Vitamin D, food and bone health – the truth about recent negative reports

Are vitamin D supplements really not working?


Emma Thornton
Qualified Nutritionist (ANutr)
@EmmaThornton
Ask Emma


20 November 2018

Why the recent confusion in terms of vitamin D for bone health?

Some of the recent headlines regarding vitamin D might have shocked you; in recent years the popularity of this vitamin has been steadily on the rise and especially here in the UK, it’s been made clear to us that we should be taking a supplement to make up for the lack of sunshine we experience for most of the year.

Vitamin D, amongst a raft of other health benefits (read up on my blog to find out more), is thought to be especially beneficial for supporting bone health, meaning that certain high risk groups of people, for example those with osteoporosis, or menopausal women are readily recommended to take a supplement.

Now, as a result of a newly published study, there have been new reports stating that ‘vitamin D may NOT be beneficial for bone health’1 and, it having been suggested that we need to review the need for supplements, it’s understandable that many of us will have been left feeling confused!

However, before we all start ditching our supplements, I’m here to decipher some of this latest research and find out if we may have jumped to conclusions too quickly!

Are there any flaws in the new claims?

Whilst some of the headlines can be terrifying, when it comes to research studies it’s important to delve a little deeper in order to understand why we may not need to make any drastic changes just yet. 

With this latest study claiming that vitamin D may not be beneficial for our bones, there are a few reasons why we should be cautious:

1 – People with deficiencies may benefit most

The study in question was a review trial, meaning it combined the results from a larger number of trials; 81 to be exact1, however, interestingly, it only included 4 studies done on people with vitamin D deficiencies. 

Therefore, this sits nicely with what we often recommend – people who aren’t deficient may not necessarily benefit from more! More isn’t always better, and contrary to popular belief this is also true when it comes to herbs or nutritional supplements. Numerous trials have shown that people with a Vitamin D deficiency, do tend to benefit from a sensible dose2,3.

2 – Vitamin D trials have a trickier study design

When it comes to vitamin D trials, it becomes tricky to stop the ‘control’ group, or the group receiving no Vitamin D supplements, from having zero exposure to vitamin D. This is because we can’t stop people going outdoors (bearing in mind sunlight is our main source of vitamin D) and therefore the people receiving ‘no dose’ may actually be benefitting. 

This can mean that the proposed benefits of the supplement group may not come out so favourably.

3 – Vitamin D isn’t the only contributing factor when it comes to bone health

We don’t just need vitamin D alone to support health; actually we need a range of nutrients including magnesium and vitamin K, then not to mention all the lifestyle factors that can have an influence too, from taking part in weight bearing exercise, to the influence of hormones. 

Therefore, it can be hard to control for all of these factors, and when it comes to bone health, looking at one isolated nutrient, may not be the best approach.

4 – Short-term trials may not be best design when assessing bone health

Many of the trials included in the review in question1 were short-term, for example, up to 3 months only. Again, when it comes to bone trials looking at bone density, this may not have been the best approach as we may have needed longer to see significant improvements.

What’s the advice for supporting your bones going forward?

When it comes to supporting bone health, going back to our naturopathic roots is always beneficial. There a large number of factors that can influence bone health, so it may not be as easy as just topping up on one specific supplement! 

Here’s my best advice:

1 – Don’t forget about your digestion

It might surprise you to hear that when it comes to supporting your bones, one of my main pieces of advice is to support your digestion. See, we need sufficient stomach acid in order to break down the foods we eat and absorb key nutrients from our diet, many of which we need to support our bones. Worryingly, there have been links with the long-term use of antacid medications and bone fractures, and this makes sense if we’re unnecessarily compromising our digestive functions. 

If you’re on medication, perhaps it’s time for a medicine review with your doctor (especially if your symptoms haven’t improved!) and if you feel your stomach needs some extra support, employing some digestive bitters such as Yarrow, may be helpful.

As well as your stomach, your liver is also an important digestive organ to consider. Your liver is responsible for recycling hormones such as oestrogen, and in turn, oestrogen can have an impact on bone health. As oestrogen levels decline, for example after menopause, we may need to make extra efforts to protect our bone density, and supporting your liver can be a good place to start!

2 – Foody focus

When it comes to supporting your bone health through diet, there needs to be a focus of a number of nutrients, and in a suitable balance to each other. When it comes to thinking about bone health, the ‘cake analogy’ can be useful. Flour (like calcium in your bones) is one of key ingredients in a cake, but without other key ingredients such as butter, sugar or eggs (magnesium, zinc or copper in the world of bones), you don’t have anything that nearly resembles or functions as a cake.

Therefore, when it comes to supporting our bones through diet, including a wide variety of fresh foods is important, but interestingly plant-based foods are also an important consideration – these foods will have naturally occurring calcium in, but crucially they will also have good amounts of magnesium and other micronutrients too.

It’s also not only important to include more of the good stuff, but also omitting things from our diet which may cause problems. Fizzy drinks for example, can have adverse effects on our bones and the acidic load they put on our bodies can risk leaching the beneficial nutrients from where they need to be.

3 - Make a move

Now, diet and supplements aren’t the only factors to consider when it comes to bone health, we should assess lifestyle habits too. Sedentary lifestyles are never going to be helpful, which comes as no surprise, but even if you partake in regular exercise, did you know it should be weight-bearing exercise for best effects? This means exercise such as cycling or swimming perhaps wouldn’t be as beneficial as options such as walking or playing tennis. 

Another obvious consideration when it comes to bone health is how much time you spend outdoors. It has to be said that dietary sources of vitamin D are pretty limited, so therefore, we really rely on sunlight to get our daily dose. Getting outdoors, even for 10 minutes in the morning or on your lunch break, can really help to up your intake. 

4– Don’t dis the supplements 

So, I definitely wouldn’t be recommending to suddenly stop your vitamin D supplement without giving this some careful thought.

It’s important to consider your digestion, diet and lifestyle first and foremost, but then, when it comes to supplements, the key is to opt for a sensible dose.

The new research suggests that anyone who isn’t deficient may not benefit from large doses unnecessarily, and this doesn’t sit well with us anyway. It’s best to stick to a more natural dose that your body can recognise and make better use of.

 

1. https://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30265-1/fulltext

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257679/

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4015454/

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