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Bone is composed of a tough organic matrix that is greatly strengthened by deposits of calcium salts. The average compact bone contains by weight about 30% matrix and 70% salts. The organic matrix of bone is 90-95% collagen fibers, and the remainder is a gelatinous material called ground substance. The collagen fibers extend primarily along the lines of tensional force. These fibers give bone its powerful tensile strength. Each collagen fiber of compact bone is repeated about every 640 angstroms along its length. The segments of adjacent collagen fibers overlap one another. The crystals also overlap, like bricks in a brick wall.
The coalition fibers of bone, like those of tendons, have great tensile strength. The calcium salts which are similar in physical properties to marble, have great compression strength. This strength, plus the strength of bonds between the collagen fibers and the crystals make the bone structure that has both extreme tensile and compression strength. Thus, bones are constructed in the same way reinforced concrete is constructed. The steel of reinforced concrete provides the tensile strength, while the cement, sand and rock provide the compression strength. The compression strength of bone is greater than the best reinforced concrete, and the tensile strength approaches that of reinforced concrete.
The blueprint of the entire skeleton is indelibly recorded in every one of the cells of the body. The initial stage in bone production is the secretion of collagen molecules by bone cells called osteoblasts. The resultant tissue becomes osteoid, a collagen-like material which differs from cartilage in that calcium salts will soon precipitate in it. As the osteoid is formed, some of the osteoblasts become entrapped in the osteoid and then are called osteocytes.
Within a few days after the osteoid is formed calcium salts begin to precipitate on the surfaces of the collagen fibers. The precipitate first appear at intervals along each collagen fiber, forming minute nidi that rapidly multiply and grow over a period of days and weeks into the finished product.
Bone is continually being deposited by osteoblasts and is continually being absorbed where osteoclasts are active. Osteoblasts are found on the outer surface of the bones and in the bone cavities. A small amount of osteoblastic activity occurs continually in all living bones so, at least some new bone is being formed constantly.
Bone is also being continually absorbed in the presence of osteoclasts. Normally, except in growing bones, the rates of bone deposit and absorption are equal to each other so, the total mass of bone remains constant. Osteoclasts usually exist in small but concentrated masses, and once a mass of osteoclasts begin to develop, it usually eats away at the bone for about three weeks, eating out a tunnel that ranges in diameter from 0.2 to 1 millimeters and is several millimeters long.
At the end of this time, the osteoclasts disappear and the tunnel is invaded by osteoblasts; then new bone begins to develop. Bone deposition then continues for several months, the new bone is laid down in successive layers of concentric circles on the inner surfaces of the cavity until the tunnel is filled. Deposition of new bone ceases when the bone begins to encroach on the blood vessels supplying the area. It appears that bone cells are very intelligent. They know when to tear down and when to build up the bones.
Bone ordinarily adjusts its strength in proportion to the degree of bone stress. Consequently, bones thicken when subjected to heavy loads. Even the shape of the bone can be rearranged for proper support of mechanical forces by deposition and absorption of bone in accordance with stress patterns. Because old bone becomes relatively brittle and weak, new organic matrix is needed as the old organic matrix degenerates. In this manner the toughness of bone is maintained.
The bones of children, in whom the rates of deposition and absorption are rapid, show little brittleness in comparison with the bones of old age, at which time the rates of deposition and absorption are slow.
Bone is deposited in proportion to the compression load the bone must carry. The bones of athletes become considerably heavier than those of non-athletes. If a person has one leg in a cast and uses crutches to get around but continues to walk on the opposite leg, the bone of the leg in the cast becomes thin as as much as 30% decalcified within a few weeks, whereas the opposite bone remains thick and normally calcified. Continual physical stress stimulates osteoblastic deposition and calcification of bones. Doctors often use walking casts to make sure the injured leg remains properly calcified. This is why rebound exercise is so important to rebuilding and maintaining healthy bones.
Go to any health club or athletic department and ask the experts employed there to show you the exercises they use to strengthen the skeleton. The skeleton is the structure to which all of the voluntary muscles are connected. You will catch them by surprise. They will stutter and stammer and then they will eventually show you several machines. Ask them to show you the machine that is designed to strengthen your bones. They will not be able to because it is not there. The health clubs and athletic directors have overlooked the importance of skeletal strength.
Increasing the G-force, by rebounding, sends a message to the bone cells telling them the entire skeletal system needs to be mineralized, dense and strong. This reduces the chance of, or even reverses the effects of, osteoporosis. The bone cells are intelligent enough to recognize an increased G-force demands stronger bones and they simply set about producing a stronger skeleton.
Building healthy bone requires the proper activity of bone-building hormones, cells, and nutrients. These are the anabolic bone-building factors. They include proper function of the hormone leptin and various nutrients such as calcium, magnesium, silica, boron, copper, manganese, sulfur, zinc, vitamin-D, omega-3 fatty acids, and protein. Maintaining bone requires an absence of inflammation that interferes with bone building and accelerates bone loss. Nutrients proven to specifically help this issue are magnesium, tocotrienols, and alkalizing fruits and vegetables. A person needs to do enough to get out of the wear and tear trend. The inflammatory wear and tear trend is the actual cause of accelerated bone loss.
Cartilage or gelatin, has chondroitin sulfate in it, glucosamine sulfate, collagen, these are all the basic raw materials to rebuild cartilage and bone, for regrowing cartilage, ligaments, tendons, connective tissue, bone foundation, bone matrix. They’ve been using gelatin and cartilage for race horses for 100 years for their cartilage and ligaments and joints. You can go into any grocery store and get some Knox gelatin. Women know about Knox gelatin, because it's good for your fingernails and your hair and your skin. It has the raw materials for your cartilage, cause it is made out of beef cartilage and beef tendon, and if you take two of those little half oz. envelopes a day in your orange juice, and you take it with an oz. per body weight of colloidal minerals, in 3 months, you're not going to have arthritis. If there is a blood supply to that joint and the bone, you will regrow bone and cartilage.
Increasing calcium intake alone actually impedes bone health. In short, increased magnesium intake stimulates the production of calcitonin which causes calcium to be deposited into bone. High magnesium intake with low calcium intake encourages deposition of calcium into bone, whereas higher calcium than magnesium intake discourages deposition of calcium into bones. Increased calcium intake stimulates the production of parathyroid hormone which causes calcium to be deposited into soft tissue.
