Bone Mineral density

Amino Man Nutritional Medicine Handbook Summary

Bone Mineral Density (BMD)

This year we had a broken toe in the family, a friend who has developed osteoporosis, a colleague who's mum's broken her arm. So I though it was time to share the love on bone mineral density.

The information in here took over 2 weeks to write. It was presented at the FA medical conference a couple of years ago.

Take home for the busy reader;

Rickets is on the increase cause kids don't go outside and play much anymore
Calcium intake isn't a given - especially in weight category or aesthetic sports - keto or paleo also struggle here
Vitamin K2 is at least as important as vitamin D for BMD - that's why both are in my vitamin D/K2 formula - along with other cofactors for bone mineral density
Supplementing with calcium on it's own is probably dangerous - if you do this you can contact me for some advice, I'll tell you to use vitamin D/K2 + collagen and use a bioavailable type of calcium called MCHC
Boron is a trace mineral which stops your body excreting too much calcium. There's plenty in Male Plus.

Sometimes the tables get lost when the emails get sent out - if you can't see them email me and I'll send the word document.

If you know anyone who would benefit from this information please do share it. As always if you enjoy it please have a look at some of the things I create on www.aminoman.com 

The second book in this 3 book series will cover all these aspects in high detail, along with other more detailed protocols and information relating to nutritional interventions to improve human performance.

In this book you will need to know the basic structure of this approach in order to best make use of the recipes, ingredients and new foods you will be eating.

These are sometimes called systems, or a biological systems approach. 

For the purposes of this book we can boil the systems down into 5 phases of how our body relates and interacts with our food intake;

Here are the pillars picked apart in a bit more detail. We’ve discussed the energy in and out in the previous chapters, relating to insulin, fasting and feeding states. As well as macro nutrients, quality, quantity, ratios and feeding windows.

Now we are going to look at structure, form and function the bones, muscles and joints. I want us to build back from the ashes as it were, thinking of the skeleton, then the joints, muscles, the mechanisms which provide energy to these structures the heart then the central function of the brain and CNS. Organs and hormones we’ll touch on also as part of this journey.

Our survival relies on the stress response and optimal immune function. Oxidative stress, inflammation and repair and detoxification will be covered here.

The final part of this section will look at what the body does, we sleep, we move, we interact. We have happiness, positivity and forward thinking, sex and reproduction, stress and depression at times and creativity, play family and community. All of these are vital for health and longevity.

  1. FORM AND FUNCTION, BONES, MUSCLES AND JOINTS.
  2. Heart, Blood, Oxygen and energy production – muscles.
  3. Brain & CNS.
  4. Hormones and organs.
  5. Stress Response, adrenals, thyroid and fatigue.
  6. Immune Response, inflammation & oxidative stress.
  7. Digestion and detoxification.
  8. Movement and exercise
  9. Being human.

Where relevant we will look at what these systems rely on nutrients wise, how they are built and repaired and the mechanisms which support these functions.

Them Bones, them bones then dry bones

What is bone made from?

Seeing what the bone is composed of gives us an idea of the types of things we need to eat more of in order to improve and maintain bone mineral density. Bone mineral density can be measured using DEXA and is given a T-score. You can also measure this using bio-impedance. A healthy bone needs good density but also good flexibility. The density is about calcium and other minerals, the flexibility is about the collagen component.

Bone is rich in collagen (33%) a type of protein we get from collagen consumed in home-made bone broth, supplements and eating collagen rich parts of animals. We can form collagen from amino acids, key ones are glycine, proline, hydroxyproline and lysine. Cofactors in forming proper cross linking and collagen structure include vitamin C, copper, iron and manganese. Copper, manganese and zinc supplementation with calcium shows greater effects on bone mineral density than taking the trace minerals or calcium alone. Taking care of collagen intake and cofactors goes a long way to helping with BMD.

How do minerals get into bone?

Vitamin D is a crucial factor in integrating calcium into the bone matrix. Low vitamin D is associated with higher bone loss and osteoporosis. Magnesium also regulates calcium uptake into bone and vitamin K2 is another critical component in regulating calcium. It specially keeps calcium in the bones and away from soft tissues thereby preventing hardening of arterial walls and calcification in general. So if you take vitamin D, cofactors are highly necessary and essential if you also consider calcium supplementation. The best type of calcium is called MicroCrystalline HydroxyApatite (MCHA). Although all forms of calcium will aid in deficiency. Coral calcium may also be a better choice. 

