Vitamin Information Center

By Maureen Williams, ND

Healthnotes Newswire (September 11, 2008)—People with digestive diseases, such as ulcerative colitis and Crohn’s disease, are especially susceptible to osteoporosis and bone fractures, due in part to nutrient deficiencies caused by malabsorption and medication side effects. A new study found that people with good vitamin D status early in the course of their disease had higher bone density and a greater likelihood of increasing bone density over time.

Healthy vitamin D levels predict healthy bones

The study, published in the American Journal of Gastroenterology, included 101 people who had recently been diagnosed with inflammatory bowel disease (IBD). Vitamin D levels in the blood and bone mineral density were measured at the beginning of the study, and bone density measurements were repeated approximately two years later.

Only 22% of the people had optimal vitamin D levels at the beginning of the study. Higher vitamin D levels were associated with higher bone density in the spine, hip, and total body. People with better vitamin D status were more likely than others to have an increase in bone mineral density over the course of the study.

The link between IBD and bone density

IBD is a group of inflammatory conditions affecting the large and small intestines. Ulcerative colitis and Crohn’s disease are the most common types, both of which are believed to be autoimmune (when the immune system attacks the body’s cells) in nature. People with IBD usually experience chronic abdominal pain and diarrhea, often with bleeding and mucus.

In people with IBD, inflammation in the bowel wall and diarrhea compromise absorption and result in nutrient deficiencies. In addition, corticosteroid medicines that are used to treat IBD can interfere with calcium absorption and metabolism. Maintaining healthy bone density requires the integrated work of a number of nutrients, including calcium and vitamin D, so it is not surprising that people with IBD have high rates of low bone density (osteopenia and osteoporosis).

Improving vitamin D status

Vitamin D is made in the body through a series of chemical reactions that begins in sun-exposed skin. Modern lifestyles with limited outdoor time and widespread use of sunscreens have led to increasing rates of vitamin D deficiency in the general population, and these rates are even higher in the elderly and people with chronic disease.

“Poorer vitamin D correlates with lower baseline bone mineral density and better vitamin D status is correlated with a gain in total bone mineral density. Early optimization of vitamin D may play an important role in preventing IBD-related bone disease,” said the researchers from the University of Manitoba in Winnipeg. Small amounts of vitamin D are found in eggs and fish, as well as fortified dairy foods and some dairy substitutes, but the authors noted that their findings suggest that adding vitamin D supplements is warranted for most people with IBD.

Increased intake of calcium and vitamin D can help prevent or slow bone loss in men, according to a pair of studies conducted by researchers from Deakin University in Melbourne, Australia.

An estimated 75 million women and men in the United States, Europe and Japan suffer from osteoporosis, a disease in which bones become thin and brittle.

Prior research has demonstrated that both calcium and vitamin D are important for the bone health of women, who are four times more likely to develop osteoporosis than men. In a 2006 study published in the journal Bone, scientists also found that older men who drank fortified milk daily experienced a 1.8 percent increase in the bone mineral density of their hip bones and a 1.5 percent increase in the density of their wrist bones.

The fortified milk contained 500 milligrams of calcium and 400 IU of vitamin D3, as well as other vitamins and minerals. The researchers noted that because the participants were given fortified milk instead of individual vitamin supplements, it was not possible to determine whether the bone density increase came from the calcium, the vitamin D, both, or some combination of those nutrients with others found in the milk.

The researchers also noted that while calcium intake was higher in participants who drank fortified milk than in control participants, this difference was not statistically significant.

In a more recent study, published in the American Journal of Clinical Nutrition, researchers followed up with 109 of the original study participants 18 months after that study’s conclusion. During that time, the participants had not been provided with fortified milk, but the bone-density improvements from the first study were still apparent.

The researchers suggested that supplementation of milk with calcium and vitamin D3, as is done in Canada, could lead to long-term bone health benefits for older men.

