Food & Fitness After 50: Good Bones

A recent article in the Washington Post caught my attention because it related to an issue that older adults frequently ask about….how to protect their bones as they age.

Hip-Fracture-Surgery-Infection-640x444According to the study published in JAMA vitamin D supplements showed no effect on reducing hip fractures where as vitamin D plus calcium had about a 16% reduction in the risk of breaking a hip. Hip fracture is one of the most serious threats to health as we age. Here’s a few facts from the Centers for Disease Control and Prevention.

  • Each year over 300,000 older people—those 65 and older—are hospitalized for hip fractures.
  • More than 95% of hip fractures are caused by falling, usually by falling sideways.
  • Women experience three-quarters of all hip fractures.
    • Women fall more often than men.
    • Women more often have osteoporosis, a disease that weakens bones and makes them more likely to break.

Dietary Supplement Use for Bone Health

A recent survey from the Council on Responsible Medicine, a leading trade association for dietary supplements, shows that among consumers over 55 years of age who take dietary supplements, 31% cite bone health as a reason for supplementation. For younger age groups, bone health is not mentioned as a reason for supplementation. That is too bad because the time to build bone is when we are young! Peak bone mass is achieved somewhere around the age of 30 or 35 so waiting until you are 60 to start worrying about bone health is a bit too late. It’s like getting concerned about your cholesterol level after you’ve had a heart attack. (Side note to my older readers…encourage your grandchildren and great grandchildren to get plenty of bone building nutrients now!)

boneMass35Anthony Thomas, Director of Scientific Affairs for Jarrow Formulas puts it this way, “Maximizing peak bone mass is important when we are young to protect against age-related bone loss.  A 10% increase in peak bone mass is estimated to reduce the risk of osteoporotic fracture later in life by 50%, so early life deserves more attention to ensure sufficient nutrient intake and status to support bone health across the lifespan.”

It Takes More Than Calcium and Vitamin D to Make a Healthy Bone

natto
Natto

While the media focuses on calcium and vitamin D, Dr. Thomas reminds us that bone is more than those two nutrients. Healthy bones need the minerals magnesium, potassium, copper, manganese, silicon, boron, and zinc. Two underappreciated vitamins are also key, vitamins C and K. Vitamin C is needed to produce collagen, the most abundant protein in the body and building block of bone. Vitamin K helps calcium get deposited into bones. There are two forms of vitamin K, referred to as K1 and K2. K1 is most well-known for its role in blood clotting. But the K2 form promotes bone building. It is hard to get sufficient K2 from foods. Dr. Thomas points out that “vitamin K2 is from bacterial origin, so it is found in fermented foods in which bacteria are used as starter cultures in cheeses and sauerkraut.  The best dietary source of vitamin K2 in the form of MK-7 is the traditional Japanese dish natto, cooked soybeans fermented by the bacteria Bacillus subtilis subspecies natto, that while popular in Japan, is not much appreciated in the U.S.“ The best way to get this form of the vitamin is with supplements sold as MK-7.

“Based on emerging research, the supplemental doses used in research is a daily dose of vitamin K2 as MK-7 is 45 micrograms upwards of 360 micrograms is recommended,” adds Dr. Thomas.

Fall Protection

While foods and supplementation can help provide nutrients for healthy bones, don’t forget the ABCs (agility, balance, and coordination) as keys to help preventing falls. We’ve written about this before (click here for the post), but it pays to work on your balance with activities like yoga, Tai Chi, or simple exercises such as balancing on one foot when you brush your teeth. When it comes to balance, we can use it….or, we can lose it!

Check out this video from Silver Sneakers for easy exercises to improve your balance

For more information on foods and supplements for bone health and tips to improve your agility, balance, and coordination, see Food & Fitness After 50, available at Amazon and other booksellers.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved.

Food & Fitness After 50: Citicoline for brain health?

In 2015 I wrote a post on a dietary supplement called citicoline. For the post click here.

HealthyBrainIn the post I wrote about learning of citicoline at a conference and was given a sample. My husband had been experiencing some trouble finding the right word when he was speaking so he wanted to try the supplement. From that day on he has continued to use the product. Although his report of improved brain health is anecdotal (one person’s subjective experience does not equal a fact) there is some research to support the positive effects of the supplement. He is such a disciple of citicoline that many of his family and friends now take it. But, should you?

I was interested in finding additional and more current, research since the 2015 post was written but didn’t find much. One reason might be that dietary supplement companies tend not to invest in rigorous experimental research trials because they are not required to do so to market a supplement. Unlike drugs, dietary supplements don’t have to prove they work to be sold; that’s why there are so many supplements readily available.

