Vitamin D, Osteoporosis Vitamin? Or Something Else?

Vitamin D…is it the new Calcium? There’s no question that your body needs Calcium AND vitamin D to make strong bones, but I’ve seen some health care professionals recommend that we ALL take calcium supplements, especially after menopause, to prevent bones from becoming brittle. The issue is, recently studies have shown that the supplemental calcium is doing more harm than good by contributing to atherosclerosis, or hardening of the arteries, which leads to heart attacks. 

osteoporosis

So then, in another effort to control hip fractures, physicians started recommending that EVERYONE take vitamin D to keep bones strong, and then a meta-analysis just came out showing that there is not a statistically significant benefit to taking large doses of vitamin D if you aren’t deficient. (If you have been prescribed vitamin D because you are deficient, BY ALL MEANS, please keep taking it!) Given this information, it appears that prescribing vitamin D for the widespread “prevention” of osteoporosis doesn’t work, and it is costing us large amounts of money in supplements and could potentially be doing some harm if people are overdosing on vitamin D. So what SHOULD we do to prevent Osteoporosis?

There is no panacea

First of all, there is nothing that you can take in pill form that is going to cure and prevent everything. Unfortunately, the manufacturers of these vitamins, minerals and other supplements want you to believe that their supplement is the answer to life. If you only take this pill, you will be beautiful, have amazing skin, eat less, weigh less, work out more, get your dream job and live happily ever after. Don’t fall for their marketing tricks! Instead, you can figure out what works for your body and what your body needs. The truth is, some people need vitamin D supplements and some people don’t. It’s not something that every single person should take. If you want to jump through all the science-y stuff and get straight to my recommendations, Click Here.

Vitamin D deficiency symptoms

Unfortunately, most people who have vitamin D deficiency are asymptomatic, or may have mild symptoms that they attribute to other things. They are also symptoms that are associated with a million other things, like fatigue, tiredness, bone and muscle pain and/or weakness, etc. Source

Get tested for vitamin D deficiency

I recommend to ALL of my patients who are having any type of health problems including weakness or fatigue to get tested for vitamin D deficiency. It’s a very simple blood test that is SO easy to perform and can be very telling. I, personally, have been deficient in vitamin D during several times of my life and was given a supplementation regimen until I came back above the goal. If you are pregnant, have darker skin, live in a northern climate with less sunshine, or stay out of the sun all the time because you stay indoors or cover your skin (with cloth OR sunscreen!), you may be at risk for vitamin D deficiency. A simple blood test will tell you. But say you have plenty of vitamin D stores, consume enough calcium, and are still worried about your bones? What can you do?

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source: http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#h4

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Bone health isn’t about just calcium and vitamin D

So now that we know that popping vitamin D and calcium pills may or may not fix our bones or prevent osteoporosis (at least not without affecting other systems), what can we do? The truth is that bone health deals with SO MUCH MORE than just calcium and vitamin D. If calcium and vitamin D solved all bone problems we would have the best rates of bone disease with our 612 pounds per person per year milk (about 1.5 gallons/week/person! Yikes!) consumption which is rich in calcium and fortified with 115-124 IU vitamin D per serving. However, that is not the case. It is estimated that 1 in 2 Americans will have or be at risk for developing osteoporosis by 2020. That number is too high considering our high milk intake! Consider, though, other countries who are less….well, processed. 

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In this map, the red means risk of fractures is >15%, yellow means it’s between 10-15%, and green means it’s less than 10%. 

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 Map Source

What is it that they’re eating in Colombia, Spain, Australia and the Phillipines that is so great at reducing risk of bone disease?! 

Spanish diet – a mediterranean diet high in fish, nuts, legumes, eggs, fruits, vegetables, cheese, tomatoes and olive oil. Moderate intake of wine and meat. Here’s a list of traditional Spanish recipes.

Colombian diet – includes large amounts of meat (!), seafood (as it is right on the ocean), coffee, fruit, beans, cheese, eggs and coconut.

Australian diet – high in meat, seafood, eggs, fruit and vegemite, a spread that is similar to nutritional yeast.

Filipino diet – high in meat, fat, seafood, vegetables, rice and coconut.

