Coffee: Concerns, Benefits and the Bottom Line

Recent research has shown coffee in a whole new light. The world’s most popular beverage may not be as harmful to health as we once thought. A concentrated source of antioxidants, coffee may even have a protective effect against certain diseases. Do the newfound perks outweigh the known side effects? A review of the most recent findings puts benefits and concerns in perspective.

Diabetes Mellitus

Earlier this year, two studies in Finland investigated the relationship between coffee consumption and type two diabetes mellitus (DM2).

One followed more than 20,000 men and women for more than 13 years, on average. Researchers concluded that those who drank three or more cups of coffee each day were less likely to develop DM2 - regardless of body mass index, alcohol consumption, or physical activity.

The other study examined metabolic markers in the blood associated with an increased risk of DM2 including elevated glucose and insulin levels. Drinking coffee was found to have a positive impact on these markers and regular coffee drinkers were less likely to have problems with blood sugar regulation.

Heart Disease

Harvard researchers studied more than 128,000 men and women free of cardiovascular disease. They found no relationship between coffee consumption and the development of heart disease, even when results were adjusted for age, smoking status, alcohol use, and body mass index. Researchers in Norway concur. After following more than 41,000 postmenopausal women for 15 years, they concluded that coffee drinkers had lower rates of inflammatory diseases, including cardiovascular disease, probably because antioxidants in coffee inhibit inflammation in the body.

Other studies have investigated the relationship between drinking coffee and risk factors for developing heart disease, such as hypertension and increased levels of homocysteine in the blood. Although caffeine can temporarily increase blood pressure, data from the Nurses’ Health Studies I and II - which included more than 155,000 women - found no association between habitual coffee consumption and hypertension in women.

A small study in the Netherlands found that chlorogenic acid, a polyphenol in coffee, raised homocysteine levels by 12 percent. Homocysteine may irritate blood vessels and cause blood to clot more easily, increasing the risk of heart disease, stroke and atherosclerosis. A study in Greece also demonstrated that coffee raises homocysteine levels, but the effect was only significant when people consumed at least 500 ml (about 16 ounces or 2 cups) of coffee each day.

Liver Disease

Researchers in Maryland investigated the association between hospitalization or death due to chronic liver disease and consumption of coffee or tea. They concluded that people who were at high risk for liver problems - such as alcoholics, diabetics and overweight individuals - and drank two or more cups of coffee or tea each day had half the risk of chronic liver disease as those who drank less than one cup per day.

Other studies have focused on specific liver diseases, such as cirrhosis and a form of cancer called hepatocellular carcinoma (HCC). Researchers in California followed more than 125,000 people without known liver problems for 16 to 23 years. They concluded that those who drank coffee were less likely to develop liver cirrhosis, especially alcoholic cirrhosis, than those who abstained. A study in Italy found that people who drank two or more cups of coffee each day reduced their risk of developing HCC, and Japanese studies concluded that the chance of dying from HHC was lower in individuals who drank at least one cup of coffee each day.

Parkinson’s Disease

Researchers in Hawaii examined the relationship between coffee and Parkinson’s disease. More than 8,000 Japanese-American men were followed for 30 years, and those who consumed more coffee and caffeine had a lower incidence of Parkinson’s disease. A study in Singapore found a dose-dependent relationship: for every three cups of coffee consumed each day, there was a 22 to 28 percent risk reduction.

Other studies estimate that, regardless of genetic susceptibility, coffee drinkers have a 30 percent reduced risk of developing Parkinson’s disease. Experts think the caffeine in coffee has a protective effect on the brain, blocking adenosine receptors and stimulating the release of dopamine. Some drugs, called dopamine agonists, used to treat Parkinson’s disease have a similar mechanism.

Side Effects

Most of the recent scientific studies scrutinizing coffee have been positive, but coffee isn’t necessarily a health food. Side effects can include restlessness, nervousness, psychomotor agitation, gastrointestinal problems, insomnia, rapid or irregular heart rate, increased production of gastric acid and increased excretion of minerals including calcium, magnesium, zinc and potassium. There are also concerns about drinking coffee during pregnancy. A recent study of more than 88,0000 women in Denmark found that the risk of fetal death was higher in pregnant women who drank coffee, especially after 20 weeks of gestation.

