Archive for the ‘Nutrition’ Category
Once again we have been treated to statisticians mushing together multiple disparate previous studies to “prove” that calcium alone, or vitamin D alone, or both together in one of many different combinations will not prevent fractures. All mushed together in a carefully selected meta-analysis, you can prove anything depending on which studies are included.
More important, asking if adding a specific dose of calcium, or vitamin D, or both, will prevent fractures, misses the entire point. Most studies did not properly account for the nutrients in each day’s diet in individual test subjects – or in individual control subjects, many of whom also consumed the nutrients being studied.
And how can you ethically ask a patient to limit their diet in a way you believe will put them at risk for fractures? You have to settle for encouraging patients who are inadvertently short on some nutrients to improve their diet. But then they do not fracture and you cannot prove that they would have if only you had withheld the information!
We help individuals improve their bone health. One size does not fit all. We do a Complete Bone Health Evaluation. Then we adjust nutrition and lifestyle as needed for that individual. In about half of women and three-quarters of men, this is enough.
Jay Ginther, MD
Spring! The Sun is back for more than 12 hours daily! The sun crossed the equator at 0529 CDT. Vitamin D? Not so fast. This is Iowa and we are still too far north.
Your skin can make Vitamin D when exposed to strong enough sunlight. Strong enough sunlight happens when the sun is high enough in the sky that its UV rays are not blocked by the atmosphere. This happens at mid-day all year round in the tropics.
Iowa needs to wait another couple of weeks for our first moments of Vitamin D from the sun. Mid-day is around 1:10 to 1:25 pm CDT, depending on location. Southern Iowa will get enough sunlight several days before northern Iowa. Late June we will have 4-5 hours of opportunity.
Unfortunately, Vitamin D, Sunburn and Skin Cancer are often a package deal. You can encourage them all, or block them all with Sun-block.
Your safest move is to protect yourself from sunburn and skin cancer, and take your vitamin D3 tablets or gel-caps. A 25-hydroxy Vitamin D blood test will show if you have achieved the ideal range of 40-80 ng/ml.
You need to take control, but this is one area where naturally can have a significant downside.
Jay Ginther, MD
Bones are over 80% protein. The organic part of bone is collagen, which is protein. Calcium is gradually deposited into the organic bone matrix to make bone stiffer. Ideal bone is mildly flexible, like a titanium airplane wing.
Healthy bones require adequate protein in your diet. Milk, cheese, and yogurt are good. Lean meats like chicken, turkey, and fish have less cholesterol than beef or pork. All sorts of beans, lentils, garbanzos (humus), nuts are vegetarian alternatives.
Protein needs are higher when you are growing, and again starting in your 60’s. The basic guideline during adulthood is 1 gram of protein for each kilo of lean weight. See our previously posted Protein Chart.
Muscle is mostly protein. Strong muscles keep bones strong by tugging on them and by compressing them. Strong muscles maintain balance and prevent falls.
Preparing protein foods from scratch can be time consuming. Some days I take the shortcut of Premier Protein Shakes. 30 grams of protein, only 1 gram sugar, low fat, only 160 calories, made from milk solids, and they have 500 mg Calcium.
Take Control Naturally by getting enough Protein in your diet.
Jay Ginther, MD
Vitamin D is necessary in order to absorb Calcium from your diet. Your skin can make some Vitamin D from the Mid-day Sun, but only in the “summer”. The sun is high enough above the horizon at mid-day only 5 months of the year in Iowa. Over half of Iowans are low on Vitamin D as summer ends in September. 7 out of 8 Iowans are low by mid April when we can first get a few minutes a day of Vitamin D. That’s the Good News.
The Bad News is that Sun Block blocks Vitamin D production in skin. You need to risk Sunburn and Skin Cancer “naturally” if you want to make your Vitamin D “naturally”. Plus you need to expose enough skin (determined by your age and personal genetics) to make enough Vitamin D.
Foods naturally high in Vitamin D3 include “yummy” Seal Blubber and Cod Liver Oil. Most Fish Oil does not have much D3. Vitamin D2 from plants (like mushrooms) is much less long lasting than D3, so we are talking pounds of mushrooms daily.
Your easiest and safest move is to take extra Vitamin D3. The amount of D3 in your multiple vitamins and minerals, calcium supplements, and milk combined are very rarely enough. Most of us need 2,000 to 5000 units of additional D3 daily.
Test for 25-hydroxy Vitamin D Level to tell if you are taking enough to get between 40 and 80 ng/ml in your blood.
Help to Take Control Naturally by getting enough Vitamin D.
Jay Ginther, MD