So what’s the deal? Well, here are some things that are common veins among these diets that are crucial for bone health. Most importantly, though, is to eat a traditional diet with tons of unprocessed, traditionally prepared foods.

Omega-3 Fatty Acids

A recent study published this past summer via Ohio State University looked at women’s consumption of omega-3 (commonly referred to as n-3) fatty acids as well as omega-3 to omega-6 ratio and rates of osteoporosis. It turns out the women who ate larger amounts of omega-3 fatty acids had lower rates of osteoporosis. Another important factor to look at is omega-3 to omega-6 ratio. The higher amounts of omega-3 in relation to omega-6 means lower risk of bone disease. That means you could eat all the fish and seafood you wanted, but if you were eating large amounts of omega-6 seed-oils like safflower oil, grapeseed oil, peanut oil, nuts and seeds, you would be increasing your omega-6 fatty acid so much so that the omega-3’s would be overpowered and wouldn’t perform as expected. This is because omega-3 fats and omega-6 fats compete for the same enzymes, which is why the ratio is so important.

So where do you get omega-3 fats? Seafood!! Fish and other sea creatures have the largest amounts of omega-3 fats and the longest chains of omega-3 fats (i.e., DHA and EPA). The longer the chains, the better, because our bodies are not great at converting shorter chains found in walnuts and flaxseeds to the longer chains that are biologically active in our body (DHA and EPA). Notice that all of the countries in the list of the least amount of bone fractures have diets high in seafood.

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Minerals

Boron

Boron is not a mineral you typically think “YES! I need boron for my Bones!”, but it’s true! According to this study, albeit a small study, eating boron rich foods improved bone mineralization in post-menopausal women. It is interesting to read this study, though, because it was a very controlled environment where the women were fed different diets by the scientists and all urine was collected as well. The women who were given 3 mg of Boron daily had markedly lower excretion of magnesium and calcium, suggesting that bone re-mineralization was increasing. Also, there is some evidence that boron can help alleviate arthritic symptoms. Boron is found in fruits, vegetables, nuts and legumes, so following a high-plant diet is the best way to get plenty of boron. (Peanut butter and raisins are two great sources of boron in the American diet.) Of course I always, always recommend food above supplements, and if you are eating a nutrient-dense diet based on fruits and vegetables, you likely don’t need a Boron supplement. Before beginning a supplement regimen, speak with your physician; however, if you have trouble eating boron-rich foods for one reason or another, here is a supplement you can take: 

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Boron 3 mg 100 tabs from Nature’s Way – $4.14

from: VitaSprings.com
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Magnesium

It has been shown that Magnesium blood levels are lower in post-menopausal women with osteoporosis. Whether this has to do with absorption or intake, that is the question and more research is needed to figure that out. I work with dialysis patients, and a couple of years ago I went to a conference all about dialysis patients, updates, nutrition, etc. One of the physicians there who was also a faculty member at a major university in Colorado had done a significant amount of research on magnesium, and had found that dialysis patients with higher levels of serum magnesium lived longer. A fascinating fact, but still just a correlation with no evidence of cause. Nevertheless, magnesium is an important mineral for your body and contributes to bone health and prevention of cardiovascular disease, but whether that is JUST the magnesium that is affecting health, or whether it is a confounding factor (i.e., a factor that happens at the same time but doesn’t always mean it is the reason for it) of a nutrient dense diet, we don’t know. What we DO know is eating vegetables is good for you ;), so eat up! 

Magnesium rich foods (try to include these in your diet BEFORE taking a supplement): coffee (Colombia, anyone?), fish sauce (common in the Philippines), Spinach, Beet Greens, Tea, Bitter Melon (totally Filipino), kelp

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Vitamin K2

Perhaps the most under-researched and under-emphasized vitamin, vitamin K2, a fat soluble vitamin, is absolutely crucial to bone health. Found in fatty meat, eggs, liver and other animal products, this is also a vitamin that has decreased in our diets because of the low-fat diet recommendations that have overpowered our nutrition system for the past 30 years. In one study looking at the relationship between vitamin K2 and osteoporosis, participants who had osteoporosis received a 45 mg vitamin K2 supplement vs. the control group which received a placebo. While the study group did not increase their bone density, they did have a statistically significant decreased rate of bone fractures, which is important to note. Here’s a scientific article explaining possible mechanisms for my science-geek friends.

