found in bone and the rest in soft tissue in the body.  The body jealously maintains about 1% of its magnesium within the blood making blood tests notoriously difficult to identify a deficiency (1).  Magnesium is our most interactive mineral.  It is essential for numerous biochemical reactions carried out within the body (over 350 in fact – more than iron and zinc combined) and interestingly the symptoms of magnesium deficiency are identical to those found in old age and include low energy levels, irregular heartbeat, clogged arteries, migraines and headaches, heavy metals build-up, high blood pressure and insulin resistance (2).

BetterYou Magnesium Oil
Magnesium – our most important mineral that we all overlook

A study published in 2005 (3) showed that a staggering 70% of the US population may be magnesium deficient and 19% didn’t even reach half the Recommended Daily Allowance, which has just been raised to 360mg in the UK.  People at serious risk of magnesium deficiency include the elderly, diabetics, children, those on low calorie diets, those over-indulging in alcohol and those engaged in heavy exercise and stressful lifestyles.

Modern Western diets

Unfortunately modern farming methods have depleted the soils and artificial fertilizer favours certain minerals over others.  Over processing food depletes magnesium levels as does increasing the shelf life of food.  Did you know that we lose over 80% of the magnesium in wholegrain flour when we convert it into white bread?  In fact, magnesium levels in our diet are half what they were hundred years ago.  Foods rich in magnesium include pumpkin seeds, nuts, wholegrains and dark green vegetables but these rarely feature within our daily staple diet.  In addition our calcium intake has never been higher (4).  Asian and African populations have a dramatically lower intake of calcium with little incidence of osteoporosis. Their magnesium intake however is at least double that of Western diets.

Magnesium deficiency develops over time so we often only notice problems when we experience changes due to age, the menopause or when our body is under stress.

Low Energy & Fatigue

Magnesium is a key mineral in the enzyme processes that convert food into energy and several studies show that individuals with low magnesium levels use more energy and therefore tire quickly.  Magnesium is critical for both the synthesis and secretion of insulin so diabetics are often found to be deficient in magnesium (5).

PMS & Hormonal Imbalances

Sufferers of PMS have significantly lower levels of magnesium suggesting a clear association.  In fact research by Dr David Thomas showed sufferers of severe PMS will tend to have common elements within their diet consuming only a quarter of their necessary magnesium but almost 80% more dairy and a staggering 275% more sugar (6)!

Insomnia

The inability to sleep may also be linked to magnesium deficiency.  If you find it difficult to sleep or find yourself waking up in the middle of the night with muscle spasms, cramps or stiffness you may benefit from higher levels of magnesium (7).

Bone Health

Although calcium is the most abundant skeletal mineral it is very poorly soluble on its own.  It requires sufficient hydrochloric acid (quantity of which reduces as we age) magnesium and vitamin D in order for it to be absorbed into the bone.  Calcium that is not made soluble cannot enter the bone and settles in soft tissue such as joints, muscles and in arteries as cholesterol plaque (8).

Cramps & Spasms

Magnesium is essential for the proper function of muscles.  Calcium is responsible for the contraction phase of muscles whilst magnesium is needed for the relaxation phase.  Cramping at night and irritating twitches in the eyelids are often clear signs of magnesium deficiency.  Restless Leg Syndrome, a poorly understood neurological disorder, responds favourably to magnesium chloride rubbed into the muscles (9).

Headaches

Many studies indicate that there is a relationship between headaches, migraines and low levels of magnesium in the bloodstream.  Magnesium helps to relax blood vessels, encouraging normalised oxygen flow to the brain (10).

Anxiety, Nerves & Irritability

A deficiency in magnesium can result in the symptoms of anxiety and irritability since magnesium is required for the manufacture of adrenal stress hormones.

Kidney Stones

Kidney stones, one of the most painful urinary disorders, have beset humans for centuries.  A kidney stone is a hard mass of chemicals from urine.  The most common type of kidney stone contains calcium oxalate.  Studies indicate that magnesium helps prevent recurrence of calcium oxalate kidney stones due to its effects on solubilising calcium in urine (11).

Skin problems

Magnesium is necessary for the elasticity and dermal protection of the skin and low levels will reduce skin cell health (12).

Magnesium absorption through the skin

Our intestines are simply not efficient at absorbing relatively large doses of magnesium from supplements and increasing the intake simply results in diarrhoea.  Absorption is dramatically reduced with poor digestive efficiency, particularly as we age or when unwell.  This is why hospitals will always favour a slow, gradual supply (IV drip) rather than an oral supplement.

