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Tomatoes: Summer’s unexpected bone builder

July 11, 2021/0 Comments/in Bone Nutrition /by Dr. Susan E. Brown

It’s tomato season! The brilliantly-colored summer treats common in all our gardens are major players in one of today’s leading-edge research topics in osteoporosis: how oxidative damage causes the inflammation which leads to bone breakdown.

What makes tomatoes so interesting to the scientists studying the effects of oxidative damage? Tomatoes are particularly highly in a bone-protective antioxidant known as lycopene. It has long been noted that people who consume more tomatoes, tomato paste, sauces, juice, and tomato products of all sorts experience a lower fracture rate than those who consume less.

So how can you get from 12 to 30 milligrams of lycopene a day without taking extra supplements? It’s really quite easy if you like tomatoes as I do. Bright red tomatoes — in sauces, soup, juices, or just plain sliced up on the plate—are loaded with lycopene!

Tomato products and lycopene content

Tomato product Serving Size Lycopene content

Tomato paste 1/4 cup 18.84 mg

Tomato puree, canned 1 cup 54.38 mg

Tomato sauce, canned 1 cup 34.25 mg

Pasta sauce, canned 1 cup 31.66 mg

Vegetable juice cocktail 1 cup 23.38 mg

Tomato juice 1 cup 21.91 mg

Tomato soup 1 cup 13.05 mg

Tomato, raw 1 whole 3.17 mg

Oh, and if you don’t like tomatoes, enjoy watermelon, papaya, grapefruit — also good sources of lycopene.
Finally, I hear this question a lot, “But aren’t tomatoes acid forming?” True, tomatoes are slightly acid forming, but their benefits outweigh any small acid contribution, which can be easily buffered with our Alkaline for Life Diet®. Be well and enjoy the fruits of summer! Here’s a recipe to get you started:

Bone-healthy salsa recipe

•    4 large tomatoes (or 6 plum tomatoes) chopped
•    1 small white onion, diced
•    Juice from 1 lemon
•    Handful of fresh cilantro
•    Salt to taste
Mix together and serve (or add a chopped cucumber for a great summer tomato salad).

References:

Sahni, S et al., Protective Effect of Total Carotenoid and Lycopene Intake On The Risk Of Hip Fracture: A 17 Year, Follow-Up From the Framingham Osteoporosis Study, JBMR, Vol. 24, No.6.2009:10861094.

Mackinnon, ES et al., Supplementation with the Antioxidant Lycopene Significantly Decreases Oxidative Stress Parameters In The Bone Resorption Marker N-telopeptide Of Type I Collagen In Postmenopausal Women. Osteoporosis international (2011) 22:1091-1101

US Dept. of Agriculture, Agriculture Research Service. USDA National Nutrient Database For Standard Reference, Release 24, Lycopene.

Take the Better Bones magnesium challenge!

March 4, 2020/in Bone Nutrition /by Dr. Susan E. Brown

Magnesium is the fourth most common mineral in our body, and over half of it is stored in the skeleton, where it works with other minerals to strengthen bone.

Magnesium is mostly lost in modern food processing, so it’s common for people to take in too little — and even in people with supposedly “normal” serum magnesium levels, there can be cause for concern, as levels may simply reflect low intake that has been offset by removal of this key mineral from bone (Ismail et al. 2010).

And as I mentioned in an earlier post, higher levels of magnesium in the body are associated with a reduced fracture rate — so making sure we get enough in the diet really warrants more attention, especially for those at risk of osteoporotic fractures.

Beyond that, magnesium is involved in more than 300 enzyme systems and is extremely important not only to our skeletal system, but also to every other system within the body, including the muscles, cardiovascular system, blood glucose regulation, and the nervous system. A few things you might not know:

Research has found that increased dietary intake confers protection not only against fractures, but also type 2 diabetes, metabolic syndrome, hypertension, and cardiovascular disease (Bo and Pisu 2008). Taking large amounts of calcium in the face of magnesium deficiency can cause calcium to precipitate out, contributing to kidney stones and hardening of the arteries.
A recent 20-year study has found that serum magnesium levels often are below normal in depressed adults. Depression that resists treatment by other means has been found to response to magnesium supplementation (Rajizadeh et al. 2017) — which makes sense, given that many commonly used antidepressants raise serum magnesium as a side effect (Eby and Eby 2010).
Except for children under the age of 5, all individuals studied, regardless of age, gender, or race, failed to consume even the recommended daily allowance (RDA) of 320 mg/day for women, 420 mg/day for men — and even that, in my opinion, is below the optimal.

My challenge for you

Can we get enough magnesium in our diets without using supplements? I’m a big believer in getting the nutrients we need through food, but I’m not sure the average person can do it — because looking at a chart of foods high in magnesium, it’s pretty clear to me that the task of getting upward of 400—800 mg/day to restore bone stores and maintain adequate serum levels is a Herculean one. (This is an important reason why Better Bones Builder contains a daily dose 300 mg of magnesium in alkalizing form.)