The Bottom Line

Everything considered, coffee can be part of a healthy lifestyle. Regular drinkers may experience lower rates of type two diabetes mellitus, heart disease, liver disease and Parkinson’s disease. However, moderation is important and coffee should never be used as a regular replacement for the good sleep that is essential to good health. Limiting intake to a cup per day is ideal. However, pregnant women, individuals who experience negative side effects and those with elevated levels of homocysteine in their blood should seek an alternative.

REFERENCES

Anderson LF et al. Consumption of coffee is associated with reduced risk of death attributed to inflammatory and cardiovascular diseases in the Iowa Women’s Health Study. American journal of clinical nutrition, 83(5):1039-46, May 2006.

Bech BH et al. Coffee and fetal death: a cohort study with prospective data. American journal of epidemiology, 162(10):983-90, Nov 2005.

Bidel S et al. Effects of coffee consumption on glucose tolerance, serum glucose and insulin levels – a cross-sectional analysis. Hormone and metabolic research, 38(1):38-43, Jan 2006.

Gale C and Martin C. Tobacco, coffee and Parkinson’s disease. British Medical Journal, 326(7390):614, Mar 2003.

Gelatti U et al. Coffee consumption reduces the risk of hepatocellular carcinoma independently of its aetiology: a case-control study. Journal of hepatology, 42(4):444-6, Apr 2005.

Hu G et al. Joint association of coffee consumption and other factors to the risk of type two diabetes: a prospective study in Finland. International journal of obesity, 25 Apr 2006.

Klatsky AL et al. Coffee, cirrhosis and transaminase enzymes. Archives of internal medicine, 166(11):1190-5, Jun 2006.

Kurozawa Y et al. Coffee and risk of death from hepatocellular carcinoma in a large cohort study in Japan. British journal of cancer, 93(5):607-10, Sep 2005.

Lopez-Garcia E et al. Coffee consumption and coronary heart disease in men and women: a prospective cohort study. Circulation, 113(17):2045-53, Apr 2006.

Olthof MR et al. Consumption of high doses of chlorogenic acid, present in coffee, or black tea increase plasma total homocysteine concentrations in humans. American journal of clinical nutrition, 73(3):532-8, Mar 2001.

Panagiotakos DB et al. The association between coffee consumption and plasma total homocysteine levels: the “ATTICA” study. Heart vessels, 19(6):280-6, Nov 2004.

Ragonese P et al. A case-control study on cigarette, alcohol, and coffee consumption preceding Parkinson’s disease. Neuroepidemiology, 22(5):297-304, Sep-Oct 2003.

Ruhl CE and Everhart JE. Coffee and tea consumption are associated with a lower incidence of chronic liver disease in the United States. Gastroenterology, 128:24-32, Dec 2005.

Tan EK et al. Dose-dependent protective effect of coffee, tea and smoking in Parkinson’s disease: I study in ethnic Chinese. Journal of the neurological sciences, 216(1):163-7, Dec 2003.

Winkelmayer WC et al. Habitual caffeine intake and the risk of hypertension in women. Journal of the American medical association, 294(18):2330-5, Nov 2005.

Alternative Hygiene Products for Women

Experts estimate that 20 billion sanitary pads and tampons end up in landfills and sewer systems each year. Not only is the environment paying the price, but women are too. Disposable hygiene products are a continuous expense and some are associated with an increased risk of toxic shock syndrome (TSS), a potentially fatal infection whose incidence is again on the rise. Alternative hygiene products such as reusable cotton pads, menstrual cups and sea sponges are a better choice for both women and the environment.

Toxic Shock Syndrome

TSS is an infection caused by the bacteria Staphylococcus aureus, a microorganism commonly found on the skin and in the vagina. When Staphylococcus aureus enter the bloodstream, they release toxins that can cause sudden hypotensive shock, organ failure and death. Although toxic shock syndrome can also be acquired through surgery, burns and open wounds, it primarily affects women using super-absorbent tampons.

Products that are more absorbent than necessary can dry vaginal tissue, leading to small tears or ulcerations that allow bacteria to enter the body. When tampons remain in the vagina too long, they become a favorable environment for bacterial overgrowth, which also increases TSS risk. It is possible for cervical caps, diaphragms and sponges to promote growth of bacteria as well, but the only cases of toxic shock syndrome related to these products developed after they had been left in the body for an unusually long period of time: 30 hours or more.