The other side of the coin relates to factors that cause the loss of bone to accelerate in the first place. These are factors that speed-up the rate at which osteoclasts take down bone. Such factors fall under the general umbrella of stress and inflammation. Excess interleukin-6 (IL-6acts as both a pro-inflammatory and anti-inflammatory cytokine), tumor necrosis factor alpha (TNFaa class of cytokines), and nuclear factor-kappa B (NF kappaBa protein complex that is a transcription factor). NF-kappaB is found in almost all animal cell types and is involved in cellular responses to stimuli such as stress) speed up the activity of osteoclasts, causing bone to be lost at an excessive rate.
Vitamin-D helps bones by protecting the bone-building cells, osteoblasts, from inappropriate cell death. However, excess TNFa and NF kappaB block the ability of vitamin-D to protect osteoblasts, leading to excess osteoblast cell death. These inflammatory signals interfere with bone building while at the same time accelerate bone loss.
85% of all arthritis is caused by Osteoporosis of the joint, ends of the bones. We're talking about degenerative arthritis, osteo arthritis, sciatica, lumbago, rheumatism, etc. They are caused by Osteoporosis of the joint ends of the bones. 75-80% of all Americans over the age of 50 get arthritis to one degree or one type or another, and according to the Centers for Disease Control, 35 to 50 million baby-boomers are going to get arthritis in the next 7 to 10 years and there’s not a single medical treatment designed to treat or fix it. Aspirin certainly doesn’t fix arthritis, it causes gastric bleeding and death. Tylenol doesn’t fix arthritis, there’s 50,000 cases of kidney failure each year, 5000 so severe you need a kidney transplant. Then there’s Ibuprofen, Advil, and Aleve, these things don’t fix arthritis, and they cause liver disease in 2-5% of users including liver sclerosis, even if you don’t drink. And then there’s metholtrexate and gold shots. These things don’t fix arthritis, they subdue your bone marrow so that you can’t make normal platelets and white blood cells. Then you have the granddaddy of all medical treatments for arthritis, Prednizone and Cortisone. They don’t fix arthritis. They subdue your immune system which leaves you open to diseases far, far more horrible than arthritis, and Prednizone and Cortisone accelerates the loss of minerals from your bone. Something you don’t want when you have osteoporosis and arthritis.
When these prescription medications and over-the-counter medications don’t work anymore to relieve pain and inflammation, the only thing left for you medically is joint-replacement surgery. And they never work out well; many times you are worse off after the surgery than you were before the surgery.
The ECM is a buffering system for acids excreted by the cells. Impairment in the ability to excrete these acids, or over-production of acids by metabolic dysregulation, will first lead to acidification of the ECM. Chronic acidification of the ECM will eventually lead to increased acidification of intracellular compartments, which can create impairment of cellular metabolic processes, especially aerobic energy production. Eventually disruption of cellular organelle functions and structures will occur. Excessive acidification of the ECM will also eventually lead to saturation of the buffering capacity of ECM proteins. This will result in mobilization of calcium, magnesium, and heavy metals from the skeleton.
When such demineralization or “mineral spilling” occurs, calcium, magnesium, and other minerals are chronically mobilized from the bone for use as mineral buffers. These minerals will be lost through the kidneys, burdening these organs, and can eventually produce mineral deficienciespossibly total body depletion of these minerals. In essence, excessive and prolonged acidic conditions will result in increased mineral mobilization from the skeleton. Such a condition will first create osteopenia (i.e., reduced bone) and in the long run will eventually progress to osteoporosis (i.e., bone holes) and compression fractures.
In adulthood, after peak bone mass is reached, estrogen deficiency in women can increase the rate of bone breakdown and cause bone loss. In men, any condition or disease causing low levels of estrogen or testosterone may also result in bone loss. Peak bone mass, defined as the maximum bone density an individual will ever have, is reached between 16 and 25 years of age. Hormonal balance is one of the factors necessary to reach peak bone mass.Low levels of estrogen in females or low levels of testosterone in males during youth and young adulthood are associated with lower peak bone mass.
Thyroid stimulating hormone (TSH), produced in the pituitary gland, directly communicates to the osteoblasts in bone (the bone building carpenters), who have TSH receptors on them. In fact, osteoblasts are listening for TSH instructions in order to pick up their hammers and go to work while at the same time telling osteoclasts not to work too hard. A number of studies demonstrate that either too little or too much TSH is hard on your bones.
Properly functioning leptin is essential for the formation and health of bones. It is a primary hormone that must work properly for bone health. Current drugs to help prevent bone loss have adverse side effects and are not even directed at the real issuemaking new bone. They only address a secondary factor in bone loss. A primary factor in bone health is to maintain leptin in good working order, not having too little leptin and not having leptin resistance.
Underweight women are prone to osteopenia and osteoporosis. Underweight women lose significant bone. Bone loss can occur during dieting as leptin levels drop. Furthermore, this problem is a more significant issue for older women. This is one reason why proper leptin management is so important. Bone loss occurs when the anorexic-like starvation metabolism is present. It accelerates in the presence of excess inflammation of any type.
Healthy bones are a more complex issue than simply the amount of bone mass. Leptin is involved with the healthy workings of bone metabolism. Leptin is involved with the formation of blood cells, both red and white cells. This activity takes place inside of bones. Leptin acts as a powerful hormone inside of bone that stimulates the formation of new bone. In fact, not only does leptin act inside bones to help make bone, recent information shows that when leptin binds to the hypothalamus gland in the brain, it facilitates the hypothalamus gland to initiate new bone formation. Furthermore, omega-3 fatty acids are essential for this leptin-regulated bone building to take place.
While most of us recognize calcium as an important mineral for bone growth, calcium represents only twenty percent of total bone mass and calcium alone is not sufficient for proper bone health and strength. Trace elements are also essential for normal growth and development of skeletons in humans. Although they are minor structural components of teeth and bone, they play important functional roles in bone metabolism and bone turnover. In addition, these minerals need to be present in the appropriate ratios in order to be optimally effective.
98% of the body's calcium is stored in our bones. Its purpose in bone is to create rigidity (giving us our distinctive shape) and as a storehouse for the body’s metabolic needs for calcium such as nerve transmission, blood clotting and wound healing.
