Smorgasbord Health 2017 – Top to Toe – The Skeleton -The progresson of Osteoporosis over 50.


health column final

As we get into our middle years and with a reduction in protective hormones a lifetime of inadequate nutrition and weight bearing exercise can lead to a weakened skeleton.  As our bones become less dense we are at risk of fractures and loss of joint flexibility.

Osteoporosis is more prevalent in women than men but affects both.  Last time I covered some of the nutrients needed to ensure dense bones and a strong skeletal structure throughout our lifetime. https://smorgasbordinvitation.wordpress.com/2017/05/11/the-incredible-structure-that-keeps-us-upright/  I am repeating the nutritional information at the bottom of this post.

Statistics for Osteoporosis

Worldwide, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every 3 seconds.

Osteoporosis is estimated to affect 200 million women worldwide – approximately one-tenth of women aged 60, one-fifth of women aged 70, two-fifths of women aged 80 and two-thirds of women aged 90.

Osteoporosis affects an estimated 75 million people in Europe, USA and Japan

For the year 2000, there were an estimated 9 million new osteoporotic fractures, of which 1.6 million were at the hip, 1.7 million were at the forearm and 1.4 million were clinical vertebral fractures. Europe and the Americas accounted for 51% of all these fractures, while most of the remainder occurred in the Western Pacific region and Southeast Asia.

Worldwide, 1 in 3 women over age 50 will experience osteoporotic fractures, as will 1 in 5 men aged over 50.

80%, 75%, 70% and 58% of forearm, humerus, hip and spine fractures, respectively, occur in women. Overall, 61% of osteoporotic fractures occur in women, with a female-to-male ratio of 1.6.

Nearly 75% of hip, spine and distal forearm fractures occur among patients 65 years old or over

A 10% loss of bone mass in the vertebrae can double the risk of vertebral fractures, and similarly, a 10% loss of bone mass in the hip can result in a 2.5 times greater risk of hip fracture

By 2050, the worldwide incidence of hip fracture in men is projected to increase by 310% and 240% in women.

The combined lifetime risk for hip, forearm and vertebral fractures coming to clinical attention is around 40%, equivalent to the risk for cardiovascular disease.

Osteoporosis takes a huge personal and economic toll. In Europe, the disability due to osteoporosis is greater than that caused by cancers (with the exception of lung cancer) and is comparable or greater than that lost to a variety of chronic non-communicable diseases, such as rheumatoid arthritis, asthma and high blood pressure related heart disease

  progression-of-osteoporosisThe progression of osteoporosis.

Unfortunately, as we approach middle age it is not just a few wrinkles and dodgy arteries we have to worry about.  Osteoporosis can develop in both women and men but women are at a higher risk over 50 and are four times more likely to suffer from the disease than men.

Osteoporosis is when the bones in the body thin and begin to develop small holes reducing the density. The bones also become brittle, leading to fractures. Some of these may go undetected as they can be very small. For example, if you suffer from consistent back pain, do not dismiss out of hand, as you could be experiencing very small hairline fractures in your spine. If the condition is not treated or diagnosed, these small compression fractures can cause a vertebra to collapse, a condition that is extremely painful and difficult to treat.

The progress of the disease is subtle. You reach maximum bone density in your 30’s and then your bone strength will slowly decrease naturally. Then add into the mix the reduction of both oestrogen hormones in women over 50 and the decrease in testosterone in men of a similar age, and you have a further loss of density.

Normal bone

normal-bone-micrograph

Osteoporosis affected bone.

osteoporotic-bone-micrograph

There are other risk factors to taken into account.

For both men and women, having a slight body frame and being very slim means that there is less bone to begin with.

Smoking from an early age for a lifetime will put you at higher risk.

Those suffering from certain eating disorders can show decreased bone density in their teens and 20’s due to vitamin and mineral deficiency. (I have seen a 16 year old girl’s x-ray showing the bone density of an 80 year old woman)!

There can be a family history of osteoporosis, if not mother then look to grandmothers.