Reusable Pads

Reusable sanitary pads are soft, comfortable, hypoallergenic and worn outside the body like disposable pads. They range in size and thickness and are available in several colors and patterns. The fabrics used to make reusable pads are usually organic cotton terry cloth, cotton flannel or cotton-hemp blends.

Unlike disposable pads that end up in the trash after they have served their purpose, these products can be washed, dried and reused. Ten dollars is an average price for a reusable menstrual pad and starter kits start at forty dollars for a variety of sizes and absorbencies. These products usually last five years.

Menstrual Cups

Reusable menstrual cups, also known as internal reservoirs, are shaped like a cup with a stem, which makes insertion and removal easy. These cups sit inside the vagina and catch menstrual fluid as it exits the cervix, and can even be worn overnight. The frequency with which the cups need to be emptied depends on the amount of flow, but two or three times per day is recommended.

These products, made of gum rubber or latex-free silicone, come in two different sizes. The smaller size usually fits women under the age of thirty who have never given birth vaginally, and the larger size accommodates women who have had at least one vaginal birth and those over the age of thirty. To disinfect reusable menstrual cups, simply wash them in warm, soapy water. Prices start around thirty dollars and each cup will last ten years or more.

Sea Sponges

Sustainably harvested Atlantic and Mediterranean silk sea sponges are natural alternatives to tampons. They can be trimmed to any size or shape and should be changed every three to six hours as they become saturated. Some women use a pad in addition to a sponge on days of heavy flow to prevent leakage. Because they have no applicator or string, sea sponges can be more difficult to insert and remove than tampons. However, tying a string around the sponge can ease removal and like any new skill, using them becomes easier with practice.

Like tampons, sea sponges are not sterile. They need to be disinfected when not immediately rinsed and reused. Sea sponges can be boiled before their first use to remove any microorganisms, but boiling them repeatedly may cause them to shrink and toughen. For regular but gentle cleansing, tea tree oil solutions remove both odor and microorganisms, including the Staphylococcus aureus bacteria associated with toxic shock syndrome. Hydrogen peroxide can be used as a disinfectant and non-toxic bleaching agent. When well cared for, natural sea sponges will last up to one year and two sea sponges cost only eight dollars.

Resources

Reusable cotton menstrual pads:

• Glad Rags (800-799-4523 or www.gladrags.com)

• Pandora Pads (888-558-7237 or www.pandorapads.com)

• Many Moons (800-916-4444 or pacificcoast.net/~manymoons)

• Wemoon (www.wemoon.com.au)

• Lunapads (888-590-2299 or www.lunapads.com)

• Mother of Eden (800-670-1364 or www.mothereve.com)

• Urban Armor (877-733-0663 or urban-armor.org)

Menstrual cups:

• The Keeeper (800-500-0077 or www.keeper.com)

• Urban Armor

• DivaCup (latex-free, 866-444-3482 or www.divacup.com).

Sea sponges:

• Jade and Pearl (800-219-9765 or www.jadeandpearl.com)

Reducing Risks Associated with Childhood Immunization

Childhood immunization remains a controversial subject, but parents, doctors and health officials can all agree on one thing. Reducing the risk of adverse effects associated with vaccines is a good thing. Parents who choose to have their children immunized can take steps at the doctor’s office and at home to minimize the chance of adverse reactions.

Delay Immunization

Babies are born with immature immune systems that continue to develop during the first four to six months of life. Before they mature, they cannot mount an adequate antibody response to vaccines. Delaying immunization until four months of age or later can reduce the risk of adverse effects and make shots more effective.

Review the Risks

Certain medical conditions increase the risk of adverse reactions to vaccines and should be discussed with the doctor prior to immunization. These include previous adverse reactions, allergies, autoimmune disease, convulsions, seizures, epilepsy and other neurologic disease, and immune system disorders such as HIV, AIDS, cancer and leukemia.

Read Vaccine Information Sheets

Vaccine providers are required to give Vaccine Information Sheets (VIS) for each vaccine administered. Request the VIS prior to the immunization and take time to read them thoroughly. Learn the risks, benefits and ingredients of each vaccine, and discuss any questions with your doctor. Before the injection, request the package insert to verify it is the right vaccine and to ensure it is given correctly.