Newswise — Softening of the skull bones in normal-looking babies might reflect vitamin D deficiency during pregnancy, according to a new study accepted for publication in the Journal of Clinical Endocrinology & Metabolism (JCEM). Furthermore, breast-feeding without vitamin D supplementation could prolong the deficiency, which might lead to a risk of serious health problems later in life, including type 1 diabetes and decreased bone density.

“Craniotabes, the softening of skull bones, in otherwise normal newborns has largely been regarded as a physiological condition without the need for treatment,” said Dr. Tohru Yorifuji, of Kyoto University Hospital in Japan. “Our findings, however, show that this untreated condition may be the result of a potentially dangerous vitamin D deficiency.”

For this study researchers evaluated 1,120 newborns for incidence of craniotabes, and at 5-7 days of age, 246 neonates (22 percent) were found to have craniotabes. Researchers also found the incidence of craniotabes had obvious seasonal variations. This clear seasonal variation strongly suggests that the condition is associated with prenatal vitamin D deficiency and likely reflects the amount of sun exposure of pregnant women.

Most importantly, vitamin D deficiency in neonates, could persist into later life, especially in breast-fed infants who do not receive a formula containing vitamin D supplementation. In this study, more than half of the breast-fed infants with craniotabes showed statistically significant low levels of serum 25-OH vitamin D, the storage form of vitamin D. Some of those infants also had symptoms of an overactive parathyroid gland consistent with vitamin D deficiency.

Vitamin D deficiency has not received as much attention as it once did, however several recent studies have reported a resurgence of the condition, even in developed countries. Vitamin D deficiency classically presents with skeletal manifestations such as rickets in childhood or the softening of bones in adults. In addition, vitamin D deficiency in adults can also lead to increased incidence of immunological diseases such as multiple sclerosis, type 1 diabetes, or even colorectal cancer.

“Until more research is done on the effects of perinatal vitamin D deficiency, we suggest treating breast-fed infants with craniotabes with vitamin D, or preferably, treating all pregnant women with vitamin D,” said Yorifuji.

Other researchers working on the study include Junko Yorifuji, Shizuyo Nagai, Masahiko Kawai, Toru Momoi, and Tatsutoshi Nakahata of Kyoto University Hospital in Japan; Kenji Tachibana and Hiroshi Hatayama of Adachi Hospital in Japan; and Hironori Nagasaka of Chiba Children’s Hospital in Japan.

A rapid release version of this paper has been published on-line and will appear in the May 2008 issue of JCEM, a publication of The Endocrine Society.

Founded in 1916, The Endocrine Society is the world’s oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology. Today, The Endocrine Society’s membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society, and the field of endocrinology, visit our web site at http://www.endo-society.org.

It takes more than drinking milk to strengthen our bones. Milk is certainly a good source of calcium, but it is only one option to prevent or retard osteoporosis, the disease that affects one out of every two women over the age of 50.

Bone density begins its slow decline between the ages of 25 and 30. By the age of 70, women can lose up to 30 percent of that density. By age 75, osteoporosis becomes as common in men as it is in women.

Osteoporosis means “porous bones” and is considered the third-leading health issue in our country, after cardiovascular and cancer problems. The most threatening areas for fractures to occur are in the spine, hips and wrists.

When bones become weak and brittle, actions as easy as bending over or even coughing can cause fractures. While hip fractures usually are a result of a fall, many fractures occur without involving any falls.

Compression fractures can develop when bones in your back simply become too weak, resulting in a stooped posture. This will increase pressure around your spine, eventually causing more compression fractures.

Three of the major risk factors for osteoporosis that we can control are lack of regular exercise, too little calcium intake and an inadequate amount of vitamin D, which is essential for calcium absorption.

People who have been physically active in their younger years have an advantage over their non-active friends: While the active types may lose some bone as they age, their chances of suffering fractures from having brittle bones are greatly reduced.

It never is too early or too late to begin strengthening the muscles and the bones. Exercise can improve muscle strength, bone density, posture and balance, all of which will help prevent falls.