How are you at making the most out of magnesium-rich foods? I’d love to hear input from readers on recipes that offer up a full day’s supply — at least 400 mg — of this vital nutrient!

Click here for the printable Better Bones, Better Body® list of magnesium-rich foods

Resources:

Bo, S., and E. Pisu. 2008. Role of dietary magnesium in cardiovascular disease prevention, insulin sensitivity and diabetes. Curr Opin Lipidol. 19(1):50–56.

Eby, G. A., and K. L. Eby. 2010. Magnesium for treatment-resistant depression: A review and hypothesis. Med Hypotheses 74(4):649–660.

Ismail, Y., et al. 2010. The underestimated problem of using serum magnesium measurements to exclude magnesium deficiency in adults; a health warning is needed for “normal” results. Clin Chem Lab Med 48:323–327.

Moshfegh, A., et al. 2009. What we eat in America, NHANES 2005-2006: Usual nutrient intakes from food and water compared to 1997 dietary reference intakes for vitamin D, calcium, phosphorus, and magnesium. U.S. Department of Agriculture, Agricultural Research Service.

Pennington, J., et al. 1986. Mineral content of foods and total diets: The Selected minerals in Foods Survey, 1982 to 1984 J Am Diet Assoc 86:876-91.

Rajizadeh, A., et al. 2017. Effect of magnesium supplementation on depression status in depressed patients with magnesium deficiency: A randomized, double-blind, placebo-controlled trial. Nutrition 35:56–60.

6 ways standard osteoporosis treatment is dead wrong: Part 3

February 19, 2020/0 Comments/in Bone Drugs, Osteopenia, Osteoporosis /by Dr. Susan E. Brown

In my previous two blogs, I’ve given you 4 important reasons why I don’t believe standard osteoporosis treatment is effective. In this final blog of the series, I want to emphasize that there is no magic bullet for optimal bone health – despite what you may have heard about calcium or bone drugs. Here’s why:

5. The calcium-centered focus has distracted us from the fact that at least 20 nutrients are essential for bone health

I’ve pointed out that calcium doesn’t reduce fracture risk and excessive calcium intake holds increased risk of cardiac problems. But if calcium isn’t the “magic bullet” for bones, what is? Well for one thing, adequate vitamin D levels are essential, and a lot of doctors are finally realizing how important vitamin D is for bone health.

Yet too little attention is still paid to other essential bone nutrients — especially vitamin K, which makes a major contribution to bone health and supports many other systems as well, but also zinc, magnesium copper, boron, folate, manganese and vitamin C.

6. Bone drugs are far less effective and far more risky than commonly thought

Here’s where it really becomes frustrating. Our health system pushes high-dose calcium (which doesn’t work) as the solution to low bone density (which is not necessarily the problem). Then when there’s no improvement in bone density from overloading the body with calcium, the typical next step is to prescribe a bone drug.

I’ve always maintained that such medications should be used only as a last resort, for very severe cases where drastic measures are needed — for instance, a person experiencing low-impact fractures or excessive, uncontrollable bone loss. This is not the situation for most people who have relatively low bone density .

With that in mind, it shouldn’t be surprising that the results of bone drug therapy are often very disappointing. Even worse, the evidence suggests no benefit from bisphosphonate bone drugs on real-world hip fracture incidence. Nor do these drugs benefit people 80 years old and older — which is, of course, the group most likely to fracture a hip!

What it all boils down to is this: If we’re to really help people to live long, healthy lives free from the fear of bone fractures, we don’t need more bone drugs. Instead, we need to change our approach by:

Carefully assessing each individual case to identify whether excessive bone loss or weakness exists;
Detecting and correcting both obvious and hidden causes of excessive bone weakening;
Broad-spectrum, whole-body support with nutrition, exercise, neuroendocrine and hormonal balance, stress reduction, and resilience enhancement.

Such an approach would limit bone drugs to the few specific situations where obvious bone weakness cannot be offset by natural means and requires heavy-duty intervention.

Missed the previous blogs? Read more.

Part 1

Part 2

* Information presented here is not intended to cure, diagnose, prevent or treat any health concerns or condition, nor is it to serve as a substitute professional medical care.

6 ways standard osteoporosis treatment is dead wrong: Part 2

February 18, 2020/0 Comments/in Bone Drugs, Osteopenia, Osteoporosis /by Dr. Susan E. Brown

I’ve written recently about two of my top six concerns about the standard approach to bone health. And now, here are two more that emphasize how women are often being misled about how to best protect their bones:

3. Contemporary osteoporosis management treats bone as if it were separate and isolated from the rest of the body

It’s tempting to look at the body the way we look at cars — as a collection of independent parts, each with a specific job. But that’s not what the body is! It’s a set of dynamic, interconnected systems that are constantly changing in response to what goes on around us and inside us.