The body needs 91 nutrients every day. A lot of people that have been taking 2000mg calcium everyday for 20 years, cause they knew it was good for them, yet they still have hypertension, insomnia, loose teeth, receding gums, low back problems, bone spurs, kidney stones, arthritis, osteoporosis, all the stuff they shouldn’t have. But it depends on what kind of calcium they take. If you take 1000 mg calcium lactate, for example, you’re not getting 1000 mg of calcium, cause 86%, 860mg is lactose, or milk sugar. Only 14%, or 140 mg is metallic or elemental calcium, and let’s use 10% for usability factors, a fair number, plus it’s easy math, 10% of 140 mg is 14. So if you take 2 of those calcium lactate tablets, each 1000 mg, you’re not getting 2,000 mg of calcium, you’re getting 2 times 14, or 28 mg. To get 2000mg of calcium from these 1000 mg calcium lactate tablets, you would have to take 30 of those with each meal. Almost a full 100 tablet bottle of these calcium lactate tablets a day. And of course, at $5 a bottle for the cheapest one, you’re looking at $150 per month just for calcium. You’ve 59 more minerals to go, 16 vitamins, 12 essential amino acids, 3 essential fatty acids, so this is not an economical way to get your nutrients as elemental minerals.
One method of assessing your magnesium status is to simply contact your health care provider and request detailed magnesium testing. Yet magnesium assessment is typically done using blood serum testing, and these tests can be misleading. Only 1% of magnesium in the body is actually found in blood, and only .3% is found in blood serum, so clinical blood serum testing may not successfully identify magnesium deficiency. Normal serum and plasma magnesium concentrations have been found in individuals with low magnesium in red blood cells and tissues. Older adults are particularly vulnerable to low magnesium status. It has been shown that aging, stress and disease all contribute to increasing magnesium needs, yet most older adults actually take in less magnesium from food sources than when they were younger.
Sixty four percent of the body's magnesium is concentrated in the bones. A lack of magnesium causes depressed osteoblast bone building and accelerated osteoclast bone loss. In the presence of lacking magnesium, growth plate of bone decreases 33 percent indicating a lack of bone building. At the same time, TNFa activity inside of osteoclasts increases up to 500 percent of normal. The lack of magnesium permits excessive inflammation in the bone, a problem that prevents calcium from building bone.
Medical authorities claim that the widespread incidence of osteoporosis and tooth decay in western countries can be prevented with a high calcium intake. However, published evidence reveals that the opposite is true. Asian and African populations with a very low intake of about 300 milligrams (mg) of calcium daily have very little incidence of osteoporosis. In Africa, Bantu women with an intake of 200 to 350 mg of calcium daily have the lowest incidence of osteoporosis in the world. In western countries with a high intake of dairy products, the average calcium intake is about 1,000 mg. The higher the calcium intake, especially in the form of pasteurized cow's milk products (except butter), the higher the incidence of osteoporosis.
Calcium, magnesium and phosphorus levels are kept in a seesaw balance by the parathyroid hormones. If calcium goes up, magnesium goes down and vice versa. With a low magnesium intake, calcium goes out of the bones to increase the calcium levels in tissues, while a high magnesium intake causes calcium to go out of the tissues and into the bones. A high phosphorus intake without a high calcium or magnesium intake causes calcium to leach from the bones and then leave the body with the urine. A high phosphorus intake with high calcium and magnesium leads to bone mineralization.
Dr Lewis B. Barnett, an orthopedic surgeon, practiced in two different US counties with very different mineral levels in soil and water. In Dallas County, Texas, with a high calcium and low magnesium concentration in the water supply, osteoporosis and hip fractures were very common, while in Hereford, Texas, with high magnesium and low calcium levels, these were nearly absent. In Dallas County, the magnesium content of bones was 0.5 per cent, while in Hereford it was 1.76 per cent. In another comparison, the magnesium content in bones of osteoporosis sufferers was 0.62 per cent, while in healthy individuals it was 1.26 per cent.
The same applies for healthy teeth as for healthy bones. In a New Zealand study, it was found that caries-resistant teeth had on average twice the amount of magnesium as caries-prone teeth. The average concentration of magnesium phosphate in bones is given as about 1.0 per cent, in teeth about 1.5 per cent, in elephant tusks 2.0 per cent and in the teeth of carnivorous animals that crush bones it is 5.0 per cent. In regard to the strength of bones and teeth, think of calcium as chalk and magnesium as superglue. The magnesium superglue binds and transforms the chalk into superior bones and teeth.
Silica is the second most abundant element on earth. It is an essential element of living matter and humans have a critical need for this element. Silica enhances the function of iron, calcium, magnesium, potassium and boron, and is essential for bone development and growth. Bones need silica to re-calcify and to strengthen bone tissue. Silica strengthens bone matrix connective tissue by enhancing cross-linking of collagen strands. Silica actually concentrates at calcification points of growing bone. A silica deficiency in tissue causes a calcium deficiency which, in turn, results in a loss of tissue elasticity. Silica deprivation leads to gross musculoskeletal deformities and diminished bone flexibility and strength. Silica is also one of the most important constituents of the body’s connective tissue, including cartilage, vascular lining, tendons, and ligaments.
Zinc regulates secretion of calcitonin from the thyroid grand which influences bone turnover. Serum and bone levels of zinc are often low in elderly osteoporotic patients, which suggests that zinc depletion may have a role in osteoporosis.
Recent studies have reported possible improvements in bone mineral density in women who supplemented with boron. Boron’s role in bone metabolism appears to be associated with its interactions with other minerals such as calcium and magnesium.
Bone abnormalities and increased susceptibility to fractures is a common manifestation of copper deficiency in humans. Copper works in conjunction with iron to form red blood cells which are manufactured in bone matrix.
In an observational study, blood manganese levels in osteoporotic women were found to be only 25% of that of control subjects. The role of manganese in cartilage metabolism appears to be centered on its involvement in the synthesis of proteoglycans, which are major constituents of cartilage's extra cellular matrix.
Approximately 10% of the body’s total sulfur content is concentrated in bone. Proteins involved in musculoskeletal development and support all require sulfur within their molecular framework.
Tocotrienols, a special form of vitamin-E, help improve bone mineral density. Unlike regular vitamin-E, tocotrienols work by lowering excess TNFa and NF kappaB, the true source of the accelerated bone loss.
There are two main types of cells in bone that act to repair and build bone, osteoblasts and osteoclasts. Osteoclasts work by building up new bone. They take raw materials, such as protein and calcium, and construct bone. Proper bone health involves a synergistic balance between osteoclasts and osteoblasts. As older or stressed bone is removed, new bone is built in its place. This process goes on throughout life. Problems occur when factors speed up the rate of bone loss or when there is difficulty making new bone.
