Preventing And Reversing Osteoporosis

A Bone Health Lifestyle

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

Woman Enjoying Autumn LeavesFall is glorious in my book.  I was up in New York a few weeks ago, and the trees were just changing – I was about a week too early for the best colors, but it was still beautiful. Then I flew out to Lake Tahoe, and it was really beautiful there.  The air was crisp and clean, and I loved all the fall decorations.

In Florida we are entering our most wonderful time of year. It’s starting to get cooler, the humidity is going down, and hurricane season is over. Hooray!  It’s great to be outdoors again!

Please remember all the people who are still going through very difficult times in the Bahamas.  Many people have lost their homes, their workplaces and the income that supports them, and some have lost loved ones. A devastating loss.

We here in the USA were blessed that Dorian didn’t come any further west and do the same thing to Florida, Georgia, and the Carolinas. I wanted to share what I have with the people who now have nothing. That made me search for places I trust that will send all the money I donate. In case you want to help, and you don’t have a favorite charity, I want to share those places with you:

https://disaster.salvationarmyusa.org

http://secure.americares.org/help/now‎

https://www.mercycorps.org/articles/hurricane-dorian-bahamas#mercy-corps-helping

Preventing And Reversing Osteoporosis

Exercise And NutritionWeight-bearing exercise builds strong bones. That statement is so common that just about everyone knows they need to exercise for strong muscles and bones, and for all the good it does for just about every system in the body.  And, we are what we eat, so nutrition is vital.

Do you like to exercise? Some people are almost addicted to exercise, but I’m not one of them.  I go to the gym and I have a fitness trainer to help me stay on track, but it fits right in with my eagerness of going to the dentist.  I must say, I’d like that to change, and maybe if I can find a workout partner, it will.

Meanwhile I need to do something because I’ve been told I have osteoporosis. Yikes! One thing for sure, I’m not taking any type of medication. I truly believe there is another solution.

While I’m not an exercise nut, I do love nutrition and I know that the body is so adaptable that if it’s given the proper nutrition, it can do miracles. I believe nutrition and exercise can reverse this osteoporosis diagnosis.

A Bone Healthy Lifestyle

A Bone Healthy Lifestyle
A Bone Healthy Lifestyle

The first thing I did was contact my friend, Steve Chaney, PhD, author of the weekly blog “Health Tips From The Professor.  He pointed me to an article he had written on a “Bone Healthy Lifestyle”. Here is a brief summary:

  • Exercise, calcium, and vitamin D are all essential for bone formation. If any of them are missing, you can’t form healthy bone. The reason so many clinical studies on calcium supplementation and bone density have come up empty is that exercise, or vitamin D, or both were not included in the study.
  • Get plenty of weight bearing exercise. This is an essential part of a bone healthy lifestyle. Your local Y can probably give you guidance if you can’t afford a personal trainer. Of course, if you have physical limitations or have a disease, you should consult with your health professional before beginning any exercise program.
  • Get your blood 25-hydroxy vitamin D level tested. If it is low, take enough supplemental vitamin D to get your 25-hydroxy vitamin D level into the adequate range – optimal is even better. Adequate blood levels of 25-hydroxy vitamin D are also essential for you to be able to utilize calcium efficiently.
  • Consume a “bone healthy” diet that emphasizes fresh fruits and vegetables, minimizes meats, and eliminates sodas and other acidic beverages. For more details on whether your favorite foods are acid-forming or alkaline-forming, you can find plenty of charts on the internet.
  • Minimize the use of medications that adversely affect bone density. You’ll need to work with your doctor on this one.
  • Consider a calcium supplement. Even when you are doing everything else correctly, you still need adequate calcium in your diet to form strong bones. Dr. Chaney wasn’t advocating a “one-size fits all” 1,000 to 1,200 mg/day for everyone. Supplementation is always most effective when you actually need it. For example:

o   If you are not including dairy products in your diet (either because they are acid-forming or for other health reasons), it will be difficult for you to get adequate amounts of calcium in your diet. You can get calcium from other food sources such as green leafy vegetables. However, unless you plan your diet very carefully you will probably not get enough.

o   If you are taking medications that decrease bone density, that may increase your need for supplemental calcium. Ask your pharmacist about the effect of any medications you are taking on your calcium requirements.