Magnesium chloride is the form favoured by our bodies as it is the result of all other magnesium compounds being exposed to the hydrochloric acid in our stomachs.  Magnesium chloride is in fact the result of evaporation of sea water. As pure and as simple as that and it is perfectly suited to absorption through the skin.  Cardiff University has just completed the first clinical trial to produce evidence that magnesium is excellently absorbed through the skin (13).  And an earlier trial in 2010 showed that the body could remineralise five times faster by skin application than by oral supplementation (14).

Written by Andrew Thomas from BetterYou

References

1. Last, W., “Magnesium Chloride for Health & Rejuvenation”.
2. Cargue, Otto, Vital Facts about Foods, 1933, quoted in J.I. Rodale, Magnesium, the Nutrient that could Change your Life, Pyramid Books, New York, 1968; also see “Excessive Calcium causes Osteoporosis”, Sircus, Mark, “Magnesium and Calcium”
3. CSIRO Minerals Report DMR-2378, September 2004.
4. Karpf, Anne, “Dairy Monsters”, The Guardian, UK, 13 December 2003. 
5. Office of Dietary Supplements, “Magnesium”. King, D. et al., “Dietary Magnesium and Creactive Protein Levels”, J. Am. Coll. Nutr. 2005 Jun; 24(3):166-71
6. http://www.mywire.com/a/WorldWatch/Nutrients-declining-food-supply/1632863/
7. Davis, W. and Ziady, F., “The Role of Magnesium in Sleep”, Montreal Symposium 1976,  also see http://www.medicalnewstoday.com/ articles/70832.php
8.12.Sircus, Mark, AC, OCD, Transdermal Magnesium Therapy, Phaelos Books, Chandler, Arizona, 2006, p.199; see http://www. magnesiumforlife.com/ or http://www. magnesiumforlife.com/thebook.shtml
9. Restless legs syndrome is treatable but under-recognised. British Medical Journal. 2 September 2006; 333:457-458 doi:10.1136/bmj.333.7566.457
10. Vergini, R., MD, “Magnesium Chloride in Acute and Chronic Diseases”,  or http://www.industryinet.com/~ruby/ magnesium_chloride.html
11. Piesse, J.W., “Nutritional Factors in Calcium Containing Kidney Stones with Particular Emphasis on Vitamin C” (review article), Int. Clin.
13. National School of Pharmacy, Cardiff University. Pub date TBC.
14. A Pilot Study to determine the impact of Transdermal Magnesium treatment on serum levels and whole body CaMg Ratios, Josling & Watkins.  Date of publication 09/04/2010.

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Dried plums can help prevent osteoporosis

As a nutritional therapist, I am always interested in new dietary approaches to protect our health as we age.  I was particularly interested to read about a recent study which found dried plums to be of significant benefit in supporting bone health.

The study, published in the British Journal of Nutrition, found that eating dried plums increased bone formation in postmenopausal women.

Although bone is often thought of as inert, it is in fact a ‘living structure’, constantly being broken down and rebuilt.  This is a process known as ‘bone turnover’.  If bone is broken down more quickly than it is remade, then osteoporosis can result.  This condition is of particular concern to postmenopausal women who produce less of the bone-protecting hormone oestrogen.

Dried plums can help prevent osteoporosis
A recent study has found dried plums to be of significant benefit in supporting bone health (2)

The bone-thinning disease, osteoporosis, is in fact a major health concern in the UK.  In the over-50s, 1 in 3 women and 1 in 12 men are affected.

The study, conducted by Professor Bahram H. Arjmandi, tested the effects of daily consumption of 100g dried plums on the bone density of 55 postmenopausal women over a 12 month period.  A control group were given 100g dried apples.

Bone health in the women was measured at 3, 6, 9 and 12 months, by measuring markers of bone turnover in the blood.  X-rays were also used at these intervals to assess bone mineral density.

Over the 12-month period, dried plums resulted in increased bone density of both the ulna (a bone in the forearm) and the spine.  No such effect was seen in the group taking the dried apple.

Professor Arjamandi reasons that the special phenolic compounds in dried plums increase levels of a hormone linked to bone formation.  These compounds also help to prevent bone from being broken down. Dried plums, or prunes, are also high in antioxidants and provide essential nutrients for bone health such as potassium, boron and copper.

Introducing dried plums into the daily diet may therefore be a positive step in the prevention of osteoporosis.  “Don’t wait until you get a fracture or you are diagnosed with osteoporosis and have to have prescribed medicine,” Arjmandi suggests, “People could start eating two to three dried plums per day and increase gradually to perhaps six to ten per day.  Prunes can be eaten in all forms and can be included in a variety of recipes.”

Dried fruits certainly offer a variety of health benefits, as they are higher in fibre and phenols, and are more nutrient-dense, than fresh fruit.  For those interested in maintaining or improving their bone health, this initial research suggests that introducing prunes in particular to the diet could be a positive step.