As with many systems in the body there’s a complex array of factors and cofactors necessary for forming and retaining bone mineral density. If one trace mineral is deficient proper bone formation can be compromised.

As well as calcium(39%) and phosphorus (17%), bone contains small amounts of many other minerals and proteins, which may include:

  • Magnesium (up to 1% of bone mineral content)
  • Sodium
  • Potassium
  • Manganese
  • Strontium
  • Zinc
  • Copper

 The following co-factor nutrients are also involved in bone metabolism:

  • Vitamin D
  • Vitamin K
  • Vitamin C
  • Boron
  • Vitamin B6
  • Iron

Calcium and calcification.

Because calcification is essentially part of aging, avoiding excessive early onset calcification is desirable. Calcium supplementation has been shown to correlate with adverse health outcomes associated with calcification e.g. atherosclerosis and heart disease. Calcium should be maintained directly through dietary sources where possible outside of specialist of preferentially followed dietary practices.

Diets which limit and are associated with lower calcium intake include keto, lower carb higher protein, lower and severely calorie restricted diets and paleo. Although you can get adequate calcium following these diets you normally have to make a special effort to do so. In these situations a combination calcium and cofactor supplement regime maybe warranted.

Here’s a list of calcium rich foods;

Sources: British Nutrition Foundation, 2005; Titchenal & Dobbs, 2007; Nutritiondata.self.com 

The table shows that:

  • The amount of calcium in a food doesn’t tell the whole story – we also need to consider how well it’s absorbed
  • Calcium absorption from dairy is only around 32% - some sources are better absorbed, some worse
  • Compared to dairy foods, we can get a similar amount of absorbable calcium in non-dairy foods such as tinned fish (with bones), and some greens such as bok choy and kale
  • On the other hand, some plant foods may have a high content of calcium but poorly absorbed (e.g. spinach). In this case, likely due to the content of oxalic acid (oxalates).

As mentioned above excessive calcium supplementation can be harmful;

Calcium supplementation has been associated with adverse effects, including:

  • Increased risk of cardiovascular events, including MI and stroke
  • Vascular calcification
  • Kidney stones

In a review article ‘Is Excess Calcium Harmful to Health?’, the authors Daly and Ebeling (Department of Medicine, University of Melbourne) find that some studies do indicate an increased risk, but the majority do not. They recommend adhering to guidelines recommending a total calcium intake of 1,000 to 1,300 mg/day through dietary sources and use of supplements where necessary. (Daly & Ebeling, 2010)

However, this is very different to taking 1,000mg or more of calcium in supplements alone. Average dietaryintake of calcium in males may be around 925mg and females 650mg (data for America – Hunt & Johnson 2007). So for most people, 500–600mg of calcium in supplements would be enough to reach the target of 1,000–1,300mg a day.

Our recommendation: For those at risk, we may advise 400–600mg of calcium a day in supplements. See the next slide for forms of calcium that may be safer and more effective. Calcium is always recommended in combination with a minimum of vitamin D, vitamin K2 and magnesium (as discussed on the following slides).

Preferred form of calcium is;

Microcrystalline hydroxyapatite (MHC) or ossein hydroxyapatite complex (OHC) may be among the best forms.

  • A meta-analysis of 6 trials found that OHC supplements had an overall better effect on for bone density than calcium carbonate (Castelo-Branco et al, 2009).
  • A randomized open trial found higher serum osteocalcin and more favourable changes in bone mineral density over 3 years in women taking OHC compared to those taking calcium carbonate (Ciria-Recasens et al, 2011)
  • A trial on 100 women found that calcium citrate, calcium carbonate and MHC had similar effects on decreasing bone resorption, but MHC’s effect on serum calcium was less. As the increase in serum calcium may be responsible for any increased cardiovascular risk of calcium supplements, this suggests that MHC may be a safer option. (Bristow et al, 2014)

Many studies find similar absorption for various different types of calcium salts, including calcium citrate, calcium citrate-malate, calcium fumarate and calcium carbonate. (e.g. Bristow et al, 2014; Weaver et al, 2002)

But: A meta-analysis of 15 human trials found that calcium absorption from calcium citrate was consistently significantly higher than that from calcium carbonate – by 21.6% with meals, and by 27.2% on an empty stomach (Sakhaee et al, 1999).

