Dear Mark: Healing Broken Bones, and Blended Soups

October 12, 2015

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For today’s edition of Dear Mark, I’m answer two questions. First, is there a way to speed up the healing process after a broken bone? What nutrients should we make sure to consume? Are there supplements we can take, foods we can eat, lifestyle modifications we can make? The next question comes from a reader trying to nurse his grandfather back to health after a bad stroke. Grandpa’s still in the hospital and can only eat through a straw. Are there better options than the tasteless slop, butterscotch pudding, and bad ice cream he’s currently receiving?

Let’s find out:

Dear Mark,

I was in a car accident and lost my right leg and my left leg has a Tibia Fibia fracture. It’s been just two months, but I am not seeing a lot of healing in the leg. What parts of the paleo diet are going to best help me in the bone healing department. I am currently taking a collagen and gelatin supplement in place of a bone broth. I fear my protein intake is low so I’ve begun supplementing with a protein shake. Wondering if you have any thoughts on bone healing. Would you recommend the Damage Control Master Formula supplement? I’ve got damage that is for sure. Any advice would be appreciated.

M

Move safely. Obviously, your mobility is limited. You can’t do nearly as much you’re used to doing. Shearing movement can hamper the healing process. And whatever you do must be done with the blessing and guidance of your physician, physical therapist, and anyone else with a stake in your healing. But some degree of movement and mechanical loading should help. Stability is good and crucial. Rigidity and immobility are not.

Protein matters. In wound healing, protein requirements go way up. Whether it’s a bad burn, a laceration, or a broken bone, you need protein to build new tissue. And even though we don’t really think of broken bones as wounds, you’re essentially recovering from a traumatic wound. The gelatin and protein powder are good starts, but you should seek to get most of your protein through whole foods, as they’ll contain other pro-bone nutrients. One review recommends around 1.5 g protein/kg bodyweight or close to 0.7 g protein/lb bodyweight for injured patients. Use powders to fill in the gaps.

Calories matter. The more healing you have, the more food you need. Bone remodeling is incredibly energy-intensive. Don’t go so far as to start putting on weight, but eat more food than you think you need.

As for specific nutrients?

Strontium has been shown to speed up fracture healing time. Strontium ranelate, a prescription form, seems to have the most backing in the literature, though there are some contraindications you should discuss with your doctor.

Vitamin D, a pre-requisite for bone formation and mineral deposition, probably helps fracture healing, although the evidence is a bit scant, with just one pilot study published to date showing improved fracture healing with supplementation. Still, vitamin D is an important nutrient that many of us don’t get enough of. Perhaps some midmorning sun-bathing sessions are in order.

Milk basic protein, a component of whey, has been shown to speed up fracture healing in animal models and is available as a supplement.

Zinc, found in oysters, red meat, and seeds, can boost fracture healing in animal models.

Don’t forget about calcium, the basic stuff of bones. Paired with vitamin D, it’s been shown to improve some markers of fracture healing in humans. Dairy, bone-in canned fish, and leafy greens are great sources of calcium.

Vitamin C helps tissue construction, and a 2004 study even found that giving tibial fracture patients a mix of vitamin C, proline, lysine, vitamin B6, and other essential nutrients (likely many of the ones listed above) decreased the healing time (PDF).

Vitamin K2 is an underutilized and under-eaten but extremely important nutrient for bone metabolism. Take a supplement or eat natto, gouda, or goose liver paté.

Silicon is a trace mineral most people don’t consider essential, but it plays a small but important role in bone health. Most mineral waters are good sources of silicon; check the label or look up the water’s website for confirmation.

Copper matters. In one study, the protective effect of calcium in drinking water on fractures was enhanced by the presence of copper.

Damage Control Master Formula is a great source of micronutrients, polyphenols, and other antioxidant compounds. It’s really the best, most comprehensive and balanced multivitamin in existence, in my humble opinion. As such, it can help control inflammation that may be slowing your fracture healing. It’s definitely worth a try.