If you already have osteoporosis, exercising can help maintain your bone mass. You should replace any high-impact exercise that could place stress on your spine (such as jogging) with more gentle weight-bearing exercises (walking).

Similarly, bending and twisting movements at the waist (such as in golf, tennis and situps) should be avoided, because they could cause the already weakened spinal bones to compress and possibly fracture.

It is important to check with your physician or physical therapist before you begin exercising, because you need to find the safest and most enjoyable exercises depending on your degree of bone loss.

Exercise prevents osteoporosis

Muscles become stronger and bone density increases as you place demands upon them; bone is a living tissue that reacts positively to exercise.

Commitment to consistent exercise is essential, because once you cease exercising, bone density benefits will also cease.

For strengthening and helping to maintain healthy bones, it is recommended to do weight-bearing exercises a minimum of 30 minutes for three days per week and resistance exercises two or three times a week.

What type of exercise is best

Weight-bearing exercises require your body to work against gravity: jogging, brisk walking, stair climbing, racquet sports and dancing are good examples. Swimming and biking, while excellent for cardio workouts, are not considered a weight-bearing exercise.

However, in some stages of osteoporosis, water exercises may be used in rehabilitation. Resistance exercise (strength training) strengthens muscles and bones throughout the entire body. These exercises involve using your muscular strength to work against the weight of another object, such as using free weights, weight machines or resistance bands.

For some resistance exercises, you can even use your own body weight as the exercise load. Balance, coordination and flexibility exercises for fall prevention include standing on one leg, sitting and exercising on an exercise ball, tandem walking, stretching, dancing, tai chi and yoga.

Nutritionally speaking

According to the National Institutes of Health, people with vitamin D deficiencies absorb less than 10 percent of available calcium they ingest. Three of the leading contenders for calcium are plain low-fat yogurt, fruit yogurt and whole, low-fat or fat-free milk.

Our body’s absorb vitamin D through sunlight and vitamin D-fortified foods, such as milk. Here are a few added suggestions to fortify your 206 bones:

• Treat yourself to 15 minutes a day without any sunscreen. That is what your body needs to produce vitamin D, the “sunshine vitamin.”

• Almonds are packed with bone health. A handful counts for about 70mg of calcium.

• Studies indicate that a cup of tea a day increases bone density.

• Eat brown instead of white. Brown rice has three times the calcium than white rice.

• Try having chopped figs over yogurt for a snack; it will give you almost half the needed calcium requirements for the day.

If you are 50 or older and have not been exercising, check with your physician before beginning ANY exercise program. Sally Anderson, a trainer, is happy to hear from readers but cannot respond to individual queries. Write her in care of LifeTimes, St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731.

Hip extensions

Strengthens hips and thighs. Place one hand on a countertop. Keeping hips facing forward, slowly lift one leg out to the side, knee facing forward, as Royce demonstrates at left. Hold a few seconds, then slowly return leg to ankle, never touching the floor. Repeat 8 to 10 times. Priscilla shows the next movement: Lift leg diagonally to the back. Hold, then slowly release leg; repeat 8 to 10 times. Tips: Contract abdominals and do not lock knees. You may add ankle weights later.

Tandem walk

Develops balance. (Not shown.) Stand with fingers lightly supported on a counter or a wall. Looking straight ahead, walk, placing one foot directly in front of other foot, making sure front heel is close to back toes; aim for 15 to 20 steps. Then, if you do not have foot or ankle issues, try walking on your heels, with the balls of your feet lifted up. Tip: Walk tall, do not lean forward.

Wringing the towel

Strengthens the wrist. Hold a towel in both hands, keeping elbows close to your sides. Wring the towel out as hard as you can, extending one wrist and flexing the other wrist at the same time; do 10 to 15 repetitions. Tip: Use your wrist muscles, not your fingers.