The current bone-loss drugs are targeted at osteoclasts, hoping to slow down the rate at which bone is removed. This may slow down inappropriate bone loss, but it does not solve the problem of building new bone or the problem of why bone loss accelerates. Such medications are second-rate, temporary solutions.
Leptin is the key hormonal signal that works on bone as well as coordinates a signal from the brain to build bone. Leptin is the key anabolic hormone for bone building, helping osteoblasts to form new bone. This is why starvation metabolism causes bone loss. Bone is not made fast enough because there is not enough leptin to help stimulate the formation of new bone.
Calcium, magnesium, silica, boron, copper, manganese, sulfur, zinc, vitamin-D, omega-3 fatty acids, and protein, fruits, and vegetables in the diet significantly help preserve bone mass in older individuals. Higher protein consumption facilitates better bone density. Strength-bearing exercise, especially rebounding, helps bones because it applies stress to bones, in essence promoting them to break down so they can be built up. It is based on the age-old principle, “if you don’t use it, you’ll lose it.” This strategy works well if a person has the energetic and nutritional capacity to repair bone and form new bone, including adequate quality dietary protein.
Broth, made from the bones of animals, has been consumed as a source of nourishment for humankind throughout the ages. It is a traditional remedy across cultures for the sick and weak. A classic folk treatment for colds and flu, it has also been used historically for ailments that affect connective tissues such as the gastrointestinal tract, the joints, the skin, the lungs, the muscles and the blood. Broth has fallen out of favor in most households today, probably due to the increased pace of life that has reduced home cooking in general. Far from being old-fashioned, broth (or stock) continues to be a staple in professional and gourmet cuisine, due to its unsurpassed flavor and body. It serves as the base for many recipes including soup, sauces and gravy. Broth is a valuable food and a valuable medicine, much too valuable to be forgotten or discounted in our modern times with our busy ways and jaded attitudes.
In general, broth is a liquid made by boiling meat, bones, or vegetables. There are many types of broths, based on what is being cooked. For example, Bieler Broth, a vegetable broth made with green beans, zucchini, and celery is a supportive remedy used in detoxification or cleansing protocols. Consommé, a rich broth made from meat, is another example. It is prepared by reducing, or prolonged simmering. Stock is another word used synonymously with broth, though some chefs denote stock as being made from bones whereas broth is made from meat.
In this chapter the two names are used interchangeably. Soup is a similar term referring to simmered vegetables, meat, and seasonings, and is defined by Webster's Dictionary as a liquid food. The difference is that soup contains solids such as meat, beans, grains or vegetables (sometimes disguised by a purée) while a broth is the liquid in which solids have been simmered and then discarded. Soup is what we think of as having for a meal. Broth is a starting ingredient for soup, and must be prepared separately beforehand.
The ingredients are as follows: bones from an animal, with or without meat and skin, enough water to just cover the bones, a splash of vinegar, and optional assorted vegetables or their scraps. Making broth requires almost no work, just put the bones in a pot, add water and vinegar, bring it to a simmer and walk away. No chopping or tending is needed.
Why then, don't people make it? Stock needs to be prepared in advance to mealtime. It needs to boil for hours, and the longer it simmers, the better it gets. An easy solution is to routinely put meat scraps into a pot, instead of the garbage can. Broth can just as easily be extracted from a single chicken breast bone as it can from a whole chicken, and it need not be raw. Broth can be allowed to simmer on lowest heat for a day or two. The greatest amount of work is at the end, when it must be strained, cooled, and put into containers, still not very troublesome. It can be kept in the refrigerator for about five days, or frozen for months. With stock on hand, homemade soup can be ready for dinner within 20 minutes.
Basically, broth will contain the ingredients that are in bone. Covering and adhering to the ends of bones to form a joint, is cartilage. Therefore broth will also contain the ingredients that are in cartilage. Bone and cartilage are both classified as connective tissue. Connective tissue is one of the four basic tissue types that exist in animals. It functions to bind or hold together and to support and strengthen the body. Connective tissue consists of a matrix, and cells that secrete the matrix. The matrix is the material that fills the space between the cells and is therefore referred to as the extracellular matrix. It is composed of protein fibers, and ground substance, which can be a liquid, a gel or a solid. Since the cells are few, it is the valuable nutrients from the matrixes of bone and cartilage, which create the substance called broth.
Extra Cellular Matrix
sodium and potassium
collagen I (90%)
The primary functions of bone are to provide a support framework, protect organs, store and release minerals, produce blood cells and store energy. In the matrix of bone, the protein, collagen, forms the fibers. Collagen has the ability to resist a pulling or tearing force, called tensile strength. It is flexible and rubbery. The other matrix component, the ground substance, is made of mineral salts. Calcium and phosphorus, in a composite called hydroxyapatite, and some calcium carbonate, form 65% of the ground substance. Water contributes 25%. The remaining 10% is formed by magnesium, sodium, potassium, sulfate and fluoride. The inorganic minerals form a solid ground substance and give bone its hardness. If bones were made only of collagen they would be rubbery, but if they were made only of minerals, they would be brittle. Together they make bone flexible and hard.
In a central cavity, bone also houses marrow. There are two types of bone marrow, red and yellow. Red bone marrow is the location for the manufacture of the cells in blood. It produces the cells in their immature forms. The final conversion into mature blood cells occurs outside the bone marrow. The cells made in the red marrow are myeloid stem cells, the precursors to red blood cells, and lymphoid stem cells, the precursors to white blood cells and platelets. Red blood cells carry and deliver oxygen to other cells, white blood cells are part of the immune system, and platelets allow for clotting. Red bone marrow also contains collagen protein fibers, sometimes called reticulin fibers, classified as type III collagen. Chicken bones have a higher concentration of red marrow, and that this considerably enhances flavor.
Yellow bone marrow is a storage site for energy in the form of lipids or fats. It contains adipocytes within which fat is stored. It also contains a small amount of blood cells and type III collagen fiber.
Cartilage is deposited in varying places in the body including the nose and ear. The joint cartilage is the primary type that gets incorporated in broth. It functions as a shock absorber and to reduce friction. In the matrix of cartilage, the fiber component is collagen protein and elastin protein. Like collagen, elastin provides strength, but it also provides stretch. It can stretch up to one and a half times its original length. The other matrix component, ground substance is made of the glycosaminoglycans (GAGs) chondroitin sulfate, keratin sulfate and hyaluronic acid. The GAGs form a gel ground substance that gives cartilage its resilience.