Check Up Healthy

A doctor should examine children and determine that they are in good health prior to all vaccinations. Postpone shots when signs of illness or fever are present, if the child has been sick recently or if a member of the household is ill.

Take Titers

Before regularly scheduled booster vaccines, ask your doctor to check antibody levels in the blood. If levels are sufficient, further immunization is unnecessary.

Avoid Allergic Reactions

Vaccines can contain several additives, including formaldehyde, aluminum, yeast, antibiotics and proteins from eggs, chickens, pigs and cows. Also, vaccine vials may include latex stoppers. If your child has any allergies, discuss the potential for allergic reaction with your doctor before scheduling the shot.

Mention Medications

Medications such as steroids, immune globulin and immunosuppressive drugs can interfere with vaccines, as can current or past treatment for cancer, and blood or plasma transfusions. Make your doctor aware of all current and recent medications and medical procedures. She or he may recommend that you postpone immunization.

Request Thimersol-Free Vaccines

Some vaccines still contain thimersol, a mercury-containing compound used as a preservative. All shots commonly given to preschool children are available in a thimersol-free form, so verify that this is the form being administered to your children.

Select Single Vaccinations

Potential adverse effects are associated with each individual vaccine, but when multiple vaccines are given at once, new adverse effects are possible. Convenient combination vaccines are becoming increasing popular because they save both time and money, but they may not be the safest form of immunization. Reduce the risk of adverse effects by requesting administration of single vaccines at separate office visits.

Take Vitamins

Vitamins A and C are necessary for immune function. Although a healthy diet is essential, taking these nutrients in supplement form before and after immunization can ensure extra support. Vitamin A can be given in the form of cod liver oil and vitamin C is available in both liquid and chewable forms. Talk to your doctor about the dosages that are right for your family.

Consider Homeopathy

The homeopathic remedy Thuja is used to treat chronic conditions related to vaccination, but it can also be taken preventatively prior to immunization. After the vaccine, the homeopathic remedy apis can help relieve pain and swelling at the injection site (a cold compress is helpful too).

Support Natural Immunity

Two important sources of natural immunity are tonsils and breast milk.

Tonsils, the major lymphatic glands at the top of the throat, produce monocytes and macrophages. These white blood cells engulf and destroy foreign cells and debris as the body’s first line of defense in infection and inflammation. These glands are an essential part of the immune system and kids who keep them have lower rates of infectious illnesses than kids who have them removed.

Breast milk contains maternal antibodies that provide passive immunity to babies. It also contains components that have antibacterial, antiviral and antiparasitic properties, such as macrophages (white blood cells), lysozyme, lactoferrin, prostaglandins, fatty acids and vitamins A and C.

Identify Adverse Reactions

Prior to immunization, talk to your doctor about the possible adverse effects of each vaccine and how to identify them. Recognizing reactions quickly can speed treatment and minimize damage. Common reactions to immunization include fever, vomiting, loss of appetite, drowsiness, irritability, and tenderness and swelling at the site of injection. These symptoms should clear within two days. Contact your doctor immediately if these symptoms last longer than 48 hours, or if at any time you observe unusual limpness or pallor, excessive sleepiness and lack of alertness when awake, convulsion, seizure or persistent high-pitched crying for more than three hours.

Keep Your Own Records

Keep records of each vaccine administered, including the date of immunization, the lot number and any adverse reactions. Report side effects to both your doctor and to the Vaccine Adverse Effects Reporting System (www.vaers.hhs.gov or 800-822-7967).

Alternatives to Antibiotics

According to the Centers For Disease Control, 75 percent of all antibiotics prescribed by office-based physicians are used to treat upper respiratory infections. 90 percent of these colds and flu cases are caused by viruses. Because antibiotics kill bacteria, not viruses, most of these prescriptions are unnecessary. Overuse of antibiotics not only compromise their effectiveness in time of true need, but they also have side effects – most commonly stomach pain, nausea and diarrhea – and they can create imbalances in healthy bacteria that help prevent infection. Fortunately, there are natural alternatives to antibiotics that can shorten the duration and severity of common colds and flu.

