In case you’ve been identified with osteopenia or osteoporosis, your physician has already mentioned calcium, vitamin D, and weight-bearing train with you. That is good recommendation, however there’s extra to it than simply these three issues.
There’s one other nutrient that deserves a seat on the desk. Most likely consider extra for combating colds and the flu than for serving to with bones. It is vitamin C.
There is a rising physique of human analysis that means vitamin C performs a a lot larger position in bone well being than most individuals notice. Dr. Tom Levy, in his e-book Loss of life by Calciumdiscusses how vitamin C additionally helps bone well being. However that e-book was printed again in 2013, and there is extra analysis since then that verifies what he already discovered. Vitamin C is a strong teammate that helps all of the vitamins collectively construct wholesome bones for you. Here is what the science exhibits and what you are able to do about it as we speak.
Your Bones Are Extra Than Simply Minerals
Most of us image bones as very mineral-dense buildings like sticks of calcium. However that is not the complete image. Bones are roughly 50% protein by quantity. The first protein is kind 1 collagen. It is the collagen that types the versatile scaffold on which mineral is constructed. This scaffolding provides bones their power and slight flexibility, they should take in affect with out snapping, like a brittle piece of chalk.
The calcium and different minerals fill in across the scaffold, which offers bones with their hardness and density. On a aspect notice, vitamin K2 cross-links one other protein, osteocalcin, which makes the protein scaffold even stronger. So vitamin K2 can be a key participant. However again to vitamin C.
With out wholesome collagen, the minerals do not have something to anchor onto. You’ll be able to take all of the calcium you need, but when your protein construction just isn’t there, your bones can be brittle and vulnerable to fracture. And the primary requirement for constructing collagen is vitamin C.
How Vitamin C Builds and Protects Your Bones
Vitamin C helps bone well being via a minimum of 4 distinct pathways, every backed by human cell analysis and medical proof.
It builds the collagen scaffold.
Vitamin C is important for the hydroxylation of proline and lysine — two amino acids that stabilize collagen fibers. With out sufficient vitamin C, collagen is structurally weak. For this reason extreme vitamin C deficiency (scurvy) has been related to bone and joint issues for hundreds of years. Research with human osteoblast cells affirm that vitamin C immediately stimulates kind I and sort III collagen synthesis in bone tissue (Malmir et al., British Journal of Vitamin2018).
It prompts bone-building cells.
Vitamin C promotes the differentiation and exercise of osteoblasts — the specialised cells chargeable for forming new bone. It enhances the expression of key bone-building markers, together with alkaline phosphatase and osteocalcin. Equally essential, vitamin C deficiency does the other: it impairs osteoblast operate whereas concurrently stimulating osteoclasts, the cells that break bone down. That is a double hit (Aghajanian et al., Journal of Bone and Mineral Analysis2015).
It helps shield bone cells from oxidative injury.
After menopause, declining estrogen exposes bone cells to elevated oxidative stress. Vitamin C neutralizes the free radicals that injury these cells — a protecting position that works independently of its collagen-building operate.
It flips genetic switches for bone formation.
Maybe probably the most thrilling latest discovery got here from a 2022 research printed in Nature Communications. Researchers discovered that vitamin C does not simply assist assemble collagen — it epigenetically controls the genetic switches that activate bone-building genes. The research confirmed that bone cell differentiation is “strictly and constantly depending on vitamin C,” indicating that this nutrient is concerned at a extra elementary degree than beforehand understood (Khani et al., Nature Communications2022).
What the Human Analysis Exhibits For Vitamin C and Bones
The analysis on the mechanisms of how vitamin C helps bones is nice, however we wish to know: does it translate into actual outcomes in actual individuals? So this is what the strongest human proof additionally tells us.
The Framingham Osteoporosis Examine — one of the crucial revered long-term epidemiological packages on the earth — tracked 958 women and men (imply age 75) over 17 years. Members with the very best whole vitamin C consumption had considerably fewer hip fractures and non-vertebral fractures in comparison with these with the bottom consumption. The distinction within the vitamin C consumption was really as a result of dietary supplements, not dietary consumption, on this inhabitants. An earlier evaluation from the identical cohort discovered that greater vitamin C consumption was related to considerably much less bone loss over 4 years (Sahni et al., Osteoporosis Worldwide2009; Sahni et al., Journal of Vitamin2008).
Two main meta-analyses have pooled knowledge from a number of observational research to evaluate the general image. A 2019 evaluation in Frontiers in Endocrinology mixed 13 research and located that individuals with the very best dietary vitamin C consumption had a 34% decrease threat of hip fracture in comparison with these with the bottom consumption (Solar et al., 2019). A 2018 evaluation within the British Journal of Vitamin discovered that greater vitamin C consumption was related to a 33% decrease threat of osteoporosis general and positively correlated with bone mineral density on the femoral neck and lumbar backbone — two of probably the most vital fracture websites (Malmir et al., 2018). Collectively, these two meta-analyses discovered the same lower within the threat of hip fracture or osteoporosis.
Research targeted particularly on postmenopausal ladies persistently present the identical sample. Ladies with greater vitamin C consumption (137–176 mg/day) had considerably decrease osteoporosis threat in comparison with these consuming 91 mg/day or much less. Ladies identified with osteoporosis had markedly decrease vitamin C ranges in blood than wholesome controls — 5.28 versus 9.77 mg/L (Brzezińska et al., Vitamins2020). Information from the Boston Puerto Rican Well being Examine confirmed that postmenopausal ladies with adequate plasma vitamin C had considerably greater hip bone density than these with low plasma vitamin C ranges (Mangano et al., Journal of Vitamin2021).