While most people lose some bone as they age, bones don’t just “wear out” over time, the way a car’s parts do. If bones are weak or rapidly become thin, it’s nearly always because of a larger systemic problem in the body. The most effective approach in this situation is a big-picture perspective that looks at bone health as an indicator of overall health — it’s been shown that older adults who experience a hip fracture have lower baseline health-related quality of life than those who don’t.

But the standard approach is to focus on the mechanics of bone breakdown and interfere with them. Most bone drugs work by targeting the cells that break bone down and stopping them from doing their job. Doing this doesn’t actually solve the problem — it just masks the effects.

Enduring bone health requires rebuilding strength and vitality. That’s why it makes sense to look at the complete body system — circulation, bone, acid-base balance — to find the places where something isn’t working right to cause bone loss, rather than focus in on halting bone loss itself, which is most often an effect of a larger problem.

4. High-dose calcium is still considered the first-line treatment, yet it does not prevent fracture, and may be harmful

Speaking of “larger problems,” let’s take a look at what happens when you try to address fracture risk with calcium supplements. There is tremendous controversy about calcium and bones, but now it’s becoming clear that high-dose calcium supplementation is not the solution.

Multiple studies show that calcium does not decrease fracture risk except in those with a very low calcium intake — and some studies suggest that taking high-dose calcium supplements can lead to an increase in arterial calcification, stroke, kidney stones. In my own research, it’s quite clear that while adequate calcium is needed for healthy bones, using high doses is counterproductive.

It seems wise to obtain the total 1,200 milligrams of calcium daily from diet and supplements as recommended by the National Institute of Health. At the same time, we recommend you also learn about the other key bone nutrients and make sure you obtain adequate doses of all these essential bone builders.

Stay tuned for next week’s blog for my final two reasons the standard approach to bone health doesn’t make sense. And as you’ll see, are far less effective and far more risky than commonly thought!

See Part 1 here

See Part 3 here.

References:

Randall, AG et al., Deterioration in quality of life following hip fracture; a prospective study osteoporosis international 2000, 11(5);460-6.

Bischoff-Ferrari HA, et al., Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr. 2007
Dec;86(6):1780-90.

Bolland MJ, Leung W, Tai V, Bastin S, Gamble GD, Grey A, Reid IR. Calcium intake and risk of fracture: systematic review. BMJ. 2015;351:h4580. doi: 10.1136/bmj.h4580.
Bolland MJ, Grey A, Reid IR. Calcium supplements and cardiovascular risk: 5 years on. Ther Adv Drug Saf. 2013 Oct;4(5):199-210. doi: 10.1177/2042098613499790
https://ods.od.nih.gov/factsheets/Calcium-Consumer/

* Information presented here is not intended to cure, diagnose, prevent or treat any health concerns or condition, nor is it to serve as a substitute professional medical care.

Recipes to help you get the benefits of blackstrap molasses

February 11, 2020/0 Comments/in Alkaline Balance, Bone Nutrition /by Dr. Susan E. Brown

I fondly recall my grandmother’s homemade blackstrap molasses cookies and her molasses sweetened, old fashioned, baked beans. If you feel like indulging your sweet tooth, you can skip the refined sugar, sucrose, dextrose, corn syrup and fructose.

A better way to add a little sweetness — along with the big nutrient benefits — is to use blackstrap molasses. See some of my favorite ideas below.

What is blackstrap molasses?

Blackstrap molasses is the thick dark syrup — full of alkalizing, bone-building trace minerals — left after the third boiling in the sugar refining process.

Nutrition in blackstrap molasses

Blackstrap molasses is rich in many key bone nutrients such as calcium, magnesium, potassium, iron, and even the hard to get trace mineral manganese. Some reports suggest you only need two teaspoons of blackstrap molasses to get 18% of the recommended daily value for manganese.

Manganese plays a special role in bone cartilage and bone collagen formation and is required for bone mineralization. In one study, women with osteoporosis were found to have ¼ the manganese levels of the women who didn’t have osteoporosis.

Compare the nutrients in blackstrap molasses to table sugar

Nutrient Content per 1 Tablespoon
Nutrient	Blackstrap Molasses (organic unsulfured)	Table Sugar
Calcium	200 mg	0
Magnesium	100 mg	0
Potassium	450 mg	0
Iron	2.70-0.73 mg	0
Sodium	30 mg	0
Manganese, Zinc, Copper, Selenium, Chromium	Trace amounts	none

Table Reference: U.S. Dept of Agriculture, USDA Branded Food Products Database, Jan. 2017

Molasses spice cookie recipe

From The Amazing Acid Alkaline Cookbook by Bonnie Ross

(Makes 24 cookies)

Ingredients

3 Tbsp water

1 Tbsp ground flaxseed

2 C light spelt flour (or gluten-free baking mix)

2 tsp baking soda

1 tsp ground cinnamon

1 tsp ground ginger

½ tsp ground cloves

1/8 tsp sea salt

2/3 C Sucanat sugar

½ C clarified butter

¼ C blackstrap molasses (originally regular molasses in the recipe)