Food as Medicine

Garlic is one of the best home remedies for upper respiratory infections. Garlic has anti-viral, anti-bacterial and anti-fungal properties. For colds and flu, chop or crush and swallow two fresh cloves each day until symptoms resolve. (If you don’t chew the garlic, its aroma is less likely to linger on your breath.)

When sick, eat only when you are hungry. Lack of appetite is a sign that your energy is better spent fighting the infection than digesting food. When hunger does strike, choose foods that are nutritious and easy for your body to break down, like steamed vegetables and vegetable soups. Chicken soup, the traditional prescription, is a good choice too, but hold the noodles. Whole grains like rice are better choices than refined grains like pasta.

Hydrotherapy

Hydrotherapy, the therapeutic use of water, is inexpensive and easy to do at home. Add a few drops of eucalyptus essential oil to a steam inhalation to clear congestion in breathing passages and fight infection at the same time. Because eucalyptus essential oil has anti-bacterial actions, it can prevent secondary bacterial infections that may develop on top of viral illness.

A warm sea salt gargle can also prevent secondary bacterial infections and soothe sore throats. Add one half teaspoon of sea salt to one cup of warm water and gargle. Repeat until all of the solution is used. Like the eucalyptus steam treatment, sea salt gargles should be done two or more times per day.

Extra Nutrients

Vitamin A has been called the “anti-infective vitamin” for good reason. It is vital to immunity and maintains the integrity of mucosal surfaces, including respiratory passages in the nose, mouth and throat. Vitamin A protects the body against viral, bacterial and parasitic infections. Because it is a fat-soluble nutrient, it must be taken with food to be absorbed. Vitamin A is toxic in high doses and pregnant women should consult with their doctor before taking vitamin A.

Zinc is also essential for healthy immune function and works synergistically with vitamin A. It is best taken with food because it may cause nausea or stomach upset. Zinc lozenges can soothe sore throats, but for best results choose a product that does not contain sugar.

Botanical Medicine

Echinacea enhances immune function by increasing the number and activity of white blood cells. It has anti-viral, anti-bacterial and anti-inflammatory actions in the body. Echinacea is best taken at the start of symptoms and can work synergistically with other herbs, like astragalus, hyssop, osha and reishi mushrooms. Licorice root, marshmallow root and slippery elm bark can soothe sore throats and help expectorate phlegm.

Botanical medicines can be taken in the form of tea, capsules, tinctures (alcohol-based liquid herbal extracts) or glycerites (alcohol-free liquid extracts). Tinctures usually have a bitter flavor and can be added to water or juice. Glycerites have a sweete flavor and are best suited to children and others who wish to avoid alcohol or cannot tolerate it.

Botanical medicines should always be taken under the supervision of a doctor, especially in the case of pregnant women.

Friendly Fevers

The body responds to infections by raising the internal temperature to create an inhospitable environment for invading microorganisms, to inhibit the growth of bacteria and viruses, and to support immune function. Fevers increase the production of white blood cells, their release into circulation and their ability to kill invading microorganisms. Fevers also increase production of antibodies, the proteins that bind to foreign substances, causing them to be destroyed.

Temperatures of 102F to 104F are common during colds and flu, and usually decrease over a period of days. There is no evidence that fevers as high as 106F cause brain damage (but high external temperatures can elevate internal temperatures to a dangerous degree). Fevers may be uncomfortable, causing fatigue and loss of appetite, but they rarely cause serious problems. The biggest concern is dehydration, so drink plenty of fluids when body temperatures rise. Suppressing a fever with over-the-counter medications such as acetaminophen can interfere with the body’s ability to heal and should be avoided unless directed by a doctor.

The Best Prescription

For upper respiratory infections, antibiotics are usually not necessary unless complications or secondary bacterial infections develop. The best prescription for colds and flu is extra sleep and plenty of fluids. Eat only when hungry, avoid suppressing fevers and use hydrotherapy, vitamin A, zinc, garlic and botanical medicines to ease symptoms and speed healing. Stay home from work and school to prevent spreading the infection, but if symptoms don’t clear within a week, a visit to your doctor is in order.

Melatonin and Cancer: Risk and Treatment

Health and disease are two great differences between ancient civilizations and industrialized cultures. Changes in lifestyle are often blamed for the rise of modern illnesses and there is no doubt that manufactured toxic compounds in air, water and food play a part. Scientists now believe that light may have important implications as well. The effects of light on melatonin production in the body are being studied for their role in cancer risk and treatment. Can something as subtle as circadian rhythm have such a serious impact?