Citicholine
Chemical structure of citicoline

To begin, citicoline is a naturally occurring brain chemical. It is not found to any great extent in foods (there is some in organ meats) but when taken as a supplement it is broken down into choline (a B-vitamin) and a compound called cytidine which is then metabolized to uridine. That’s important because citicoline can’t cross the protective blood brain barrier but choline and uridine can. Once in the brain the compounds convert to citicoline, sometimes called CDP-choline. In turn, citicoline increases the brain chemical phosphtidylcholine that helps brain function and increases the number of chemical messengers in the brain.

When I first reviewed the literature the small number of studies that had been published cautiously suggested that supplemental citicoline could be an effective treatment for mild cognitive impairment but more research was needed to see if the effect was long term (most studies are short term…a few weeks to a few months) and if it could slow the progression to dementia.

A study published in 2012 was well-controlled: by a well-controlled study I mean the participants in the study were randomized to treatment and it was double-blind…neither the researchers nor the participants knew who was getting the citicoline or placebo. The researchers studied 60 healthy women, between the ages of 40 and 60, and showed that when given either 250 or 500 milligrams of citicoline both groups improved on tests to measure mental attention compared to the placebo group. However, this was another short-term study; just 28 days.

My quest to find more current research was unsuccessful so I turned to Natural Medicines Database for their review. The conclusion, which was last updated in November of 2019, was that citicoline is “possibly effective” for a decline in memory and thinking sills that occur with normal aging. Supplemental citicoline “seems to help memory loss in people aged 50 to 85 years.” The review noted there is insufficient evidence to say it prevents or reverses memory losses in those with Alzheimer’s Disease. There are minimal side effects, although some people report trouble sleeping, headache, or nausea.

The dose of citicoline ranges from 250 milligrams to 2000 milligrams a day, but the range of 250 to 500 milligrams is a usual dose used the research studies.

If you choose to try citicoline, it is always recommended to discuss with your health care provider. And, be sure to include all over-the-counter medications, including dietary supplements, when your doctor asks about medications you are taking.

CDP_suplrgI found over 150 products marketed that contain citicoline, some with fanciful names, liked Active Mind or Brain Wave that claim to “speed up your brain.” Many of those products also contain caffeine; the likely source of “speeding” the brain. If you get the blessing from your physician and want to try it, stick to one that just contains citicoline. Two reputable products are Cognizin (Kyowa Hakko) and Citicoline CDP choline (Jarrow). The Jarrow formula is the one that my husband takes.

As for me, my memory is good and I haven’t found a reason to try a supplement, but my husband believes it has helped him.

To learn more about dietary patterns and supplements for those 50, 60, 70, and beyond, check out Food & Fitness After 50available on Amazon and other booksellers.

Disclosure: I have no financial connection to any dietary supplement, including the citicoline brands mentioned in this article.

 

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved.

 

Food & Fitness After 50: Supplements for healthy aging?

VitaminsType “supplements for healthy aging” in Google and 26,200,000 results show up! I’m constantly being asked about supplements but I want to know what supplements are on your radar. I’m working on an article for health professionals on supplements commonly used by those of us in our 50s, 60s, 70s, and beyond. And, your input is important to help me narrow down the wide field.

I know from consumer survey data from supplement trade groups that that vitamins (like vitamin D) and minerals (like magnesium) are popular, as are supplements that claim to support “healthy aging,” “heart health, and “bone health.” But, I don’t know what supplements fit neatly into those boxes and would like to know if you take any supplements or are curious about supplements you’ve read about or seen advertised in print or on television.

When I reviewed some of those 26,200,000 results, I was impressed with the creativity of the names and claims. From youngevity to longevity to herbal supplements that claim to be the “root of anti-aging.” (And, of course, we all know there is no such thing as anti-aging; even animals kept in the purest environments age.)  And, the names are cool, too, sort of like the names of the paint samples in Home Depot: “cell shield,” “ReVerse,” “Imortalium, ” and my favorite…. Super Ultra Mega longevity, because super isn’t a strong enough descriptor.

Broccoli and pillsSo, email me (chrisrosenbloom@gmail) or hit me up on twitter @chrisrosenbloom and help me compile my list. And, of course I promise to share what I learn about the supplements (what works, what doesn’t, what might, and what is just plain hype) with you in a future post.

Thanks!

Food & Fitness After 50: Want a killer physique?

“Some supplements work for some people some of the time. Many supplements don’t work for anybody any of the time.”  