  • If you do use a calcium supplement, make sure it is complete. Don’t just settle for calcium and vitamin D. At the very least you will want your supplement to contain magnesium and vitamin K. Dr. Chaney recommends that it also contain zinc, copper, and manganese.

Between increasing my exercise and ramping up all the nutrients that build bone, I just know that by this time next year I’m going to be surprising the doctor with my great health

Risk Factors of Prostate Cancer

Vitamin D Deficiency?

Author: Dr. Stephen Chaney

Vitamin D

Is vitamin D deficiency one of the risk factors of prostate cancer? What if something as simple as maintaining optimal vitamin D status could decrease your risk of prostate cancer? There is a lot of indirect evidence suggesting that vitamin D deficiency might affect your risk of developing prostate cancer. For example:

  • Prostate cancer incidence and vitamin D deficiency parallel each other. Both are highest in northern latitudes, in African American men, and in older men.
  • Prostate cancer mortality rates are highest for patients diagnosed in the winter and at Northern latitudes.

However, clinical studies looking at the correlation between 25-hydroxy vitamin D (the biologically active form of vitamin D in the blood) and prostate cancer incidence have been inconsistent. Because of this there has been considerable controversy in the scientific community as to whether or not there was any correlation between vitamin D deficiency and prostate cancer.

Vitamin D Deficiency and Cancer

That’s what makes the recent headlines suggesting that vitamin D is associated with decreased risk of aggressive prostate cancer so interesting. Does this study show low vitamin D to be one of the risk factors of prostate cancer? Have the conflicting data on vitamin D deficiency and prostate cancer finally been resolved or is this just another case of dueling headlines? Let’s start by looking at the study itself.

This study (Murphy et al, Clinical Cancer Research, 20: 2289-2299, 2014) enrolled 667 men, aged 40-79 (average age = 62), from five urology clinics in Chicago over a four year period. These were all men who were undergoing their first prostate biopsy because of elevated serum PSA levels or an abnormal DRE (that’s doctor talk for digital rectal exam – the least favorite part of every guy’s physical exam). The clinics also drew blood and measured each patient’s 25-hydroxy vitamin D level at the time of the prostate biopsy.

This study had a number of important strengths:

  • It was conducted at a northern latitude. Because of that 41.2% of the men in this study were vitamin D deficient (<20 ng/ml) and 15.7% were severely vitamin D deficient (<12 ng/ml). That’s important because you need a significant percentage of patients with vitamin D deficiency to have any chance of seeing an effect of vitamin D status on prostate cancer risk.
  • The study had equal numbers of African American and European American men. That’s important because African American men have significantly lower 25-hydroxy vitamin D status and significantly higher risk of prostate cancer than European American men.
  • All of the men enrolled in the study had elevated PSA levels or abnormal DREs. That’s important because it meant that all of the men enrolled in the study were at high risk of having prostate cancer. That made the correlation between vitamin D status and prostate cancer easier to detect.
  • This was the first study to correlate 25-hydroxyvitamin D levels with prostate biopsies at the time of biopsy. That’s important because it allowed the investigators to distinguish between aggressive tumors (which require immediate treatment and have a higher probability of mortality) and slow growing tumors (which may simply need to be monitored).

The results were pretty dramatic:

  • In African American men vitamin D deficiency (<20 ng/ml) was associated with an increased risk of prostate cancer diagnosis at time of biopsy.
  • In both European American and African American men severe vitamin D deficiency (<12 ng/ml) was associated with increased risk of aggressive prostate cancer diagnosis at time of biopsy.

