Calcium Revisited

A study published online May 23 in the Journal of Clinical Endocrinology and Metabolism  examined data from 9033 community-dwelling men and women participating in the Canadian Multicenter Osteoporosis Study. They found that in women a total calcium intake of about 1,000 mg/day was associated with lower all-cause mortality. It didn't matter whether the calcium came from food or supplements. In men this association was not found. The study may have been underpowered and therefore not found an association with men. This study is in contrast to some recent studies that found calcium associated with higher mortality, although again, mainly in men. I feel that it is safe to recommend women, especially those at risk for osteoporosis, take calcium/magnesium supplements with vitamin D3 and K2. If they are consuming a varied diet containing calcium rich foods, then I generally recommend about 500-600 mg calcium in a mixed supplement. I vary the amount I recommend based on their diet and risk factors. 

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More Bad News About NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are advertised as the go-to medication for any kind of pain or inflammation. Inflammation is seen as unequivocally bad. In reality, the inflammatory response is a normal response to an injury or insult to any part of your body. It is the response that repairs the lining of your gut, among other tissues. The molecules that blocked by taking NSAIDs are important for the proper function of your heart. A meta-analysis published online in the May 30 edition of The Lancet found that all NSAIDs, with the exception of naprosyn, are bad for your heart. This includes ibuprofen and diclofenac and COX-2 inhibitors such as Celebrex. Naprosyn did not appear to have adverse effects on the heart, but is very hard on the gut. This study just drives home how alternatives to these medications need to be used. This can be the use of cold, heat, exercise, weight loss, or topical treatments. I like Curcumin and Boswellia preparations, as well as the homeopathic remedy, Traumeel. 

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Statins and Diabetes

Since 2012 the USFDA has mandated a labeling change to all statins except pravastatin, warning that statins can raise blood sugar and HbA1c levels (an indicator of long term elevated blood glucose levels). Recent research has either confirmed the risk, or found the increased risk insignificant. The study that found the risk significant found the atorvastatin, rosuvastatin, and simvastatin were associated with a 22%, an 18%, and a 10% increased risk of new-onset diabetes respectively. These were found at moderate and high doses in people starting at an average of age 73 and followed for 14 years. The bottom line is here that although statins may have some benefits, they are not without risk. Ironically, having diabetes puts one at a significant increased risk of a cardiovascular event--something one is trying to avoid by taking statins. 

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Both Aerobic and Resistance Training Optimal for Diabetics

People with type 2 diabetes benefit from both aerobic and resistance training. Doing both seems to be optimal. A re-examination of data from a HART-D trail published in JAMA  in 2010 showed that the beneficial effects of exercise can be traced to the increased level of fitness and the decreased waist circumference. Belly fat is inflammatory fat, and it is important to reduce this fat. Exercise is an excellent way to start. This study did not show that increased muscle mass is responsible for the beneficial effects of exercise, although it seems it should, as muscles become more sensitive to glucose with exercise. Either way, the bottom line is that it is very important for people with type 2 diabetes to exercise. This study showed beneficial effects at 140 minutes per week cumulative, or 110 minutes of aerobic and 30 minutes of resistance exercise. This study was published in May 2013 in Diabetes Care. 

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Don't forget Iodine

Before iodized salt, it was not unusual for people not living near an ocean to develop a goiter. This was due to a diet deficient in iodine. Pregnant women who don't get enough iodine can have a child with a lower IQ, a recent paper published in Lancet (May 22, 2013) points out. We know that extreme iodine deficiency with hypothyroidism can result in a child with cretinism. The Lancet article points out how many women are mildly iodine deficient now. In England salt is not iodized, and not all salt is iodized here. Milk can be a good source of iodine, but organic milk has less iodine. Why, I don't know. It is important for pregnant women to take prenatal vitamins, as they all include iodine. Also consuming seafood can be helpful, but only in limited quantities, as so much seafood is contaminated with mercury. 

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Korean Ginseng Berry Helps Erectile Dysfunction

A study published online found that an extract of standardized Korean ginseng berry, 350 mg extract per tablet, improved all domains of sexual function in men with erectile dysfunction. There were no changes in blood chemistry and no side effects in this study. Korean ginseng has few reported adverse effects, but those include headache, insomnia, gastric problems, and constipation. It is important to note that this study used Korean, not American or Siberian ginseng. It also used the berry. A quick scan online did not show a specific product that can be bought online that meets the criteria of this study. However, that doesn't mean that someone is going to start marketing this soon!


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Diets High in Fiber May Prevent Stroke

A study published in the March 28 issue of Stroke found that diets high in fiber reduce the risk of stroke by up to 7%. We already knew that fiber-rich diets reduce blood pressure and low-density cholesterol, both of which play a role in stroke. So it comes as no surprise that diets rich in fiber would also reduce the risk of stroke. The researchers analyzed 8 relevant cohort studies from the United States, Europe, Australia, and Japan published between 1990 and 2013, comprising over 200,000 individuals. The follow-up ranged from 8 to 19 years. They were unable to assess soluble vs. insoluble fiber. What is also difficult to assess is it the fiber alone that is making the difference? or is it that fiber comes with fruits and vegetables, sources rich in phytonutrients that improve the health of the blood vessels? I think that eating a diet very rich in whole and fresh fruits and vegetables will automatically be rich in fiber as well as in phytonutrients. Diets with processed foods are low in both fiber and phytonutrients. 

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Fitness Can Protect Against Some Cancers

Findings presented at the 2013 annual meeting of the American Society of Clinical Oncology by Dr. Lakoski showed that in men, the highest levels of cardiorespiratory fitness decreases the risk of developing lung cancer (by 68%) and colon cancer (by 38%) in men. No effect on prostate cancer was noted. The study was done on 17,049 men (mean age 50 years) who had been assessed once at the Cooper Institute in Dallas. They were then followed for 20-24 years. Even if men weren't obese, if they weren't fit, their risk of getting cancer, and then dying of it was higher than in the fittest men. 

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