If you have a history of repeated fractures then it may be that you have brittle bones and you will need to be additionally careful and under medical supervision as you move into middle age.

If you already suffer from rheumatoid arthritis you could be at a higher risk of osteoporosis.

Heavy alcohol consumption can lead to thinning of the bones.

If you have stopped exercising – especially weight bearing exercise that strengthens the bones such as walking regularly.

Last but not least is eating too restricted diet.  As we get older our appetites decrease naturally, we tend to reduce our weight bearing exercise, do not spend time outside in the sun obtaining Vitamin D, and we listen to nutritional advice which tells us to drop full fat dairy, cheese and butter from our diets!!

Diagnosis of Osteoporosis.

I believe that every woman over 55 and men over 65 should have a bone density test to discover where their bone health actually is following the reduction of the two hormones involved. The doctor will also take into account your medical history – particularly if you have had a number of fractures in the past. You should also have a urine and blood test to rule out any other reasons for bone loss and the blood test will show the levels of both oestrogen and testosterone.

A reminder of the nutrients needed to build and maintain healthy bone if you missed the first post.

As I have already mentioned in a previous blog there are certain nutrients that are essential for bone health and I gave brief notes about them. Today I am going to go into one of the most important vitamins for bone health and that is vitamin D. Also, a vitamin that gets little press but that also plays an important role in our bone health and that is Vitamin K.

There is increasing concern that vitamin D (that incidentally thinks it is a hormone) is becoming deficient, particularly in children as we see a rise in the cases of rickets.

Once you have read the notes on this vital nutrient, you can identify if perhaps you are missing it in your diet or lifestyle, and if your family might be at risk.

Vitamin D

If ever there was a reason to get out and lie or walk in the sun for 40 minutes in the mornings, getting your daily recommended dose of Vitamin D is it. In fact, 3 hours in sunlight, spread over a week, in moderate climates, without using any sunblock is sufficient to boost your levels of what is known as the sunshine vitamin. However, you may need less, or more, depending on latitude, time of day and air pollution.

It is not advisable to lie out in the heat of summer in Spain, for example, for 3 hours without protection but you will still receive beneficial amounts through sunblock of under factor-8. Most of what we require on a daily basis is produced in the skin by the action of sunlight and many of us who suffer from depression through the dark winter months are actually missing around 75% of our required daily dose of 1000 IU.

There are a number of diseases that result from a deficiency of Vitamin D and over the years, since it was identified in cod liver oil, there has been increasing research into its role in the body.

In Victorian times children with rickets or bow-legs were a common sight. You rarely see this in developed countries today, although in Southern Asia there is still a problem. In adults the condition is called osteomalacia (soft bones) and it is estimated that millions of people who suffer from unexplained bone and muscle pain actually have this condition. There has been an increase in recent years in the incidence of rickets in the western world and some of this is down to the decrease in outside activity for our children.

More of them are kept inside for safety reasons, many no longer walk to school, go outside at playtime, have football or other team sports encouraged. They sit in front of the television or computer instead of playing in the street and when they do go in the sun they are plastered in factor 30 and above.

They also have too much fizzy pop in their diets and the chemicals in these are not bone friendly. We have gone away from the free school milk and there is too much sugar in our diets which is acidic and leeches mineral from the bones.

How is Vitamin D involved in our bones?

Our bones are living tissue that grows and regenerates throughout our lifetime. It is not static and old bone is removed and replaced with new bone continuously, a process that requires that the essential elements of bone to be available from our diet and from chemical reactions in the body.

There are four main components in bone that are needed to ensure it is strong and able to repair itself on a daily basis.

  • Minerals – Calcium, Magnesium and Phosphorus.
  • Matrix – Collagen fibres (gristle)
  • Osteoclasts – Bone removing cells
  • Osteoblasts – Bone producing cells.

If you ever made papier-mâché sculptures at school you will have used a chicken-wire framework, first of all, to establish the shape that you wanted. Over this you would have laid your strips of wet paper and allowed them to harden. The bone making process is very similar.

