As was pointed out by the initial physio assessment, nutrition for me needs to focus on collagen / connective tissue building foods.  It turns out these types of foods will also be particularly important for Carl to help out with the integrity of his ankle (considering the fracture and associated tissue damage).  So, let’s talk about what ingredients are required for building and repairing healthy connective tissue – the stuff that makes up our bones, joints, tendons, ligaments, cartilage, fascia and so much more.

I’m going to lay the nutrition part of this down in a table to keep things simple (otherwise I’d need to write a book on it).  I’m going to add some more to it in coming days, so check back again for an extended list of foods!

Nutrients required for collagen and connective tissue formation and integrity:

Nutrient	Function	Source
Collagen	The main protein of connective tissue	Bone broths,
Glucosamine	Main precursor to producing GAGs (along with B1, B2, B3, B5, Mg, K, Lipoic acid, glutamine)	Bone broths, shells of shellfish (think crispy prawn tails!)Also produced endogenously (in the body)
Chondroitin		Skate Liver OilArtichokes help in production of chondroitin sulfate (high in glucuronic acid)
Sulfate	Combines with chondroitin to make up cartilage.Required for the process of sulfation, to produce Glucosamine sulfate and chondroitin sulfate which help facilitate cartilage repair and collagen production. (Other nutrients required for proper sulfation include: Mg, B12, B6, B9)	Broccoli, cauliflower, garlic, cabbage, onions, radishes, mustard.Eggs, whey protein (both high in cystiene, which contains high sulfate). MSM powder (biologically available source)
GAGs (glycosaminoglycans)	Required to build connective tissue.	Bone broths
Bioflavonoids	particularly anthocyanidins (these phytonutrients help link collagen fibres together in a way that strengthens the matrix of the cnnective tissue) and catechins (prevent the breakdown of collagen).	Anthocyanidins:Acai, Blueberries, blackberries, cranberries, black currants, cherries, spirulina, cinnamon, red grapes, egg plant, purple corn, red cabbage, red onions. Catechins: Green tea, acai, raw peaches, apricots, plums, nectarines, cherries, raw cacao,
Vitamin C	required to convert lysine and proline into hydroxylysine and hydroxyproline – the forms used to build collagen.	Unpasteurised fermented veggies, Papaya, camu camu, gubinji, capsicum, strawberries, broccoli, pineapple, brussel sprouts, kiwifruit, oranges, rockmelon, kale.
Superoxide dismutase (SOD)	reduces joint tissue inflammation	Spirulina
Zinc	Required for protein synthesis – i.e. for production of connective tissue such as cartilage, bone.  Required for the antioxidant SOD.	Oysters, Venison, lamb, grass fed beef, scallops, sesame seeds, pumpkin seeds, prawns.
copper	Required to produce SOD (see zinc).Required for cross-linking and naturation of collagen	Sesame seeds, cashews, soybeans, sunflower seeds, tempeh, chickpeas, lentils
Manganese	Required to produce SOD (se zinc)Formation of cartilage, bone, ligaments, tendons, fascia.	Brown rice, chickpeas, spinach, pineapple, pumpkin seeds, tempeh
glycine	Major component of collagen	Bone broth
Proline	Major component of collagen	Egg whites
Lysine	Major component of collagen and elastin	legumes
Glutamine	Increases plasma Human Growth Hormone by stimulating the pituitary gland (which then increase muscle growth)	Cabbage, especially when fermented (eg. Sauerkraut)Beef, chicken, fish, eggs, beetroot, beans, spinach, parsley. Produced endogenously.
Glucuronic acid	Component of Chondroitin	Globe artichokes
Hyaluronic acid (HA)	Stimulates growth of connective tissue.  Acts as a lubricant in joints and as a glue, improving the integrity of connective tissue.	Echinacea stimulates the production of HA by stimulating fibroblast activity.  Echinacea also inhibits the enzyme hyaluronidase – an enzyme which breaks down HA.
Proteolytic enzymes	To break down scar tissue	Nattokinase (in Natto)Bromelain (in pineapple) Papain (in papaya)

It’s all well and good looking at the nutrients required for connective tissue repair, however, as with all areas of health, nutrients are not the only ingredients.  Things like stress, lack of sleep and exposure to environmental toxins all affect our hormone levels, resulting in increased cortisol, decreased glucose absorption into cells and therefore an inability to make glucosamine (due to inablitiy to make enough GAGs).

Not only that, but we need to look at our toxin exposure and burden – how hard is your liver having to work and how much back log does it have to deal with?  Can you reduce the chemical exposure in your homes?  Your diet?  Your workplace?  The reason being that one of the liver detox pathways – glucoronidation – requires a lot of glucaronic acid (an amino acid which is a major component of chondroitin) to complete the job of detoxifying some drugs, hormones (esp cortisol and oestrogen) and pollutants.  If your liver is using up most your glucuronic acid for detoxifying, then there won’t be much left to make chondroitin.

Sulfation, like glucuronidation, is another important liver detoxification pathway, primarily responsible for detoxifying hormones and some drugs (e.g. NSAIDs).  As the name suggests, this pathway uses a lot of sulfur molecules.  So once again, if the majority of your sulfur is going to detoxification then you have little left to bind to glucosamine and chondroitin to repair cartilage.

So basically, eat a diet high in bone broths, good quality protein from good quality (ideally organic grass fed) meats and eggs, loads of veggies, unpasteurised fermented veggies, kombucha (a fermented tea that makes the glucuronic detox pathway more effective) loads of berries, fruit, healthy fats (fish, grass fed beef, extra virgin cold pressed flax oil / meal, eggs, avocado, nuts, seeds, coconut, butter, ghee, cold pressed EV olive oil, skate liver oil), and low in grains and sugar is the way to eat your connective tissue healthy.

You (and we) are also however going to need to keep a clean (low toxin) environment, clean drinking water, have plenty of good quality sleep and keep stress levels low.  Meditation and a detoxification plan would therefore be a perfect part of your connective tissue repair protocol.