Food & Fitness After 50: Is There an Optimal Protein Intake for Older Adults?

A recent paper from three international protein gurus reviews the science behind the recommendations that older adults need more protein than young, healthy adults. The opening sentence of the paper sums up the current state of the science: “The optimum protein intake for adult health remains controversial.” How could that be?  The authors explain that why we know general requirements for protein we don’t know optimal intakes. Why there are limits to what we know about protein and aging?

  • Older adults, especially older women, are often not included as participants in research studies on protein needs.
  • Recommendations for protein are often derived from young, healthy adults. Healthy is a key word because we know that many older adults have chronic health conditions. Obesity, diabetes, high blood pressure, heart disease, and cancer affect 3 of 4 adults over the age of 65.
  • Research studies that look at protein intake and muscle mass in older adults are of short duration; most last less than 6 months. Since muscle loss is gradual, the short-term studies may not have time to show a positive effect of increasing protein.

While we may not have the definitive answer to the question posed in the title of this post, there is much we do know and here are some key points from the article:

  • The Recommended Dietary Allowance (RDA) for protein is inadequate for older adults due to something called the “anabolic resistance” of muscle. (Anabolic means building up and is the opposite of catabolic or breaking down.) Anabolic resistance means that the signals to build up muscle through strength training or eating protein is muted in older adults. This resistance can be overcome with an increased amount of strength training or a higher intake of protein.
  • When older adults experience a period of muscle disuse, which can occur during illness or injury, signals to muscle protein are blunted and a practical way to overcome this is through a higher protein intake, especially protein-rich foods that contain a key amino acid, leucine. Protein is made up of units called amino acids and 9 of the 22 amino acids are considered essential, meaning that we can’t make them in the body, so they must be consumed through diet. Leucine is one of the 9 essential amino acids and has been found to play a critical role in protein synthesis.
  • Sarcopenia, literally meaning vanishing flesh, is the progressive loss of muscle as we age. It doesn’t start when we are 60; it starts at about the age of 40 (even earlier in those who are inactive). Between the ages of 20 and 90, we can lose over 50% of our muscle mass due to sarcopenia and inactivity.

So, where does all of this leave us? The authors conclude that older adults should increase protein…both quality and quantity at meals. Consuming at least 30 grams of protein per meal, with 2.5 grams of leucine or more can overcome the anabolic resistance of aging muscle. While not all studies agree on meal timing, the authors also conclude that spreading the protein evenly across meals is better than backloading all the protein at one meal.

So, what does that mean for us? To recap to maintain muscle you need two things: progressive, resistance strength training and nutrition. Protein is a key nutrient for building and keeping muscle.  A few facts about protein:

  • High quality protein contains all 9 of the essential amino acids (EAAs) and includes:
    • Animal protein (beef, pork, poultry, fish, eggs, milk, cheese, cottage cheese, kefir, yogurt)
    • Soy protein (tofu, edamame, soy burgers, patties, crumbles, soymilk, cheese, yogurt)
  • The following foods do not contain all the EAAs, but they contribute to total protein intake:
    • Nuts (almonds, walnuts, etc.), almond butter, seeds (sunflower, chia, flax), legumes (peanuts, pinto, navy black beans, split peas, black-eyed peas, and other starchy beans and peas), peanut butter, pasta, rice, and whole grain bread.
  • Try and spread the protein evenly in 3-4 meals each day.

Examples of 30-gram protein meals

Sample meals and snacks with ~30 grams of protein

6 oz Greek yogurt (18)*

1 oz granola (4)

Small banana (1)

Skim milk latte (6)

2 scrambled eggs with 1 oz cheese and spinach (21)

8 oz soymilk (7)

½ slice whole grain toast (2)

Smoothie made with 1 ounce whey protein powder (20)**

6 oz Greek vanilla yogurt (18)

½ cup frozen berries (1)

Large green salad with veggies (2)

4 oz grilled chicken or salmon (28)

1 Tablespoon sunflower seeds (1)

1 Tablespoon chopped nuts (1)

3 oz tuna mixed with mayo (21)

2 slices of whole grain bread (7)

Lettuce, tomato, banana peppers or other veggies (2)

1 cup pasta (6)

3 oz turkey or beef meatballs (21)

Green salad with balsamic vinegar dressing (1)

1 cup cottage cheese (28)

1 Tablespoon chopped nuts (1)

3 slices fresh or canned peaches (1)

