Bone Buffet Part 3

In part 1 we discussed some of the major players in bone health, including vitamin D, magnesium and calcium. In part deux, we discussed K2 and its role in helping the bones stay strong. In part 3 we now discuss exercise and its effect on the bones.

Squatting will build you some strong hip bones

Squatting will build you some strong hip bones

Just like muscles need stimulus to grow, bones need stimulus to stay strong. Stimulus is in this case another word for load bearing exercise. The body is a marvelous adaptive machine that will change its structure as needed to cope with its environment. If little load bearing activity is done, there is little reason that the bones would need to be as dense because there is no load. Essentially your body recruits what it needs for the job. If you are moving a piano out of your house and into a new one, you’ll probably recruit some stout men with muscle to do it. But if you’re only moving a few light boxes now and again you won’t need those manly men to help. Your body is no different. If you’re not moving pianos regularly there is no reason for your body to get muscular and your bones to get stronger.

In one study, sedentary females were randomly assigned to either a training or a control group. The training group did progressive high-impact exercises 3x per week for 18 months. Bone mineral density (BMD) was measured at different sites in the lower limbs by x-ray absorptiometry. Women in the training group had increased measurements in the femoral neck, a common hip fracture site. No difference was seen at non-weightbearing sites. While this study doesn’t look directly at breaks, BMD is important to keeping the bone stronger if a fall is to occur. 1

Another study looked at the back muscle strength of elderly women aged 58-75 years old. 27 women had performed progressive resistive back-strengthening exercises for 2 years and 23 were controls. The BMD in the spine was the same after 2 years, but after the 10 year follow-up the women who had done the exercise had the higher BMD. There were a total of 14 vertebral fractures in the control group and 6 in the exercise group, a difference that was significant. 2

In a meta-analysis out of the Netherlands researchers found that in randomized controlled trials, reduction or reversal of bone mass was consistent for both the lumbar spine and femoral neck, common fracture sites. 3

Another study looking at young men 19-25 years assessed the effects of high intensity powerlifters with lower intensity “recreational trainees” and control. While the high intensity lifters experienced increases in BMD in the spine, femoral neck and trochanter, the lower intensity and control had no differences except in the trochanter region. 4 It seems that lifting in a manner that defies gravity is what really makes the bones want to get stronger. Load bearing exercise such as jogging, stair climbing, squatting and deadlifting force your skeleton against gravity. Non-load bearing exercise like swimming and cycling, while also very good at conditioning, don’t do so much for the bones in terms of density.

Good eats with the proper nutrition and good exercise with the right emphasis in load bearing types of activities are good for your bones. Staying active and proper nutrition is really important for all aspects of life though not just your bones. The nutrients we discussed in part 1 and deux are important for not just bones but other aspects of life and exercise keeps your body and your brain sane and functioning. I personally believe that the biggest obstacle for most people when it comes to lifestyle is their brains telling their bodies they can’t do something. As soon as the brain gives up the body doesn’t stand a chance. Find something fun that you enjoy doing and can do regularly and eat clean and healthy most of the time. I think a piece of cherry pie is ok once in a while, but I can count on one hand how many times a year I get it. I should probably be nicer to myself.
CIAO

1. Heinonen, Ari, et al. “Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures.” The Lancet 348.9038 (1996): 1343-1347.
2. Sinaki, M., et al. “Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women.” Bone 30.6 (2002): 836-841.
3. Wolff, I., et al. “The effect of exercise training programs on bone mass: a meta-analysis of published controlled trials in pre-and postmenopausal women.” Osteoporosis international 9.1 (1999): 1-12.
4. Tsuzuku, S., et al. “Effects of high versus low-intensity resistance training on bone mineral density in young males.” Calcified tissue international 68.6 (2001): 342-347.

Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.

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Bone Buffet Part Deux

Bring on the Bone Buffet Part deux

Last time we talked about some of the nutrients that are needed for bone health. Vitamin D, calcium, phosphorus, and magnesium are all important components. We also discussed some of the problems with just using vitamin D and calcium, those being that although they do seem to help in some cases, they don’t help in all cases. What else do we need?

Vitamin K2

K2

K2

K2 is a fat soluble vitamin which has different biological properties than K1. K1 (phylloquinone) is what is found is green vegetables and is responsible for the clotting of the blood. K2 (menaquinone) has different functions in the body, although it may also help in coagulation of blood. One of the main functions seems to be in how calcium is used in the body. K2 helps Gla protein and osteocalcin in bone formation. Chris Masterjohn has a great article about it here: http://www.westonaprice.org/fat-soluble-activators/x-factor-is-vitamin-k2#bone.

Commercially available preparations exist as two main forms; MK4 and MK7. Others are available but these two forms are the most studied. MK4 has a shorter half-life and for clinical purposes may necessitate a multiple dosing regimen per day to be effective for those who want to supplement. MK7 is the form that is found in Natto and also commercially. It has a longer half-life and probably only needs to be taken once daily.

Lets take a look at some of the studies that make K2 a winner and part of your bone buffet.