Sucanat sugar for coating

Directions

Preheat the oven to 375 degrees F. Lightly coat two 9-x-13-inch baking sheets with clarified butter, or line them with parchment paper and set aside.
In a small bowl, combine the water and flaxseed. Stir well and let sit for 10 minutes.
In a medium-sized bowl, whisk together the flour, baking soda, cinnamon, ginger, cloves, and salt. Set aside.
In a large mixing bowl, combine the flaxseed mixture, sugar, butter, and the blackstrap molasses. Mix well with a spoon until blended.
Add the dry ingredients to the wet ingredients and mix well with a spoon until blended.
Lightly coat a plate or pan with sugar. Using your hands, shape the dough into 1½-inch balls and roll each ball over the sugared surface. Arrange the balls on the prepared baking sheets, leaving about 2 inches between the balls to allow for spreading.
Bake for 8 to 10 minutes or until the edges are set but the middle of the cookie is still soft. Let cool for 10 minutes and serve.

More ways to use blackstrap molasses

Molasses apple cider tea

This warming drink involves two of my alkalizing favorites. I simply put 1 Tbsp of blackstrap molasses and 1 Tbsp apple cider vinegar in a cup of hot water and enjoy.

Wholesome alternative sweetener

As a simple sweetener, I like the flavor of blackstrap in yogurt, oatmeal, homemade granola, and even tea. It also works to replace some of the honey or maple syrup in your recipes with blackstrap.

Barbecue sauce or veggie glaze

If you prepare homemade barbecue sauce try mixing a bit of blackstrap to secret BBQ sauce. Or, if you like to spice up things by glazing your root crops, try mixing a bit of blackstrap with butter for a flavorful glaze.

Source for nutrition information: Whole Foods

Find out if Black Strap Molasses is Acidic or Alkaline Forming

20 key bone building nutrients — an overview

January 31, 2020/0 Comments/in Bone Nutrition /by Dr. Susan E. Brown

Depending on how we count them, there are at least 20 bone building nutrients which are essential for optimal bone health — “essential” in that our bodies cannot manufacture them, so we must get them from our food and drink. Let’s take a quick look at them, one by one, so you can get a better idea of their roles in bone health and how much of each you should be getting.

Remember, none of these nutrients does its work in isolation — you need some of each and every one, so they can all work together to keep your bones standing strong all your life long. Taking a top-grade multivitamin–mineral complex and essential fatty acids will ensure that your cells have adequate levels of these nutrients ready at hand from minute to minute, day after day, to prevent bone loss leading to osteoporosis, other degenerative diseases, and accelerated aging.

Printable copy of the 20 Key Bone-Building Nutrients as researched by Dr.Brown for 35+ years

(Click on individual nutrients to learn more about these bone building nutrients and find a full chart at the bottom…)

20 Essential Bone Building Nutrients

Calcium (Ca):

Adult RDA or AI*:
1000 – 1200 mg
Common therapeutic range for bone health (daily intake):
800 – 1200 mg
Dietary considerations concerning adequacy of average daily intake:
Typical diet is inadequate, averaging 500 – 850 mg
Add up your intake from diet and supplementation:__________________

Phosphorus (P):

Adult RDA or AI*:
1250 mg 9 – 18 years old
700 mg adults
Common therapeutic range for bone health (daily intake):
800 – 1200 mg
Dietary considerations concerning adequacy of average daily intake:
Inadequate intake is rare except in elderly and malnourished. Excess intake common with use of processed foods and soft drinks —
1500 mg/day in men
1025 mg/day in women
Add up your intake from diet and supplementation:__________________

Magnesium (Mg):

Adult RDA or AI*:
420 mg adult men
320 mg adult women
Common therapeutic range for bone health (daily intake):
500 – 1,000 mg
Dietary considerations concerning adequacy of average daily intake:
Intake generally inadequate among all ages, sexes, and classes except children under the age of 5; 40% of total population and 50% of adolescents consume 66% of RDA; and 56% of all Americans have intakes below Estimated Average Requirement (EAR)
Add up your intake from diet and supplementation:__________________

Chromuim (Cr):

Adult RDA or AI*:
30 – 35 mcg adult men
20 – 25 mcg adult women
Common therapeutic range for bone health (daily intake):
200 – 1000 mcg
Dietary considerations concerning adequacy of average daily intake:
Common intake in the US is 50 mcg or lower
Add up your intake from diet and supplementation:__________________

Silica (Silicon – Si):

Adult RDA or AI*:
No values set to date
Common therapeutic range for bone health (daily intake):
5 – 20 mg
Dietary considerations concerning adequacy of average daily intake:
Intake significantly higher in men (30–33 mg/day) than in women (~25 mg/day), yet generally suboptimal Silica is the first element to go in food processing
Add up your intake from diet and supplementation:__________________