Back extension

Strengthens shoulders, back, neck, spine and hips. Begin by lying on your stomach on a mat with arms in front of you, palms facing downward. Keeping legs on mat, lift head, arms and chest off the mat. Bend elbows, bringing them in toward your shoulders, feeling a slight pinch of the shoulder blades. Hold for several seconds, then extend arms to original position and repeat several times. Tip: Do not hold your breath.

Wringing the towel

Strengthens the wrist. Hold a towel in both hands, keeping elbows close to your sides. Wring the towel out as hard as you can, extending one wrist and flexing the other wrist at the same time; do 10-15 repetitions. Tip: Use your wrist muscles, not your fingers.

An adolescent’s vitamin K status could have important long-term implications on bone health, and a better status may protect them from osteoporosis later in life, suggests a new study.

An improved status of the vitamin was found to improve bone mineral content and bone mass in the whole body, according to the study with 307 healthy children with an average age of 11.2 published in the British Journal of Nutrition.

“As children grow the increase in bone mass may fail to keep up with the increase in height, or length of the bone, and as a consequence, this imbalance may result in fracture,” said lead author Marieke Summeren from University Medical Centre Utrecht.

“But the main threat of a long-term shortage of K vitamins is that peak bone mass may be compromised, and as we age and begin to lose bone density, the risk of fracture in later life is increased.”

Osteoporosis is characterized by low bone mass, which leads to an increase risk of fractures, especially the hips, spine and wrists. An estimated 75 million people suffer from osteoporosis in Europe, the USA and Japan.

Women are four times more likely to develop osteoporosis than men.

Potential reduction of osteoporosis has traditionally been a two-pronged approach by either attempting to boost bone density in high-risk post-menopausal women by improved diet or supplements, or by maximising the build up of bone during the highly important pubescent years.

About 35 per cent of a mature adult’s peak bone mass is built-up during puberty.

The new study followed the children for years and correlated vitamin K status, measured as a ratio of undercarboxylated osteocalcin (ucOC) to carboxylated osteocalcin (cOC), to bone mineral content (BMC) and markers of bone metabolism.

Osteocalcin is a vitamin K-dependent protein and is essential for the body to utilise calcium in bone tissue. Without adequate vitamin K, the osteocalcin remains inactive, and thus not effective.

Summeren and co-workers report that large variations were observed in the vitamin K status of the children, both at the start and end of the two-year study. Nonetheless, an improved vitamin K status over the time period, as was observed in 281 children, was associated with a significant increase in BMC.

“There are two types of vitamin K from dietary sources. Vitamin K1 is found in leafy green vegetables, and Vitamin K2, also called menaquinones, are predominately found in fermented cheeses, curd, and the fermented soy called natto,” explained co-author Leon Schurgers from VitaK and Cardiovascular Research Institute at the University of Maastricht.

“Vitamin K1 is mostly used by the liver where it is involved in the synthesis of certain blood clotting factors. Vitamin K2 is also equally active outside the liver, in tissues including bone. Thus it is important to have good sources of both types of vitamin K!”

The research adds to a growing body of science linking the vitamin to improved boned health, particularly in post-menopausal women. The Maastricht-based researchers previously reported that daily supplements of vitamin K2 maintained hipbone strength in postmenopausal women, while placebo led to weakening (Osteoporosis International, doi: 10.1007/s00198-007-0337-9).

The double-blind, placebo controlled study followed 325 healthy women with no osteoporosis for three years and also found that vitamin K2 supplements boosted the women’s bone mineral content (BMC), compared to placebo.

The new study also included researchers from VU University Medical Centre and the Danone Research Centre Daniel Carasso in France.

