For those who’ve been recognized 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. In all probability 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 implies vitamin C performs a a lot larger position in bone well being than most individuals understand. Dr. Tom Levy, in his e book Dying by Calcium, discusses how vitamin C additionally helps bone well being. However that e book was revealed 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 reveals and what you are able to do about it at this time.
Your Bones Are Extra Than Simply Minerals
Most of us image bones as very mineral-dense constructions 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 varieties the versatile scaffold on which mineral is constructed. This scaffolding provides bones their energy and slight flexibility, they should take in impression with out snapping, like a brittle piece of chalk.
The calcium and different minerals fill in across the scaffold, which supplies bones with their hardness and density. On a facet observe, 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 may take all of the calcium you need, but when your protein construction isn’t there, your bones might 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 by at the very least 4 distinct pathways, every backed by human cell analysis and medical proof.
It builds the collagen scaffold.
Vitamin C is crucial for the hydroxylation of proline and lysine — two amino acids that stabilize collagen fibers. With out sufficient vitamin C, collagen is structurally weak. This is the reason extreme vitamin C deficiency (scurvy) has been related to bone and joint issues for hundreds of years. Research with human osteoblast cells verify that vitamin C straight stimulates kind I and kind III collagen synthesis in bone tissue (Malmir et al., British Journal of Diet, 2018).
It prompts bone-building cells.
Vitamin C promotes the differentiation and exercise of osteoblasts — the specialised cells accountable for forming new bone. It enhances the expression of key bone-building markers, together with alkaline phosphatase and osteocalcin. Equally vital, vitamin C deficiency does the other: it impairs osteoblast perform whereas concurrently stimulating osteoclasts, the cells that break bone down. That is a double hit (Aghajanian et al., Journal of Bone and Mineral Analysis, 2015).
It helps defend bone cells from oxidative harm.
After menopause, declining estrogen exposes bone cells to elevated oxidative stress. Vitamin C neutralizes the free radicals that harm these cells — a protecting position that works independently of its collagen-building perform.
It flips genetic switches for bone formation.
Maybe essentially the most thrilling current discovery got here from a 2022 examine revealed in Nature Communications. Researchers discovered that vitamin C would not simply assist assemble collagen — it epigenetically controls the genetic switches that activate bone-building genes. The examine confirmed that bone cell differentiation is “strictly and constantly depending on vitamin C,” indicating that this nutrient is concerned at a extra elementary stage than beforehand understood (Khani et al., Nature Communications, 2022).
What the Human Analysis Reveals For Vitamin C and Bones
The analysis on the mechanisms of how vitamin C helps bones is nice, however we need to know: does it translate into actual outcomes in actual individuals? So here is what the strongest human proof additionally tells us.
The Framingham Osteoporosis Research — one of the revered long-term epidemiological applications on this planet — tracked 958 women and men (imply age 75) over 17 years. Contributors with the 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 truly 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 Worldwide, 2009; Sahni et al., Journal of Diet, 2008).
Two main meta-analyses have pooled information from a number of observational research to evaluate the general image. A 2019 evaluation in Frontiers in Endocrinology mixed 13 research and located that folks with the best dietary vitamin C consumption had a 34% decrease danger of hip fracture in comparison with these with the bottom consumption (Solar et al., 2019). A 2018 evaluation within the British Journal of Diet discovered that greater vitamin C consumption was related to a 33% decrease danger of osteoporosis total and positively correlated with bone mineral density on the femoral neck and lumbar backbone — two of essentially the most vital fracture websites (Malmir et al., 2018). Collectively, these two meta-analyses discovered the same lower within the danger of hip fracture or osteoporosis.
Research centered particularly on postmenopausal ladies persistently present the identical sample. Girls with greater vitamin C consumption (137–176 mg/day) had considerably decrease osteoporosis danger in comparison with these consuming 91 mg/day or much less. Girls recognized with osteoporosis had markedly decrease vitamin C ranges in blood than wholesome controls — 5.28 versus 9.77 mg/L (Brzezińska et al., Vitamins, 2020). Information from the Boston Puerto Rican Well being Research 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 Diet, 2021).