Zinc (Zn):

Adult RDA or AI*:
11 mg adult men
8 mg adult women
Common therapeutic range for bone health (daily intake):
12 – 30 mg
Dietary considerations concerning adequacy of average daily intake:
Average intake is 46–63% of RDA. Marginal zinc deficiency is common, especially among children
Add up your intake from diet and supplementation:__________________

Manganese (Mn):

Adult RDA or AI*:
2.3 mg (AI) adult males
1.8 mg (AI) adult females
Common therapeutic range for bone health (daily intake):
2 – 10 mg
Dietary considerations concerning adequacy of average daily intake:
Intake generally inadequate, at 1.76 mg adolescent girls; 2.5 mg adult men and 2.05 mg adult women
Add up your intake from diet and supplementation:__________________

Copper (Cu):

Adult RDA or AI*:
900 mcg (0.90) adults
Common therapeutic range for bone health (daily intake):
1 – 3 mg
Dietary considerations concerning adequacy of average daily intake:
75% of diets fail to contain RDA. Average daily intake is below the RDA
Add up your intake from diet and supplementation:__________________

Boron (B):

Adult RDA or AI*:
No RDA established
Common therapeutic range for bone health (daily intake):
3 – 5 mg
Dietary considerations concerning adequacy of average daily intake:
Common daily intake is only 0.25 mg, to possible optimum of 3.0 mg
Add up your intake from diet and supplementation:__________________

Potassium (K):

Adult RDA or AI*:
4700 mg adults
Common therapeutic range for bone health (daily intake):
4000 -6000 mg
Dietary considerations concerning adequacy of average daily intake:
Adult intake averages 2300 mg for women and 3100 mg for men
Add up your intake from diet and supplementation:__________________

Key Vitamins

Vitamin D

Adult RDA or AI*:
600 IU 1-70 yr
800 IU >70 yr
Common therapeutic range for bone health (daily intake):
800–4000 IU and up, as needed
Dietary considerations concerning adequacy of average daily intake:
Numerous experts say that a billion people worldwide are deficient today. Deficiency is especially common among people who are elderly, dark skinned, and those with little UV sunlight exposure. A simple, inexpensive blood test for 25(OH)D is the best way to determine vitamin D status and need
Add up your intake from diet and supplementation:__________________

Vitamin C

Adult RDA or AI*:
90 mg adult men
75 mg adult women
Common therapeutic range for bone health (daily intake):
Oral 500–3000 mg (and upward to bowel tolerance), as needed
Dietary considerations concerning adequacy of average daily intake:
Average daily intake is about 95 mg for women and 107 mg for men. Based on US survey of nearly 9000 people, intake for 31% of population is below Estimated Average Requirement (EAR)
Add up your intake from diet and supplementation:__________________

Vitamin A

Adult RDA or AI*:
2997 IU adult men
2331 IU adult women
Common therapeutic range for bone health (daily intake):
5000 IU or less
Dietary considerations concerning adequacy of average daily intake:
44% of US population has intake below EAR
Add up your intake from diet and supplementation:__________________

Vitamin B6

Adult RDA or AI*:
1.3–1.7 mg adult men
1.3–1.5 mg adult women
Common therapeutic range for bone health (daily intake):
25 – 50 mg
Dietary considerations concerning adequacy of average daily intake:
Studies indicate widespread inadequate vitamin B6 consumption among all sectors of the population; >50% of population consume 70% RDA
Add up your intake from diet and supplementation:__________________

Folic acid/folate
(vitamin B9)

Adult RDA or AI*:
400 mcg (0.4 mg) adults
Common therapeutic range for bone health (daily intake):
400–1000 mcg (0.4–1 mg)
Dietary considerations concerning adequacy of average daily intake:
Inadequate intake common among all age groups; although improving with food fortification, 49% of participants in NHANES survey had intakes below Estimated Average Requirement (EAR)
Add up your intake from diet and supplementation:__________________

Vitamin B12

Adult RDA or AI*:
2.4 mcg adults
Common therapeutic range for bone health (daily intake):
150–1000 mcg
Dietary considerations concerning adequacy of average daily intake:
Up to 40% of US population have marginal B12 status. Older people and vegans are especially at risk
Add up your intake from diet and supplementation:__________________

Vitamins K1 and K2

Adult RDA or AI*:
K1: 120 mcg adult men
90 mcg adult women
K2: No recommended intake but among the essential bone building nutrients
Common therapeutic range for bone health (daily intake):
K1: 150–1000 mcg, K2 as MK-7: 45–360 mcg
Dietary considerations concerning adequacy of average daily intake:
Up to 40% of US population have marginal B12 status. Older people and vegans are especially at risk
Add up your intake from diet and supplementation:__________________

