Dial D for Density…Bone Density That Is

Vitamin D is crucial for calcium absorption.  Dietary sources are mainly fortified foods such as milk, other dairy products, and some orange juices as well as oily fish and cod liver oil.  Vitamin D is also manufactured by the body when skin is exposed to sunlight.  People who get little or no sun exposure tend to have higher rates of breast, colon and prostate cancer plus MS.  Sunscreens reduce the body’s absorption of vitamin D.  Many scientists believe if you get 10-15 minutes of sun exposure on your face and arms at least twice a week, you may not need to consume any dietary vitamin D or supplements. 

The Women’s Health Initiative contained a study of the effect of higher dosages of calcium and vitamin D on bone density, fractures and colorectal cancer.  Some of the data is conflicting.  For example, the WHI showed no clear benefit from calcium supplements even when combined with vitamin D (1000 mcg of calcium and 400 IU of vitamin D daily).  In those women taking the supplements, bone density slightly improved, risk of fracture did not improve, and risk of colon cancer was no lower.

More recently, a study led by the University of Pittsburgh Graduate School of Public Health determined that women with low levels of vitamin D have an increased risk of hip fracture.  The authors of this study, a professor of epidemiology and her colleagues, reviewed patient data from 400 women who had been enrolled in the WHI for seven years and had experienced hip fractures.  Comparing their levels of 25 hydroxyvitamin D, an indicator of vitamin D status, to a control group, the authors noted that as vitamin D concentrations decreased, risk of hip fractures climbed. 

Says the lead scientist, Dr. Jane Cauley:  “The risk of hip fractures was 77 percent higher among women whose 125 hydroxyvitamin D levels were at the lowest concentrations.  This effect persisted even when we adjusted for other risk factors such as body mass index, family history or hip fractures, smoking, alcohol use, and calcium and vitamin D intake.”

Find the full article at www.upmc.com.

How can one study conclude low levels of vitamin D increase the risk of hip fractures and another conclude that increased vitamin D does not lower the risk of hip fractures?

There are some problems with the WHI study.  Namely:

• The placebo group took calcium and vitamin D on their own
• Most patients got adequate calcium and vitamin D from food
• There were relatively few fractures in the group as a whole
• It may take more than 400 IU of vitamin D to reduce fracture risk or influence cancer
• Not all participants took the prescribed amount of supplements for the duration of the study (seven years)

Perhaps the recent study is more reliable since the authors targeted a smaller, well-defined group of patients. 

If you believe that higher amounts of vitamin D will protect your bones, you may not be able to get enough from food or sunlight.  This is partly because the ability to manufacture vitamin D from sunlight and utilize it declines with age.  It’s nearly impossible to get enough without supplementation. 

Current recommended intake is 200 IU for people aged 50 and under, 400 IU for those 51-70, and 600 IU for those over 71.  Growing numbers of scientists and health authorities believe that more is better—up to a point (since vitamin D is a fat soluble vitamin and thus can be stored in the body).  Those aged 70 and over should take 800-1000 IU daily, especially those people with dark skin or African Americans.

 There are two main forms of vitamin D:  vitamin D3 or cholecalciferol and vitamin D2 or ergocalciferol.  Once consumed, both are converted in the body to the active form.  D2 has been found to be less than one-third as potent as D3 and shorter-acting. 

Many supplements (including One-A-Day and Centrum) contain D3.  Quite a few health food store brands contain D2 (Solgar, Nature’s Plus, Rainbow Light, KAL).  At least one Vitamin Shoppe supplement (Mega-Vites) contains D2.  Look for D3 or cholecalciferol on your supplement bottles.

Eat Smart, Stay Healthy

The zen masters say we should view our bodies as temples, meaning that we must pay as much attention to our physical as our spiritual well-being. Why? Unlike the friendly tennis game where you may be allowed “do overs,” we only have one shot with our body. What we do it with and what we put into it may have far-reaching effects. It may be the difference between whether we die of cancer or old age, whether we spend our golden years in pleasure or pain. Eating intelligently can keep us far ahead of our unhealthy tennis partner.

How much should we eat?

It’s important to know how many calories you need to keep yourself well fueled. Even if you’re eating smart, you may be eating too much and thus gaining weight. In a 2006 survey of 1,000 US adults, 88 percent of respondents could not accurately estimate their calorie needs. The average American adult gains one to two pounds a year even though the American Institute for Cancer Research has recommended a weight gain of no more than eleven pounds in adulthood.

Middle-age weight gain has been attributed to many chronic illnesses such as diabetes, heart disease, cancer and arthritis. For an accurate estimate of your recommended calorie needs based on height and weight, go to www.mypyramid.com and click on MyPyramid Plan. Other websites such as www.nutristrategey.com/activitylist.htm calculate the number of calories you burn while exercising. With this information, you’re ready to start eating smart.