Stir fry with ½ cup tofu (10)

Carrots, broccoli, edamame (16)

1 cup brown rice (5)

3 oz cheddar cheese (21)

6 whole grain crackers (2)

8 ounces skim milk (8)

*grams protein in parentheses

 **most protein powders have ~20 grams protein per serving, but check labels

For those not used to thinking in terms of grams of protein (probably most of you), here are a few keys to understanding protein:

  • 1-ounce of beef, pork, fish, poultry, and cheese has about 7 grams of protein. Most of us don’t eat 1-ounce portions of these foods, so if you eat a 5-ounce portion of grilled salmon for dinner, you’ve eaten 35 grams of protein and that doesn’t count the other foods you have with the meal.
  • Dairy foods are rich in protein, the amino acid leucine, as well as other nutrients needed for muscle health such as vitamin D and calcium. 8-ounces (1 cup) of dairy milk has 8 grams of protein, but 8-ounces of ultra-filtered milk, such as Fairlife, has 13 grams of protein. Contrast that with Silk Almond milk that has only 1 gram of protein per serving. The point is that not all “milk” is a rich-protein source.
  • Foods carry a nutrition facts panel that tell you 2 important pieces of information: the serving size is of the food and how many grams of protein are in in one serving. That’s an important thing to keep in mind because you might be eating more than the stated serving size, meaning you are also getting more protein.

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  • I like to look for snacks that are nutrient-rich but not too high in calories. My recent favorite is kefir, a fermented milk drink with 11 grams of protein in 8-ounces, and is rich in probiotics, too.

I reached out the authors (aka, protein gurus) to ask them for a practical take-away from their article.

Meet the gurus

Dr. Stuart Phillips is a professor in the Department of Kinesiology at McMaster University, Hamilton, Canada (follow him on twitter @mackinprof).

“I’d recommend emphasizing the consumption of nutrient-dense sources of high-quality protein like dairy and eggs at meals that are traditionally lower protein: breakfast and lunch. My go-to protein food at breakfast (and sometimes lunch too) is Greek-style yogurt or Icelandic Skyr. Both are cultured dairy, rich in high quality protein, and many other necessary nutrients, and tasty and versatile as a base for berries and nuts.”

Dr. Doug Padden-Jones is a professor in the Department of Nutrition and Metabolism at The University of Texas Medical Branch, Galveston, Texas .

“For generally healthy adults, establish a dietary framework that includes a moderate amount of high-quality protein at each meal. Factors such as energy needs, physical activity, health status, body composition goals, and satiety should be weighed to determine protein needs. But, During periods of  physical disuse (injury, illness, inactivity) middle-age and older adults are at increased risk of muscle/function loss so just meeting the RDA for protein ( 0.8 g protein/kg/day)  is insufficient. Aggressive support with high quality protein (whey /leucine) and activity may help preserve muscle health.”

Dr. Donald Layman is a an emeritus professor in the Department of Food Science and Human Nutrition a the University of Illinois at Urbana-Champaign, Urbana, Illinois. (Follow him on twitter @donlayman).

 “A key for maintaining muscle health as we get older is dietary protein. Surprisingly, adults have higher protein needs than children because we have a continuous need to repair and replace proteins in our body but our efficiency of making new proteins declines with age. The best proteins are meats (including fish), eggs, and dairy. Vegetable proteins are popular, but they always have lower quality than animal proteins. You will need to consume 30% to 50% more total protein if you chose to use plant proteins. So, a 25 g whey protein shake would require at least 35 g of soy protein to be equivalent.” 

 

Dr. Christine Rosenbloom is a registered dietitian nutritionist and a nutrition professor emerita at Georgia State University in Atlanta. Along with Dr. Bob Murray, she is the author of Food & Fitness After 50.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved

Food & Fitness After 50: The Scoop on Collagen

Bob bike 2
Dr. Bob enjoying his just desserts after a long bike ride

Survey data from the Council for Responsible Nutrition (a trade association for dietary supplements) shows that 78% of adults over the age of 55 take supplements. Reasons for supplement use include overall wellness and healthy aging. It is no surprise that people are asking about one of the hottest supplements…collagen. I reached out to my friend and co-author of Food & Fitness After 50 to ask him some of your top questions about collagen. Dr. Bob Murray is an exercise physiologist and is passionate about exercise and health. He consults with many companies on hydration, protein, and supplement use in active populations, including older adults.