In a 2-year RCT, calcium citrate-malate (a combination of calcium citrate and calcium malate) had significantly better results in reducing bone loss than calcium carbonate (Dawson-Hughes et al, 1990).

In a 2008 review of the evidence on calcium citrate-malate, it was found to:

  • Promote the consolidation and maintenance of bone mass
  • Decrease bone fracture risk in the elderly, and slow the rate of bone loss in old age
  • Be a particularly beneficial form of calcium for those with low stomach acid
  • Not increase the risk of kidney stones – instead, it protects against stone-forming potential.

Magnesium is critical for bone health;

  • As well as playing a structural role in bone, magnesium regulates calcium absorption and deposition in bone, influencing the activity of osteoblasts and osteoclasts. (Ods.od.nih.gov, 2015)
  • Magnesium deficiency is often found in studies of women with osteoporosis (e.g. Okyay et al, 2013; Mutlu et al, 2007).
  • Magnesium intake has been found to correlate with bone quality in Korean women (Kim et al, 2011).
  • In some trials, magnesium supplementation has correlated with an increase in bone density in osteoporotic women (Stendig-Lindberg et al, 1993) or decreased bone turnover (Aydin et al, 2010) 

Magnesium sources;

  • Green vegetables, e.g. kale, spinach, chard
  • Pumpkin seeds, hemp seeds, sunflower seeds
  • Nuts – including almonds, hazelnuts, cashews
  • Beans and pulses
  • Whole grains and grain flours e.g. rye, oats, buckwheat
  • Seaweeds – e.g. kelp, wakame

Food Name

Magnesium per 100 g

 Seeds - Pumpkin/Squash - Dried

535 mg

Cereal - 100% Bran

473 mg

Seeds - Sunflower - Dried

353 mg

Seeds - Sesame - Dried - Whole

351 mg

Cereal - Wheat Germ - Toasted

320 mg

Nuts - Almonds - Shelled - Chopped

296 mg

Nuts - Filbert/Hazel - Dried - Chopped

285 mg

Nuts - Cashews - Dry Roasted

260 mg

Nuts - Brazil - Dried - Shelled

225 mg

Seaweed -Spirulina - Dried

195 mg

Nuts - Peanuts - Spanish - Dried

179 mg

Whey - Sweet - Dry

173 mg

Nuts - Walnuts - Persian/English

169 mg

Nuts - Pistachio - Dried

159 mg

Cereal - Wheat - Puffed - Plain

142 mg

Nuts - Pecans - Dried - Halves

128 mg

Seaweed - Kelp (Kombu) - Raw

121 mg

Milk- Non-fat - Instant - Dried

118 mg

Nuts - Macadamia - Dried -

116 mg

Flour - Whole Wheat - Stirred

113 mg

Seaweed - Wakame - Raw

107 mg

 

The best forms of magnesium include;

Magnesium citrate: An RCT on 46 individuals found that magnesium citrate resulted in a higher mean serum magnesium and salivary magnesium concentration after 60 days than magnesium oxide or amino acid chelate (Walker et al, 2003).

Increased solubility and bioavailability of magnesium citrate over oxide was also found in an earlier study using both in vitro and in vivo analysis (Lindberg, 1990).

Magnesium glycinate: In patients with impaired magnesium absorption due to ileal resection, magnesium from glycinate was substantially better absorbed than from oxide (23.5% vs 11.8%). The researchers found that it may be absorbed in part as an intact molecule via dipeptide transport. (Schuette et al, 1994).