A network of collagen fibres forms the base and they are then overlaid with minerals. The strength of the finished bone is dependent on the amount of mineralisation that takes place. Osteoclasts will remove old bone when needed and this results in a need to produce new collagen matrix to attract new minerals for the repair process.

Vitamin D is essential to ensure that sufficient calcium and phosphorus is attracted to the new matrix and that strong new bone is produced. It begins its work in the intestines where your food is processed and assists in the absorption of calcium. If you are deficient in Vitamin D the bone becomes calcium depleted (osteomalacia) increasing your risk of fractures.

Unfortunately, if you are deficient in this vitamin more bone is discarded than replaced leading to soft and malformed bones.

Rickets, for example, is the result of soft and insufficient bone material in the legs allowing them to bend and stunting their growth. In adults the disease is called osteomalacia and because the symptoms are usually related to unspecific muscle and bone pain it can remain undiagnosed for years. This leads to chronic pain and the truth is that therapeutic doses of vitamin D may be the only treatment necessary.

Food Sources and supplementation.

vit d 2

Apart from sunshine, vitamin D can be obtained from a small range of foods including egg yolk, fish oil and liver. A glass of milk contains only 100 IU of the vitamin. It can be tough from just food sources to reach 1000 IU per day of the vitamin so getting out into the daylight on a daily basis is important. Certainly, I have found that taking good quality fish oil capsules over the years has been of benefit to me. There are supplements that you can take and if this is recommended it is usually in the form of calcium and D3 together to aid absorption. There is a new D3 spray for children, but I do advise that you ask a qualified practitioner or your doctor before you use.

Vitamin K

Vitamin K is of particular interest to women in relation to osteoporosis risk because one of the causes of heavy periods is a deficiency of this vitamin. And if this has been a regular occurrence during fertile years, this deficiency could lead to early thinning of the bones.

There are two forms of the vitamin that the body can utilise. The first is K1 (phylloquinone), which is from plant sources and the other is K2 (menaquinone) which is produced by bacteria in our own intestines. This is where many of us get into trouble because we are not eating sufficient raw and unprocessed foods for health and additionally many of us suffer from bacterial imbalances in the gut so do not produce sufficient from that source either.

The vitamin is fat-soluble and is stored in the liver. Studies indicate that approximately 50% of the stores come from our diet and the balance from bacteria in the intestines. We need healthy bile production for efficient absorption of Vitamin K and our lymphatic system circulates it throughout the body.

Apart from helping reduce excessive bleeding during menstruation it is also used therapeutically for the prevention of internal bleeding and haemorrhages, including emergency treatment for overdoses of blood thinners such as Warfarin.

Blood clotting is a critical function in the body that solidifies blood to prevent us from bleeding to death from external or internal injuries. Vitamin K is essential for the production of a protein called prothrombin and other factors involved in the blood-clotting function and is therefore necessary to prevent haemorrhages.

Also, interestingly, Vitamin K activates other enzymes that decrease the clotting ability so it assumes the role of regulator within the blood stream. An example of this might occur if a clot forms within a blood vessel that could block the flow, and needs to be dispersed.

As the vitamin works within the body it changes from function to function according to the various interactions with enzymes and at one stage it acts as an antioxidant preventing oxidative damage to cells. There may also be a role for the vitamin in cancer prevention as it is believed it may stimulate rogue cells to self-destruct.

Bone Health and Vitamin K

The vitamin has also been the subject of a great deal of research in recent years as scientists discovered that it played a significant role in liver function, energy production in the nervous system, and in preventing bone loss as we age by assisting the absorption of calcium.

Vitamin K is needed to activate osteocalcin, the protein that anchors calcium into the bone, building and repairing the structure. A deficiency in the vitamin can therefore lead to brittle bones and osteoporosis.

Food sources for Vitamin K

vitamin K

It is very easy to obtain sufficient Vitamin K through diet and you will find that good sources are: Dark green leafy vegetables, such as spinach, broccoli and cabbage, asparagus, Avocado, Broccoli, Brussel sprouts, Green beans, Green Tea, Carrots, Eggs, Liver, Potatoes and Tomatoes.