Source: British Journal of Nutrition
Published online ahead of print, doi:10.1017/S0007114508921760
“Vitamin K status is associated with childhood bone mineral content”
Authors: M.J.H. van Summeren, S.C.C.M. van Coeverden, L.J. Schurgers, L.A.J.L.M. Braam, F. Noirt, C.S.P.M. Uiterwaal, W. Kuis, C. Vermeer

NattoPharma, Norway, and P.L. Thomas today note the publication of a new study demonstrating vitamin K’s role in promoting healthy bones in children. Published online at the British Journal of Nutrition link, the researchers followed 307 healthy children, with an average age of 11.2 years, over a two year period and measured skeletal bone mineral content. They found improved status of the K vitamins over the two year period resulted in better mineral content and improved bone mass of the whole body.

According to the lead author, Marieke Summeren, Ph.D., “As children grow the increase in bone mass may fail to keep up with the increase in height, or length of the bone, and as a consequence, this imbalance may result in fracture.” She continued, “But the main threat of a long-term shortage of K vitamins is that peak bone mass may be compromised, and as we age and begin to lose bone density, the risk of fracture in later life is increased.”

Study author Leon J. Schurgers,Ph.D.commented, “Numerous population studies and interventional trials have established the consumption of K vitamins to bone strength, structure and the reduction of the risk of fracture. This is due to the need to activate the vitamin K-dependent protein osteocalcin, which is essential for the body to utilize calcium in a healthy bone tissue. Unfortunately, most people, including children, are likely deficient in the K vitamins related to the need for bone health.”

This is among the first studies linking K vitamins to bone health in children. Vitamin K status was evaluated by measured by the amount of active osteocalcin to inactive osteocalcin. Without adequate vitamin K, the osteocalcin remains inactive, and thus not effective. Previous research has evaluated vitamin K status in children and found that they have inadequate K vitamins consumption to fully activate osteocalcin.

“There are two types of vitamin K from dietary sources. Vitamin K1 is found in leafy green vegetables, and Vitamin K2, also called menaquinones, are predominately found in fermented cheeses, curd, and the fermented soy called natto,” stated Schurgers. “Vitamin K1 is mostly used by the liver where it is involved in the synthesis of certain blood clotting factors. Vitamin K2 is also equally active outside the liver, in tissues including bone. Thus it is important to have good sources of both types of vitamin K!”

The recommended intakes of vitamin K today are based solely on coagulation. However, K vitamins are also necessary for the activation of osteocalcin, a protein necessary to transport calcium from the blood to form healthy bone matrix. Also, K vitamins are needed to activate matrix GLA protein (MGP), the most potent inhibitor of vascular calcification known. In essence, K vitamins are necessary to keep calcium in your bones and out of your arteries.

About Vitamin K2
The role of newly recognized vitamin K2 has for the past decade been linked to two of the most important health issues, osteoporosis and cardiovascular disease. This link specifically centers on calcium utilization- implying that there is concurrent arterial calcification and osteoporosis when metabolism of calcium is inadequate. K vitamins are essential to activate proteins involved in calcium metabolism.

Numerous population studies and interventional trials have established the consumption of vitamins K and K2 to bone strength, structure and the reduction of the risk of fracture. More recently, and specifically to vitamin K2, a significant role in cardiovascular health has been established.

A study published in the Journal of Nutrition called the “Rotterdam Study” in 2004, followed over 4,800 people for a ten year period. The study found increased intake of specifically vitamin K2 from dietary sources significantly reduced the incidence of arterial calcification and the risk of CHD mortality by 50% as compared to low dietary vitamin K2 intake. In this study, vitamin K1 had no effect at all.

# # #

PLT offers a natural vitamin K2 under the trade name MenaQ7 in alliance NattoPharma, Norway, the owner of the brand MenaQ7.

About MenaQ7™
MenaQ7 provides Natural Vitamin K2 as an extract of natto, a fermented soy food from Japan. Natto is particularly rich in the highly bio-available form of vitamin K2 called menaquinone-7 (MK-7). MenaQ7 provides the only commercially available Natural Vitamin K2 with guaranteed actives and stability, clinical substantiation and international patents awarded and pending.