Let’s start with the basics. What is collagen and are there different types of collagen in the body?

Collagen-structure.800x345-wWe can think of collagen as the glue that holds us together. Collagen is the name for a large family of proteins found in the body.  In fact, there are so many types of collagen proteins that collagen turns out to be the most abundant protein in the body. Collagen proteins make up connective tissues throughout the body.  The term “connective tissues,” makes many people immediately think of tendons, ligaments, and cartilage, three good examples of connective tissues.  Muscles, skin, and bones also contain large amounts of connective tissues and therefore large amounts of the collagen proteins that intertwine to give those tissues the structure, strength, and elasticity required for the many different roles required of connective tissues. It should be obvious that the connective tissue in bone has a different role to play compared to the connective tissue in muscles or skin. That’s why so many different kinds of collagen proteins are needed throughout our bodies.

When I was younger, I remember my friends dissolving Knox gelatin in water and drinking it to strengthen their nails. Is gelatin the same as collagen?

The connective tissues of cows, pigs, and chickens are the primary source of gelatin produced for human consumption.  As a result, gelatin is rich in collagen proteins.

Is collagen a complete protein, that is one that contains all the essential amino acids needed by the body?

Collagen is an incomplete protein and is low in the amino acids that are associated with building muscle mass and strength.  However, collagen proteins are high in two amino acids—glycine and proline—that appear important in stimulating the growth of connective tissues in physically active people.

There are many claims for collagen supplements…from preventing wrinkles and strengthening skin to improving joint flexibility and strengthening muscles and bone. Is there any good human evidence that collagen supplements will help with any of those body systems?

The best way to sum up the current state of affairs is that the benefit claims for consuming collagen are long on theory and short on evidence.  That’s not to say that there isn’t some evidence suggesting benefits to skin, joints and muscles, but that evidence has yet to reach the levels of quality and quantity required to draw comfortable conclusions about the magnitude and reproducibility of the benefits associated with consuming collagen proteins on a regular basis.

It is well known and accepted that protein is needed for muscle protein synthesis, is collagen any better than simply getting more protein from whey protein or other protein-rich sources?

iStock Older man lifting weights smallMaybe, but much more research is needed to either confirm or deny that consuming collagen benefits muscle mass and strength beyond what we know occurs by increasing dietary protein intake. There are a growing number of studies that report benefits to muscle strength, joint pain, and repair of connective tissue, but there are a greater number of studies that report no benefits.  The unsatisfying answer to your question is that we’re going to have to wait and see what future research has to say,

Do you think older adults need to use collagen as a supplement?

Collagen production does naturally decline with age and there are studies that report benefits of collagen consumption in older adults.  Maybe the best news is that there is little to no risk of trying collagen supplements, aside from the possibility of spending money on something that does not work.

There are so many forms of collagen being sold…hydrolyzed, peptides, raw, undenatured and found in various forms from liquids, powders, tablets, chews and even gummies….if someone wanted to take collagen what is the form and dose that is currently recommended?

The current research indicates that the effective dose seems to be 15-20 grams of collagen per day, along with 200-250 mg of vitamin C to aid in collagen synthesis. The body seems to respond best to the presence of collagen peptides—short chains of a few amino acids—and most forms of dietary collagen contain such peptides. Look for products containing hydrolyzed collagen or collagen peptides on the label.

1800ss_getty_rf_vitamin_cI’m glad that Dr. Bob mentioned vitamin C and its role in collagen production. Vitamin C is most frequently thought of a nutrient that helps our immune system, especially fighting the dreaded winter cold, but it has a fascinating history (well, fascinating to most dietitians!). At the end of the 15th century, a disease called scurvy was the major cause of disability and death of sailors undergoing long sea voyages. Without access to fruits or vegetables, sailors developed bleeding gums, lost their teeth, had poor wound healing, and frequently old wounds would open up (called dehiscence). All because they were deficient in vitamin C and its important role in collagen production. Collagen helps anchor teeth in our gums and jawbone, as well as helping to keep skin healthy and elastic. It wasn’t until the 1930s that a Hungarian scientist, Dr. Albert-Szent-Gyorgyi, discovered and isolated ascorbic acid (a contraction of anti-scorbutic), better known as vitamin C.