In a meta-analysis researchers looked at several studies using K2 and looking at fractures. The results were overall very good. K2 decreased hip, vertebral and all other fractures significantly over placebo. 1

A 2 year study in Japan showed that the incidence of spine fracture was reduced by 19.4% with patients taking 45mg K2 per day over placebo. Both groups were taking 120mg elemental calcium per day. 2

In another study out of Japan, subjects received either calcium, vitamin k2, etidronate (a bisphosphonate/osteoporosis drug) or both etidronate and K2. The group on both K2 and etidronate had the least amount of fractures. K2 alone was about the same as etidronate alone and calcium alone faired the worst. The graph is showed here. 3

K2 alone does as well as a drug and in combination really decrease fractures

K2 alone does as well as a drug and in combination really decrease fractures

One problem with a lack of vitamin K is arterial calcification. This is that soft tissue calcification that I was discussing in the last article. It appears that vitamin k is useful for keeping the arteries clear of calcium. This is discussed in an article. 4 In another article, researchers compared two groups of people, 1 group using coumarins (blood thinning drugs) and healthy controls. They found that the degree of calcification in the subjects using coumarins had more arterial calcification in the femoral artery than those not using them. 5 Calcification in the arteries is a really bad thing. I mean really bad. This is one of the steps toward creating clots and creating blockages that could easily become fatal.

K2 seems to be a winner is this bone buffet. K2 also seems to be linked with cardiovascular health and cancer. That will likely be a topic coming soon. So where do you get K2?

Butter from grass fed cows, egg yolks, chicken liver, goose liver, Brie and Gouda cheeses and Natto (fermented soy) are all natural sources.

Butter is one of my favorite sources of fat soluble vitamins!

Butter is one of my favorite sources of fat soluble vitamins!

It is the bacteria in your gut that determine how much you get without eating these types of foods. It is speculated that some people who have absorption issues may not absorb the K2 like others would, increasing the need for supplementation and the need to heal up the gut. The supplements mentioned above are available online. I will say that the doses used in the studies are typically 45mg/day. The online brands are between 100mcg and 1000mcg. So if you got the 1000mcg dose (1mg) you’d need 45x that to match the studies. I don’t know if that amount is truly needed or if smaller amounts would work just as well, but it is something to consider. I believe Thorne makes a liquid form that will more easily get you that amount, but it’s expensive for a 30 day supply.

A dose of 45mg/day doesn’t appear to be harmful so taking that amount should be fine. The RDA isn’t established but reference intakes are around 100mcg/day.

In part 3 we’ll discuss 1 more key factor in good bone health…stress!

CIAO

  1.  Cockayne, Sarah, et al. “Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials.” Archives of internal medicine 166.12 (2006): 1256.
  2. Shiraki, Masataka, et al. “Vitamin K2 (menatetrenone) effectively prevents fractures and sustains lumbar bone mineral density in osteoporosis.” Journal of bone and mineral research 15.3 (2000): 515-521.
  3. Iwamoto, Jun, Tsuyoshi Takeda, and Shoichi Ichimura. “Combined treatment with vitamin K2 and bisphosphonate in postmenopausal women with osteoporosis.” Yonsei Medical Journal 44.5 (2003): 751-756.
  4. Theuwissen, Elke, Egbert Smit, and Cees Vermeer. “The role of vitamin K in soft-tissue calcification.” Advances in Nutrition: An International Review Journal 3.2 (2012): 166-173.
  5. Roger J. M. W. et al. “Chronic coumarin treatment is associated with increased extracoronary arterial calcification in humans.” Blood Journal 2010 115: 5121-5123

Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability  for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.

Bone Buffet Part 1

There has been a lot of talk over the past decade or so of howHive 5 skeleton bones need vitamin D to be strong. Doctors give out vitamin D and calcium all the time at the pharmacy and many people take them on their own because they think they need both the calcium and the D to have strong bones. While it is true that humans do require calcium and vitamin D for strong bones it’s a bit like saying that if I eat lots of protein my muscle are going to be Greek god status and awesome. While it’s true that your muscles need plenty of protein to get big and stay big, eating lots of protein in and of itself will do absolutely nothing to grow muscles. So what’s the deal with bones?

Minerals

Bones are made of calcium phosphate crystals that are on a collagen matrix. Calcium is important just as phosphorus is important for the imbedding of these crystals in the matrix. Osteoblasts (bone cell builders) lay down the materials to build bone, while osteoclasts (bone cell destroyers) will break down these crystals and liberate the calcium into the blood stream. This process is happening all the time. Parathyroid (PTH) hormone is one of the hormones responsible for this process.

PTH also increases activated vitamin D production for use in the gut so more calcium is absorbed. Magnesium is needed for proper function of the cells in the bone and calcium regulation due to vitamin D. Magnesium is also needed for the conversion of active vitamin D. If a person is taking vitamin D and is already low on magnesium, the body will get it from somewhere and the muscles are likely to suffer from depletion, causing twitching, restless leg and cramping, according to Dr. Carolyn Dean. 1 She even says angina and heart attacks may be a magnesium deficiency problem, but that’s for another post. Studies looking at bone density and magnesium intake haven’t been very conclusive one way or the other however. So if we have a magnesium deficiency we potentially have a problem with vitamin D and sensitivity to PTH and responsible for bone health. 2,3

Calcium is important because that is primarily what our bones are made of, at least the inorganic part of them. Along with phosphorus, these two combine to make the crystals that form the rigidity of the bones.