Although the vitamin is fairly resilient it is better to eat plant sources either raw or lightly steamed to obtain the maximum benefits. Freezing reduces the amount of the vitamin so you need to eat a little extra of frozen vegetables than fresh.

Final note is on exercise. Whilst it is preferable that your exercise is taken outside in the fresh air and sunshine, it is obvious that during the winter months this is not always a pleasurable option. Dancing, yoga, aerobics, jogging, walking and light weight training are all good forms of inside activity. Find the combination that works for you. There is also a plus to even 30 minutes exercise per day. It will keep your weight down and also stimulate your appetite. This will enable you to continue to consume sufficient foods containing the essential nutrients you need for bone health.

 

Please feel free to comment or share.. Thanks for dropping by Sally

 

Smorgasbord Health 2017 – Top to Toe – The Incredible structure that keeps us upright.


Smorgasbord Health 2017

Unless we break a bone or crack one, we tend to take our skeleton for granted.  As we get older we can also experience problems within the structure particularly in the joints that limit our mobility and provide an excuse for not doing quite as much exercise as we should!

However, it is never too late to help your bones as our diet and our exercise levels do have an impact on the regeneration of this essential framework.

I am going to give an overview today on our skeleton and then follow that up with a closer look at the essential nutrients needed in the formation and maintenance of our bones and the precious marrow that is held inside them.  This marrow is essential for our immune system and overall health.  Arthritis in its various forms is likely to affect most of us as we grow older and I will cover the three most common – Osteo-Arthritis, Rheumatoid Arthritis and Gout during the series. The other area that is an increasingly more prevalent problem for the elderly is osteoporosis.

The Skeleton.

We often marvel at the magnificent structures that have been built over the last few thousands of years. The pyramids remain a mystery and their complexity and their resilience to time and man’s destructive influences overawe us.

Instead of being overawed we tend to take for granted our own support structure which is actually as marvellous and as complex as any building or edifice from the ancient or civilised worlds. Buildings are in the main fixed, with the rare exception of a revolving door or floor.

Our bodies on the other hand not only have to be structurally sound but also have to move, requiring intricate and sophisticated engineering systems to maximise strength and mobility.

Every bone in our body, and there approximately 200 of them, is a particular shape because it has a specific role to play. Where flexibility is required, cartilage takes over from bone but it is the joints and ligaments that provide us with our unique ability to stand upright and move with such grace and flexibility

Obviously the skeleton provides an essential framework for our outer layer as well as supporting us as we move through life. But our bones have some vital functions that also are essential to our health and survival.

At birth we have far more bones in our body despite our small size; around 350 which over the years will fuse together into larger units. A baby’s skull has tiny bones with gaps between called fontanelles. This allows the skull to be molded sufficiently to pass through the birth canal without damage to the mother or the baby’s brain.

Not only does a baby have more bones than an adult but more cartilage, which is more flexible. As the baby grows this cartilage will harden into bone and the process continues well into a person’s late teens.

Bones lengthen in the arms and legs at each end at the growth plate, which is made up of cartilage. This cartilage slowly hardens and becomes bone and when no more cartilage is left in late teens or early 20’s, growth stops.

From a nutritional point of view these years of bone growth, fusion of the skeleton and hardening of the bones themselves is critical. Poor diet from birth into early teens can have a dramatic effect on bone health in middle age resulting in Osteo-arthritis and osteoporosis.

Bone health is not just associated with our structural skeleton because underneath this tough and solid outer layer is the soft and vital marrow where all our blood cells are produced that keep us alive. You will find more details in blood health in an upcoming series of posts.

What do we need to keep our bones healthy?

Calcium helps bone to develop. When we make new bone tissue the body first puts down a framework of a protein called collagen. Calcium from the blood then infuses the framework and when the calcium crystals have filled the entire structure the collagen and the calcium form the strength and flexibility of the bone. In a reverse process when we do not get sufficient calcium from our food or fluids, calcium is borrowed from existing bones, which of course weakens them. As calcium is not just used to manufacture bone but also to assist in neural communication and heart and lung functions, demand has to be met by taking in sufficient through diet to prevent further bone density loss.