The authors concluded: “Our work supports the hypothesis that 25-hydroxy vitamin D is a potential biomarker that plays a clinically significant role in prostate cancer, and it may be a useful modifiable risk factor in the disease”.

That’s “science speak” for “adequate vitamin D status may help prevent prostate cancer” or “low vitamin D may indeed be one of the risk factors of prostate cancer.”

VitaminD-smashes-cancer

Why Have Some Studies Failed To Find A Correlation Between Vitamin D Deficiency and Prostate Cancer?

The authors of the current study had an interesting hypothesis for why some previous studies have not seen an association between vitamin D status and prostate cancer risk. When you compare all of the previous studies, the strongest correlations between vitamin D deficiency and prostate cancer were the studies conducted at northern latitudes, in African American men, or focusing on aggressive prostate cancer as an end point.

That offers a few clues as to why other studies may have failed to find a link between vitamin D status and prostate cancer risk. For example:

  • The clue that the correlation between vitamin D deficiency and prostate cancer risk was strongest at northern latitudes and with African American men suggests that you need to have a significant percentage of subjects with deficient or very deficient levels of 25-hydroxy vitamin D before you can see a correlation. Other studies may have failed to show a correlation simply because most of the men in the study had normal vitamin D status.
  • The clue that the correlation is strongest for aggressive prostate cancer is more subtle. The authors hypothesized that prostate cancer develops over a lifetime. If that is the case, measuring vitamin D deficiency at the time of diagnosis may not represent the lifetime vitamin D status. The vitamin D status could have decreased because the men were older or had become overweight, or the vitamin D status could have changed simply because they moved from one geographical location to another.

In contrast, the progression from benign to aggressive prostate cancer is generally short term, so it would be affected by the most recent vitamin D status. If that is the case, then the vitamin D status measured at the time of diagnosis may more accurately reflect the vitamin D deficiency that affected the aggressiveness of the cancer.

 

The Bottom Line

1)     The latest study suggests that vitamin D deficiency (<20 ng/ml serum 25-hydroxy vitamin D) may significantly increase the risk of prostate cancer. The correlation between low vitamin D status and prostate cancer risk is strongest for African American men.

2)     The study also suggests that severe vitamin D deficiency (<12 ng/ml serum 25-hydroxyvitamin D) may significantly increase the risk of aggressive prostate cancer in both African American and European American men.

3)     This is a very well done study, and it is consistent with many, but not all, of the previous studies. Clearly more research needs to be done. Future research should be focused on high risk subjects and subjects with low vitamin D status so that the correlation between vitamin D status and prostate cancer risk can be adequately tested.

4)     This is another example of why I recommend that you have your serum 25-hydroxy vitamin D level measured on a regular basis and that you aim to keep it in the normal range (20-80 ng/ml). Some experts believe that 30-80 ng/ml is optimal.

5)     If you are African American, overweight, live in northern latitudes or it is winter, you may need supplemental vitamin D3. 1,000 – 4,000 IU/day of vitamin D3 is generally considered to be safe. If higher amounts are needed to normalize your 25-hydroxy vitamin D levels I recommend that you consult your physician for the appropriate dose.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Is Vitamin D Overhyped?

Are Clouds Gathering For the Sunshine Vitamin?

Author: Dr. Stephen Chaney

Clouds Obscuring The SunWe’ve known for years that vitamin D plays an essential role in calcium metabolism and is important for bone health. In fact, the use of vitamin D to prevent and cure rickets is one of the greatest success stories in the field of nutrition.

However, in recent years a number of studies have suggested that adequate vitamin D status was also important in reducing the risk of cancer, heart disease, diabetes, infectious diseases and autoimmune diseases – as well as overall mortality. Suddenly it seemed as if vitamin D could leap over tall buildings in a single bound (I realize that I’m probably dating myself with that analogy).