Written by Nadia Mason

References

1.  Shirin Hooshmand, Sheau C. Chai, Raz L. Saadat, Mark E. Payton, Kenneth Brummel-Smith, Bahram H. Arjmandi.Comparative effects of dried plum and dried apple on bone in postmenopausal women. British Journal of Nutrition, 2011; 1 DOI: 10.1017/S000711451100119X

2.  Image courtesy of Just4you.

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The sunshine vitamin: Vitamin D and healthy immunity

New research supports the link between vitamin D and a healthy immune system.  The recent study of almost 7,000 adults in the UK has confirmed a link between Vitamin D levels and the risk of infection (1).

Vitamin D - The Sunshine Vitamin
New research supports the link between vitamin D and a healthy immune system. (5)

Natural sunshine can provide our bodies with up to 10,000iu vitamin D each day.  This ‘sunshine vitamin’ helps to boost the body’s defences by increasing levels of ‘anti-microbial peptides’.  Working like natural antibiotics, these peptides mount an attack against unwanted infections.

During the winter months, infections such as colds, flu and chest infections are common.  It is believed that this increased risk of infection is due in part to the lower levels of vitamin D that we receive in the colder months.

There is however increasing concern over vitamin D levels throughout the year. After all, most of us are careful to protect our skin from the sun during the summer months, a sensible measure to help prevent burning, premature skin ageing and to protect against skin cancer.
The study, conducted by researchers from University College London, looked at the relationship between Vitamin D levels and infection. Higher levels of vitamin D were linked with lower risk of infection.

For each 10nmol/l (4ng/ml) increase in vitamin D, the risk of infection dropped by 7 per cent.  The researchers discovered a further link between higher vitamin D levels and better lung function.

While this particular study was epidemiological in nature, it will be interesting to see how future controlled trials will further our understanding.  After all, vitamin D not only supports the immune system and bone health.  More recently, deficiency has been linked with cardiovascular disease, impaired glucose tolerance, poor muscle development and certain types of cancer (2).  The Department of Health now recommends that certain groups in the UK population should take daily vitamin D supplements (3).  These groups are:

• all children aged six months to five years old
• all pregnant and breastfeeding women
• all people aged 65 and over
• people who are not exposed to much sun, such as those who are confined indoors for long periods

BioCare BioMulsion D
BioCare’s BioMulsion D provides 2000iu vitamin D in just two drops

• people with darker skins such as people of African-Caribbean and South Asian origin

While vitamin D can be obtained in the diet through oily fish such as salmon and sardines, it is generally believed that supplementation is the most viable way of ensuring adequate intake.  A recent European policy document concludes that “only vitamin D supplements or vitamin D enriched food products are truly viable options for optimising the vitamin D status” (4).

Bolstering your vitamin D levels can be as simple as spending some time outdoors every day, while ensuring that you eat vitamin D enriched foods such as breakfast cereals, milk, margarine and soy drinks.  Those who would like to take an easily absorbed supplement might consider an emulsified liquid vitamin D such as Biocare’s BioMulsion D which provides 2000iu vitamin D in just two drops.

 

Written by Nadia Mason

References:

1. Berry DJ, et al. Vitamin D status has a linear association with seasonal infections and lung function in British adults. British Journal of Nutrition. Available on CJO June 2011 doi:10.1017/S0007114511001991

2. Vieth R, Bischoff-Ferrari H, Boucher BJ, Dawson-Hughes B, Garland CF, Heaney RP, Holick MF, Hollis BW, Lamberg-Allardt C, McGrath JJ, Norman AW, Scragg R, Whiting SJ, Willett WC, Zittermann A. The urgent need to recommend an intake of vitamin D that is effective.  Am J Clin Nutr 2007;85:649–50. 

3. NHS Choices. “Vitamins and Minerals – Vitamin D”.  Web article. Visited on 30th June 2011.

4. The Standing Committee of European Doctors. Vitamin D Nutritional Policy in Europe.  March 2010. Visited on 30th June 2011.

5. Image Ccourtesy of  digitalart.

 

 

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Fish and fish oils may be important for bone health

The long chain omega 3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), found in oily fish such as salmon, mackerel, trout and sardines, play an important role in optimal health.  As previously mentioned in my blog posts they are important for our hearts, brain, eyes and may protect against various conditions.  There is also some evidence to suggest that these fatty acids are important for bone health and perhaps prevent against osteoporosis and osteoarthritis.

Pharma Nord Bio Fish Oil
A new study has found that fish consumption may protect against bone loss.

A new study published in the American Journal of Clinical Nutrition (1) has found that fish consumption may protect against bone loss.  The study aimed to look at the association between dietary intake of fatty acids and fish and bone mineral density in older adults (average age of 75 years).  The study tracked changes in bone mineral density over a four year period.