How can I be a smarter eater?

Liz Applegate, PhD, who writes for Runner’s World, makes the following recommendations for smarter eating. It’s a matter of choosing your foods more intelligently and with an eye for health.

In: omega-3 eggs Out: standard eggs

Why: the omega-3 fats in these enhanced eggs boost immunity, protect against Alzheimer’s disease, heart disease, and cancer, and may lessen symptoms of depression

In: dark beer Out: light beer

Why: darker brews may have a few more calories per bottle than lighter versions, but in general they have far more antioxidants from the wheat and other grains used to make them

In: olive oil dressing Out: creamy dressing

Why: you’ll save about 90 calories per two tablespoons

In: mustard, low-sodium soy sauce, salsa Out: ketchup and mayonnaise

Why: condiments like mayonnaise and ketchup add unwanted calories and sodium while mustard and salsa contain antioxidants

In: organic fat-free milk Out: 2% milk

Why: 8 ounces of fat-free milk saves you more than 30 calories and 4 grams of fat over 2% milk and organic milk can help you avoid trace amounts of chemicals and hormones

In: Kefir Out: yogurt

Why: yogurt is a great source of calcium but often comes with lots of sugar and without healthy live bacteria while Kefir is a low-fat liquid yogurt with extra live cultures to boost immunity

In: pomegranate or cranberry juice and club soda Out: sugary fruit drinks

Why: real juices such as pomegranate and cranberry are loaded with the powerful cancer fighters anthocyanidins, and combined with club soda, can save you 50 calories per serving

In: natural peanut butter and fruit spread Out: standard peanut butter and jelly

Why: natural peanut butter contains peanuts, salt and nothing more and paired with real fruit spread, there’s no added sugar such as corn syrup or high-fructose corn syrup

In: roasted chicken Out: deli meats

Why: many deli meats are high in fat and if you remove the skin from the chicken, you reduce your fat intake

In: part-skim mozzarella or feta cheese Out: brie or cheddar

Why: brie and cheddar are loaded with saturated fat and calories and switching to feta or part-skim mozzarella saves about 30 calories and 5 grams of fat per ounce

In: trans fat-free spread Out: butter

Why: butter has 7 grams of saturated fat per tablespoon while margarine contains trans fats, so it’s a trade-off

In: sweet potatoes or red-skin potatoes Out: white potatoes

Why: potatoes with colorful flesh and skins contain more antioxidants than their pale counterparts

In: berries, kiwi, melon Out: green grapes

Why: all fruit is good but it pays to eat fruit that is higher in fiber and lower in calories

In: Canadian bacon Out: bacon

Why: Canadian bacon has twice the protein and half the fat per serving when compared to regular bacon

In: ground turkey Out: ground beef

Why: cut 10 to 20 grams of fat per 3-oz serving by substituting ground white meat turkey for ground beef

In: baby romaine lettuce and spinach Out: iceberg lettuce

Why: iceberg lettuce offers little nutrition while young romaine and spinach leaves are rich in carotenes and other phytochemicals

In: snow peas, peppers, radishes Out: carrots and celery

Why: carrots and celery are good but add peppers for vitamin C, snow peas for the electrolyte potassium and radishes, which contain compounds that protect muscles

In: whole-grain bread Out: white bread

Why: whole-grain has more antioxidants and fiber (3 to 4 grams per 1-oz slice) than its white counterpart

In: low-carb tortillas Out: white-flour tortillas

Why: white-flour tortillas pack 150 calories and 0 fiber while low-carb versions offer 8 grams of fiber for just 90 calories

What’s left?

Choosing the most nutrient dense foods we can will lead to healthier eating. Below is a chart compiled from the USDA and National Institutes of Health and broadcast on the CNN website that shows the best sources for various nutrients our bodies need. Keep it handy and take it to the grocery store with you!

Calcium Milk, other dairy products Cornmeal Wheat flour Collards Rhubarb Sardines Spinach Soybeans Turnip greens Salmon, canned with bone Kale   Fiber Barley Bulgur Beans Peas Wheat flour, whole-grain Oat bran Dates Tomato products Raspberries Cornmeal Artichokes   Folic Acid Turkey/chicken giblets Lentils Cowpeas/black-eyed peas Orange juice Beans (specifically kidney, pinto, navy) Chickpeas Okra Spinach Asparagus Beef liver

Vitamin C Oranges, orange juice Peppers (sweet and chili) Grapefruit juice Papayas Strawberries Broccoli Brussels sprouts Peas Kiwi fruit Sweet potato     Antioxidants Beans Blueberries Cranberries Artichokes Blackberries Prunes Russet potatoes Pecans Apples Cinnamon     Iron Mollusks, clams Turkey or chicken giblets Enriched whole wheat flour Enriched rice Soybeans Tomato products Spinach Liver Beef Jerusalem artichokes, raw Baking chocolate, unsweetened squares

 

Antioxidants, Free Radicals, Exercise, and YOU

Given the abundance of vitamin and mineral supplements on the market today, it’s no wonder we swallow pills, gulp energy drinks, and chew protein bars at an alarming rate chasing the cure for cancer, turning back the hands of time or transforming our bodies into robust, lean-muscled machines. My pantry sports an arsenal of supplements recommended to correct nutritional imbalances as outlined in two tests I have taken over the past few years. Despite the testing, I wanted to know more about why I should take these supplements, particularly the antioxidants.