So when I saw the headlines about a new study (Theodoratou et al, BMJ, 2014;348:g2035 doi: 10.1136/bmj.g2035)  that concluded all of those benefits of vitamin D were unconfirmed, I was not surprised. After all there have been many examples of periods in which individual vitamins were reported to have miraculous benefits – only to have most of those benefits debunked by subsequent studies. I fully expected that would be the theme of this issue of “Health Tips From the Professor”.

But when I read the article I found that the study had multiple flaws (more about that latter). I also discovered that the same issue of the British Medical Journal had another, much better designed, study that came to the exact opposite conclusion (Chowdhury et al, BMJ 2014;348:g1903 doi: 10.1136/bmj.g1903).

Funny how only the first study made it into the headlines. It’s only the negative news that sells.

Is Vitamin D Overhyped?

The first study was a very large meta-analysis that included 107 systematic reviews, 74 meta-analyses of observation studies (studies that compare population groups) and 87 meta-analyses of randomized, placebo controlled trials. In case you were wondering, the total number of patients enrolled in these studies must have numbered in the hundreds of thousands.

The authors of the study reported that:

  • There was no relationship between vitamin D intake and cancer, heart disease, autoimmune disease, infectious diseases, diabetes and other diseases. In other words, they concluded that most of the recent excitement about vitamin D was just hype.
  • There was also no evidence that vitamin D increased bone density or reduced the risk of fractures and falls in older people – in contrast to many previous studies.

Based on this evidence the authors said “universal conclusions about vitamin Ds benefits cannot be drawn [from current data]” and that vitamin D “might not be as essential as previously thought in maintaining bone mineral density”.

Both of those statements are pretty revolutionary, but a study this large has to be true – right? The answer is a definite maybe. The problem is that many of the studies included in this meta-analysis were poorly designed by today’s standards. Remember the old saying “garbage in, garbage out”.

The Study Is Flawed

My specific criticisms of the study are:

1)     The conclusions about vitamin D and bone density were seriously flawed. The authors acknowledged that previous studies have shown that calcium and vitamin D together increased bone density, but they considered calcium to be a confounding variable and only included clinical trials using vitamin D supplementation alone. That shows a complete misunderstanding of the biochemical role of vitamin D.

The purpose of vitamin D is to maintain constant levels of blood calcium, not to build strong bones.

  • When blood levels of calcium are high, vitamin D lowers it by depositing the calcium in bones.
  • When blood levels of calcium are low, vitamin D raises it by leaching calcium from bone.

That’s why vitamin D and calcium work together. It is utter nonsense to expect vitamin D to increase bone density or prevent fractures unless you make sure that calcium intake is at least adequate.

2)     Most studies of vitamin D supplementation did not stratify the data based on low versus high levels of 25-hydroxy vitamin D at the beginning of the study. That’s important because you would only expect vitamin D supplementation to be of benefit in people with low levels of 25-hydroxy vitamin D to begin with. If their 25-hydroxy vitamin D levels are already optimal, vitamin D supplementation is unlikely to be of additional benefit.

3)     Finally, the authors did not separate the studies based on whether vitamin D2 or vitamin D3 was used. That’s important because some recent studies have suggested that D3 is more beneficial than D2.

Is Vitamin D Beneficial After All?

SunThe second study came to the exact opposite conclusions. It was also a very large study. It included 73 observational studies (849,412 participants) and 22 randomized, placebo controlled studies (30,716) participants. Here is what the authors of this study concluded.

  • High blood levels of 25-hydroxy vitamin D decreased the risk of heart disease by 35%, cancer by 14% and overall mortality by 35%.
  • Supplementation with vitamin D3 reduced overall mortality by 11%, while supplementation with vitamin D2 increased overall mortality by an insignificant 4%.
  • 65% of the US population can be classified as vitamin D insufficient (blood levels of 25-hydroxy vitamin D of below 30 ng/ml) and 4% as severely deficient in vitamin D (blood levels below 10 ng/ml)
  • Vitamin D deficiency contributes to 13% of the deaths in the United States. For comparison the corresponding numbers for other major risk factors are: smoking – 20%, physical inactivity – 11% and alcohol – 9%.
  • About the only point on which the two studies agreed was that there is a need for more, better designed studies to clarify the benefits of vitamin D.