For more information on the health benefits of MenaQ7, please visit www.menaq7.com

About NattoPharma
NattoPharma, Norway, is a publically-traded company and the exclusive international supplier of MenaQ7 natural Vitamin K2. NattoPharma has entered into a multi-year research and development program to substantiate and discover the health benefits of natural vitamin K2 for applications in the exciting marketplace for functional food and health food supplements. www.nattopharma.com

About PL Thomas
PL Thomas, a New Jersey-based ingredient supplier, offers fifty years of innovation in securing reliable, high quality raw materials for the food/functional food and nutrition industries. PLT is a one-stop resource for application solutions, current industry information and technical service, and specializes in water-soluble gums and clinically-supported botanical extracts. www.plthomas.com

For more information, please contact Eric Anderson at eric@plthomas.com - 973-984-0900 x215.

We can get the vitamins and minerals our body needs by eating a balanced, varied and colourful diet.

But there is one vitamin that we can make ourselves, simply by exposing our skin to sunlight.

Vitamin D is made in the skin after interaction with UVB rays and plays a vital role in the build up of bone density.

The importance of vitamin D extends further – it affects immune function, helping to avoid colds and flu and it protects against cancer and the development of diabetes.

A recent study by experts at Harvard Medical School has added to the evidence that a low vitamin D status is linked to an increased risk of heart disease.

Vitamin D may also help regulate blood pressure and be involved in reducing inflammation.

The amount of vitamin D made by our skin depends primarily on the amount of sunlight, which, in turn, depends on:

The latitude we live at – the south has the advantage over the north

The season – summer wins over winter

The time of day – mid-day comes out tops.

Vitamin D production also decreases as we age – it is slower in dark-skinned people and is lower in obese people as vitamin D is thought to be stored in fat, which makes it less readily available.

To ensure our vitamin D levels are kept topped up we need to get out more, whatever the weather as it doesn’t have to be bright sunshine.

By exercising at the same time we will doubly benefit our hearts.

It pays to create opportunities – walk to work, alight from the bus a couple of stops earlier, walk the kids to school, go for a lunchtime walk, get out at the weekend to garden, bike or hike.

Remember not to cover up too much, just leave some skin exposed so that you can actually restore those vitamin D levels.

As springtime sunrays strengthen, 10 to 15 minutes uncovered or with a low sunscreen factor before 11am and after 3pm could be enough to boost our vitamin D status without tanning or burning.

Sunlight is the cheapest way to top up your vitamin D but there are a few foods that contain vitamin D:

Oily fish such as sardines, fresh tuna, salmon, trout, mackerel and kippers – eating two portions of oily fish a week will also provide you with heart-healthy omega 3 fats

Eggs and shiitake mushrooms

Cod liver oil

Fortified breakfast cereals.

For more information and advice about healthy living, contact Heart Research UK on 0113 297 6206 or email lifestyle@heartresearch.org.uk

The first line of defense is sound nutrition and of course exercise, but also necessary are supplements. This is due to free radical damage. With supplements you will be able to provide optimal cellular protection. There are various state-of-the-art anti-aging supplements that are proven to work thanks to research. Perhaps you can consider this your very own Anti-Aging Life Extending Supplement Program.
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Vitamins D is a fat-soluble seco-sterol hormone precursor that is responsible for sustaining optimal levels of calcium and phosphorus in our blood stream. To some extent, Vitamin D is manufactured by our skin though exposure to sunlight. The best time for sunlight exposure is during the spring and fall seasons.. Winter sunlight is too weak for the production of Vitamin D. Many of us do not get enough exposure to sunlight during the year. We have been convinced that the sun is not good for our skin, so when we are exposed to sun we have come to use clothing and sun screen to “protect” ourselves from the sun. Most of us spend most of our time indoors. These factors have resulted in making Vitamin D deficiency a common if not major health problem. It has also been found that older people and many younger women, especially African-American women, and those who live in Northern climates with less time exposure to sunlight are at risk for Vitamin D deficiency.
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