Vitamin D is essential for bone formation;

Vitamin D

Calcitriol, the active form, transported to multiple target

organs in the bloodstream regulating gene transcription

  • Muscle function (Stimulation of calcium intake by sarcoplasmic reticulum)
  • Anti-inflammatory and antioxidant effects.
  • Black athletes at high risk
  • HEALTH AND PERFORMANCE BENEFITS (International Journal of Sport Nutrition and Exercise Metabolism, 2008, 18, 204-224)
  • Plasma levels correlate with muscular strength and function in recovering patients/et risk populations (e.g. Elderly - Bischoff, 1999)
  • Levels below 50nM affect coordination and below 30nM severely impair strength (Reviewed by Pfeifer et al., 2002)
  • Following immobilisation, supplementation alongside calcium may theoretically support rehabilitation CO FACTORS REQUIRED!

Bone specific functions of vitamin D include;

Vitamin D:

  • Maintains serum calcium and phosphorus in adequate concentrations to allow mineralization of bone matrix
  • Promotes differentiation of osteoblasts
  • Stimulates osteoblast expression of bone-building proteins such as osteocalcin and osteonectin
  • Influences growth and apoptosis of other skeletal cells such as hypertrophic chondrocytes.

Sometimes people don’t respond properly to vitamin D supplementation in this case resistance from lack of cofactors normally the issue;

  • Co Factors;
  • Magnesium – has anyone reported muscle cramps after taking vitamin D?
  • Vitamin K 2 at least as important for BMD
  • Vitamin A, zinc, boron
  • Always give mg with vitamin D
  • Always assess vitamin K status and increase green leafy vegetables nuts and seeds, fatty foods with K2
  • Magnesium deficiency reduces the response to vitamin D therapy
  • We have many instances of magnesium deficiency in athletes
  • Postgrad Med J. 1985 Jan;61(711):47-8
  • Lifshitz F, Harrison HC, Harrison HE. Response to vitamin D of magnesium deficient rats. Proc Soc Exp Biol Med. 1967 Jun;125(2):472–476
  • The Lancet, Volume 303, Issue 7864, Pages 963 - 965, 18 May 1974 doi:10.1016/S0140-6736(74)91265-3

Vitamin K is involved in the synthesis of several proteins in bone.

In particular, vitamin K is required for the γ-carboxylation of osteocalcin, a calcium-binding protein that is expressed in bone. Undercarboxylated osteocalcin lacks the ability to bind calcium and increases risk of fracture. (Iwamoto, 2014; Kasukawa et al, 2014)

In a Japanese study examining the association between intakes of calcium, magnesium, vitamin D and vitamin K and incidence of hip fracture, the strongest inverse correlation was found with vitamin K and hip fracture incidence compared to intake of the other nutrients. (Yaegashi et al, 2008)

Several studies suggest a protective effect of vitamin K2 on calcification, heart disease, cancer and other degenerative disease. 

Main dietary form of vitamin K is K1 – phylloquinone – found primarily in green leafy vegetables. The form found in bone is primarily K2 – menaquinones – synthesised by the gut bacteria.

Observational studies have found a link between low K1 food intake and increased risk of fractures (e.g. Torbergsen et al, 2015).

But: in clinical trials, K1 supplementation up to 5000µg/day has shown little benefit for bone mineral density (Gundberg et al, 2012).

K2 supplementation hasshown some positive results:

  • A placebo-controlled trial on 325 women found that those taking 45mg/day of K2 for 3 years showed increase in bone mineral content and femoral neck width (Knapen et al, 2007)
  • Lower-dose vitamin K2 (1.5mg/day) for 12 months was found to maintain forearm bone density in postmenopausal Japanese women better than placebo. (Koitaya et al, 2014)

The long-chain menaquinone-7 (MK-7) form of K2 has a much longer half-life than K1, allowing greater accumulation in the body, and induces more complete carboxylation of osteocalcin. (Schurgers et al, 2007)

Food sources of vitamin K1 and K2 can both be important.

K1: Green leafy vegetables – kale,
chard, spinach, parsley, watercress,
Brussels sprouts, cabbage.

K2: Eggs, cheese and butter
(preferably from grass-fed/
pastured animals), fermented
foods (e.g. sauerkraut).

