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: 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.

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!