The results of the study showed that high intakes of fish, 3 or more servings of fish a week, were associated with maintenance (ie no changes) in bone mineral density in men and women.  The study was only an association study so it does not prove that eating fish can prevent bone loss in old age however, previous studies  have also found that eating a diet rich in fish or having good intakes of the fish oils EPA and DHA, may contribute to a reduced risk of osteoporosis.  It is thought that the fish oils may be working to protect bone through their anti-inflammatory actions.  Inflammation in the body is known to be involved in the process of bone loss.

More evidence and further research is needed before firm conclusions can be drawn, however, oily fish has been shown in numerous studies to benefit health so including at least 2 servings a week in the diet is a good idea.   For individuals who don’t regularly eat fish a fish oil supplement rich in DHA and EPA may be worth considering but it is always best to check with a medical doctor prior to starting any new supplement regimen.

A healthy diet is important for strong, healthy bones.  Calcium, vitamin D are well known to be important for healthy bones but there are many other nutrients that are involved in bone strength such as magnesium, zinc, copper, potassium, silicon, manganese, vitamin K, vitamin C, vitamin B and phytonutrients – biochemical plant compounds found in fruits and vegetables.  A varied, healthy diet, especially on rich in fruits and vegetables and unprocessed unrefined pulses, beans, nuts/seeds and wholegrains, will provide a huge array of nutrients that may positively impact bone health.  Please read my other posts relating to bone health for more information on how good nutrition may be helpful to keep bones strong.

(1)  Emily K Farina EK et al.  2011.  Protective effects of fish intake and interactive effects of long-chain polyunsaturated fatty acid intakes on hip bone mineral density in older adults: the Framingham Osteoporosis Study.  Am J Clin Nutr.  93:1142-1151.

Written by Ani Richardson

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The importance of vitamin D for calcium utilisation in the body

 In January  I wrote about the benefits of combined calcium and vitamin D supplements for fracture prevention.  Many adults, particularly women, are interested in eating for bone strength and prevention of osteoporosis (or brittle bones).

Many people still assume that a higher calcium intake is key for osteoporosis prevention.  As you can see from the posts linked above there are many nutrients that interact to protect our bones.  Calcium is, indeed, very important for bones however, recent evidence (1) seems to suggest that increasing calcium intakes may not help bone strength if the body is deficient in vitamin D, or body levels are insufficient.  This is a worrying concern since, as you will know from my past posts on vitamin D, most people in the UK have insufficient levels of this crucial vitamin.

This recent study (1) explored the importance of dietary calcium intake and blood serum vitamin D status with regards to bone mineral density in about 5000 women and men.  The researchers found that among men and women vitamin D status seemed to be the dominant predictor of bone mineral density relative to calcium intake.  The study highlights the importance of vitamin D and its ability to help the body utilise calcium efficiently, thus helping to explain why increasing calcium intakes alone is not always a successful way of dealing with osteoporosis prevention. 

Calcium is vital for bone mass, but nutrient interactions do need to be taken into account.  “The study supports the idea that correcting inadequate blood levels of vitamin D is more important than increasing dietary calcium intake beyond 566 mg a day among women and 626 mg a day among men for better bone mineral density” (2).  It seems that only women with the very lowest vitamin D levels seemed to benefit from higher calcium intakes.

Again, this adds to the evidence for the importance of vitamin D, to recap: most people in the UK do not get enough vitamin D and have insufficient/deficient levels in their blood.  There is no current consensus about the amount of daily vitamin D intake necessary to maintain blood levels at around 40-50 nmol/l (which is currently seen as optimal by many medical practitioners).  Most adult (age 18 and over) individuals in the UK would probably require a supplement of around 2000iu vitamin D daily.  It is always a good idea to check with a medical doctor prior to starting any supplement regimen.  Higher doses, up to 5000iu daily, may well be useful but I would not recommend such a regimen unless under the supervision of a medical doctor who can monitor blood levels regularly.  When looking for vitamin D supplements two forms are generally available.   Cholecalciferol, known as vitamin D3, and ergocalciferol or vitamin D2. Cholecalciferol is generally taken to be the more potent, easily absorbed and preferred form of vitamin D.

 (1)Bischoff-Ferrari HA et al.  2009.  Dietary Calcium and Serum 25-Hydroxyvitamin D Status in Relation to BMD Among U.S. Adults. Journal of Bone and Mineral Research.  24 (5): 935- 942

(2)Press release.   USDA/Agricultural Research Service (2010, March 15). Vitamin D and calcium interplay explored. ScienceDaily. Retrieved March 15, 2010, from http://www.sciencedaily.com­ /releases/2010/03/100312133716.htm

Written by Ani Kowal

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