Cartilage has enjoyed fame as a supplement for osteoarthritis in the form of shark cartilage. It has been studied for joint disease, and gastrointestinal disease. Cartilage dramatically improves degenerative joint disease, including rheumatoid arthritis. It also improves inflammatory bowel disease.
Cartilage has a poor blood supply. It actually produces chemicals known as antiangiogenesis factors (AAFs) that inhibit the growth of blood vessels into it. This seemingly unfortunate quality can actually be used to advantage in the fight against cancer. Cancer cells grow very rapidly. They achieve rapid proliferation by stimulating the growth of new blood vessels to support themselves. AAFs are now being used as a treatment to inhibit the growth of blood vessels into cancer cells. As a medicine, AAFs are given in the form of cartilage.
Cartilage supplementation also stimulates B, T, and macrophage immune cells. Malnutrition (protein deficiency) is the most common form of immune suppression in the world. That is because the immune system is composed primarily of protein, including antibodies, receptors and chemical signalers. When it is considered that 80% of the immune system lines the gastrointestinal tract, the role of cartilage gains importance, since it can nourish both the gut and the immune system.
Pharmaceutically prepared cartilage is very expensive, often prohibitively so. But cartilage can be extracted at home, by making broth. Broth recipes stress the quality that can be obtained from using highly cartilaginous parts of animals. These parts will be joint areas, like chicken feet and beef knuckles, trachea and ribs, or anatomy with a concentration of glycosaminoglycans, like hooves and skin.
To summarize, cartilage (broth) can be considered for use in the following conditions: arthritis, inflammatory bowel disease (Crohn's disease and ulcerative colitis), cancer, decreased immune system states, and malnutrition.
Collagen comes from the word kolla, which means glue. True to its verbal root, it has been used as glue in the past. It functions to hold the body together. One fourth of all the protein in the body is collagen. It is the framework for the extra cellular matrix of bone, cartilage and skin. Another word for collagen is gelatin.
Collagen is a scientific term for a particular protein in the body, while gelatin is a food term referring to extracted collagen. It is usually encountered in powdered form, but gelatin also describes the collagen extracted into broth. Properly prepared broth will gel, just like Jell-O, when cooled, because collagen is rubbery and flexible.
Webster's Dictionary defines gelatin as "the…substance extracted by boiling bones, hoofs, and animal tissues." Since collagen is present in both bone and cartilage, it can be extracted from either of the two connective tissues and be labeled as gelatin. Most commercial gelatin today is extracted from animal skin, another connective tissue which contains collagen. Gelatin, is what most people think of as the main ingredient in broth. Bone broth differs from gelatin in that it also contains minerals and GAGS. Traditionally made stock uses bone and cartilage and produces a higher quality result. It also produces a safer result considering that commercial gelatin contains small amounts of monosodium glutamate (MSG).
Although it seems obscure today, gelatin has been studied and recommended, with great enthusiasm, by the medical community in the past. In 1937 Dr. Pottenger said, "Gelatin may be used in conjunction with almost any diet that the clinician feels is indicated." From the late 1800s to the mid-1900s, gelatin was the subject of many studies. One of the reasons gelatin is so infrequently studied today, is due to a lack of standardization. Without a consistent item, researchers in the past found it difficult to reproduce findings.
In Gotthoffer's survey, one general area of health prescription clearly comes to the fore, and that is digestion. Most notably, he refers to over 30 years of research on gelatin's ability to improve the digestion of milk. In the early 1900s gelatin was therefore recommended as an ingredient in infant formula, to decrease allergic reactions, colic and respiratory ailments. Gelatin was also reported to increase the digestibility of beans and meat (which gives credence to the practice of serving meat with gravy). It was also found that gelatin increased the utilization of the protein in wheat, oats and barley, all gluten-containing grains. Gluten is a notoriously difficult to digest protein for many people. Those that suffer from gluten allergy are diagnosed with Celiac disease, a debilitating condition.
Gotthoffer also found gelatin to be prescribed for both hyper- and hypo-stomach acidity. He cites three physicians who report gelatin to "work better and more rapidly than bismuth and tannin" in clinical practice. A more recent study by Wald, demonstrated that glycine (a main ingredient in gelatin) stimulates gastric acid secretion.
Another recent study found that "gelatin as feed supplement protected against ethanol-induced mucosal damages in rats." This directly supports the traditional thought that broth is healing and coating to the gastrointestinal lining, and gives a scientific explanation for broth's ability to calm and soothe. Gelatin has also been found to improve body weight as well as bone mineral density in states of protein undernutrition. Additionally, studies have shown that convalescing adults, who have lost weight because of cancer, fare better if gelatin is added to their diet. It is said to be tolerated when almost nothing else can be.
Some of the medical communities in other parts of the world value gelatin too. In Chinese herbal medicine, gelatin is an important herbal remedy, in use for thousands of years. Its Chinese name is e jiao. It is classified as a tonic herb. Tonics strengthen or supplement insufficiency and weakness. They are considered nourishing and enhance the body's resistance to disease. They are used for states of deficiency. Gelatin is used to tonify the blood, in particular.
This correlates to Western medical knowledge since, as we will see, glycine, a key ingredient in gelatin, plays a vital role in the blood. Also if gelatin is extracted from bone, then marrow, where blood cells are produced is also extracted. Chinese studies have shown gelatin to increase red blood cell and hemoglobin count, increase serum calcium level, increase the absorption and utilization of calcium, and prevent and treat myotonia atrophica (muscle wasting).
To summarize, gelatin (broth) can be considered for use in the following conditions: food allergies, dairy maldigestion, colic, bean maldigestion, meat maldigestion, grain maldigestion, hypochlorhydria, hyperacidity (gastroesophageal reflux, gastritis, ulcer, hiatal hernia) inflammatory bowel disease (Crohn's disease and ulcerative colitis), irritable bowel syndrome, leaky gut syndrome, malnutrition, weight loss, muscle wasting, cancer, osteoporosis, calcium deficiency and anemia.
Over 15 types of collagen have now been identified, but histology classifies three main types. Type I is in bone, skin, ligaments, tendons and the white of the eye. Type II is in cartilage. Type III is in bone marrow and lymph, and is also called reticulin fiber.