Dr. Christine Rosenbloom is a registered dietitian nutritionist and a nutrition professor emerita at Georgia State University in Atlanta. Along with Dr. Bob Murray, she is the author of Food & Fitness After 50.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved

Food & Fitness After 50: The Best Way to Accelerate Recovery after Injury or Illness

Within the past months, three friends have been surprised, and not in a good way. One slipped on the stairs and shattered her ankle, one got the flu that knocked him out for about 3 weeks, and a third had dizzy spells that resulted in the need for a pacemaker. All were in their mid-60s, were in good health, and had been physically active prior to the injury or illness.

Best Defense Against Illness or Injury

They all said the same thing: they recognized the importance of being in good shape prior to the accident or illness. All agreed that it aided in their recovery. In a recent post, we met Ed who said, “get in shape to stay in shape.”   We could expand that and say, “being in shape is the best defense when injury or illness happens.” The friend with the broken ankle had it surgically repaired and could not put weight on the ankle for several weeks. A regular at strength training, she recognized that her strong upper body helped her through recovery. She was able to push herself out of a chair and use crutches with ease and she couldn’t image how difficult it would have been to get around without strong muscles.

“Skeletal Muscle Matters”

Older people exercisingAt a recent nutrition workshop on nutrition across the lifespan,  Dr. Roger Fielding, Director of the Nutrition, Exercise Physiology, and Sarcopenia Lab at Tufts University, says, “skeletal muscle matters!” It makes up 45-50% of our total body mass and our muscles move us; if we lose our muscle mass, we lose our mobility and losing mobility is associated with increased mortality. Translation: people with strong muscles live longer (more on this and tips to get and stay strong can be found in Food & Fitness After 50).

Aging = Loss of Muscle, unless we do something about it

One thing that is certain about aging is that it is accompanied by a progressive loss of muscle mass unless we do something about it. No supplement or superfood will preserve your muscle mass; the only way to do it is through strength building activities. We start to lose muscle around age 40 and continue to lose about 2 to 4% each year. The decline is even more rapid during illness and injury. So, preserving muscle mass with regular, progressive strength training and eating enough protein, can be like putting money in the bank for a rainy day. When you have the unavoidable acute illness (such as the flu), a chronic illness (like a pacemaker), or an injury (a broken ankle), you’ve got reserves to see you through the down time when brief bouts of muscle disuse can accelerate muscle loss.

My friends were in good shape, but not everyone is

It is clear that physical activity that preserves muscle mass is critical to maintaining good function as we age, but older adults may spend up to 85% of their waking hours being sedentary! The good news is that it doesn’t take a lot to get strong muscles. Muscles are “plastic,” meaning they can quickly adapt to the stimulus of weight training to regain mass, strength, and function. Just two bouts each week of progressive, resistance exercise training can really turn back time when it comes to muscle strength. It doesn’t take an expensive gym membership or fancy machines. Start with simple exercises like squats or lunges or stair climbing; add exercise bands or tubing for upper body strength. Or, hire a certified personal trainer to show you the proper form and how to build up strength to challenge your muscles. Whatever you choose, just do it! You will be stronger, fitter, and better able to withstand the inevitable injury or illness that comes as we age. exercise bands

Which will you choose?

Poet Henry Wadsworth Longfellow said, “To be seventy years old is like climbing the Alps. You reach a snow-covered summit and see behind you the deep valley stretching miles and miles away, and before you other summits higher and whiter, which you may have the strength to climb, or may not. Then you sit down and meditate and wonder which it will be.”

I hope you choose to stay strong to keep climbing!

 

 

 

Guilt-free snacks?

Snacks
The email caught my eye…”guilt-free snacks for healthy habits.” Sounded like something I would be interested in and it had all of the buzz words for today’s consumer: “pure, natural, real, organic, gluten-free, and straight from nature.”  Well, that last one is a lie because no processed snack food comes “straight from nature.” I’ve never seen a chocolate hazelnut brownie coconut butter tree or a dark chocolate Brazil nut bush.

Never mind that, snacking is big business and many of us graze all day long, forgoing meals for snacks. So, how did these 3 “guilt-free” snacks fare on closer look? Spoiler alert….not so good.

For those of us 50+ adults, snacks should be nutrient-rich but not calorie-rich. Even for the most active among us, calories count and I’ve seen many older adults sabotage their weight and fitness goals by consuming too many “healthy” snacks. Snacks have calories and to avoid the weight creep of aging we have to be mindful of calories from all snacks. Let’s take a closer look at these so-called “guilt-free snacks.”