If using supplements, vitamin K2 should be preferred.

http://www.westonaprice.org/health-topics/abcs-of-nutrition/on-the-trail-of-the-elusive-x-factor-a-sixty-two-year-old-mystery-finally-solved/

BORON

  • Low boron intake may result in impaired bone health (Nielsen, 2008)
  • Affects mineral retention and excretion
  • Boron supplementation (3mg/day) was found to reduce urinary excretion of calcium and magnesium in postmenopausal women previously on a low-boron diet, consistent with prevention of bone demineralization. (Nielsen, 1987)
  • Boron has been found to increase the conversion of oestrogen to its most active form, 17 beta-estradiol (Nielsen, 1987).
  • “Boron may play a role in bone metabolism, but its role is most likely to be associated with its interactions with other minerals and vitamins such as calcium, magnesium and vitamin D.” (Volpe, 1993)

Food sources of boron include; Primary sources are vegetables, fruits and nuts – another reason we should eat more of them!

 Good Sources of boron include:

Raisins, prunes, dates, avocado, walnuts, peanuts.

Vitamin C

Vitamin C is essential for production of collagen in the bone matrix.

Vitamin C scavenges free radicals that may negatively affect bone health.

Studies have suggested that vitamin C can induce osteoblast and osteoclast formation.

Human studies generally showed a positive relationship between vitamin C and bone health.

Copper, zinc and iron;

A meta-analysis of eight studies involving 2,188 subjects found that low serum levels of copper, iron and zinc may be important risk factors for osteoporosis. (Zheng et al, 2014)

Copper deficiency has been described as a cause of osteoporotic lesions in the humans and animals (Strain, 1988).

Zinc and copper are essential cofactors for enzymes involved in the synthesis of various components of the bone matrix. (Lowe et al, 2002)

Zinc has a stimulatory effect on osteoblastic bone formation and bone mineralisation, and inhibits osteoclastic bone resorption. Zinc has been found to have an anabolic effect on bone and help restore healthy bone in various conditions including ageing and fracture healing. (Yamaguchi, 2010)

Zinc deficiency in athletes can increase the risk of osteoporosis. (Micheletti et al, 2001)

Iron participates in enzymatic reactions involved in collagen synthesis (collagen makes up 90% of bone protein). Iron is also vital for vitamin D activation and deactivation. (Toxqui & Vaquero, 2015)

Both iron overloadand iron deficiencyare associated with low bone mass and osteoporosis (Toxqui & Vaquero, 2015). Both situations are worth considering and checking for in athletes.

Supplementing calcium may worsen deficiencies in copper and zinc: “Ca [calcium] supplementation may accentuate the problem of reduced Zn and Cu levels by impairing the absorption of simultaneously-ingested Zn and the retention of Cu” (Lowe et al, 2002)

Protein in Bone Health

Protein is a key nutrient for bone health and prevention of osteoporosis.

  • “selective deficiency in dietary proteins causes marked deterioration in bone mass, micro architecture and strength”
  • “large prospective epidemiologic observations indicate that relatively high protein intakes, including those from animal sources are associated with increased bone mineral mass and reduced incidence of osteoporotic fractures”

(Bonjour, 2005)

Protein supplements (20g/day) were found to reduce bone loss in elderly patients with a recent osteoporotic hip fracture (Schürch et al, 1998)

In a cross-sectional study of 96 women, those in the highest quartile for protein intake (72g/day) had an average 5% higher BMD than those in the two lowest quartiles (Rapuri, 2003).

“Rather than having a negative effect on bone, protein intake appears to benefit bone status, particularly in older adults.” (Tucker, 2009)

However, some studies havereported greater risk of fractures with high protein intakes: e.g. in the Nurses Health Study, protein intake of over 95g per day was associated with forearm fracture compared to intake of less than 68g per day. (Feskanich et al, 1996)

Daily recommended protein intake of 0.8 g/kg body weight/day, may be too low for the primary and secondary prevention of fragility fractures. (Bonjour, 2011)

Recommendation:

A ‘perfect’ amount of protein for preventing bone loss has not been defined. We generally advise at least 1g/kg body weight up to a maximum of 2g/kg body weight on a long-term basis – also depending on physical activity levels.

Could low grade acidosis be a factor in bone loss?