Protein fibers are created by stringing together amino acids, the building blocks of protein. Collagen differs from the average protein in that it is composed of a high concentration of certain amino acids. Specifically, about one third of collagen is composed of glycine, the smallest amino acid. Another third of collagen is composed of proline (and hydroxyproline, the active form of proline). The small size of glycine along with the properties of proline, allows for the unique triple helix shape of collagen. A smaller portion of the amino acids lysine and hydroxylysine are also incorporated into collagen. The remaining structure is made from other amino acids that vary.
Scurvy is a disease caused by a deficiency of vitamin C. It results in symptoms such as bleeding gums, bruising, and poor wound healing. These manifestations are actually due to a deficiency of collagen, because vitamin C is needed to synthesize collagen. It converts proline into hydroxy proline. Collagen, along with minerals is needed for the creation and healing of bone. It is also integral to cartilage formation and repair, along with GAGs.
To summarize, collagen (broth) can be considered for use in the following conditions: poor wound healing, soft tissue injury (including surgery), cartilage and bone injury (including dental degeneration).
Amino Acid Profile of Gelatin
27.2 g/ 100 g
15.5 g/ 100 g
13.3 g/ 100 g
4.4 g/ 100 g
0.8 g/ 100 g
Glycine is the simplest amino acid. It contributes to the manufacture of other amino acids and is incorporated into important structures in the body. It is a primary ingredient in the synthesis of heme, the vital portion of our blood that carries oxygen. It is used in the synthesis of creatine, which buffers energy and shuttles energy across membranes in muscle tissue, especially the heart. It contributes to the synthesis of bile salts. It is incorporated into purines and pyrimadines, and nucleic acids, which form our DNA and RNA. It is used as a cofactor in phase I detoxification, during the final oxidation. It is one of the three amino acids needed to form glutathione, the key phase II detoxification enzyme. Glycine is used in gluconeogenesis, the synthesis of glucose from amino acids (protein) during times of fasting, and therefore affects the stabilization of blood glucose levels.
Glycine is classified as a nonessential amino acid because we can synthesize it within our body. Many scientists believe it is necessary to consume it though. In fact, Yu and associates found that glycine metabolism is directly responsive to dietary glycine and that prolonged abstinence in the diet may limit the formation of heme, glutathione, purines and creatine. Jackson has concluded that a marginal state of glycine is more common than previously thought. Jackson also found that certain conditions increase our need for glycine, such as sickle cell anemia and pregnancy. In the case of sickle cell anemia, the high rate of heme destruction increases the requirement for glycine. In pregnancy, the growing fetus creates a demand for glycine that is two to ten times greater than normal, and two to ten times greater than the need for other amino acids.
Additional studies have reported positive results with glycine for health conditions. Glycine is associated with a strongly reduced risk of asthma. Glycine stimulates gastric acid secretion. Glycine is particularly helpful due to its high concentration in connective tissue and also due to the increased need for creatine in wound healing. It has also been found to be the rate-limiting step in rapid growth, of which both wound healing and fetus growth are an example. The ability of the liver to perform protective synthesis is limited by the amount of glycine available. Gelatin is recommended as a glycine supplement for patients with jaundice and other liver problems.
Broths are often used in modified fasting and cleansing regimes. In the fasting state, glycine is used for gluconeogenesis. During periods of fasting when no food or energy source is being consumed, our body breaks down our own protein tissues, such as muscle, to create energy from. If broth is consumed, it supplies an outside source of glycine, which limits or prevents degeneration during the fast. Since glycine is also used for phase I and II detoxification, it puts broth into the category of a liver tonic (or liver supportive). Broth helps the body to detoxify during a detox, and in fact at any time it is eaten.
To summarize, glycine (broth) can be considered for use in the following conditions: anemia, fatigue, detoxification, blood sugar dysregulation, muscle wasting, wound healing, pregnancy, infant and childhood growth, asthma, hypochlorhydria, jaundice and liver support.
Proline is found in most of the proteins in the body. One of its main roles is in the structure of collagen. It is incorporated into connective tissues such as bone, skin, ligaments and tendons, and cartilage. Proline is also considered a nonessential amino acid, but, as with glycine, it may be considered 'conditionally essential' in that it is important to consume proline dietarily. Research shows that proline levels drop significantly when it is absent from the diet. Proline has also been shown to have beneficial effects for memory and the prevention of depression.
There are other compounds in broth that gel besides collagen. The ground substance of cartilage is made of proteoglycans, huge sugar and protein molecules. Attached to a core protein are long strands of glycosaminoglycans (GAGs) also called mucopolysaccharides. These structures are naturally jellylike. As mentioned, the GAGs in cartilage are hyaluronic acid, chondroitin sulfate and to a lesser degree, keratin sulfate. Hyaluronic acid forms a central strand to which chondroitin and keratin sulfate bond.
Hyaluronic acid is strongly negatively charged, which allows it to attract and bond a large amount of water. This molecule is therefore aptly entitled hydrophilic, or water-loving. Dr. Francis Pottenger, who researched gelatin in the 1930's, believed that this hydrophilic nature was at the root of gelatin's digestive benefits by attracting digestive juices to the surface area of our food. He coined the term hydrophilic colloids to describe this process. Hyaluronic acid is viscous and slippery. It lubricates joints and helps in wound healing by assisting migration of phagocytes.
Chondroitin Sulfate is a jellylike substance, now famous as a supplement for joint pain associated with osteoarthritis. It functions to support and provide adhesiveness. It lines blood vessels and plays a role in lowering atherosclerosis, cholesterol and heart attacks.
Minerals have three major functions in the body. First, they provide a structural base for connective tissue like bone. Second, they create electrical potentials allowing for conduction of nerve signals and movement across cell membranes. Third, they act as catalysts for enzymes in physiologic processes. They transform the food and air we breathe into energy, vibrant health, and consciousness.
Minerals are essential to life but they are not easy to digest. In the stomach, the presence of hydrochloric acid is necessary to physically break down our food, but also to extract elemental minerals from the food that we've eaten. A similar reaction takes place in the making of broth. An acid is necessary to remove the minerals from the bone. This is the purpose of using vinegar (acetic acid) when making broth. As stated in The Principles of Anatomy and Physiology, "If inorganic minerals are removed by soaking bone in a weak acid such as vinegar, it results in a rubbery, flexible structure." This rubbery flexible structure is the leftover collagen/gelatin. The chemical reaction that extracts the minerals is an acid-base reaction, in which the vinegar is the acid, and the minerals are the base.
