Tag Archive | nutritional deficiency

Calcium Supplements: After the Scary Story

Calcium supplement use may raise heart attack risk

Did you catch this headline? Last week all the media outlets reported the results of a German nutrition study that tracked 24,000 people over an 11-year period. Participants who took calcium supplements had almost double the heart attacks of those who didn’t take calcium. The authors concluded that we should ditch the supplements and meet our calcium needs from food sources. While that is generally a very good approach with most nutrients (a handful of supplements can’t atone for a junky diet!), there’s some missing information here: How much calcium were the un-supplemented participants getting from their diets? How much of what forms of calcium were the others taking, and how much were they also getting from their diets? What were their bodies able to absorb?

More important, were they taking vitamin K2? As I mentioned before, it’s responsible for directing calcium to our bones, and away from our arteries. Although bacteria in our intestines can convert some vitamin K1 (the renowned blood-clotter) into K2, even if we ate several cups of leafy greens a day, without a good serving of Japanese natto or a supplement, we’d still be deficient. If the calcium-popping participants weren’t also taking K2 then it’s not surprising their arteries were overloaded.

And what were the participants’ vitamin D levels? There’s an important partnership between vitamin D and vitamin K2; too little of one prevents the other from doing its best work. If the supplementing group had vitamin D levels in any way typical of people in Germany’s northern latitude – their calcium may well have wandered into their hearts.

And what were they all eating? Adding calcium supplements to a highly-processed diet might well have compounded other issues.

In the absence of definitive answers, how is a diligent bone-lover to respond? It was just months ago that my own doctor advised me to take 1500 mg per day of calcium supplements, with no discussion of how I eat or any other supplement than magnesium; I don’t feel at all inclined to go back and ask for her updated advice, especially since she also insisted I take bisphosphonate drugs!

The approach that makes sense to me is to continue with a non-processed  diet, based largely on a wide variety of fresh vegetables, with some meat, fish, nuts, fruit, eggs, yogurt, cheese, healthy fats, and non-gluten grains. Consistent with the COMB study I mentioned before I also take K2, D, magnesium, and fish oil. (That report recommended strontium citrate, which I took for a month. However, I figured out it was the cause of some daily headaches that developed, so stopped. I’ll try strontium again soon, as other support nutrients may be better balanced now.) I also take silica, boron, a multi-mineral supplement that includes 500 mg calcium,  a vitamin B complex, and vitamin C.

When new information comes out it can be hard to make sense of it. Personally, after reflecting on this news I don’t find it too scary after all.

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Believable Good News

A new Canadian study has followed a group of people just like me: those who are responding to osteoporosis purely with lifestyle adjustments, without taking bisphosphonate drugs. Medical researchers from the University of Alberta and University of Calgary prescribed six micronutrients and an exercise program, then tracked the results. I’m delighted to see that over the year of the study the bone density of the participants increased more than it would have with the standard pharmaceutical drugs.

Of course, one reason I like this study is because it seems to validate my approach. Another is that no drug company funded the work, and for me that adds credibility. The authors appear to be squeaky clean with regard to conflicts of interest that may have skewed the results.

On the negative side, the sample wasn’t entirely representative of the low-bone-density population; the authors worked exclusively with people the doctors call “non-compliant”, who had already decided not to use the recommended drugs. Some had abandoned the drugs after experiencing continued decline of their density while taking them. Others had explored their options and just wanted a non-pharmaceutical approach. To me that suggests a cohort that is more health-aware than the average population, more likely to do their own critical investigations, eat a better diet, and resort to fewer pharmaceutical products in general. Really, though, I’m not concerned about the non-representative sample: when it comes right down to it, all I want to know is what will work for ME and the people I care for! And with that prescription I will comply.

Lifestyle adjustments in the study

So what did the participants do? Here’s the list:

Table 1: Combination of micronutrients (COMB) Protocol for Bone Health.


COMB protocol for bone health

(1) Docosahexanoic acid or DHA (from Purified Fish Oil): 250 mg/day
(2) Vitamin D3: 2000 IU/day
(3) Vitamin K2 (non-synthetic MK7 form): 100 ug/day
(4) Strontium citrate: 680 mg/day
(5) Elemental magnesium: 25 mg/day
(6) Dietary sources of calcium recommended
(7) Daily impact exercising encouraged

In earlier posts I’ve already talked about vitamins D and K2, strontium, magnesium, and calcium. Although I take fish oil containing DHA for general good health, I hadn’t heard that it’s particularly helpful for bones. According to the study: “Both DHA and vitamin D are involved in the regulation of many genes and…associated with improved bone strength.”

As for the exercise component, the authors said: “Patients were also instructed to commence and maintain a regimen of daily impact exercises such as jumping jacks or skipping where possible as impact has been associated with prevention of bone density loss.

How much did it help?

The mean improvement in BMD (bone mineral density) was impressive: 3% in the hip, 4% in the neck of the femur, and 6% in the spine. That was contrasted with a continued decline in BMD among the study dropouts, and substantially lower improvements using bisphosphonate drugs. Unlike the drugs, the study protocol delivers no side effects.

What will I change?

I’m already taking the micronutrients suggested by the study, although in different amounts. My calcium is not exclusively from food sources, as I consume very little dairy food, and I’m not confident that I can meet all my requirements all the time with my diet. These days I take 200 mg of DHA, 6000 IU of D3, 100 micrograms of K2, 340 mg of strontium citrate, 420 mg of magnesium citrate, and 1000 mg of a calcium supplement. I plan to leave those as they are for now. At the moment I get impact exercise three or four times a week at the gym, with some walking in between, and heavy gardening all summer. That didn’t prevent osteoporosis in my case, but adding some jumping jacks into my non-gym days is worth a try.
Combination of Micronutrients for Bone (COMB) Study: Bone Density after Micronutrient Intervention

Take your silicon, or give up now.