Unfortunately vitamin K2 has not been well studied and so its sources are not well defined, other than saying that it is present in fatty animal foods like egg yolks, butter, liver, chicken and beef. Also, vitamin K2 is produced by bacteria who convert vitamin K1 (found in leafy greens) to K2, so some hard and soft cheeses are rich in vitamin K2 as well as natto, a traditional Japanese fermented soybean dish, and possibly sauerkraut due to the fermentation of the cabbage.
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Overall Recommendations 

Do not follow a low-fat diet

As can clearly be seen by our need for vitamin K2, plus other fat soluble vitamins, a low-fat diet is clearly not a good idea. Furthermore, traditionally eschewed foods like butter, organ meats and cheeses are actually really important for bone health.

Eat your leafy greens

Leafy greens are great for mineral intake like magnesium, iron and calcium. You actually can get plenty of calcium from just leafy greens and broccoli, despite the recommendation for 3 servings of dairy a day. I am not hating on dairy; I love to have a serving of yogurt for the great probiotics every day, but I do not think dairy is the solution to all bone problems; you have to get your leaves in, too.

Fermented foods rock

Natto is a great example of this, but other fermented foods like sauerkraut, cheese, yogurt, etc., could be instrumental in helping you keep your bone density because of the bacterial conversion of vitamin K1 to K2. Also, fermented foods tend to be better tolerated by people than their non-fermented counterparts, to keep that in mind.

Eat a varied diet full of nutrient-dense foods

Lastly, the more varied your diet is, the better. Make sure you are trying new things often or at least switching up the same ol’, same ol’. If you’re craving something different, go out on a limb and try it. You may really be benefiting your health by getting some nutrient or phytochemical that you didn’t even know (and science didn’t even know) you needed.

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Best Probiotics for Kids & Children

This is part of my FAQ Series. Disclosure: I use affiliate links in this post, and if you click through this site and buy any of these products, I will receive a commission, and you will be supporting this website and all the hard work and research I do. Thank you!

Question: “What is the best probiotic supplement I can give to my kids? Can they take an adult probiotic supplement, or do they need one specifically formulated for children? Please advise.”

bestprobiotics

Answer: Probiotics have been proven to help a number of health conditions including, but not limited to : IBS/IBD (Irritable Bowel Syndrome/Irritable Bowel Disease), Recurrent Yeast Infections, UTI’s, Allergies, Autoimmune Diseases, etc. People often ask me whether they can give their kids probiotics supplements. They ask me if there are any powdered supplements they can mix up for their kids or anything chewable. Also, for kids that are old enough, I get asked if they can take an adult probiotic supplement without adverse side effects, or if the dose should be lower. I answer all these questions, and more, below.

Food Above Supplements

The number one best way to get probiotics into your child is to give them probiotic-containing foods. Kefir and Yogurt, for example, according to the National Yogurt Association, contain more than 100 million living bacterial cultures per gram. If you consider a 4 ounce container, which is over 100 grams, that is 10 billion cultures in a very delicious format. In addition to that, most cultured products contain 5 or more strains of bacteria, and kefir usually contains up to 12. That is a lot of good bacteria for your gut! Compare that to popular supplements that contain only one strain. Furthermore, home fermented probiotic foods may have any number of strains of bacteria. It’s hard to even know for sure because they are usually “wild caught”. Also, price is a factor. If you are buying yogurt as a snack, you are already going to spend the money on snacks, so you might as well get a 2-for-1. 

As far as supplements go, it may be difficult for the bacteria in capsules to make it to the small bowel intact.  They may die in transit, or get killed by stomach acid. This is one reason it’s important to buy a quality probiotic supplement; however, if you can – get your kids their probiotics from some plain yogurt with fresh fruit or a kefir beverage. You could also try them on sauerkraut or other fermented foods, but I would understand if you couldn’t get your children to eat it – the sour taste can be unappealing to a child.