Since there are no standards for the preparation of, or ingredients in, commercial broth, it is possible that manufacturers are skipping the vinegar step, or perhaps not even using bones, both of which would leave the broth devoid of minerals. This may be why canned soup does not contain the same amount of minerals as home cooked. The milligrams of minerals in vegetable soup increase 2-8 fold when cooked at home.
Bone contains calcium and phosphorus, and to a lesser degree, magnesium, sodium, potassium, sulfate and fluoride. Bone is an excellent source of minerals. All of the minerals present in bone, except fluoride, are macrominerals, which are essential for proper nutrition and are required in greater amounts than 100mg/day. The only macromineral not present in bone is chlorine.Minerals have numerous functions in the body beyond the composition of bone, which is why the body will rob the bones and tissues to maintain steady levels of minerals in the blood and other fluids.
Deficiencies of minerals can be acquired, similar to vitamin deficiencies. Generally there are two ways this can happen, lack of intake in the diet, or lack of absorption in the intestines. Broth can be an excellent remedy for both of these causes of mineral deficiency because it provides easily absorbed extracted minerals, plus promotes healing of the intestinal tract.
Unlike vitamins, minerals do not have defining deficiency diseases, but rather a collection of associated deficiency signs, symptoms and diseases. Interestingly, many of the deficiency symptoms of minerals are mood and behavior disturbances. This offers a scientific explanation for broth's ability to soothe and stabilize. It is reasonable to assume that previous to the development of pharmaceutical mineral supplements, bone broth was an important supply of minerals, especially in the winter when fresh fruit and vegetables are less available, and warm food is preferred. Even just one generation ago broth was a part of most household and restaurant repertoires. Yet today, neither nutrition nor science textbooks list bone as a dietary source of minerals.
Calcium is the most abundant mineral in bone, present both as hydroxyapatite (bonded to phosphorus) and calcium carbonate. It is also the most abundant mineral in the body. Calcium is necessary for the normal functioning of nerve conduction and muscle contraction (including the regulation of the heartbeat). It facilitates neurotransmitter release, and hormone action via its relay role as a second messenger, thus playing an important role in mood and endocrine balance. Proper blood clotting and tissue repair is also dependent on calcium. It is necessary for the passage of fluids between cell walls. It is a cofactor for the activity of hundreds of enzymes. It is involved in the production of the body's primary energy source, adenosine triphosphate (ATP), due to its role as a citric acid cycle intermediate. Calcium is involved in immune function by helping to stabilize mast cells. It regulates cell reproduction and it also regulates the manufacture of proteins. As we can see, calcium is a vitally important mineral, so important, that it is maintained at a constant amount in the bloodstream at all times, to be readily available for the body's needs.
Intake of calcium is reported to be low in the Basic American Diet. Calcium (broth) can be considered for use in the following deficiency signs, symptoms and conditions: pain and inflammation, cramps, muscle spasms, delusions, depression, insomnia, irritability, hyperactivity, anxiety, palpitations, hypertension, high cholesterol, allergies, brittle nails, periodontal and dental disease, pica, rickets, osteomalacia, osteoporosis and any situation that creates bone loss such as aging, immobilization, postmenopause, and caffeine, tobacco, and alcohol use.
Phosphorus is an ingredient of ATP, the body's source of energy. It is therefore a regulator of all enzymes via activation reactions. It is a component of nucleic acids, which make up our DNA, phospholipids which make up our cell membranes, and cyclic adenosine monophosphate (cAMP) which as a second messenger, relays information into the cells. It buffers acids, and regulates osmotic pressure intracellularly.
Phosphorus (broth) can be considered for use in the following phosphorus deficiency signs, symptoms and conditions: decreased attention span, fatigue, weakness, muscle weakness, celiac or sprue disease, rickets, osteomalacia, primary hyperparathyroidism and seizures.
Magnesium is present in enzymes that generate and stabilize ATP. It is involved in over 300 enzyme reactions and acts as a cofactor for vitamins B1and B6. It is involved in the synthesis of cAMP, fatty acids, proteins, nucleic acids and prostaglandins via delta-6-desaturase. It contributes to muscle excitability, nerve transmission and allows the parathyroid gland to function normally. Magnesium deficiency is the most common dietary deficiency in the U.S.
Magnesium levels in the diets of 10 different, non-industrialized groups, still eating their traditional diets, were 1302,850% higher than are consumed in the modern diet. Magnesium deficiency causes a reduction in all antibodies (except IgE) and antibody forming cells due to its involvement in protein synthesis.
Magnesium (broth) can be considered for use in the following magnesium deficiency signs, symptoms and conditions: loss of appetite, nausea, vomiting, diarrhea, fatigue, nervousness, anxiety, restlessness, confusion, hyperactivity, insomnia, muscular irritability and weakness, allergies, immunodepression, kidney stones and heart attack.
The electrolytes sodium and potassium have a major influence on osmotic balance between cells and the interstitial fluid (electrolyte balance), establishing ion gradients across cell membranes, and neutralizing positive and negative charges on proteins and other molecules. Their electrical conductivity is necessary for nerve signals, muscle contraction (including the heart) and hormone/ neurotransmitter release. Sodium, in particular, is important in nerve and muscle function and maintaining water balance. Potassium acts as a catalyst in carbohydrate and protein metabolism. Intake of potassium is low in the American diet. Both minerals are involved in helping us adapt to stress, and during situations of prolonged stress such as cancer, the body's stores can be depleted.
Potassium (broth) can be considered for use in the following potassium deficiency signs, symptoms and conditions: cramping, shallow breathing, fatigue, nausea, vomiting, confusion, increased urination, and heart attack.
Sodium (broth) can be considered for use in the following sodium deficiency signs, symptoms and conditions: muscle weakness, dizziness, headaches, hypotension, increased heart rate, shock, mental confusion, stupor and coma.
Sulfur is a component of connective tissues (cartilage and skin, as chondroitin and keratin sulfate), proteins (enzymes and antibodies), hormones, and B vitamins (thiamin and biotin). It is involved in energy production, blood clotting, phase II detoxification and bile secretion from the liver.
Sulfur (broth) can be considered for use in degenerative arthritis, and detoxification.
Fluoride is not considered an essential mineral for humans.
