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 means vitamin C performs a a lot larger position in bone well being than most individuals understand. Dr. Tom Levy, in his guide Loss of life by Calcium, discusses how vitamin C additionally helps bone well being. However that guide was printed again in 2013, and there is extra analysis since then that verifies what he already discovered. Vitamin C is a robust teammate that helps all of the vitamins collectively construct wholesome bones for you. This is what the science reveals and what you are able to do about it at present.
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 sort 1 collagen. It is the collagen that varieties the versatile scaffold on which mineral is constructed. This scaffolding provides bones their power and slight flexibility, they should take up 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 facet be aware, vitamin K2 cross-links one other protein, osteocalcin, which makes the protein scaffold even stronger. So vitamin K2 can also be a key participant. However again to vitamin C.
With out wholesome collagen, the minerals haven’t got something to anchor onto. You may take all of the calcium you need, but when your protein construction isn’t there, your bones will likely be brittle and susceptible 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 means of no less than 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. Because of this 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 straight stimulates sort I and sort 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 necessary, 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 Analysis, 2015).
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 essentially the most thrilling current 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 repeatedly depending on vitamin C,” indicating that this nutrient is concerned at a extra elementary degree than beforehand understood (Khani et al., Nature Communications, 2022).
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 here is what the strongest human proof additionally tells us.
The Framingham Osteoporosis Research — probably the most 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 attributable to 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 threat 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 threat of osteoporosis general and positively correlated with bone mineral density on the femoral neck and lumbar backbone — two of essentially the most crucial fracture websites (Malmir et al., 2018). Collectively, these two meta-analyses discovered the same lower within the threat of hip fracture or osteoporosis.
Research centered particularly on postmenopausal ladies constantly present the identical sample. Girls 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. 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). Knowledge from the Boston Puerto Rican Well being Research confirmed that postmenopausal ladies with enough 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 acquired simply 250 mg/day of vitamin C along with their normal osteoporosis remedy confirmed considerably better bone mineral density after 1 yr than these on normal remedy 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 plain remedy” (Biomedical and Pharmacology Journal, 2014).
One necessary nuance: a 2024 research utilizing Mendelian randomization — a genetic methodology for testing causality — didn’t discover a direct genetic causal hyperlink between vitamin C ranges and osteoporosis threat (Liu et al., Hereditas, 2024). This does not imply vitamin C is unhelpful, but it surely does recommend the connection is advanced. Vitamin C doubtless works greatest as a part of a complete dietary strategy, as a crew member, not because the star quarterback.
The Bone Well being Staff: 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 crew 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 comfortable 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 kind new bone and protects them from oxidative injury. A complete-foods plant-based food regimen with slightly further vitamin C is nice for bones, because the vitamins work synergistically. A vitamin D3 / K2 complement can also be necessary.
Sensible Steps You Can Take At the moment
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 kind, akin to 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 a lot of causes why a better consumption of vitamin C is useful, as I’ve written about beforehand.
The Backside Line
It will 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 extensively accessible. 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 may by simply taking calcium and vitamin D. You are able to do much more to regulate your personal well being.
Undertake the Hallelujah Food regimen and eat a big salad day-after-day. Keep energetic with weight-bearing train and take further vitamin C. Use a holistic dietary strategy 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 Overview With Meta-Analyses of Latest Research.” Frontiers in Endocrinology, 10:844. PubMed
- Malmir H, Shab-Bidar S, Djafarian Ok. (2018). “Vitamin C consumption in relation to bone mineral density and threat of hip fracture and osteoporosis: a scientific assessment and meta-analysis of observational research.” British Journal of Diet, 119(8):847–858. PubMed
- Brzezińska O, et al. (2020). “Position of Vitamin C in Osteoporosis Improvement and Remedy — A Literature Overview.” Vitamins, 12(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.” 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 Issues, 24:113. PubMed
- Mangano KM, et al. (2021). “Ample Plasma Vitamin C Is Associated to Larger 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 Put up-Menopausal Girls.” Biomedical and Pharmacology Journal, 7(2).DOI