Bone health needs to be dealt with by age group. Obviously babies, children and adolescents have a different requirement for calcium as they are in such a rapid growth phase. There are some recommendations for calcium daily requirements but because of the complex mechanism of bone development calcium is not the only requirement. Vitamin D is essential for the process as is weight bearing exercise.  Other nutrients such as Vitamin K also play a role which I will cover later in the series.

Children’s’ bodies are an eating machine that is highly efficient in taking what it requires from food and metabolising it into the required components for health. There has been a great deal of research in the last few years into the role of dairy products as a source of calcium for bone health leading to some concerns that excess dairy provided calcium may lead to accelerated bone loss rather than the reverse. However, dairy products still feature high on the list of food sources for this crucial mineral and whatever the results of current research, there is no doubt that bone health requires Calcium and Vitamin D combined with weight bearing exercise.

Best food sources of calcium

The average requirement for a child is as follows:

  • · 1 to 3 years – 500mg per day
  • · 4 to 8 years – 800mg per day
  • · 9 to 18 years – 1,300mg per day

As adults between the age of 19 and 50 we need 1,000mg per day but after 50 we need slightly more and should be taking in at least 1,200mg per day from nutritional sources. Recent research is indicating that it may be harmful to take in large doses of supplemental calcium.  https://smorgasbordinvitation.wordpress.com/2017/05/04/smorgasbord-health-2017-nutrients-in-the-news-can-take-calcium-supplements-damage-your-heart/

All these food sources will provide 300mg of calcium and it is important to obtain the mineral from as varied a source as possible so that you obtain not just the calcium, but the different nutritional benefits of the individual foods.

  • · Dairy products. Milk 250ml, Yoghurt 175ml, Cheese including low fat varieties 50gm.
  • · Fish products. Canned Salmon with bones 213gm, Canned sardines with bones 213gm.
  • · These products provide 150mg of calcium per serving.
  • · Fruit and vegetables. Oranges x 3, Figs x 6, Baked beans ½ can, Broccoli 250gm, Brussel sprouts x 10 large. Spinach 250gm.
  • · There is also calcium in seeds and nuts such as almonds, hazelnuts and sesame seeds and in fortified drinks like orange juice.

The role of Vitamin D in bone health

The importance of this Vitamin that actually thinks it is a hormone, cannot be overstressed.  It is becoming increasingly evident that this vitamin is showing signs of being deficient in many children’s diet and lifestyle resulting in far more cases of rickets or soft bones.  It is essential for so many functions within the body but is difficult to source especially in the winter months and from limited foods within the diet.

Image

Vitamin D enables calcium to leave the intestine and enter the bloodstream. It also works in the kidneys to help reabsorb calcium which might otherwise be excreted in urine.

One of the problems regarding this particular vitamin is that the best way to produce Vitamin D in the body is to get out in the sunshine, unprotected for 30 to 45 minutes 5 times a week. Exposing your hands, arms and face in this way is usually enough to satisfy the body’s requirement. In this day and age of fears about skin cancer, people are either wearing heavy sunscreens or not exposing their skins at all to sunlight. Also, as we age we become less able to utilise sun to make our Vitamin D. As we reach adulthood we tend to play outside far less than children and this limits our exposure to sunlight. Failing exposure to sunlight then we need to take in sufficient Vitamin D through our diet and this means including free-range eggs, salmon, mackerel, sardines, tuna, cod liver oil.

The last part of the bone health equation is weight bearing exercise

Apart from ensuring that we take in the right ingredients for the production of bone we also need to stimulate bone to continue growing and strengthening.

We all need frequent, weight bearing exercise. Bone is a living tissue and it constantly changes density, gaining and losing strength according to how often it is used. The old saying that I keep repeating ‘use it or lose it’ applies to our bones as well as most other parts of our body. Exercise stimulates calcium absorption in bone and bone also responds to an increase of blood flow during activity. This ensures that not only calcium but other vital nutrients are also absorbed.