A small however notable randomized trial discovered that postmenopausal ladies who acquired simply 250 mg/day of vitamin C along with their normal osteoporosis therapy confirmed considerably larger bone mineral density after 1 yr than these on normal therapy alone. That is not even very a lot vitamin C, nevertheless it was sufficient to make a distinction. The researchers concluded it was “a secure and low-cost addition to plain therapy” (Biomedical and Pharmacology Journal2014).
One essential nuance: a 2024 research utilizing Mendelian randomization — a genetic technique for testing causality — didn’t discover a direct genetic causal hyperlink between vitamin C ranges and osteoporosis threat (Liu et al., Inheritance2024). This doesn’t suggest vitamin C is unhelpful, nevertheless it does counsel the connection is advanced. Vitamin C seemingly works finest as a part of a complete dietary strategy, as a staff member, not because the star quarterback.
The Bone Well being Crew: Vitamin C’s Place within the Lineup
Supplemental vitamin C, along with what you get out of your vegatables and fruits, seems to be useful primarily based on the proof above. Bone well being is a staff effort.
You want calcium for the constructing blocks. You want magnesium to stability calcium. Vitamin D helps calcium get absorbed to the appropriate locations. Vitamin K2 directs the calcium to the appropriate locations—to the bones and to not delicate tissues like cartilage and the partitions of your arteries.
Weight-bearing train stimulates bone transforming and strengthens bones. Vitamin C builds the collagen scaffold that holds issues collectively. It additionally prompts the cells that type new bone and protects them from oxidative injury. An entire-foods plant-based food regimen with somewhat additional vitamin C is nice for bones, because the vitamins work synergistically. A vitamin D3 / K2 complement can be essential.
Sensible Steps You Can Take At this time
The Hallelujah Food regimen emphasizes a excessive consumption of recent, uncooked vegatables and fruits, in addition to vegetable juice. It will present you simply with 200-300 milligrams of vitamin C a day simply out of your meals.
As well as, 1,000 milligrams of vitamin C in complement type, akin to liposomal vitamin C or sodium ascorbate, is a superb thought and can assist bones. Most animals make their very own vitamin C, and there are various the explanation why a better consumption of vitamin C is helpful, as I’ve written about beforehand.
The Backside Line
It might be good to have extra large-scale randomized managed trials, however we now have sufficient proof to behave, from long-term inhabitants research, small trials, analyses of a number of research, and mechanistic research that present how vitamin C works.
Vitamin C is reasonable and is broadly obtainable. It’s best to take extra vitamin C for a lot of causes, together with stronger bones.
In case your DEXA scores have you ever involved, do not assume you are doing all you’ll be able to by simply taking calcium and vitamin D. You are able to do much more to manage your individual well being.
Undertake the Hallelujah Food regimen and eat a big salad daily. Keep lively with weight-bearing train and take additional vitamin C. Use a holistic dietary strategy to totally help your physique, together with your skeleton.
References
- Sahni S, et al. (2009). “Protecting impact of whole and supplemental vitamin C consumption on the danger of hip fracture — a 17-year follow-up from the Framingham Osteoporosis Examine.” Osteoporosis Worldwide20(11):1853–1861. PubMed
- Sahni S, et al. (2008). “Excessive vitamin C consumption is related to decrease 4-year bone loss in aged males.” Journal of Vitamin138(10):1931–1938. PubMed
- Zeng LF, et al. (2019). “Can Dietary Consumption of Vitamin C-Oriented Meals Scale back the Threat of Osteoporosis, Fracture, and BMD Loss? Systematic Overview With Meta-Analyses of Latest Research.” Frontiers in Endocrinology10:844. PubMed
- Malmir H, Shab-Bidar S, Djafarian Okay. (2018). “Vitamin C consumption in relation to bone mineral density and threat of hip fracture and osteoporosis: a scientific overview and meta-analysis of observational research.” British Journal of Vitamin119(8):847–858. PubMed
- Brzezińska O, et al. (2020). “Function of Vitamin C in Osteoporosis Improvement and Therapy — A Literature Overview.” Vitamins12(8):2394. PubMed
- Liu Z, et al. (2024). “Serum vitamin C ranges and threat of osteoporosis: outcomes from a cross-sectional research and Mendelian randomization evaluation.” Inheritance161:43. PubMed
- Thaler R, Khani F, et al. (2022). “Vitamin C epigenetically controls osteogenesis and bone mineralization.” Nature Communications13:5883. PubMed
- Aghajanian P, et al. (2015). “The Roles and Mechanisms of Actions of Vitamin C in Bone: New Developments.” Journal of Bone and Mineral Analysis30:1945–1955. PubMed
- Morton DJ, Barrett-Connor EL, Schneider DL. (2001). “Vitamin C Complement Use and Bone Mineral Density in Postmenopausal Ladies.” Journal of Bone and Mineral Analysis16(1):135–140. PubMed
- Zhang R, et al. (2023). “Affiliation between a number of nutritional vitamins and bone mineral density in older adults.” BMC Musculoskeletal Problems24:113. PubMed
- Mangano KM, et al. (2021). “Ample Plasma Vitamin C Is Associated to Larger Bone Mineral Density amongst Postmenopausal Ladies from the Boston Puerto Rican Well being Examine.” Journal of Vitamin151(12):3764–3772. PubMed
- Pande V, Choubey J. (2014). “Does Administration of Vitamin C Enhance Osteoporosis in Publish-Menopausal Ladies.” Biomedical and Pharmacology Journal7(2).DOI