Other Nutrients

Fats

Adult RDA or AI*:
Should comprise minimum of 7% total calories. General recommendation is not to exceed 30% of caloric intake
Common therapeutic range for bone health (daily intake):
20–30% of total calories is perhaps more ideal
Dietary considerations concerning adequacy of average daily intake:
Average American consumes ~33% of his/her calories in fat. Consumption of essential fatty acids (EFA’s), however, is frequently inadequate
Add up your intake from diet and supplementation:__________________

Protein

Adult RDA or AI*:
0.8 g/kg per day adult males and females
125-lb person = 45 g
175-lb person = 63 g
56 g adult males
46 g adult females
Common therapeutic range for bone health (daily intake):
1.0–1.5 g/kg
Dietary considerations concerning adequacy of average daily intake:
Daily intake commonly exceeds 100 g, but the elderly and some women often have very deficient intake. Higher protein intake should be balanced with higher RDA level potassium intake from food sources
Add up your intake from diet and supplementation:__________________

About… Dietary Reference Intakes (DRI),
Adolescent Recommended Dietary Allowances (RDA),
Adult Recommended Dietary Allowances (RDA),
Adequate Intakes (AI), and
Estimated Average Requirements (EAR)
The Dietary Reference Intake (DRI) is a system of nutritional guidelines developed by the Institute of Medicine (IoM) of the US National Academy of Sciences. It was first introduced in 1997 to broaden the set of existing Recommended Daily Allowance (RDA), which is the system currently still in use in food nutrition labeling. The DRI includes two sets of values that serve as goals for nutrient intake (from the National Academy of Sciences). These are the RDA andAdequate Intake (AI).
Table of RDAs for Adolescents and Teenagers.
Recommended Dietary Allowances (RDA) represents the daily dietary intake of a nutrient regarded to be sufficient for meeting the requirements of nearly all (97–98%) healthy individuals in each age and gender group. The RDA reflects the average daily amount of a nutrient considered adequate to meet the needs of most healthy people. If there is insufficient evidence to determine an RDA, an AI is set.Adult RDA figures come from: National Academy of Sciences, Institute of Medicine, and the Food and Nutrition Board, through the United States Department of Agriculture Food and Nutrition Information Center website.
Adequate Intake (AI) values are more tentative than RDA, but both may be used as goals for nutrient intake.
In addition to the values that serve as goals for nutrient intakes, the DRI includes a set of values called Tolerable Upper Intake Levels (UL). The UL represent the maximum amount of a nutrient that appears safe for most healthy people to consume on a regular basis.
The Estimated Average Requirement (ERA) calculations are the average daily nutrient intake level estimated to meet the requirement of half of the healthy individuals in a particular life stage and gender group. They are established by the Institute of Medicine (IoM).
Keep in mind that these are values that are meant to cover adequacy for most folks, not for optimizing health! The common therapeutic dose for bone health may be significantly higher in “special need” cases.

7 top nutrients for bone health

August 3, 2018/0 Comments/in Bone Nutrition /by Dr. Susan E. Brown

“But I have always taken my calcium and vitamin D! Why do I have osteoporosis?”

This is what I often hear from frustrated and disappointed women who have just been told about the results of their declining bone density measurements. The misconception here is that there are only a small number of important bone nutrients.

In reality, there are at least 20 nutrients that are directly essential for the development and maintenance of healthy bones. If even one of these nutrients is in short supply, bone health will suffer and attaining optimum bone health will be impossible.

How to start boosting bone nutrition

Building stronger bones is a journey. Where do you start? To help you begin increasing your intake of bone nutrients, I narrowed the 20 key bone-building nutrients to the 7 most important ones that you can start working on through your diet or through a supplement. The chart below describes what the bone nutrients are needed for, good food sources, and details on the amount of this nutrient you should consume every day.

If you want additional information about these nutrients, see my article here. I also encourage you to learn more about my Better Bones Builder formula that contains optimal amounts of key nutrients for bone.

Learn more about all 20 key bone nutrients as researched by Dr. Susan Brown

Click each nutrient to see what she has written on each one!

Top References:

Heaney, R., & Weaver, C. 2003. Calcium and vitamin D. Endocrinol. Metab. Clin. N. Am., 32 (1), 181–194, vii–viii. URL (abstract): (accessed 05.20.2008).

Brown, S. 2008. Vitamin D and fracture reduction: An evaluation of the existing research. Alt. Med. Rev., 13 (1), 21–33. URL (PDF): (accessed 05.22.2008).

Holick, M. 2006. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin. Proc., 81 (3), 353–373. URL: (accessed 05.13.2008).

Hanley, D., & Davison, K. 2005. Vitamin D insufficiency in North America. Symposium: Vitamin D Insufficiency: A Significant Risk Factor in Chronic Diseases and Potential Disease-Specific Biomarkers of Vitamin D Sufficiency. J. Nutr., 135 (2), 332-337. URL: (accessed 05.13.2008).

Holick, M. 2005. The vitamin D epidemic and its health consequences. J. Nutr., 135 (11),2739S–2748S. URL: (accessed 05.13.2008).