The types of exercise that we take part in tends to differ at various ages but are no less important to bone health. Children, particularly during their incredible growth rate, need to not only take in the nutrients but also actively stimulate their bones into normal growth. Bones can also store calcium for later use during exercise, which makes it even more important. Walking and playing team sports, hiking, tennis, dance and martial arts are all good examples of weight bearing exercises suitable for children but certain activities need to be supervised to make sure that children are not exercising beyond their body’s capabilities. Bones are still not fully formed and joints are vulnerable to damage.

Other weight bearing exercises suitable for adults include walking, dancing, jogging, aerobics but these exercises will only benefit the bones being used and in this case it is the legs. To fully benefit the bones in the rest of the body we need to also take part in resistance exercise which uses muscular strength to improve muscle mass and strengthen bones.

The action of pulling on bone by the muscle actually stimulates it to grow so weight lifting and floor exercises such as push-ups will be very effective. Again these types of exercise should be supervised to maximise the benefits.

Our bones are hidden from view and we invariably only know we have a problem when we suffer a fracture. A couple of external indicators might give you a clue to your skeletal health and that is your teeth and nails. If they are strong and in good condition this should indicate that your bones will also be receiving sufficient calcium and Vitamin D.

As we get older a bone density test is a good idea, particularly for women who are going through the menopause and in the years following this natural process. Early detection of a problem will enable you to deal with the problem by making either some dietary changes or working the appropriate exercise into your lifestyle.

More on our bone health and the diseases we can impact by diet and lifestyle changes next time.

Health Bite of the Day – Osteoporosis – not just little old ladies with a dowager hump. Get checked out!


Image

The progression of osteoporosis.

Unfortunately, as we approach middle age it is not just a few wrinkles and dodgy arteries we have to worry about.  I have looked at general bone health in the last few blogs and today I will be covering Osteoporosis as this can develop in both women and men.

Admittedly, women are at a higher risk over 50 and are four times more likely to suffer from the disease than men. 

Osteoporosis is when the bones in the body thin and begin to develop small holes reducing the density. The bones also become brittle, leading to fractures.  Some of these may go undetected as they can be very small. For example, if you suffer from consistent back pain, do not dismiss out of hand,  as you could be experiencing very small hairline fractures in your spine.  If the condition is not treated or diagnosed, these small compression fractures can cause a vertebra to collapse, a condition that is extremely painful and difficult to treat.

The progress of the disease is subtle.  You reach maximum bone density in your 30’s your bone strength will slowly decrease naturally.  Then add into the mix the reduction of both oestrogen hormone in women over 50 and the decrease in testosterone in men of a similar age, and you have a further loss of density.

Normal bone

Image

Osteoporosis affected bone.

Image

There are other risk factors to taken into account.

For both men and women, having a slight body frame and being very slim means that there is less bone to begin with.

Smoking from an early age for a lifetime will put you at higher risk.

Those suffering from certain eating disorders can show decreased bone density in their teens and 20’s due to vitamin and mineral deficiency.  (I have seen a 16 year old’s X-ray showing the bone density of an 80 year old)!

There can be a family history of osteoporosis, if not mother then look to grandmothers.

If you have a history of repeated fractures then it may be that you have brittle bones and you will need to be additionally careful and under medical supervision as you move into middle age.

If you already suffer from rheumatoid arthritis you could be at a higher risk of osteoporosis.

Heavy alcohol consumption can lead to thinning of the bones.

You have stopped exercising – especially weight bearing exercise that strengthens the bones such as walking regularly.

Last but not least is restricted diet.  It is a vicious cycle as you get older.  Our appetites decrease, we tend to reduce our weight bearing exercise, do not spend time outside in the sun and we listen to nutritional advice which tells us to drop full fat dairy, cheese and butter from our diets!!

Diagnosis of Osteoporosis.

I believe that every woman over 55 and men over 65 should have a bone density test to discover where their bone health actually is following the reduction of the two hormones involved.  The doctor will also take into account your medical history – particularly if you have had a number of fractures in the past.  You should also have a urine and blood test to rule out any other reasons for bone loss and the blood test will show the levels of both oestrogen and testosterone.