Physiological Functions

Melatonin, a hormone produced and secreted primarily by the pineal gland in the brain, regulates our circadian rhythm of natural sleep and wake cycles. Patterns of melatonin secretion vary by time of day and also by season. Levels are lowest during daylight hours and begin to rise in the evening. They remain high for most of the night, promoting sleep. Melatonin levels abate in early morning hours, promoting wakefulness. Young children have the highest levels of nighttime melatonin and production declines gradually with age.

Melatonin has other essential functions in the body. It has antioxidant actions and plays a part in controlling the timing and release of female sex hormones such as estrogen. It also has an important role in immunity because it helps to regulate the development and function of white blood cells, specifically helper T-cells and natural killer cells that destroy cancer cells.

Light suppresses melatonin secretion and darkness stimulates it. When people are exposed to excessive light during the night or too little light during the day, natural cycles of melatonin are disrupted. The most dramatic effects occur in people who work night shifts, such as hospital employees and commercial flight crews.

Cancer Risk

Researchers at Brigham and Women’s Hospital and Harvard Medical School have conducted several studies on melatonin, night shift work and breast cancer. Examining Nurses’ Health Study data from women with invasive breast cancer and cancer-free women, they found that those who worked rotating night shifts experienced increased levels of estrogen and decreased levels of melatonin.

The researchers also concluded that lower melatonin levels were associated with an elevated risk for developing breast cancer. Women who worked rotating night shifts for one year or more, including at least 3 night shifts in addition to day and evening shifts during the same month, had a moderately increased risk of breast cancer. Those who worked rotating night shifts for 30 years or more had an even higher breast cancer risk.

Although the protective effect of melatonin has been most studied in relation to breast cancer, researchers have found that women who work rotating night shifts also have an increased risk of colorectal cancer. Other preliminary studies have found that melatonin may play a protective role in prostate cancer as well.

Cancer Treatment

Studies show that melatonin is a critical component in the treatment of cancer. Scientists in Spain found that melatonin reduces circulating levels of estrogens by inhibiting their production and interfering with estrogen receptors in the body. At breast tumor sites, melatonin acts as a selective estrogen receptor modulator (SERM) much like pharmaceutical drugs by the same name that are used to treat breast cancer.

In a more general cancer study, researchers in Italy followed more than 1,600 patients with advanced, untreatable tumors. Some patients were only given chemotherapy treatment and others received 20 milligrams of melatonin daily during darkness hours in addition to chemotherapy. Weakness, wasting, low platelet levels and low white blood cell counts were less common in those who received the adjunct melatonin treatment compared to the patients who were given chemotherapy alone. Those treated with melatonin also experienced greater benefits from the chemotherapy, measured by tumor response rate and stabilization of tumor growth, and significantly fewer side effects, including mouth inflammation, cardiotoxicity and neurotoxicity (harmful effects on heart and nerve tissues). Additionally, the one-year survival rates were significantly higher in the patients given melatonin.

A study in Germany demonstrated that melatonin induces apoptosis, or programmed cell death, in colorectal cancer cells. Researchers in Texas found that melatonin reduced prostate cancer cell multiplication by a mechanism that involved sex hormone receptors. Research studies on melatonin and the treatment of various types of cancer continue.

The Bottom Line

Artificial light has become an essential element of life in industrialized societies, especially during hours of darkness. However, spending time outdoors during daylight hours and dimming lights indoors during evening hours can minimize disruption in melatonin secretion. Avoiding night shift work also helps maintain a healthy circadian rhythm and reduces the risk of cancer, particularly breast cancer.

Melatonin has great potential for treating cancer and reducing side effects of conventional chemotherapy treatment. Melatonin has very low toxicity and overall adverse effects are not significantly more common with melatonin than with placebo. However, people interested in supplementing melatonin should consult with their doctor.

The Calcium Debate

Osteoporosis in the United States has been called an epidemic. It has also been called a myth, a normal part of aging rather than a disease. In the middle of this debate is calcium. Experts recommend supplementation as a way to prevent osteoporosis and bone fracture, but worldwide population studies have shown that people who consume the most calcium (like those in the United States and Scandinavian countries) also have the highest rates of fracture, while people who consume the least (like those in Asian and Mediterranean cultures) have the lowest fracture rates. If bone loss is the problem, is calcium really the answer?
   