A small however notable randomized trial discovered that postmenopausal ladies who obtained simply 250 mg/day of vitamin C along with their customary osteoporosis therapy confirmed considerably higher bone mineral density after 1 12 months than these on customary therapy alone. That is not even very a lot vitamin C, but it surely was sufficient to make a distinction. The researchers concluded it was “a secure and low-cost addition to straightforward therapy” (Biomedical and Pharmacology Journal, 2014).
One vital nuance: a 2024 examine utilizing Mendelian randomization — a genetic technique for testing causality — didn’t discover a direct genetic causal hyperlink between vitamin C ranges and osteoporosis danger (Liu et al., Hereditas, 2024). This doesn’t suggest vitamin C is unhelpful, but it surely does recommend the connection is complicated. Vitamin C seemingly works greatest as a part of a complete dietary method, as a workforce member, not because the star quarterback.
The Bone Well being Group: Vitamin C’s Place within the Lineup
Supplemental vitamin C, along with what you get out of your fruit and veggies, seems to be useful based mostly on the proof above. Bone well being is a workforce effort.
You want calcium for the constructing blocks. You want magnesium to steadiness calcium. Vitamin D helps calcium get absorbed to the fitting locations. Vitamin K2 directs the calcium to the fitting locations—to the bones and to not delicate tissues like cartilage and the partitions of your arteries.
Weight-bearing train stimulates bone reworking 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 harm. An entire-foods plant-based weight loss plan with a bit of additional vitamin C is nice for bones, because the vitamins work synergistically. A vitamin D3 / K2 complement can be vital.
Sensible Steps You Can Take Right now
The Hallelujah Weight loss plan emphasizes a excessive consumption of recent, uncooked fruit and veggies, 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, reminiscent of liposomal vitamin C or sodium ascorbate, is a good thought and can assist bones. Most animals make their very own vitamin C, and there are numerous causes why a better consumption of vitamin C is helpful, as I’ve written about beforehand.
The Backside Line
It could 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 affordable 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 suppose 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 personal well being.
Undertake the Hallelujah Weight loss plan and eat a big salad every single day. Keep lively with weight-bearing train and take additional vitamin C. Use a holistic dietary method to completely 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 Research.” Osteoporosis Worldwide, 20(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 Diet, 138(10):1931–1938. PubMed
- Zeng LF, et al. (2019). “Can Dietary Consumption of Vitamin C-Oriented Meals Cut back the Threat of Osteoporosis, Fracture, and BMD Loss? Systematic Assessment With Meta-Analyses of Latest Research.” Frontiers in Endocrinology, 10:844. PubMed
- Malmir H, Shab-Bidar S, Djafarian Okay. (2018). “Vitamin C consumption in relation to bone mineral density and danger of hip fracture and osteoporosis: a scientific evaluate and meta-analysis of observational research.” British Journal of Diet, 119(8):847–858. PubMed
- Brzezińska O, et al. (2020). “Function of Vitamin C in Osteoporosis Improvement and Remedy — A Literature Assessment.” Vitamins, 12(8):2394. PubMed
- Liu Z, et al. (2024). “Serum vitamin C ranges and danger of osteoporosis: outcomes from a cross-sectional examine and Mendelian randomization evaluation.” Hereditas, 161:43. PubMed
- Thaler R, Khani F, et al. (2022). “Vitamin C epigenetically controls osteogenesis and bone mineralization.” Nature Communications, 13:5883. PubMed
- Aghajanian P, et al. (2015). “The Roles and Mechanisms of Actions of Vitamin C in Bone: New Developments.” Journal of Bone and Mineral Analysis, 30:1945–1955. PubMed
- Morton DJ, Barrett-Connor EL, Schneider DL. (2001). “Vitamin C Complement Use and Bone Mineral Density in Postmenopausal Girls.” Journal of Bone and Mineral Analysis, 16(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 Problems, 24:113. PubMed
- Mangano KM, et al. (2021). “Enough Plasma Vitamin C Is Associated to Better Bone Mineral Density amongst Postmenopausal Girls from the Boston Puerto Rican Well being Research.” Journal of Diet, 151(12):3764–3772. PubMed
- Pande V, Choubey J. (2014). “Does Administration of Vitamin C Enhance Osteoporosis in Publish-Menopausal Girls.” Biomedical and Pharmacology Journal, 7(2).DOI
Supply hyperlink