Bischoff–Ferrari, H., et al. 2007. Calcium intake and hip fracture risk in men and women: A meta-analysis of prospective cohort studies and randomized controlled trials. Am. J. Clin. Nutr., 86 (6), 1780–1790. URL (abstract): (accessed 06.17.2008).

Steingrimsdottir, L., et al. 2005. Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake. JAMA, 294 (18), 2336-2341. URL: (accessed 06.17.2008).

Dawson–Hughes, B., et al. 1997. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. NEJM, 337 (10), 670-676. URL: (accessed 06.17.2008).

Dawson–Hughes, B., et al. 1990. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. NEJM, 323 (13), 878–883. URL: (accessed 05.13.2008).

Brown, S. 2006. “Bone nutrition.” In Scientific Evidence for Musculoskeletal, Bariatric, and Sports Nutrition, ed. I. Kohlstadt, p. 458. Boca Raton, FL: CRC Press.

Knapen, M., et al. 2007. Vitamin K2 supplementation improves hip bone geometry and bone strength indices in postmenopausal women. Osteoporos. Int., 18 (78), 963–972. URL: (accessed 05.14.2008).

How much vitamin D do you need to reduce breast cancer risk?

March 1, 2018/in Bone Nutrition /by Dr. Susan E. Brown

It has been recognized for over a decade that vitamin D has a protective effect against a variety of cancers, including breast cancer (Garland et al., 2006; Krishnan et al., 2010). But new research from our friends at GrassrootsHealth on vitamin D and breast cancer has me really excited. The group has found that maintaining a higher vitamin D level can reduce breast cancer risk by — are you ready for it? — a whopping 80 percent.

Higher vitamin D levels reduce breast cancer risk AND reduce bone loss

GrassrootsHealth recently combined two randomized clinical trials from Dr. Joan Lappe (Lappe et al., 2007; McDonnell et al, 2016) looking at women over four years. What they found was that was that those women who had vitamin D blood levels equal or greater then 60 ng/mL — the same levels helpful in preventing bone loss — had an 80% lower risk of breast cancer than women with concentrations less than 20 ng/mL (a very deficient level indeed).

Meanwhile, a similar study conducted recently showed that women with a vitamin D level above 38 ng/mL (about the level conventionally regarded as “adequate) had a 21% lower risk of breast cancer than women with levels at or below 24.6 (O’Brien et al., 2017).

You can’t help but notice the difference in risk reduction at 60 ng/mL versus 38 ng/mL is rather large. It reinforces what I’ve maintained all along — that current serum vitamin D recommendations are too low for women to get the best protective effects. But it also strongly supports the need for everyone to keep tabs on their vitamin D levels to ensure they don’t fall below the minimum level for bone health (and overall health).

Watch my interview with Carol Baggerly, the founder of GrassrootsHealth, to learn more about this groundbreaking research and Grassroots Heath’s new D-Action Cancer Prevention Society!

Test Your Vitamin D at Home!

References

Garland CF, Garland FC, Gorham ED, Lipkin M, Newmark H, Mohr SB, Holick MF. The role of vitamin D in cancer prevention. Am J Public Health. 2006 February; 96(2): 252–261.

Krishnan AV, Trump DL, Johnson CS, Feldman D. The role of vitamin D in cancer prevention and treatment. Endocrinol Metab Clin North Am. 2010 Jun;39(2):401–418.

Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007 Jun;85(6):1586–1691.

McDonnell SL, Baggerly C, French CB, Baggerly LL, Garland CF, Gorham ED, Lappe JM, Heaney RP. Serum 25-hydroxyvitamin D concentrations ≥40 ng/ml are associated with >65% lower cancer risk: pooled analysis of randomized trial and prospective cohort study. PLoS One. 2016; 11(4): e0152441.

O’Brien KM, Sandler DP, Taylor JA, Weinberg CR. Serum vitamin D and risk of breast cancer within five years. Environ Health Perspect. 2017; DOI:10.1289/EHP943.

What’s good for the bones is good brain health

February 15, 2018/in The Natural Approach /by Dr. Susan E. Brown

Not long ago, I spoke with Dr. Steven Masley, whose book The Better Brain Solution I found fascinating. I couldn’t help but notice, when I read the book, that his solution to maintaining longevity and healthy brain function sounded awfully familiar to me!

Stronger bones, stronger mind

Looking at over 100 clinical markers of aging, ranging from brain speed to arterial plaque growth to bone density, in concert with lifestyle factors such as diet, fitness, toxin exposure, and stress management in more that 1000 patients, Steven has found that many of the same things we use to help prevent osteoporosis and bone fractures can also reduce the risk of long-term memory loss. “We’ve been able to show which things help your memory, which things improve your brain, and it turns out many of these things are also good for your heart and your bones,” he says.