NUTRIENTS

As I have already mentioned in a previous blog there are certain nutrients that are essential for bone health and I gave brief notes about them.  Today I am going to go into one of the most important vitamins for bone health and that is vitamin D. Also, a vitamin that gets little press but that also plays an important role in our bone health and that is Vitamin K.

There is increasing concern that vitamin D (that incidentally thinks it is a hormone) is becoming deficient, particularly in children as we see a rise in the cases of rickets.

Once you have read the notes on this vital nutrient, you can identify if perhaps you are missing it in your diet or lifestyle, and if your family might be at risk.

Vitamin D

If ever there was a reason to get out and lie or walk in the sun for 40 minutes in the mornings, getting your daily recommended dose of Vitamin D is it. In fact, 3 hours in sunlight, spread over a week, in moderate climates, without using any sunblock is sufficient to boost your levels of what is known as the sunshine vitamin. However, you may need less, or more, depending on latitude, time of day and air pollution.

It is not advisable to lie out in the heat of summer in Spain, for example, for 3 hours without protection but you will still receive beneficial amounts through sunblock of under factor-8. Most of what we require on a daily basis is produced in the skin by the action of sunlight and many of us who suffer from depression through the dark winter months are actually missing around 75% of our required daily dose of 1000 iu.

There are a number of diseases that result from a deficiency of Vitamin D and over the years, since it was identified in cod liver oil, there has been increasing research into its role in the body.

In Victorian times children with rickets or bow-legs were a common sight. You rarely see this in developed countries today, although in Southern Asia there is still a problem. In adults the condition is called osteomalacia (soft bones) and it is estimated that millions of people who suffer from unexplained bone and muscle pain actually have this condition. There has been an increase in recent years in the incidence of rickets in the western world and some of this is down to the decrease in outside activity for our children. 

More of them are kept inside for safety reasons, many no longer walk to school, go outside at playtime, have football or other team sports encouraged.  They sit in front of the television or computer instead of playing in the street and when they do go in the sun they are plastered in factor 30 and above.

They also have too much fizzy pop in their diets and the chemicals in these are not bone friendly.  We have gone away from the free school milk and there is too much sugar in our diets which is acidic and leeches mineral from the bones.

How is Vitamin D involved in our bones?

Our bones are living tissue that grows and regenerates throughout our lifetime. It is not static and old bone is removed and replaced with new bone continuously, a process that requires that the essential elements of bone to be available from our diet and from chemical reactions in the body.

There are four main components in bone that are needed to ensure it is strong and able to repair itself on a daily basis.

  • · Minerals – Calcium, Magnesium and Phosphorus.
  • · Matrix – Collagen fibres (gristle)
  • · Osteoclasts – Bone removing cells
  • · Osteoblasts – Bone producing cells.

If you ever made papier-mâché sculptures at school you will have used a chicken-wire framework, first of all, to establish the shape that you wanted. Over this you would have laid your strips of wet paper and allowed them to harden. The bone making process is very similar.

A network of collagen fibres forms the base and they are then overlaid with minerals. The strength of the finished bone is dependent on the amount of mineralisation that takes place. Osteoclasts will remove old bone when needed and this results in a need to produce new collagen matrix to attract new minerals for the repair process.

Vitamin D is essential to ensure that sufficient calcium and phosphorus is attracted to the new matrix and that strong new bone is produced. It begins its work in the intestines where your food is processed and assists in the absorption of calcium.  If you are deficient in Vitamin D the bone becomes calcium depleted (osteomalacia) increasing your risk of fractures.

Unfortunately, if you are deficient in this vitamin more bone is discarded than replaced leading to soft and malformed bones.

Rickets, for example, is the result of soft and insufficient bone material in the legs allowing them to bend and stunting their growth. In adults the disease is called osteomalacia and because the symptoms are usually related to unspecific muscle and bone pain it can remain undiagnosed for years. This leads to chronic pain and the truth is that therapeutic doses of vitamin D may be the only treatment necessary.