Dr. Ron Maughan, Emeritus Professor of Sports and Exercise Nutrition, Loughborough, United Kingdom

body building supplementsIn my last post, I discussed the basics of dietary supplements with a focus on multivitamin-minerals. This week, let’s talk about muscle building and weight loss supplements. Bottom line up front: there are some sports supplements that can help active adults train harder and recover faster, but most of what you read about, like the headline, “want a killer physique?” won’t happen without hard work in the weight room and a stringent diet to reduce body fat. A supplement by itself, despite wild claims, will not give you a killer physique. Sorry. And, weight loss supplements are not much better.

Headlines can be persuasive!

So, what can we say about muscle-building and weight loss supplements. First, here are few more headline grabbing claims:

  • “Drop body fat in a single dose”
  • “Boost muscle growth by 600%”
  • “Incinerates excess fat”
  • “Produces immediate results in energy, size, strength, pumps, performance, mental focus, and training intensity.”

The downside of weight loss supplements

Between 5-20% of supplements (mostly muscle-building and weight loss supplements) contain prohibited substances: for athletes, that could mean a positive drug test and banishment from sport. For older active adults, it could mean physical harm. For example, a  weight loss supplement called SmartLipo 365  was found to contain unlabeled sibutramine and phenoltphathein. Sibutramine is an appetite suppressant that was taken off the US market in 2010 and phenoltphathein is not approved for dietary use due to concerns of causing cancer.

Many of the supplements for weight loss contain harmful substances when taken in high doses; case in point, 25% of emergency room visits for adverse effects from dietary supplements are from weight loss supplements, with cardiac symptoms being the primary complaint. Not too surprising when many of these supplements contain stimulants. Don’t be fooled by so called “natural, herbal” stimulants like guarana, kola nut, or green tea extract. A stimulant is a stimulant. Consumer Reports identified 15 supplement ingredients to always avoid. It’s worth taking a look at the list and stay away from supplements containing any on the list.

One popular weight loss supplement that has it’s 15 minutes of fame on a popular doctor’s television show is garcinia cambogia. It is a small fruit that is traditionally used as flavor enhancer in cooking. It contains a substance called hydroxycitric acid that has been touted as a weight loss miracle.  However, in a 12-week study  on overweight men and women the researchers concluded, “garcinia cambogia failed to produce significant weight loss and fat mass loss beyond that observed with placebo.”

What does work?

For active athletes, a few supplements have stood the test of time (and research), including caffeine, B-alanine, beetroot juice, and creatine. Here’s a quick overview of what types of athletes might benefit, the effective dose, and the expected result.

Caffeine: Most of us know that caffeine can help keep us alert and ward off fatigue. Caffeine’s main effect is on the central nervous system. It is an adenosine receptor antagonist. Adenosine induces sleep and fatigue, so blocking thee ffects of adenosine with caffeine promotes a more alert state. The response to caffeine is highly variable (some of you can’t fall asleep if you have even a tiny amount of caffeine in the evening, while others can drink a pot of coffee and have no trouble sleeping). A small dose of caffeine can be effective for sports performance; just 2 to 3 milligrams per kilogram of body weight; for a 154-pound person, that is a dose of 140 to 210 milligrams of caffeine or the amount found in a small to medium cup of coffee. More certainly isn’t better!

B-alanine: This amino acid can buffer lactic acid and shows promise in athletes performing high intensity exercise (sprints). Some research shows it might also help endurance athletes who need to sprint hard to the finish line. This is not needed by recreational athletes. Effective dose is about 3-6 grams/day.

Beetroot Juice: Beets are naturally high in nitrate and it might increase skeletal muscle efficiency by lowering oxygen demand. It is used by endurance athletes who run or cycle. To be clear, nitrate is not carcinogenic, but nitrite can combine with amino acids from foods to form nitrosamines, which may be cancer-causing. In research studies, a dose of about 4 mg/kg/body weight has been used. My advice, eat beets!

Creatine: It is used a source of muscle energy and is in short supply during high intensity exercise, like sprinting or weight lifting . Supplemental creatine is usually taken as a powder mixed with water or juice, 3 to 5 grams/day. It can increase muscle stores of creatine by 10 to 30% and, when combined with exercise, can increase muscle cell volume. Researchers describe the benefits of supplemental creatine as, “small increases in lean body mass with repeated, high-intensity duration (less than 30 seconds) exercise.” For most healthy, active older adults, creatine supplementation isn’t necessary.

For more information on dietary supplements, check out Food & Fitness After 50.

 

 

 

 

Resvertrol: Longevity Miracle?