The part that may be new to my readers is that this research finds blood sugar to be one of the key elements of maintaining both healthy brain and heart. “We know that probably the number one factor that contributes to memory loss is elevated blood sugar and insulin resistance,” he told me. “When brain cells become insulin resistant, they literally shut down — they’re not able to use glucose as energy. And over time, it leads to brain cell death and literally the brain starts shrinking.”

5 steps for improving brain health

His five-step solution to this problem is where the conversation went toward familiar topics:

Healthy foods: A diet rich in green, leafy vegetables makes your brain, on average, 11 years younger, says Steven, who also recommends eating oily fish and nuts to provide omega-3 fatty acids and lists nearly a dozen other foods that are also part of an alkaline diet.
Exercise: “Just like for bones,” Steven says, “we see a benefit… the fitter you are, the better your brain function.”
Specific nutrients: Vitamin D, magnesium, and B vitamins — all important in bone health — are also key brain health.
Stress reduction: “If you don’t manage [stress], your cortisol rises, your blood sugar goes up, and it literally shrinks your brain,” he says.
Probiotics: “I really like the idea of a probiotic for a healthy gut” as a way to support brain health, he adds.

I named my bone health program “Better Bones, Better Body” because I understood that what was good for the bones would benefit the rest of the body as well—and it’s nice to get still more scientific confirmation that the approach works. But Steven’s research also underscores the sheer number of people who need to learn the value of this approach. “The #1 most expensive disease in America today is memory loss,” Steven told me. “It’s supposed to double in just the next 12 years. It’s skyrocketing.” He points to the fact that “50% of all Baby Boomers, and 30% of all adults, have insulin resistance… they’re high risk for memory loss, heart disease, diabetes, and probably bone loss, too!”

If you want to hear what else Dr. Steven Masley had to say, watch our video interview.

Root vegetables are winter’s gift to bones

February 4, 2018/in Bone Nutrition /by Dr. Susan E. Brown

How many of you recognize the root cellar depicted below? That cold-weather storage area actually looks just like the well-used root cellar in my parents’ house.

As our ancestors knew in the days before refrigeration, hardy, storable root vegetables like potatoes, carrots, parsnips, sweet potatoes, and so forth make for delicious, warming, winter foods — and as an added bonus, they have tremendous value for bone health. They are highly alkalizing and packed with important bone-building nutrients, and as an extra benefit, root veggies can satisfy our sweet tooth if cooked at length.

Root vegetables: plentiful and versatile

At a time of year when field-fresh, organic vegetables may be harder to find in cold northern latitudes, you can almost always count on roots being readily available.

In our Better Bones Better Body Program, we suggest everyone consume at least one root vegetable daily in summer and perhaps two in winter. Root vegetables can easily substitute for bread, pasta, and grains in supplying carbohydrates for energy, yet their high potassium content means they help alkalize the body, unlike acid-forming grains.

I enjoy most root crops, but my favorite is the potato — maybe because of my Irish grandmother, who ate her own “home fried” potatoes every morning, or perhaps because one large baked potato eaten with skin offers a whopping 1626 grams of potassium!

Winter root crops pack a lot of bone-building nutrients

Potassium isn’t all roots have to offer. The table below details the amount of various key bone-building nutrients found in popular root crops. We have standardized these to 100 g of each of vegetable (just so you know, a large baked potato weighs about 229 g).

An easy root vegetable recipe to savor

While I love baked potatoes all year around, one of my favorite winter recipes is roasted root vegetables. I use a number of different roots together with onion, some olive oil, and seasoning. Maybe you want to try out the recipe below; I’d love to hear of your personal warming winter root vegetable recipes.

Roasted Root Vegetables

This dish is so versatile that I have actually eaten it for breakfast alongside cooked quinoa and a poached egg. It is a great addition to almost any meal.

Ingredients:

6 large cloves of garlic, whole

5 medium-sized parsnips, diced into 1-inch cubes

4 medium-sized potatoes, unpeeled and diced into 1-inch cubes

2 large sweet potatoes, unpeeled and diced into 1-inch cubes

2 large onions, sliced lengthwise

1 medium-size butternut squash, diced into 1-inch cubes

¼ cup light olive oil

1 teaspoon sea salt

Optional herbs: parsley, oregano, or rosemary

Preheat oven to 400°F. Lightly coat two 9 × 13 inch baking dishes with vegetable oil and set aside.
In a large bowl, combine garlic, parsnips, potatoes, onions, squash, and olive oil. Toss well.
Add sea salt (and any herbs you desire) to the vegetables and toss again.
Transfer the vegetables to the prepared baking dishes, spreading them out in a single layer.
Roast the vegetables for 35 minutes or until lightly browned and fork tender, and serve.

Yields 8 servings.

Timesaver tip: The first time you make this dish, cut up more than you need of everything except the onions and freeze the extra in a gallon-size freezer bag. Then the next time you want it, all you have to do is thaw it, cut the onions, season, and bake!