Food Sources and supplementation.

Apart from sunshine, vitamin D can be obtained from a small range of foods including egg yolk, fish oil and liver. A glass of milk contains only 100 IU of the vitamin. It can be tough from just food sources to reach 1000 IU per day of the vitamin so getting out into the daylight on a daily basis is important. Certainly, I have found that taking good quality fish oil capsules over the years has been of benefit to me. There are supplements that you can take and if this is recommended it is usually in the form of calcium and D3 together to aid absorption.  There is a new D3 spray for children, but I do advise that you ask a qualified practitioner or your doctor before you use.

Vitamin K

Vitamin K is of particular interest to women in relation to osteoporosis risk because one of the causes of heavy periods is a deficiency of this vitamin.  And if this has been a regular occurrence during fertile years, this deficiency could lead to early thinning of the bones.

There are two forms of the vitamin that the body can utilise. The first is K1 (phylloquinone), which is from plant sources and the other is K2 (menaquinone) which is produced by bacteria in our own intestines. This is where many of us get into trouble because we are not eating sufficient raw and unprocessed foods for health and additionally many of us suffer from bacterial imbalances in the gut so do not produce sufficient from that source either.

The vitamin is fat-soluble and is stored in the liver. Studies indicate that approximately 50% of the stores come from our diet and the balance from bacteria in the intestines. We need healthy bile production for efficient absorption of Vitamin K and our lymphatic system circulates it throughout the body.

Apart from helping reduce excessive bleeding during menstruation it is also used therapeutically for the prevention of internal bleeding and haemorrhages, including emergency treatment for overdoses of blood thinners such as Warfarin.

Blood clotting is a critical function in the body that solidifies blood to prevent us from bleeding to death from external or internal injuries. Vitamin K is essential for the production of a protein called prothrombin and other factors involved in the blood-clotting function and is therefore necessary to prevent haemorrhages.

Also, interestingly, Vitamin K activates other enzymes that decrease the clotting ability so it assumes the role of regulator within the blood stream. An example of this might occur if a clot forms within a blood vessel that could block the flow, and needs to be dispersed.

As the vitamin works within the body it changes from function to function according to the various interactions with enzymes and at one stage it acts as an antioxidant preventing oxidative damage to cells. There may also be a role for the vitamin in cancer prevention as it is believed it may stimulate rogue cells to self-destruct.

Bone Health and Vitamin K

The vitamin has also been the subject of a great deal of research in recent years as scientists discovered that it played a significant role in liver function, energy production in the nervous system, and in preventing bone loss as we age by assisting the absorption of calcium.

Vitamin K is needed to activate osteocalcin, the protein that anchors calcium into the bone, building and repairing the structure. A deficiency in the vitamin can therefore lead to brittle bones and osteoporosis.

Food sources for Vitamin K

It is very easy to obtain sufficient Vitamin K through diet and you will find that good sources are:

  • · Dark green leafy vegetables, such as
    spinach, broccoli and cabbage
  • · Asparagus Avocado          Broccoli
  • · Brussel sprouts     Green beans     Green Tea
  • · Carrots      Eggs     Liver
  • · Potatoes    Tomatoes        

Although the vitamin is fairly resilient it is better to eat plant sources either raw or lightly steamed to obtain the maximum benefits. Freezing reduces the amount of the vitamin so you need to eat a little extra of frozen vegetables than fresh.

Final note is on exercise.  Whilst it is preferable that your exercise is taken outside in the fresh air and sunshine, it is obvious that during the winter months this is not always a pleasurable option.  Dancing, yoga, aerobics, jogging, walking and light weight training are all good forms of inside activity.  I have a treadmill that I use to cover a couple of miles a day and in the summer this is outside and I swim everyday.  Find the combination that works for you.  There is also a plus to even 30 minutes exercise per day.  It will keep your weight down and also stimulate your appetite.  This will enable you to continue to consume sufficient foods containing the essential nutrients you need for bone health.