Best Kid-Friendly Probiotic Supplements

The above being said, it is possible that your child doesn’t like yogurt or kefir and won’t eat it or other probiotic foods. If that is the case, I would (usually) recommend a supplement. There is no proof that a kid formulated supplement is any different from an adult formulated supplement, that I can find. Seems like a marketing trick to me. Instead of looking for kid formulas, when looking at a supplement, it’s important to look for two things: number of live, active cultures AND number of bacterial strains. The number of cultures is important because you want to put as many bugs in as possible to give them the best chance at survival. Some of them are going to get killed on the way to your small bowel, and that’s ok; but the more you take, the more will make it. The number of strains is important because there are millions of different types of bacteria and they all have different functions within our gut. One study showed that your gut has more than 5,600 strains of bacteria in it. For this reason, the more types of strains you take, the better you are going to control any symptoms you may be having because you have a better chance of them surviving and crowding out the bad bacteria, and that’s one of the points of taking probiotics. The bad bacteria can cause bloating, pain and suffering, and have been linked with IBS. The overgrowth of the bad bacteria results in a condition called SIBO.

Powders

Udo’s Choice Infant’s Blend Probiotic Powder, 2.64 oz, Flora Health – $16.30

from: VitaSprings.com is a good choice because it contains 1 billion live, active cultures in just 1/4 teaspoon. There are 6 different strains.

Think about that for a second. You can just mix this small amount of powder into your infant or child’s food, and get a decent amount of probiotics, albeit a tenth of the amount they would get from a 4 ounce cup of yogurt. This is great for infants who are still drinking formula or breastmilk – yes you can mix it into that! You could also mix it into juice (although I do not recommend much juice), mashed sweet potatoes (not too hot, or else you’ll kill those good bugs!), applesauce, or any number of other foods. Feel free to get creative. You won’t have to worry about getting your kids to swallow a pill. This is appropriate for children ages 0-5, although it could be used for adults or seniors, even.

 

 

This is another excellent product,  iFlora Multi-Probiotic Powder, 1.48 oz, Sedona Labs – $25.95
from: VitaSprings.com.

This one is a little more expensive; however, it contains 16 strains versus only 6 in the one above. The serving size is the same, 1/4 teaspoon. This one contains 16 billion bacteria per serving. If the above product is the cadillac of probiotics, this iFlora product is the Rolls Royce. It packs more probiotic punch per serving, hence the steeper price. I would highly recommend this product if you can afford it. Also, don’t be afraid to stick it in the fridge to keep the cultures as fresh as possible.

Note. I realize that iFlora has a product “specially formulated “for kids. I have not read any evidence that children’s probiotics need to be any different from adult probiotics, and it has fewer strains, which is why I recommend using the adult version for kids, unless your child is having difficulty tolerating supplements.

 

Chewables

I personally would choose a powder over a chewable; however, if this is what you want, go for it! I could understand if you had a child who had diarrhea and wasn’t really in the mood to eat food but would be willing to chew a pill. 

Chewable Probiotics, 120 Tablets, Roex – $29.95
from: VitaSprings.com

This would be an example of a chewable product. It’s raspberry flavored. It only contains 3 strains and 10 billion cultures. There are a couple of caveats, however, in addition to the few strains. First of all, it contains xylitol, a sugar alcohol. Sugar alcohols have been linked with intestinal symptoms due to … bacterial overgrowth!!! So I’m not sure it’s the best choice to be feeding the potentially bad bacteria with the good bacteria. Also, this contains milk, so if you are feeding probiotics because your kid can’t have yogurt due to dairy intolerance, avoid this one. If you can figure out a way to work in the powder, I would do that.

 

 

Here’s another option that contains no xylitol, and is instead sweetened with stevia: 

Probiotics Plus Colostrum Chewable, 90 Tablets, ChildLife Essentials – $18.32
from: VitaSprings.com

Again, though, there are only 3 strains in this chewable tablet. I tried to do some research, and couldn’t find the number of live active cultures. Also, this tablet has milk proteins in it, although it does say on the label that it is “milk free”, which is somewhat misleading. I would avoid it if your child has any tolerance issues with milk.

 

 

So, in the end, I would recommend the iFlora product, but you may decide on something else because of price and individual tolerance. If you do go the store and buy a product, just remember to look for the number of strains and the number of live active cultures. Also look at the other ingredients, and make sure there’s nothing funky in there. It doesn’t hurt to google the inactive ingredients in anything you choose.

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