Bone Mineral Density

Bones are composed of protein matrix and minerals like calcium, and they continuously regenerate themselves. Cells called osteoclasts break them down and cells called osteoblasts build them back up. The balance between bone destruction and bone growth determines bone density. The body favors growth during younger years while the skeleton is developing and maturing, but after the age of 30, the balance shifts toward bone loss. Around age 50, declining levels of estrogen and testosterone may speed the process.

Below average bone mass is known as osteopenia when the deficiency is slight and osteoporosis when it becomes more advanced. Low mineral density makes bones more fragile and increases the risk of fracture. For older adults, hip fracture is often a life-changing event. Only 25 percent of elderly individuals who sustain such an injury are able to return to their pre-fracture activity level. Most require specialized long-term care in a rehabilitation facility or nursing home and 25 percent die within one year.

Calcium

Researchers have found that a high intake of calcium does improve bone mineral density, but long-term observational studies have not found lower rates of bone fracture with high calcium intake. Some studies have even suggested that too much of the mineral may increase the risk of kidney stones, prostate cancer and ovarian cancer.

The National Osteoporosis Foundation recommends 1000 milligrams (mg) of calcium each day for adults until age 50, and 1200 mg per day thereafter. Because these routine recommendations do not take dietary sources into account, many people get more calcium than they need. The average adult in the United States consumes about 300 mg of calcium per day from non-calcium-rich foods. Each serving of dairy products (one cup of milk or yogurt, or one and a half ounces of cheese) and each cup of cooked spinach add approximately 300 mg of calcium. Three ounces of sardines (with bones) or one cup of cooked collard or turnip greens accounts for an additional 400 mg. When considering supplementation, these estimations make it easy to calculate true calcium needs.

Calcium should always be taken with magnesium in a 2:1 ratio. Calcium citrate is the most easily assimilated form, which is optimal for older adults who tend to have less stomach acid. Studies have also shown that unlike other forms, calcium citrate inhibits kidney stone formation.

Other Influences

Calcium is not the most important factor in bone health. Studies have shown that weight-bearing and resistance exercises, as well as impact activities like walking, jogging and dancing, are the best protection against osteoporosis and bone fracture. The reason behind the research is simple: force applied to bone triggers growth and the absence of force leads to deterioration. Exercise not only makes bones stronger and more resistant to breaking, it strengthens muscles and improves balance and coordination so falls are less likely. Walking at least two hours each week can reduce the risk of hip fracture in elderly adults, but choosing a variety of activities that apply force to a variety of bones gives the best results.

Other factors found to have a positive affect on bone mass include vitamins D and K; both are necessary for the absorption and utilization of calcium. Researchers in Germany who studied black cohosh found that the herb had positive effects on bone metabolism equal to estrogen replacement therapy, but without increasing the risk of breast cancer, heart disease, blood clots and strokes.

In contrast, factors that negatively impact bone density include smoking, diets high in protein and/or sodium, and consumption of saturated fat, caffeine, soda and excessive amounts of alcohol. Osteoporosis can also result from chronic kidney disease, hyperthyroidism, certain kinds of cancer, stomach surgery and medications such as corticosteroids, anticonvulsants, antidepressants, tetracyclines, some cancer drugs, thyroid hormones and antacids containing aluminum.

The Bottom Line

The bottom line for stronger bones is regular exercise, outdoor activities and a healthy, balanced diet that includes foods high in calcium and at least one daily serving of dark green vegetables, rich in vitamin K, such as broccoli, turnip greens or spinach.

People who don’t spend enough time in the sun to generate adequate levels of vitamin D (determined by a simple blood test) can compensate by adding sardines, herring, salmon and/or cod liver oil to their diets.

To reduce the risk of falls and fracture, older adults should live in clutter-free environments with good lighting, have their sight and hearing tested annually, wear rubber-soled shoes and always use caution when walking on slippery or uneven surfaces.