My quest started when I read an article in August’s News-Medical.Net about a new study at Brigham and Women’s Hospital and Harvard Medical School which concluded that middle-aged women at risk for heart disease don’t benefit from taking the antioxidant supplement combo of vitamins C, E and beta carotene. Why then, am I taking all three? Before rushing to the kitchen and tossing pill bottles in the trash, I thought I should dig a little deeper. I’m glad I did.

Studies by their nature have a narrow scope. It would be foolish to add more variables than are necessary because your research couldn’t conclude whether it was A, B or C that produced the results. Or maybe it was some combination of all three.

In the previously-mentioned study, researchers were only concerned with 1. heart disease, 2. antioxidant supplements and 3. middle-aged women at risk for heart disease. While I am not a risk for heart disease, I am a woman and I take antioxidant supplements. This study doesn’t consider two other factors that are important to me: can antioxidants be helpful to the body for other reasons and does an athlete have special needs?

What are antioxidants and what do they do?

Antioxidants are substances found in some vitamins and minerals which neutralize the oxidative effect of free radicals. Under normal circumstances, free radicals are essential for good health because they help fight infection and assist in the contraction of smooth muscles in the blood vessels. Left unchecked or when the body is under stress, free radicals can cause damage resulting in chronic disease, cancer, and cardiovascular disease. Free radicals can also damage cellular enzymes leading to cell damage and death which accelerates the aging process. Free radicals may also lead to eye diseases such as cataracts and macular degeneration. Antioxidants work by themselves and in concert with one another to fight any imbalance in the body.

Where do antioxidants come from?

Antioxidants are found in vitamins C and E and the beta carotene form of vitamin A. Fruits and vegetables are good sources of these vitamins.

Vitamin E is fat soluble and can be found in high-fat foods such as vegetable oils, avocados, nuts, seeds, wheat germ, and whole grains.

Vitamin C is water soluble and interacts with vitamin E to protect each other. Foods high in vitamin C are broccoli, oranges, strawberries, grapefruit juice, and red bell peppers and eating them raw is better.

Beta carotene, a form of the fat-soluble vitamin A, is found in fruits and vegetables with dark, rich colors such as carrots, pumpkin, sweet potatoes, winter squashes, cantaloupe, pink grapefruit, apricots, broccoli, spinach and other dark-green leafy vegetables.

What causes excessive production of free radicals?

A number of body “stressors” can cause free radicals to run amok, such as excessive or strenuous exercise, pollution, pesticides, cigarette smoke, and other environmental pollutants.

Endurance exercise can increase oxygen utilization from ten to twenty times over the resting state. The longer or more intense the workout, the greater the production of free radicals. Fortunately, our bodies adapt. Studies show that regular physical exercise enhances the antioxidant defense system and protects against exercise-induced free radical damage.

Those athletes most at risk for free radical damage are the “weekend warriors” because their sporadic activity level overwhelms the defenses. They are the ones who benefit the most from antioxidant supplementation.

Do well-trained athletes need supplementation?

While antioxidants don’t improve performance, they may counteract the side effects of high activity levels such as muscle soreness or respiratory infection.

Even if your diet is rich in antioxidants by consuming 8-9 servings of fruits and vegetables daily, you may still lack enough antioxidants to combat free radical damage. There is no definitive answer regarding supplementation, and the risks of long-term use of high doses of some antioxidants are unknown, but many sports nutrition experts such as Chris Carmichael and Joe Friel highly recommend supplementation.

The following are some guidelines for daily supplementation:

Vitamin C 500-1000 mg

Vitamin E 200-400 IU

Beta carotene 10 mg

 

Sources:
Carmichael, Chris. Food for Fitness. New York, NY: G.P. Putnam’s Sons, 2004.

Cordain, Loren, PhD and Joe Friel, MS. The Paleo Diet for Athletes. Rodale, Inc., 2005.

George Mateljan Foundation website, “World’s Healthiest Foods” at www.whf.org, September 3, 2007.

News-Medical.Net at www.news-medical.net. Vitamin supplements no benefit to women’s heart health. August 14, 2007.
Reavley, Nicola. The New Encyclopedia of Vitamins, Minerals, Supplements and Herbs. New York, NY: M. Evans & Co., Inc., 1998.
Website at www.rice.edu/~jenky/sports/antiox.html.