Vitamin Information Center

CHEVY CHASE, Md.—Diets high in protein and cereal grains produce an excess of acid in the body which may increase calcium excretion and weaken bones, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM). The study found increasing the alkali content of the diet, with a pill or through a diet rich in fruits and vegetables has the opposite effect and strengthens skeletal health.
“Heredity, diet and other lifestyle factors contribute to the problem of bone loss and fractures,” said Bess Dawson-Hughes, M.D., of Tufts University, Boston and lead author of the study. “When it comes to dietary concerns regarding bone health, calcium and vitamin D have received the most attention, but there is increasing evidence that the acid/base balance of the diet is also important.”
Average older adults consume diets that, when metabolized, add acid to the body, said Dr. Dawson-Hughes. With aging, we become less able to excrete the acid. One way the body may counteract the acid from our diets is through bone resorption, a process by which bones are broken down to release minerals such as calcium, phosphates and alkaline (basic) salts into the blood. Unfortunately, increased bone resorption leads to declines in bone mass and increases in fracture risk.
“When fruits and vegetables are metabolized they add bicarbonate, an alkaline compound, to the body,” said Dr. Dawson Hughes. “Our study found that bicarbonate had a favorable effect on bone resorption and calcium excretion. This suggests that increasing the alkali content of the diet may attenuate bone loss in healthy older adults.”
In this study, 171 men and women aged 50 and older were randomized to receive placebo or doses of either: potassium bicarbonate, sodium bicarbonate, or potassium chloride for three months. Researchers found subjects taking bicarbonate had significant reductions in calcium excretion, signaling a decrease in bone resorption.
“In this study, we demonstrated that adding alkali in pill form reduced bone resorption and reduced the losses of calcium in the urine over a three month period,” said Dr. Dawson-Hughes. “This intervention warrants further investigation as a safe and well tolerated supplement to reduce bone loss and fracture risk in older men and women.”
Other researchers working on the study include Susan Harris, Nancy Palermo, Helen Rasmussen, and Gerard Dallal of Tufts University in Boston and Carmen Castaneda-Sceppa of Northeastern University in Boston.
The article “Treatment with Potassium Bicarbonate Lowers Calcium Excretion and Bone Resorption in Older Men and Women,” will appear in the January issue of JCEM.

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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NEW YORK (Reuters Health) - Softening of the skull bones in normal-appearing newborns is tied to a vitamin D deficiency in the womb, according to Japanese researchers.

They suggest that breast-fed infants with this condition may need vitamin D supplements.

Soft skull bones, also known as craniotabes, in normal newborns is usually regarded as no cause for alarm, but Dr. Tohru Yorifuji at Kyoto University Hospital and colleagues dispute this in their report in the Journal of Clinical Endocrinology and Metabolism. They point to evidence that the condition is associated with type 1 diabetes, reduced bone mass during childhood, and lowered immunity.

In their study, the researchers screened 1120 normal infants at 5 to 7 days of age. Craniotabes was considered present when “the skull bones reversibly bended by application of pressure by the examiner’s fingers.”

They found that 246 babies, or 22 percent, had craniotabes. The highest rate occurred among infants born in April and May, and the lowest in those born in November.

Vitamin D production in the body is triggered by sunlight, and Yorifuji’s team points out that the rate of craniotabes “was influenced by the daylight hours approximately 4 months prior to delivery.” They say this strongly suggests that “the condition is associated with vitamin D deficiency in utero.”

Low vitamin D levels and other abnormalities at 1 month of age were more common in babies who were breast-fed than in those who were fed formula at least part of the time, the investigators found.

They therefore recommend “treating breast-fed infants with craniotabes with vitamin D, or preferably, treating all pregnant women with vitamin D.”

SOURCE: Journal of Clinical Endocrinology and Metabolism, online February 12, 2008.