Vitamin Information Center

Healthnotes Newswire (August 28, 2008)—Building and maintaining bone is complex work involving many nutrients, such as calcium, vitamin D, magnesium, boron, vitamin K, and essential fatty acids. A new study found that low levels of vitamins B6 and B12 and high levels of homocysteine were associated with increased risk of hip fracture.

B vitamins, homocysteine, and changes in bone

The study, published in the Journal of Clinical Endocrinology and Metabolism, included 714 senior men and women who were participating in the longstanding Framingham Study. Tests to measure bone density and blood levels of homocysteine, folic acid, and vitamins B6 and B12 were done at the beginning of the study and bone density was measured again after four years.

People with low vitamin B6 levels experienced more bone density loss than people with normal B6 levels, and people with B6 deficiency lost the most bone. Low and deficient levels of vitamins B6 and B12, as well as high levels of homocysteine (a potentially toxic amino acid byproduct), were each independently associated with more hip fractures.

How B vitamins and homocysteine are connected

Folic acid and vitamins B6 and B12 are all involved in the metabolism of homocysteine, and when any of these vitamin levels drops, homocysteine can accumulate, potentially leading to negative health effects. Getting more of these vitamins through diet or supplements can bring down high homocysteine levels. A high homocysteine level is a risk factor for heart disease, and some evidence suggests it might also be a risk factor for a number of other conditions including stroke, clotting problems, inflammatory bowel disease, Alzheimer’s disease, hypothyroidism, death from diabetes, pregnancy complications, and osteoporosis.

Despite their connection, B vitamins and homocysteine appear to have distinct effects on bone loss and fracture risk. “This study suggests that low vitamin B6 status, but not elevated homocysteine, is an important determinant of bone loss in community dwelling elders,” the study’s authors concluded.

Getting more B vitamins

The best way to get more vitamin B6 and folic acid is to eat plenty of fruits, vegetables, whole grains, and legumes. Vitamin B12 is found in animal foods and fish, and possibly sea vegetables and tempeh, a cultured soy food. Eating more of all three of these vitamins, especially folic acid, from food and supplements is a good strategy for reducing high homocysteine levels.

Although vitamin B6 and folic acid are usually readily absorbed, some health conditions can interfere with vitamin B12 absorption, such as gastritis, inflammatory bowel disease, infections of the digestive tract, and any condition that causes malabsorption. People with these conditions might need to take high-potency supplements and should consult their doctor first.

(J Clin Endocrinol Metab 2008;93:2206–12)

Maureen Williams, ND, received her bachelor’s degree from the University of Pennsylvania and her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, WA. She has a private practice in Quechee, VT, and does extensive work with traditional herbal medicine in Guatemala and Honduras. Dr. Williams is a regular contributor to Healthnotes Newswire.

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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.