  • Dark chocolate Brazil nuts. A 4-oz bag sells for $6.00 with 5 servings/bag. Each serving has 230 calories, 18 g fat, 7 g saturated fat, 12 g sugar, and 3 g protein. Let’s face it, how many of you can stop at one serving? A pretty pricey snack, loaded with calories, fat and sugar and not much protein to promote satiety…that feeling of fullness that keeps you from eating more a few hours later.
  • Chocolate hazelnut brownie coconut butter. This one costs $13.33 for a 12-oz jar. Two tablespoons comes with 220 calories, 20g fat and 3 g protein. Coconut butter is all the rage and we can debate the health aspects of it another time, but as a snack it packs a calorie and fat wallop.
  • Crunch cluster almonds. A one-oz serving will set you back 160 calories and 13 g fat with only 5 g protein. And, a 9-oz bag costs $6.32.

To me, a guilt-free snack is affordable and delivers on nutrition and taste. Snacks that are much (much!) less expensive and more (more!) nutrient-rich include plain Greek yogurt (100 calories and 18 g protein) mixed with your favorite seasonal fruit or try cottage cheese (1/2 cup has 90 calories and 13 g protein) with a few whole grain crackers. If you like a creamy, cheesy snack, try a portion-controlled wedge (like The Laughing Cow spreadable cheese wedges with only 35 calories per wedge) on crisp apple slices.

Don’t be fooled by the health-halo surrounding “guilt-free” snacks. Eat nourishing, healthy snacks without the high price tag. I’ll bet you have some in your fridge right now!

 

Healing Foods

Although I was in denial for about 6 years the truth is I needed a total hip replacement. For me, an old high school injury + 25 years of running + age = osteoarthritis. I tried physical therapy, cortisone injections, glucosamine, chondroitin, oral meds, and even acupuncture, and while everything helped for a little while, the reality was that the cartilage cushion in my hip just wasn’t coming back. I was sure I was too young for such a big surgery, although my surgeon’s PA assured me I was a year over the average age of patients getting hip replacements (thanks for reminding me of my age). I learned from the American Academy of Orthopaedic Surgeons website that hip replacement “is one of the most successful operations in all of medicine,” with more than 285,000 performed each year in the U.S.

So, I had a total hip replacement five weeks ago today. The first 2 and half weeks were rough but then I got my strength back (thanks to home physical therapy) and am walking 2 miles a day without pain and without a limp…no more swaying when I walk!

In all the preparation leading up to the surgery no one talked about the importance of nutrition in recovering from surgery, so here is my advice to anyone having major surgery.

1. Eat high quality protein foods before and after surgery. Foods that contain all of the essential amino acids are need to keep your immune system strong (the last thing you want is to get sick before surgery). After surgery protein-rich foods help wound healing and to make blood cells to replace blood losses from surgery. Expect a poor appetite after surgery (my appetite was depressed for about 2-3 weeks after surgery) so eat small portion of protein several times a day. For example, eat a hard cooked or a scrambled egg for breakfast, a piece of string cheese mid-morning, Greek yogurt for lunch (regular yogurt is OK, but Greek yogurt is higher in protein), shredded chicken in chicken soup for dinner and a handful of almonds in the evening to get protein at every meal and snack. As your appetite picks up, add cereal and milk, peanut butter toast, turkey on a bagel, grilled cheese, a small lean steak, or a tofu noodle bowl.

2. Vitamin C-rich foods are needed to make the protein collagen that provides strength to the surgical wound. In the old days when vitamin C deficiency led to scurvy (it was prevalent in those undergoing long sea voyages with little access to fruits or vegetables) it was common for wound dehiscence or the opening up of old wounds.We don’t have to worry about scurvy today and it is easier for us to get vitamin C by eating citrus fruits or drinking orange juice. I snacked on my favorite seasonal fruit, Clementine tangerines, every afternoon. If your appetite is not good, try a supplement of vitamin C or a vitamin C adult gummy.

3. Zinc is a mineral found in meat, fish, poultry and dairy foods, with smaller amounts found in whole grains, legumes and nuts. Zinc is needed to repair cells and keep a healthy immune system. Get zinc from foods rather than supplements…too much zinc can cause nausea and vomiting.

4. Tart cherry juice is a potent source of anti-oxidants and many athletes use it to reduce muscle soreness and inflammation after exercise. And, tart cherries also contain melatonin which might help improve sleep quality. Tart cherries aren’t the same as the sweet cherries that you eat for a snack; so, it you want to try it look for tart cherry juice. One 10.5 ounce bottle contains the equivalent of about 45 tart cherries which is enough to reduce inflammation and pain.