The Bottom Line:

1)     Two studies were published in the April 2014 issue of the British Medical Journal. The first concluded that all of the supposed benefits of vitamin D – including increasing bone density – were not supported by the available data. The second study concluded that adequate intake of vitamin D significantly reduced deaths due to heart disease and cancer and also significantly reduced overall mortality. Somehow, only the first study made it into the headlines. Why does that not surprise me?

2)     The suggestion in the first study that vitamin D may not be essential for strong bones is based on a complete misunderstanding of the role of vitamin D in the body. There are ample clinical studies showing that vitamin D and calcium together are essential for strong bones. Nobody who understands biochemistry would expect vitamin D to increase bone density in the absence of calcium, but the authors only considered studies that excluded calcium in drawing their conclusion that vitamin D did not increase bone density.

3)     The only point of agreement between the two studies is that more and better studies are needed to sort out the benefits of vitamin D and what levels of vitamin D are optimal. I wholeheartedly agree.

4)     My advice is to ignore the headlines telling you that vitamin D is dead. On the other hand, don’t get caught up in the hype and buy megadoses of vitamin D supplements. While the evidence is rock solid that vitamin D and calcium together are essential for strong bones, the jury is still out on some of the other health benefits of vitamin D.

5)     If you are supplementing with vitamin D you should know that the RDAs for vitamin D are 600 IU for ages 1-70 and 800 IU over 70. The safe upper limit has been set at 4,000 IU. You should only go above that on a doctor’s advice.

6)     However, people metabolize vitamin D with different efficiencies, so I strongly recommend that you get your blood levels of 25-hydroxy vitamin D tested and let your doctor help you determine how much vitamin D you should be getting.

7)     Finally, a number of recent studies suggest that vitamin D3 may be more effective than vitamin D2, so I only recommend supplements that contain D3.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Will Non-GMO Foods Be Less Nutritious?

The Unintended Consequences of the Proposed Non-GMO Labeling Laws

Author: Dr. Stephen Chaney

CerealPost Foods recently announced that their Grape Nuts cereal will be completely non-GMO. General Foods followed suit by announcing that their Original Cheerios will also be non-GMO. That’s good news, right?

Maybe, but it turns out that the new non-GMO Grape Nuts will no longer contain vitamins A, D, B12 or riboflavin, and the amount of riboflavin in a serving of Cheerios decreased from 25% of the daily recommended value (DV) to 2% of the DV.

The cereal manufacturers claim that their new cereals are more wholesome, but one nutrition expert said “The new products are arguably less healthy given their lower vitamin content.”

I’ve never been one to claim that throwing a few vitamins into a serving of cereal turns it into a nutrition powerhouse, but the decreased vitamin content of the new non-GMO cereals does raise a few questions.

  • Why were the vitamins removed?
  • Did it have anything to do with the cereals being non-GMO?
  • Does this mean that the non-GMO processed foods of the future will be less nutritious than the foods they replace?

The cereal manufacturers were mum when asked these questions, so we will need to rely on some scientific sleuthing and a bit of intuition to get the answers.

The Flaw in The Proposed Non-GMO Labeling Laws

I first discussed this topic a few months ago in a “Health Tips From The Professor” article titled “When is GMO Non-GMO?” I received a lot of irate comments from people who take every word on the non-GMO websites and videos as the gospel truth. (The professor has never been one to shy away from controversy when he sees claims that aren’t based on good science.)

However, I think my article was misunderstood by some of my readers, so let me review my conclusions briefly:

  • There are definitely environmental concerns around the widespread use of GM crops – especially those that allow heavy pesticide and herbicide usage.
  • There are potential health concerns related to the consumption of unprocessed GM foods and proteins derived from GM foods – although those heath concerns have been blown way out of proportion in the media.