Last month a small study of 27 men in their 60s got national attention. The author of the study, a doctoral student, gave some of the men 250 milligrams of a resveratrol supplement and the other half got a placebo. The men were all healthy but not physically active. The men were put through a rigorous exercise program for 8 weeks. At the end of the study all the men showed improvements in physical fitness but the men not getting the resveratrol supplement showed greater improvement in fitness and blood lipid levels. The media reported that resveratrol “negated” exercise benefits and started the worried well wondering if they should toss their expensive resveratrol supplements in the trash and stop drinking red wine.

Resveratrol is a polyphenolic compound found in the skin of red grapes, berries, grape juice, pistachios and peanuts. The compound has antioxidant properties, reduces inflammation, initiates programmed cell death (a good thing in cancer prevention), improves nerve function and improves insulin sensitivity. All of these changes are good for human health but the problem is that most of the studies on resveratrol were done in animals or test tubes; very few studies were conducted in humans and no long term studies have been done for benefits or safety. For example, mice got anywhere from 22-400 milligrams of resveratrol per kilogram of body weight….far more than we would get in supplement form. And red wine, has about 1-2 milligrams PER BOTTLE of wine, according to ConsumerLab.com

So, even though evidence is slim for the benefits of resveratrol supplements on human health that hasn’t stopped the flood of supplements marketed to seniors. Dr. Oz has even blessed resveratrol as one of the “4 supplements for a longer life.” So, now, based on one small study, resveratrol is bad?

Not so fast, resveratrol is found in many healthy foods and we should all be consuming berries, grapes, and nuts as part of a healthy diet. Red wine, in moderation, and consumed with a meal, has heart health benefits beyond resveratrol. But, that small study did remind us that supplements are not thoroughly evaluated by the Food and Drug Administration for effectiveness or safety….let the buyer beware! Don’t believe the Internet supplement sales hype and stay healthy the old fashioned way….exercise and eat well. And, enjoy a glass of red wine if you drink alcohol without worry that you will get “too much” resveratrol.

How do you choose your vitamin/mineral supplements?

ConsumerLab.com posted survey results about popular supplements. While not a “scientific” study in that the respondents were self-selecting (that always introduces bias into a study) it did show some interesting trends about supplement use. The five most popular supplements were fish oil, multivitamins, vitamin D, calcium and CoQ10. The first four didn’t surprise me given the media attention to fish oil and vitamin D, but the CoQ10 did…until I thought about the role of CoQ10 in protecting the heart muscle in those older adults who have congestive heart failure. There is also some support for using it when taking a statin to lower cholesterol, although the evidence for that is not as clear.

But, what I really thought about when I saw the survey is how does one choose among the hundreds of supplements on the shelves of grocery stores, pharmacies, and retail stores (there are even whole stores devoted to selling supplements anddon’t even get me started on the Internet sales!)

I offer these tips in choosing supplements:

1)Know what supplements you really need. Ask your doctor or qualified health professional (like a registered dietitian) about what supplements might be best for you. I often find that people supplement with nutrients that are plentiful in their diets yet not taking nutrients that they are lacking. A quick way to evaluate your dietary intake is to go to mypyramid.gov and analyze your usual dietary intake. You might find that you get plenty of vitamin C because you drink orange juice, eat broccoli, and snack on tangerines, yet your intake of omega-3-fats are low because you don’t like to eat fatty fish.

2)Look for third-party verification that you are getting a quality supplement. Ever noticed the “USP” symbol on your supplement? That stands for United States Pharmacopeia and it means that the supplement meets strict criteria for quality ingredients and quality manufacturing processes. ConsumerLab.com is another group that tests supplements to make sure that the supplement contains what it says it contains on its label. Third party verification doesn’t mean that the product will work for you, but it does insure that you are getting what you are paying for and getting a quality product.

3)Take supplements according the dosing instructions and make sure to check sources like WebMD for any nutrient-drug interactions. For example, if you take a blood thinner you don’t want to take a vitamin supplement that has a lot of Vitamin K as it can block the effectiveness of the drug. Also remember that supplements are a supplement to a healthy diet–eating a poor diet and expecting a supplement to keep you healthy is wishful thinking. Supplements take time to work;they are not like an antibiotic that can cure an infection in a few days. For example, glucosamine and chondrotin may help those with osteoarthritis but it can take months to know if it is working.

4)If claims for supplements sound too good to be true then they probably are. Think about how many people say that vitamin C is the cure for the common cold…if that was true, wouldn’t we all just take vitamin C and never suffer through another cold again? So, be realistic about your expectations for supplements.

5)Lastly, look at the various options for supplements. I don’t eat enough fatty fish (the new Dietary Guidelines for Americans 2010 suggest eating 2 fatty fish meals a week) so I take fish oil. The first supplement I tried made me taste fish oil all day so I take one that controls that problem.