5. Fiber may not seem to fit with the “healing” foods theme of this article, but after surgery including high fiber foods in your diet (along with plenty of water) can alleviate constipation. Prescription pain meds are well known to cause constipation so stock up on prune juice or dried prunes. Drink about 4-5 ounces of prune juice or eat 2-4 dried prunes each day to keep things moving without having to resort to harsh chemical laxatives.

No one wants to have surgery, but if it happens, use foods to help you heal and bounce back to be better than the old you!

Healthy Aging

Healthy aging isn’t an oxymoron. You can be healthier and more fit at 60 than you were at 40 if you exercise–both aerobic exercise (brisk walking, jogging cycling, etc) and weight training or resistance exercise. While most of us know that aerobic exercise is important for good health, as we age strengthening our muscles may be even more important for good health. It is especially important for functional health–that is, being able to perform the everyday activities that we did when we were young without even thinking about them. Things like lifting and carrying a 50-pound bag of dog food or reaching the top shelf in the kitchen cabinet or maintaining our balance without worrying about falling. We lose muscle mass as we age, something researchers call sarcopenia, but it can be prevented with strength training and diet.

You don’t have to go to a gym to strength train, although that is a good option. Using resistance bands or hand weights can have the same effect as fancy gym equipment–the key is to do it two or three times a week and eat a diet with good quality protein to promote muscle strength. The two go hand-in-hand. I always tell athletes that you can’t push protein into muscle to make it bigger–you have to pull it in with strength training.

What is a good diet for muscle? Research suggests getting high quality protein three times a day. Aim for 20 grams of protein at breakfast, lunch and dinner. Spreading the protein throughout the day is better than eating it all at one meal. What is high quality protein? Protein from meat, fish, dairy foods, eggs, or soy is all high quality. Twenty grams of protein is found in a little over 2 cups of milk or yogurt, and 3 ounces of meat, fish, or poultry and 3 eggs. Nuts are also a good source of protein and make for a good protein-rich snack.

I recently retired after 30 years of teaching and one of my colleagues said we spend the first 30 years of life getting our education, the second 30 years making a living, and if we are lucky the next 30 years enjoying life and doing what we love. Here’s to the next 30 years–now I’ll have time to get fitter and pick up those weights.

Nutrients for healing

After the recent blast of cold air that blanketed the country, including the deep south, I had planned to write about comfort foods and share my favorite soup recipes, but then I fractured my wrist and have been focusing on healing nutrition. Working with athletes for many years has given me a glimpse into the healing process, but I never had to experience it for myself.

Healthy bone needs more than calcium–it takes 17 different nutrients to make a strong bone. Let’s start with protein–a key building block of bone. Protein is needed for growth and repair so I am focusing on high quality protein that provides all of the essential amino acids–low-fat milk, yogurt, eggs, lean meat, and low-fat cheese. Soy protein is another complete source of protein, and beans, while not providing all 22 of the essential amino acids, has the highest protein content of vegetables.

Zinc and copper help heal bone by building collagen–the protein matrix for wound healing. Seafood, sunflower seeds, nuts, mushrooms, and wheat germ are all good souces of these trace minerals.

Two vitamins that are frequently overlooked in the healing process are vitamins A and C–vitamin A promotes bone growth and remodeling and vitamin C is also needed for collagen formation and bone repair. Citrus foods and dark red and green veggies and fruits provide both vitamins.

OK, we do have to recognize the superstar, calcium, since 99% of calcium is found in bone. I like low-fat dairy because not only does it give me needed calcium, but also vitamin D, protein, and vitamin A. Drink calcium-fortified orange juice for both calcium and vitamin C. A multi-vitamin mineral supplement doesn’t give you enough calcium, so take calcium carbonate or citrate every day. I prefer calcium citrate as it is well absorbed without food. The recent 2009 position paper from the American Dietetic Association recommends taking no more than 500 milligrams of calcium at one time, so split your dose.

My perfect bone healing meal? Lean beef fajitas with red and green peppers, mushrooms. and a side of black beans and citrus fruit salad. A big glass of cold low-fat milk–the margarita will have to wait until after the bone heals. Alcohol is not good for bones. Now, if only I could find a nutrient that would help me type faster with my left hand…..