In a 2009 population study of 1028 men and women aged 20–72 years, high net endogenous acid production (an estimate of dietary acid load) was correlated with lower BMD and lower osteocalcin levels in women, but not in men. (Rahbar et al, 2009)

A study on 1218 men and 907 women found that potential renal acid load was negatively associated with BMD at the proximal femur in men with low calcium intake. (Mangano et al, 2014)

A small study on eight healthy volunteers found that an acid-forming diet increased urinary calcium excretion by 74% compared to a base-forming diet. (Buclin et al, 2001)

However, in a 2015 study on 861 elderly men and women, dietary acid load was notfound to be associated with BMD, fracture risk or diagnosis of osteoporosis. (Jia et al, 2015)

Improving Acid Alkaline Balance

 Acid-forming foods (according to calculations for potential renal acid load): Grains/cereals, hard cheeses and other dairy products, followed by animal proteins. Refined sugars may also contribute.

Base-forming foods: Vegetables and fruit and vegetable proteins e.g. legumes.

High dietary acid load has been frequently blamed on diets high in animal proteins. However, an analysis of pre-agricultural diets compared to contemporary diets found that: “The historical shift from negative to positive NEAP [net endogenous acid production] was accounted for by the displacement of high-bicarbonate-yielding plant foods in the ancestral diet by cereal grains and energy-dense, nutrient-poor foods in the contemporary diet.” (Sebastian et al, 2002). This study indicates we should be reducing the emphasis on cereal grains and processed foods in the modern diet to correct acid load, rather than reducing protein intake.

 TEA

Tea drinking is associated with better bone density.

A study on over 1,000 postmenopausal women found that tea drinkers (black or green tea) had an average 3–4.5% higher BMD than non-tea drinkers, and lost only 1.6% of bone over 4 years versus 4% loss in the non-tea drinkers. BMD did not improve in line with number of cups drunk – i.e. 4 cups a day did not give significantly better results than 1 cup a day. (Devine et al, 2007)

The flavonoids and lignans in tea may be responsible for helping to maintain BMD. (Devine et al, 2007)

But: a high coffee intake has been found to increasethe risk of fracture in some studies (e.g. Hallstrom et al, 2006; Barrett-Connor E et al, 1994); and high overall caffeine consumption has been reported to decrease BMD and increase fracture risk, with a negative effect on osteoblasts (Tsuang et al, 2006).

Recommendation: Tea consumption may be helpful in moderation – 1–4 cups a day – if suitable for the individual.

Bone Broth and Chicken Soup

Traditionally made bone broth – often studied as ‘chicken soup’ – provides a gentle source of easily absorbed minerals. 

A study at the Charles A. Dana Research Institute, Boston found that cooking a bone soup with a beef bone for 24 hours at an acidic pH increased the calcium content of the soup. (Rosen, 1994)

Bone broth is also rich in gelatin (collagen), which provides amino acids such as glycine, proline and lysine for supporting the body’s own collagen production.                

All those with bone health concerns could benefit – especially those who can’t eat dairy or some of the other calcium-rich foods.

Broth can be thought of as a protein supplement, and a calcium supplement. The chemical ingredients extracted from broth are glycine and proline (collagen/ gelatin), calcium and phosphorus (minerals), hyaluronic acid and chondroitin sulfate (GAGs) (Glycosaminoglycans), and other minerals, amino acids and GAGs in smaller amounts.

Stress and Cortisol

Studies in older adults show an inverse association between cortisol levels and bone density, and a positive association between cortisol and fracture risk. (Bedford & Barr, 2010)

Cortisol may also affect bone health in younger women. A study on 140 healthy women 19–35 years of age found that urinary free cortisol (even within the normal range) was negatively associated with total body bone mineral density. (Bedford & Barr, 2010)

Recommendation: Emphasize the importance of stress relief and relaxation in athletes.

Melatonin and Sleep

Melatonin affects bone metabolism:

  • Melatonin contributes to bone formation by promoting differentiation of stem cells into osteoblasts
  • Melatonin is also thought to reduce bone resorption
  • Night time workers show increased fracture risk, possibly related to changes in the circadian rhythm.

(Amstrup et al, 2013)

  • Melatonin can induce production of osteoblasts, while inhibiting production of osteoclasts
  • The antioxidant properties of melatonin may also help to protect bone
  • Disruption of melatonin rhythms by light exposure at night, shift work, and disease can adversely impact on bone.