Health Benefits of Pasture-Raised Animals

The agricultural revolution dramatically changed our diet. When humans started growing their own food rather than foraging for it, and keeping domestic livestock instead of hunting wild game, grains became a staple food. The human diet wasn’t the only one affected; most of the animals raised for food in the United States now eat grain too. These changes in diet and lifestyle have been followed by changes in health, for people as well as livestock. Surely other factors, from pollution to processed foods, have played prominent roles in the rise of chronic diseases that were virtually nonexistent in early human cultures, but researchers are learning that the animal products we consume are an important piece of the puzzle. The differences between pasture-raised animals and their grain-fed counterparts are more significant than we once thought.

Pasture-Fed Animals

Pasture-raised is a more accurate term than grass-fed when it comes to animals that graze. Plants in the pasture compose a salad bar of species: several kinds of grasses, legumes like clover and lupine, and broad-leaf plants such as plantain and dandelion. These greens contain generous amounts of folic acid, beta-carotene, vitamin E and omega-3 fats. Unlike grain-fed animals, cows and chickens that eat wild greens produce meat, milk and eggs with high levels of these nutrients. Their high-fiber, low-starch diet and a lifestyle of continuous movement make these animals leaner and more similar to the wild game our ancestors ate.

Researchers in the Department of Dairy Science at the University of Wisconsin found that meat from pasture-raised cows also contain high levels of conjugated linoleic acid, a fatty acid that is being studied for its role in the prevention of cancer, atherosclerosis, diabetes and obesity.

Grain-Fed Animals

In the United States, hundreds of millions of animals that would once have grazed in pastures are now raised on factory farms. These confined animal feeding operations (CAFOs) are able to boost productivity and lower costs by raising large numbers of livestock in one location and feeding them grain. Corn is the grain of choice because it is cheap and it causes animals to gain weight quickly, providing more meat in less time than traditional pasture grazing. Due to their different diet, grain-fed animal products lack the omega-3 fats found in those of pasture-fed animals, but they do contain more total fat, saturated fat and omega-6 fats.

The diet of animals raised in CAFOs also includes by-products of other animals, medications to buffer gas and acid in the rumen that result from an unnatural diet of grains and antibiotics to thwart infections that are common in crowded quarters. Not surprisingly, CAFOs also contribute to air and water pollution, toxic waste production, antibiotic resistance, loss of biodiversity and dependence on the fossil fuels necessary to grow and transport so much corn.

Fatty Acid Composition

Although grain-fed animal products lack the folic acid, beta-carotene and vitamin E of those that eat their natural diet of wild greens, changes in fatty acid composition may be the most important difference. Experts estimate that the dietary ratio of omega-6 to omega-3 fatty acids was close to 1:1 for our ancient ancestors, but the ratio found in the average American diet is much higher (closer to 20:1) as a result of too many omega-6 fats and too few omega-3 fats.

Both omega-6 and omega-3 fats are essential elements in our diet because our bodies need them but cannot make them. However, more is not always better. Too many omega-6 fats, like those found in grain-fed animal products, and too few omega-3 fats, like those found in pasture-fed animal products, can have serious consequences for our health.

Effects on Human Health

Studies have shown that excessive intake of omega-6 fats is associated with autoimmune diseases such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis and lupus erythematosis. These conditions have in common high levels of inflammatory leukotrienes derived from omega-6 fats. Supplementation with omega-3 fats, which lowers the fatty acid ratio, has been shown to decrease disease activity and reduce the need for anti-inflammatory medications.

Studies in Italy found that, in vitro, prostaglandins derived from omega-6 fats have carcinogenic properties and omega-3 fats have the opposite effect. Omega-3 fatty acids antagonize the formation of inflammatory prostaglandins, which may explain their anticancer action. Research has also shown that omega-3 fats play an important role in the prevention of breast and prostate cancers.

Other illnesses that have been linked to too many omega-6  and too few omega-3 fats include cardiovascular disease, type two diabetes mellitus, asthma, hay fever, depressive disorders and dry eye syndrome. Furthermore, researchers at the University of California in San Diego found that a high ratio was associated with decreased bone mineral density in both men and women, regardless of age, body mass index, lifestyle factors and hormone replacement therapy.

The Bottom Line

Clearly, the fats in our diet, and the animals we eat, have a significant impact on our health. Raising the animals we eat on pasture supports not only a healthier planet, but healthier people as well.