May 27, 2015

Director's Letter

BONES--we've all got them!

As we spend this week on bones, I want to introduce you to Dr. Susan Brown and her website, BetterBones.com. She has been an innovator and contributor to bone health for over 20 years. Here is an excerpt from her web site which explains how she started and her passion for bones:

Dr. Brown first became interested in bone health when she lost her grandmother, at the age of 102, to complications from a hip fracture. Dr. Brown couldn't help wondering, how much longer might this alert and active woman have lived had she not fractured her hip? Her interest grew into a compulsion as she sought to understand why the disease existed and what we could do about it.

As an anthropologist using a cross-cultural perspective, Dr. Brown discovered that the nature of osteoporosis is very different than commonly believed. She found that cultures with the highest calcium intake also have the highest osteoporosis rates, despite conventional wisdom that calcium levels dictate bone health. Dr. Brown's research found that though people in many countries have lower bone density than we do in the United States, their fracture rates are significantly lower. Her research led her to a startling conclusion: the disease of osteoporosis is a preventable disorder created by our lifestyles and eating habits.

Dr. Brown and I did a Vitamin D Seminar together in Syracuse in 2008. The audience feedback from this one, "My doctor won't order a vitamin D test for me" was a major factor in the initiation of our D*action project--providing home test kits for those who wanted them. She has many items on her site beyond vitamin D that will be useful for helping assess and maintain your bone health. Take a look. She's a trusted resource.

While most doctors agree vitamin D is good for bones, there is still the discrepancy that some feel a little is enough (20-30 ng/ml). Once again our D*action data shows that vitamin D serum levels between 40-60 ng/ml may help prevent fractures.

Onwards!

Carole Baggerly

Director, GrassrootsHealth

A Public Health Promotion & Research Organization

Moving Research into Practice NOW!

Your Data Your Answers:

Does Vitamin D reduce the likelihood of broken bones?

Vitamin D was first studied to improve bone health and eradicate rickets. Almost every doctor is aware that vitamin D is important for skeletal health. There are thousands of studies that back up this point. But what have we found through our D*action data? Any differences?

Your Data

When signing up for D*action we ask our participants if they have fallen in the last six months and if so how many times. The next question asks if they have broken a bone in the last 6 months and if so, how many times, which bone and the reason for the break. While these two questions are not linked, we are able to glean if the broken bone was from the fall by the free responses given.

Your Answers

The analysis presented here is limited to participants aged 65 years and older (17% of all participants) since that age group is most likely to experience the effects of bone health. Within this group, 11% experienced a fall and 2% experienced a broken bone in the 6 months prior to their first test. Of those who broke a bone, the average number of breaks was one and the most common bones were in the feet and hands. The most common reasons were falling, tripping and running into furniture/wall.

Falls

Our data did not show a difference in falls based on serum levels. There was no difference in serum levels between those who fell in the prior 6 months and those who didn't. The median serum level was 44 ng/ml for both those who fell and those who didn't.

Broken Bones

But does vitamin D help prevent breaks? We plotted the percentage of participants age 65+ who broke a bone vs. their vitamin D blood levels. Here are the results:

Notice:

Those who broke a bone were more likely to have a serum level <40 ng/ml than ≥40 ng/ml.

Those with serum levels <20 ng/ml had 3 times the risk of breaking a bone compared to those ≥40 ng/ml.

What about the normal population?

A quick Google search finds that approximately 33% of adults age 65+ will fall within a year (Medicine.net). For D*action, 22% of our participants aged 65+ fell within the last 12 months.This is 33% fewer falls than in the general population. Our average serum level is 44 ng/ml, the average in NHANES (the National Health and Nutrition Examination Survey) which is a representation (probably a little high) of the general population is about 28 ng/ml.

According to a study by Janssen et al., Vitamin D deficiency, muscle function, and falls in elderly people, vitamin D deficiency is responsible for muscle weakness which can then lead to falls, and then the likelihood of a break. Since our average vitamin D level is 44 ng/ml, this would not be considered deficient (our measure is a minimum of 40 ng/ml). This would account for the much lower break ratio in our population. Janssen et al. found "Vitamin D supplementation in vitamin D-deficient, elderly people improved muscle strength, walking distance, and functional ability and resulted in a reduction in falls and nonvertebral fractures." They also noted an improvement in bone density after supplementation.

We did not notice a difference in number of falls with respect to vitamin D level, very likely because we don't have enough of the low values of vitamin D found in the general population. (Our lows are 20-30 ng/ml whereas the general population would have lows in the 5-20 ng/ml range.)

Video of the Week

Vitamin D: Interactions of Vitamin D and Calcium
Robert Heaney, MD
Creighton University

Watch Now

Robert P. Heaney, MD, is a clinical endocrinologist specializing in nutrition. Until retirement in 2014 he held the John A. Creighton University Professorship. He is world-renowned for providing nearly 50 years of advancements in our understanding of bone biology, osteoporosis, and human calcium and vitamin D physiology. He is the author of three books and has published over 400 original papers, chapters, monographs, and reviews in scientific and educational fields. At the same time, he has engaged in nutritional policy issues and has helped redefine the context for estimating nutrient requirements. Dr. Heaney also currently holds the position of Research Director at GrassrootsHealth.

This 25 minute video is from our Diagnosis and Treatment of Vitamin D Deficiency seminar which was held in conjunction with UC San Diego School of Medicine in the spring of 2010. Heaney says he is "reviewing some of the basics" but this is a great talk for those that want to understand how vitamin D works within the body and how it interacts with other nutrients.

This talk also covers vitamin D and bone health. How calcium, phosphorus, and vitamin D combine to support the skeletal system. How the different values of vitamin D in your blood stream, both 25(OH)D and 1,25 hydroxyvitamin D, have an effect and are necessary for calcium absorption. He scientifically refutes the myth that higher doses of vitamin D supplements cause hypercalcemea.
Note: Much of the presentation talks about vitamin D in nmol/L. To convert nmol/L to ng/ml, divide by 2.5. GrassrootsHealth recommends vitamin D blood levels of 40-60 ng/ml (100 - 150 nmol/L).

Watch Now

Editor's Letter

We are going back to the roots of vitamin D this week, discussing vitamin D and bone health. In this case the science has been moved into practice, as most every doctor agrees that vitamin D is good for your bones.

Writing this issue reminded me of the first time I took our D*action questionnaire. At that time my oldest was a 7 year old boy. I think the question about breaks was "how many times have you fallen in the last 6 months?" It was a scale, not a text box, and it didn't scale high enough. It is the JOB of a 7-year old boy to fall. To jump. To leap. To fall. To get up and try again. It made me think about health and vitamin D sufficiency - maybe if we are sufficient in nutrients we can have this child-like attitude. We too can jump and risk falling.

I am not recommending that you go out and jump from the roof tops just because you are vitamin D replete, but what about a little skip now and then?

Keep jumping!

Susan Siljander

Marketing Director, GrassrootsHealth

A Public Health Promotion &

Research Organization

Moving Research into Practice NOW!

Order Your Home Vitamin D Test TODAY!

Your participation in this project funds all the GrassrootsHealth research and promotion.

The natural bone health expert

There is a Better Way, a way that will not only naturally improve your bone health, but also naturally improve the health of your entire body. We call this "Better Way," The Better Bones Revolution.

View Web site