If the proposed Non-GMO labeling laws stopped there, they would be scientifically justified. But they go one step further by requiring that processed foods labeled as non-GMO cannot contain any ingredient obtained from a GM source. There is no scientific justification for this.

  • Nutrients (sugars, oils & vitamins) derived from GM sources are chemically and biologically indistinguishable from those same nutrients derived from non-GMO sources.

The intentions of the proposed non-GMO labeling laws are good, but whenever you go beyond what good science supports there are often unintended consequences – such as the vitamin-depleted non-GMO cereals that the food manufacturers have just announced.

Will Non-GMO Foods Be Less Nutritious?

Non-GMOTo understand the answer to that question, let’s look at what probably happened to the vitamins in the non-GMO cereals.

In today’s world many vitamins are purified from genetically modified microorganisms – bacteria & yeast that have been modified to overproduce certain vitamins. In evaluating the significance of that statement, here are a few facts to consider:

1)     We have gotten vitamins from these sources for many years.

    • B vitamins have been obtained from yeast for at least a hundred years.
    • A significant portion of the vitamins we absorb on a daily basis are made by bacteria in our gut.

2)     The only difference today is that these microorganisms have been genetically modified to overproduce the vitamins.

3)     These are naturally sourced vitamins.

  • The microorganisms are the same ones that have provided these vitamins for generations.
  • The enzymes used by the microorganisms to make the vitamins are the same.

4)     There is no downside to the use of GM organisms as a source of natural vitamins.

    • There is no environmental risk from the use of these GM microorganisms. They don’t contain any dangerous genes that could wreak havoc if they escaped from the food processing plants.
    • Because the purified vitamins are indistinguishable from those obtained from non-GMO sources, there are also no health risks.

5)     The advantage of using these GM organisms is clear. It substantially lowers the cost of vitamins and allows them to be used in the mass market – for example, in popular breakfast cereals.

6)     Most food manufacturers can’t simply use non-GMO sourced vitamins and raise their prices.

    • A recent poll showed that 53% of Americans prefer non-GMO foods, but only 11% are willing to pay more for those foods

What Does the Future Hold?

Even though they are scientifically flawed, the proposed non-GMO labeling laws will probably become the law in several states in the near future. (Good science has never played much of a role in political decisions.)

Currently, there simply aren’t enough non-GMO vitamins available to supply the mass market – even if price were no concern. So, in the short term, many non-GMO processed foods are likely to be less nutritious than the foods they will replace – as we just saw with Grape Nuts and Cheerios.

However, most people feel that American ingenuity and the law of supply and demand will eventually result in a bigger supply of reasonable priced non-GMO vitamins. When that happens non-GMO processed foods will be just as nutritious as the older GM versions.

However, at this point nobody knows how long that will take.

The Bottom Line:

1)     There is a scientific basis for environmental and potential health concerns regarding genetically modified whole foods and the protein extracted from these foods.

2)     However, proposed non-GMO labeling laws would require that a processed food be labeled as genetically modified if it contains any nutrient purified from a genetically modified organism.

3)     There is no scientific justification for this requirement. Purified vitamins from GM and non-GM microorganisms are chemically and biologically indistinguishable. Furthermore, the GM microorganisms used to produce the vitamins pose no environmental or health risks.

4)     Non-GMO vitamins (vitamins prepared from non-GMO microorganisms) are currently in short supply and are very expensive compared to vitamins prepared from GM microorganisms.

5)     Consequently, the unintended consequence of these proposed non-GMO labeling laws will likely be that many of the new non-GMO processed foods will contain fewer vitamins and, therefore, will be less nutritious than the foods they replace – at least in the short term. The new non-GMO Grape Nuts and Cheerios may be just the tip of the iceberg.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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