(Maria and Witt-Enderby, 2014)

Recommendation: Pay attention to supporting melatonin production by ensuring athletes get 7–8 hours sleep, reduce exposure to light in evenings, sleep in a dark room, etc.

OTHER FACTORS

  • Soft drinks: especially cola drinks, which can be high in both phosphoric acid and refined sugar (high phosphorus and low calcium intake is associated with hyperparathyroidism and bone loss – Calvo & Park, 1996)
  • Alcohol: moderate intake shows positive effects on bone (e.g. Tucker, 2009) while chronic excessive alcohol consumption is linked to osteopaenia, increased risk of fractures and delays in fracture healing (Chakkalakal, 2005).
  • Low stomach acid, acid-suppressing medication or gastric surgery:
    • Atrophic gastritis, gastric surgery or long-term use of acid-suppressing drugs may reduce absorption of dietary and supplementary calcium.(Sipponen & Härkönen, 2010)
    • Alternative calcium salts such as calcium citrate can be a better form of supplementation in those with low stomach acid. (Blanch & Pros, 1999)

 Collagen Peptides 

About 90% of bone protein consists of type 1 collagen. (Toxqui & Vaquero, 2015)

Collagen peptide supplementation has been found in several studies to be helpful for joint pain and osteoarthritis, with anti-inflammatory and pain-relieving effects (e.g. Kumar, 2015).

Collagen supplementation may also be supportive for bone mineral density:

In a study on young rats trained with running exercise, hydrolysed collagen supplementation was found to enhance the effect of exercise on bone mass when compared to the rats not given collagen (Takeda et al, 2013).

In a 2015 RCT on 39 osteopenic women, those taking collagen together with calcium and vitamin D suffered substantially less bone loss after 12 months than those taking just the calcium and vitamin D (Elam et al, 2015).

More study needs to be done in this area to examine the effect of collagen supplementation on bone density in human athletes…

Cissus quadrangularis

Cissus is an indigenous plant of India that has been long used as a ‘medicinal’ herb for promoting fracture healing (Deka et al, 1994; Singh et al, 2013).

Animal studies have shown faster initiation of fracture healing in those treated with cissus compared to controls (Deka et al, 1994).

Cissus also found to have an anti-osteoporotic effect in ovariectomized female rats (Shirwaikar et al, 2003).

In a 2013 RCT on 60 adults with mandibular fracture, those given cissus (2 caps twice a day) showed improved fracture healing compared to controls – measured by increased osteopontin expression in CD4+ cells, reduction in pain, swelling, and mobility at fracture sites and improved biting force (Singh et al, 2013).

Cissus may support bone healing by increasing expression of insulin-like growth factor-1 (IGF-1) and the IGF-1 receptor in osteoblasts (Muthusami et al, 2011).

Ipriflavone

  • Flavanoid
  • Structure it is similar to phytoestrogens like genistein and daidzein, ipriflavone has not been shown to exhibit estrogenic activity on the classic estrogen target organs
  • Enhances BMD more than calcium alone
  • Can slow detox enzymes like grapefruit juice does
  • May lower white cell count

Dried prunes and plums appear to contain bioactive compounds which offer short and longer term bone building and protective effects.

Consumption of these almost certainly has a positive effect on bone mineral density in post-menopausal women a high risk group. The advantages also include keeping the bowel regular and they taste delicious and sweet.

Omega 3 does appear effective in helping calcium uptake into bones also but both have to be given or present for a measurable effect. Tip; both occur in small fish with soft bones like sardines and sprats. Regular omega 3 consumption and supplementation is a good idea in general and may also help with your bones.

Acid alkaline Balance

https://www.nutraingredients.com/Article/2012/04/05/Vitamin-K1-or-K2-effective-for-bone-boosting-potential-Study

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5494092/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566462/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4469220/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5318168/

https://www.holisticprimarycare.net/topics/topics-o-z/vitamins-a-supplements/354-copper-deficiency-may-underlie-osteoporosis-anemia-and-neurodegenerative-disorders.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452226/

HEART, BLOOD, OXYGEN + ENERGY PRODUCTION

 

 

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