Is broth a food or a medicine? It has traditional use as both. As a food it is generally incorporated into other dishes, serving as a base structure to make soup, stew, sauce or gravy, or to cook grains and beans in, instead of water. Broth is not a complete protein, since it only contains three amino acids. A complete protein needs to contain all 8 essential amino acids. Therefore it is not a meat replacement, but it can be used as a meat extender. Since glycine is used to make other amino acids, it is considered protein sparing. In addition, because glycine is used to make energy in gluconeogenesis, consuming glycine spares your own body protein from being broken down to make energy. Broth is not a meal replacement, which is why it is used as a starting point for soup, or as the first course of a meal.
As a medicine, it is often used alone, sipped at intervals or drunk much like a tea. The word tea, besides referring to the popular beverage, also refers to a form of herbal medicine. "Tea" can be used to describe an infusion or a decoction. To make an infusion, pour boiling water onto herbs, let soak for 510 minutes, discard the herbs, and drink the tea. This is how black tea, is made. A decoction differs in that it is made by directly boiling the herbs in water, for 2040 minutes. This method is used on substances that are tougher, like roots, or bones. Broth is a bone and cartilage decoction, or tea. What this process is doing, with herbs or bones, is removing the active chemical ingredients into the water by means of heat, time, and acid, making the nutrients immediately available to absorb. (Vinegar is also used to remove the minerals from plants when making extractions.) Using the standard of herbal formulation, broth qualifies as a medicine.
Being both a food and a medicine, broth has some distinct benefits. In general, food is a form of medicine that has few side effects and is difficult to overdose on. There is less likelihood of forgetting to take the medicine, since eating is a part of a normal daily routine. This is especially true if the medicinal food can be incorporated into established eating patterns, such as using broth to cook grain for a patient who eats grain on a regular basis. Using leftover meat and vegetable scraps to make medicine is a pretty smart form of recycling. It is an example of using the entirety of what Nature provides. Most importantly, broth tastes good, it's a delicious food that people enjoy eating, and that makes the best medicine.
Broth can be thought of as a protein supplement, and a calcium supplement. The chemical ingredients extracted from broth are glycine and proline (collagen/ gelatin), calcium and phosphorus (minerals), hyaluronic acid and chondroitin sulfate (GAGs), and other minerals, amino acids and GAGs in smaller amounts.
Broth is inherently calming, consoling, and restorative to our spirit and vigor. Brewing broth fills a home with an aroma of indefinable goodness. That, in itself, is medicine. Because it's easy to absorb, tastes good, and contains a rich concentration of nutrients, broth makes a distinctively good medicine.
To 'support and strengthen' the function of connective tissue.
To 'support and protect' the function of bone.
To 'store energy,' the function of yellow bone marrow.
To act as a 'shock absorber and reduce friction,' the function of cartilage.
To be 'flexible and strong,' the function of collagen.
To 'hold it together' and 'keep it together,' also the function of collagen.
To 'soup up,' to increase the power or speed of.
To 'put stock in,' to trust.
1. Bonesfrom poultry, fish, shellfish, beef, lamb--cooked remnants of a previous meal, with or without skin and meat
raw bones, with or without skin and meat--use a whole carcass or just parts (good choices include feet, ribs, necks and knuckles)--don't forget shellfish shells, whole fish carcasses (with heads) or small dried shrimp
2. Waterstart with cold water (enough to just cover the bones) or 2 cups water per each pound bones
3. Vinegar a splashapple cider, red or white wine, rice, balsamic 2 tablespoons per 1 quart water or 2 pounds bones--lemon juice may be substituted for vinegar (citric acid instead of acetic acid)
4. Vegetables (optional)peelings and scraps like ends, tops and skins or entire vegetable celery, carrots, onions, garlic and parsley are the most traditionally used, but any will do if added towards the end of cooking, mineral content will be higher
Combine bones, water and vinegar in a pot, let stand for 30 minutes to 1 hour, bring to a simmer, remove any scum that has risen to the top, reduce heat and simmer (648 hrs for chicken, 1272 hrs for beef). To reduce cooking time, you may smash or cut bones into small pieces first. If desired, add vegetables in last ½ hour of cooking (or at any point as convenience dictates). Strain through a colander or sieve, lined with cheesecloth for a clearer broth. Discard the bones. If uncooked meat was used to start with, reserve the meat for soup or salads.
An easy way to cook broth is to use a Crockpot on low setting. After putting the ingredients into the pot and turning it on, you can just walk away. If you forget to skim the impurities off, it's ok; it just tastes better if you do. If you wish to remove the fat for use in gravy, use a gravy separator while the broth is warm, or skim the fat off the top once refrigerated. Cold broth will gel when sufficient gelatin is present. Broth may be frozen for months or kept in the refrigerator for about 5 days.
1. SoupMake soup by adding vegetables, beans, grains or meat to broth. Briefly cook vegetables and meat with butter or oil in the bottom of a stockpot (5 minutes). Add broth, and grains or previously soaked beans if you wish. Simmer until everything is cooked through. Time will vary with the ingredients used, but count on a minimum of 20 minutes. Season at the end of cooking with salt and pepper and spices of your choice. Consult cookbooks for specific recipe ideas.
2. Cooking LiquidUse broth in place of water to cook rice, beans or other grains. Bring broth to a boil, add grains or beans, reduce heat and cook for instructed time. Or you can simmer vegetables or meat in a little seasoned broth until cooked. Remove to a plate, thicken broth with cornstarch, arrowroot or flour, then pour over vegetables and meat.
3. GravyMake gravy to put on vegetables, meat or biscuits. Put fat (removed from the broth, or use butter) in a skillet. Add any type of flour, 1 tablespoon at a time, and stir constantly until browned. Whisk in broth and cook till thickened. Add salt and pepper to taste.
4. TeaDon't forget you can just add salt and sip broth like tea. This is especially nice in the winter or if you're feeling sick. Since broth is simultaneously energizing and calming, it can take the place of morning coffee, afternoon tea, or evening nightcap. Try it in a thermos and sip throughout the day. Of course, the most traditional use for seasoned broth is as a first course, to enhance the digestion of any meal to come.
*Pork bones are not generally recommended for prepared ahead broth, but are cooked into stew and soup recipes, and boiled pig skin is traditionally consumed for many of the same purposes as broth.
**Raw bones and meat may be browned first in the oven, or in the bottom of the stockpot to enhance flavor and color.
hyperchlorhydria (reflux, ulcer)
inflammatory bowel disease (Crohn's Disease and Ulcerative Colitis)
intestinal bacterial infections
irritable bowel syndrome
loss of appetite
weight loss due to illness