That’s my conclusion after reading about this essential element. The collagen matrix of our bones – the framework to which calcium and other minerals attach – is largely made up of silicon. Its strength and flexibility depend on silicon. Silicon is also the catalyst for the production of collagen, which is then used throughout the body.

A recent study of 35,000 middle aged and older women concluded that supplementing with calcium alone provided no protection from bone fractures. Of course if you’ve read all of my blog posts this is no surprise to you. Plainly, it’s unrealistic and outright erroneous to think bones need just one component to thrive. And  silicon is another vital contributor.

Here’s the puzzle: one quarter of the earth’s crust is made of silicon, so how can our bones possibly be deficient? It seems that while silica (a form of silicon) is widespread in the soil, the plants that take it up don’t form a large enough part of the standard diet. This is because it concentrates in the outside husks of grains, and the husks are removed from most of our foods. If all the grains you eat are unrefined, you may get enough silicon, but a lot of white flour and white rice slip into the diets of most people in my culture; those foods are devoid of silicon. And in my case I don’t consume any wheat because of my gluten intolerance, so my diet surely falls short.

Dr. Gifford Jones describes a study that showed significant improvement to bone mineral density in subjects who took a silicon supplement called BioSil. Their results were convincing enough for me, so I’m taking BioSil. You’ll have to wait until September to find out what my bones think of it, but for now, here is my tip: If you’re inclined to take this supplement DON’T buy the drops! They have an absolutely ghastly flavour. (My husband, who likes strong flavours including natto and durian, got curious about BioSil after watching my facial contortions. So he had to taste it for himself, and agreed it’s outstandingly bad.) Mercifully, BioSil also comes in capsules, so if I ever finish my first bottle I’ll switch to that format. Of course there are also other brands of similar products; I just bought the first one I read about.

There’s more good news about silicon: it improves our nails, hair, and skin. After just three months on it I notice that my nails are stronger. I can’t say my wrinkles have gone away, but here’s hoping. And another piece of good news – although we’ll have to wait longer to see how this works out – silicon supplementation lowers the risk of dementia.

The elusive K2

It turns out that K2 is an oft used name. I knew it applied to the second highest mountain peak in the world, located between Pakistan and China. And I’m telling the whole truth when I tell you that until just now I didn’t know it is a word whispered between illegal drug users. But did YOU know that it is also a vitamin that your bones must have?

Maybe you’ve heard of vitamin K. Have you wondered how it rated the 11th letter of the alphabet, when the previous vitamins were A-B-C-D-E? Why it isn’t vitamin F? Well, it turns out that the Danish scientist who identified it referred to it as the Koagulationsvitamin because of its role in coagulation, and that starts with a K. Eventually scientists figured out that there are several forms of this vitamin, and this initial variety was renamed K1

Without vitamin K1 we are prone to hemorrhaging because the blood doesn’t clot appropriately. It’s easy to get enough of this, though, because it’s abundant in leafy green vegetables. Kale is an excellent source of K1.

Another member of the family, vitamin K2, has a major effect on bone metabolism by regulating calcium. While directing the calcium to our bones, where it’s needed, it effectively transfers it away from our arteries, preventing arteriosclerosis. So the gain to our bones also benefits our hearts.

But here’s the problem: while some vitamin K2 can be formed in the body from vitamin K1, the most biologically active form can’t, so must be taken from food or a supplement. The best food source of K2 is a traditional Japanese fermented soybean food called natto.

As it happens, my husband and one daughter love natto, so every now and then I make a batch for them, a three-day process that involves soaking, cooking, then fermenting soybeans with a culture hand-carried from Japan. I can tell you more about this if you want to know. But most non-Japanese people have a very hard time eating natto. Whether it’s the smell reminiscent of stinky socks, the mucous-like threads that hang from a spoonful, or the overpowering taste – chances are it would take you some time to acquire the taste for this food.

So in the case of vitamin K2, for the sake of your bones I strongly suggest you buy a supplement. To help absorption, take it with a bit of fat because K is fat-soluble.

You must meet Boron.

Never heard of boron? Then your bones may thank you for reading this.

Boron is a trace mineral that affects many of our metabolic processes. Of particular interest to me at the moment is that it plays key roles in our calcium status and bone density. It turns out that boron is a vital cofactor in the body’s use of Vitamin D and magnesium, helping us to metabolize them. Too little boron? That seems to demineralize bones, flushing precious calcium and magnesium into our urine, just as if we were nutritionally deficient.

The good news is that we can get boron from lots of foods: almonds, walnuts, avocados, broccoli, potatoes, pears, prunes, honey, oranges, onions, chick peas, carrots, beans, bananas, red grapes, red apples and raisins are some of the best sources. The bad news? The actual boron content of those foods depends on the soil in which they’re grown.

In these days of factory farming and well-traveled foods it’s not possible to keep track of how much boron we’re actually getting. Still, if you eat a diet rich in a variety of fruits, vegetables, nuts, and seeds you may well average the recommended 3 mg per day. Estimates of the typical American diet – emphasizing milk, meat, grains and junk – fall far short of that.

It would be easy to recommend that we each take a boron supplement for bone insurance. But isn’t the higher road a balanced diet? It has infinitely more benefits, too.