Vitamin D

Vitamin D of course is a big player in this game. D helps with calcium absorption and helps maintain a normal level of PTH indirectly. People with high levels of PTH all the time have low bone density and are at higher risk for fractures. The problem we see though is that some studies show that D alone or in conjunction w/calcium either do little or nothing depending on the study. What gives?

One study looked at several studies containing thousands of patients. The patients were primarily elderly people in institutions. Vitamin D alone didn’t seem to do much, while vitamin D and calcium did reduce the risk of hip and non-vertebral fractures, but there wasn’t any difference with vertebral fractures.3 When looking at patients who received vitamin D analogues, the risk of hypercalcaemia (too much calcium in the blood) increased.

One study from the Women’s Health Initiative looked at Vitamin D 400IU and Ca 1000mg daily. The risk of vertebral fractures went down, but the hip fractures stayed the same. 5

Problems

One problem that has been highlighted in the last couple of years is the increased risk of cardiovascular disease with the use of supplemental calcium and vitamin D. In the Women’s Health Initiative researchers found an increase risk of cardiovascular events if they weren’t taking them at the beginning of the study. Women who were already taking them didn’t seem to be at increased risk. 6

Soft tissue calcifications have also been reported with calcium supplementation. You read about those from time to time on different websites and on the news and indeed that is a problem if it is occurring. The only tissues that are supposed to be calcifying are teeth and bones. Calcifications in the arteries are indeed problematic for people because they lead to heart disease and death. I will discuss this more in Part 2, but if this is happening then it needs to be stopped because calcification of soft tissue really is a problem.

I personally don’t think supplementation with calcium is always necessary. For people that can tolerate dairy, it is a good source of calcium. Leafy greens are also an excellent source and should be part of a diet anyway. Spinach, kale and collard greens will get you there. Sardines are also a great source. People who used the buffered form of vitamin C also get some calcium from those tablets (buffered C is usually Calcium Ascorbate). A balanced and healthy diet will get you all the calcium you need.

Vitamin D is present in certain foods like milk (added) and certain fish (oysters, salmon) as well as eggs. Most of the D is made by our bodies though when our skin comes in contact with the UVB from the sun. The only problem is most of us are indoors and for only 4 months or so a year are the rays actually strong enough to create D. Cod liver oil is a great way to get both A and D and then of course there is supplementation. If that is the route you’re going, use D3 as it is the type that we produce before it’s converted to its active form.

Magnesium is also problematic because according to some research, almost 70% of Americans are magnesium deficient. 7 Magnesium can be obtained from nuts and greens. Supplements exist as well. Ionic magnesium can be purchased in water from WaterOz in Idaho. Magnesium orotate and glycinate are also very good and absorbed well. I would avoid Magnesium oxide unless you’re looking for a good laxative and nothing else. It doesn’t get absorbed well and really does have the ability to clear out your bowels. I also think taking magnesium 2-3 times a day at smaller doses is better than 1 bigger dose daily. It gives the bowel a chance to absorb smaller amounts of magnesium and doesn’t overload it to cleanse your bowel, like magnesium oxide will. I might add that I have anecdotal reports from people that say the magnesium helps them relax and sleep better.

These nutrients are essential to bone health. They are indeed part of a buffet for your bones, but they aren’t the whole story. I think many of the studies performed have not shown really good results for bone health is because the researchers are too focused on 1 or 2 things and aren’t looking at the whole picture. Again I think it’s the whole “eat lots of protein to build big muscles” analogy. It’s true you need these nutrients for bones, but there is more to it than that. We’ll explore more of this is part 2.

CIAO

1.    http://www.naturalnews.com/042007_magnesium_bone_health_dr_carolyn_dean.html

2.  Carpenter, T. O. “Disturbances of vitamin D metabolism and action during clinical and     experimental magnesium deficiency.”  Magnesium research: official organ of the International Society for the Development of Research on Magnesium 1.3-4 (1988): 131

3.   Zofková, I., and R. L. Kancheva. “The relationship between magnesium and calciotropic hormones.” Magnesium research: official organ of the International Society for the Development of Research on Magnesium 8.1 (1995): 77.

4.   Avenell, A., et al. “Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis.” ACP J Club 144.1 (2006): 14.

5.   Cauley J, et al “The Women’s Health Initiative calcium plus vitamin D supplementation trial: Health outcomes 5 years after trial completion” ASBMR 2012; Abstract 1136.

6.   Bolland, Mark J., et al. “Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis.” BMJ: British Medical Journal 342 (2011).

7.   “Dietary Magnesium and C-reactive Protein Levels,” Journal of the American College of Nutrition, Vol. 24, No. 3, 166-171 (2005).

Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability  for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.