There are some “alternative” therapies showing promise:

Pulsed low-dose ultrasound has strong evidence for the healing of fresh fractures and weaker evidence for the healing of “delayed union” (or slower to heal) fractures. It might be worth a shot.

Infrared light may also improve fracture healing. Many professional sports teams are using infrared lasers to improve athlete healing times.

Parathyroid hormone administration may be able to speed up healing.

This review paper discusses some other therapies with potential for healing bone fractures. You can’t exactly get stem cell therapy or bone marrow concentrate aspirate off Amazon, so print it out and discuss them with your doctor.

For further discussions on bone health, stay tuned for a post in the coming weeks.

My Grandfather recently suffered a major stroke, and although he’s back on semi-solid foods, the range of things he can eat is still fairly limited. The bigger problem is that the “food” they’re serving him in the hospital is so heavily processed, so devoid of flavour, that he eats nothing but the butterscotch pudding and ice cream that they bring with the meal. After tasting some of his food, I can’t say I really blame him. I’ve found some nice butternut squash soup recipes, but I’m curious what some of your favourite recipes for purée type soups are? Maybe something with a nice bone broth?

Thanks!

Steve

Great question. Here are three options you can try. I apologize in advance for imprecise measurements. Unless I’m putting together a recipe book (and getting lots of help/cajoling from editors and co-authors), I don’t really weigh and measure.

Throw together a basic seafood chowder. With clams, mussels, oysters, fish—any edible sea creature, really—they are nutritional powerhouses. Assemble garlic, shallots (the better onion), pre-cooked and cooled potatoes, herbs, broth, olive oil/butter, and cream. Here’s what I do:

Sweat shallots and garlic in either some olive oil/ butter (or both), or cook up some chopped bacon and use the resultant fat as a cooking fat.
Add a few splashes of white wine, reduce.
Add broth. Typically you’d use a fish broth, but I find that poultry broths work well. Heck, I’ve used rich beef broth before.
Drop in some finely chopped rosemary and thyme. Dried is fine.
Add some heavy cream. Add the potatoes (already cooked and cooled for maximum resistant starch, remember). Simmer and thicken. Allow it to get thicker than you’d prefer, because adding the seafood in the next step will increase the liquid.
Add the seafood. It’ll cook fast, so don’t overcook.
Blend.

Simple butternut squash soups are fantastic. Winter squash in general blend up incredibly well. Find a good one (it should be heavy in your hand), steam it until soft, blend flesh with broth, salt, and a little fat (olive oil, butter, cream, whatever you prefer), then heat? Baby, you’ve got yourself a soup you can drink through a straw that only took a few minutes to make. Some good salty pork sausage goes really well with a butternut squash soup.

Paul Jaminet recently published the baby food recipe he’s been giving his son as a supplemental food. If you made a few changes, it’d be perfect for grandpa. Here’s what I’d do:

Increase the liver. Having grown up with parents who made it on the regular, most grandpas (and grandmas) can usually handle more liver than the average Millennial.

Use whole eggs rather than just yolks. Paul omits the whites for allergic reaction concerns, which you don’t have in this situation. Seniors recovering from health issues need more protein, particularly when they’re on bed rest. To cook the whites, you’d obviously have to drop the eggs in while the porridge simmers. Time it so the white is fully cooked and the yolk is still soft.

Add some more animal. Include something like chuck roast, brisket, beef shank, oxtail, chicken thigh that breaks down and softens up when cooked for sufficient time.

Use bone broth instead of water. Adds gelatin and other important nutrients. Also, tastes way better than water.

Include some leafy greens. A mix of baby kale, chard, and spinach work great in soups and blend up nicely.

Basically, anything will work and be better than the swill they’re offering at the hospital. Have fun with it!

That’s it for today, folks. If anyone else has any recommendations for M or Steve, such as soups or nutrients they can try, add them down below! I for one am always interested in new soup recipes.