Organic Foods and
the USDA
Osteoporosis Protection
Lifestyle and Osteoporosis
Dietary Supplements
for Osteoporosis
Ask Dr. J: Fish Oil
Supplement Safety
References
In the Health News
Diet and Disease
Recipe of the Month:
Veggie Kebabs for the Grill
Dear Friends,
The USDA (United States Department
of Agriculture) has never been
a strong supporter of organic
agriculture or organic foods in
general. Their original attempt
to allow irradiated foods, sewage
sludge, and genetically modified
foods to be included in their
organic definition was overwhelmingly
opposed by the organic food industry
and large numbers of consumers.
As a result, they dropped those
regulations.
Later, they denied that organic
foods were any better than conventionally
grown products, and even issued
warnings about the dangers of
organic foods! They have been
resting since then, but now they
seem poised to once again make
it harder for consumers to know
that whether what they are eating
is organic, or whether non-food
products claiming to be organic
really are.
The USDA announced an enforcement
directive of April 23, 2004, including
the following statement: “when
practices provided for in paragraphs
(a) through (d) are insufficient
to prevent or control crop pests,
weeds, and diseases, the producer
may use synthetic substances listed
in § 205.601 of the National
List.”
This suggests to me that regulations
of pesticides are not as strict
as they should be. According to
the Organic Consumers Association,
non-agricultural products such
as fish, body care products, pet
foods, fertilizer, and clothing,
may be labelled “organic”
with little to no regulation or
assurance of authentic organic
ingredients. In addition, the
regulation situation is confusing,
because it appears that if both
the producer of supposedly organic
foods and the certifier do not
know the ingredients of the pesticides,
they can certify the food as organic.
This is part of a widespread
problem of choosing healthy foods–awareness
is not enough if we can’t
trust the labeling of the foods
to be accurate. As much as I encourage
organic gardening and growing
as much of your food as possible,
it is almost inevitably only a
small part of the food intake
for most people. Being able to
choose organic foods in the marketplace
is essential if you want to take
the best care of your own and
your family’s nutrition.
Public demand is fueling the
fast-growing increase in organic
production and distribution, which
may be seen as threatening to
large-scale conventional farms
and the enormous food processing
industry. They would like nothing
better than to be able to call
their products organic to “catch
the wave” of this industry
without having to be strict about
the quality of their foods. The
only way to maintain real organic
foods is to pressure the USDA
to adopt high standards. I suggest
joining the Organic Consumers
Association at www.organicconcumers.org,
and The Campaign to Label Genetically
Modified Foods (www.thecampaign.org),
as well as www.saveorganicfood.org.
Everyone who is concerned about
their health is aware of the need
to prevent osteoporosis, or age-related
deterioration of bone structure
leading to a higher risk of fractures.
Osteoporosis has been in the news
lately, because of recent studies
showing that dietary supplements
are likely to help prevent the
decline of bone density and reduce
the incidence of fractures.
Bones are dense with a collagen
and non-collagen protein matrix
and mineral deposits, mainly calcium
phosphate. Bone is a living and
growing tissue, and gains some
of its strength from constant
remodeling and repair of micro-fractures
that occur regularly from normal
wear and tear. Cells that are
responsible for the remodeling
are of two types, osteoblasts
that form bone, and osteoclasts
that break down bone to release
calcium. The balance of osteoblast
and osteoclast activity influences
bone density.
Strong bone formation is a slow
process (remodeling bone takes
many months), and it requires
a number of nutrients (vitamins
C and D, calcium, phosphorus,
magnesium, and possibly manganese,
copper, and others), proper hormonal
balance, and weight-bearing exercise.
Vitamin C is essential for the
production of collagen, contributing
to the basic bone matrix. Hormones
involved in establishing and maintaining
bone density include growth hormone,
parathyroid hormone, adrenal hormones,
testosterone, estrogens, progesterone,
and thyroid hormone.
Women have a lower bone density
than men, and their loss of bone
after thirty years old accelerates
with the menopausal decline in
estrogen levels. Men’s bone
density also declines with age,
but osteoporosis occurs later
because of their higher peak bone
density. After the age of 80,
both men and women are at great
risk of fractures from weakened
bones. Adequate dietary calcium
is not the only influence on bone
calcium, although it is important.
Some diet and lifestyle factors
lead to calcium loss in the urine.
For example, caffeine, salt, phosphorus,
and sugar in the diet can lead
to excessive excretion of calcium
(phosphorus and sugar are main
ingredients in soft drinks, associated
with increased osteoporosis).
Smoking and excessive alcohol
intake are also associated with
increasing osteoporosis risk.
High dietary protein may also
cause calcium to be excreted,
but it also may increase absorption
from food, leading to mixed results
in scientific studies, although
the evidence suggests that excessive
meat consumption is also a risk
factor.
Weight-bearing exercise stimulates
bone formation and remodeling.
Impact causes some strain on the
bone, and this in turn leads to
increased activity of the bone-forming
cells. In one study of 126 post-menopausal
women, strength training to build
muscle mass significantly increased
hip bone density over two years.
Vitamin D is essential for the
absorption of calcium from the
intestinal tract leading to increased
calcium deposition in the collagen
matrix. It is produced by the
action of UV from sunlight on
cholesterol in the skin (it is
really a steroid hormone called
cholecalciferol, not a true vitamin).
It is also present in a few foods.
Vitamin D is one of the few nutrients
that may be toxic in high doses,
but it is likely that most elderly
people are not getting enough
because of lack of sun exposure
and declining production in the
skin with age. Recommendations
for vitamin D range from 200 to
800 IU daily.
Recent studies show that a risk
factor for heart disease, high
serum homocysteine, is also related
to increased risk of osteoporosis,
and that vitamin supplements can
reduce that risk. Dutch researchers
studied 2400 subjects over 55
years old, for three to six years,
concluding that those with the
highest homocysteine had about
double the risk of fractures as
those in the lowest range.
Homocysteine may interfere with
collagen cross linking, decreasing
bone strength. The second study
in the New England Journal of
Medicine examined 2000 men and
women, aged 59 to 91, over 12
to 15 years. They also found a
direct relationship of homocysteine
with the incidence of fractures,
with the highest level of homocysteine
associated with two to three times
as many fractures as the lowest
levels.
Dietary supplements of vitamin
B6 (100 to 200 mg), folic acid
(1000 to 5000 mcg), and vitamin
B12 (1000 mcg) all help to reduce
the level of homocysteine in the
blood. These are simple, safe
supplements that also lower the
risk of heart disease. However,
these are not the only beneficial
supplements for bone density.
Ipriflavone is a modified flavonoid
derived from soy, and it both
inhibits bone breakdown and enhances
calcium deposition in bone. The
usual dose of ipriflavone is 600
mg daily. A number of studies
show that over a one year period,
ipriflavone increases bone density
while placebo subjects see a decline.
All subjects also received 1000
mg of calcium in several of the
studies.
Soy isoflavones (genistein and
daidzein) have some phytoestrogenic
effects and help bone density.
A study of menopausal women taking
40 gms of soy protein daily (90
mg of isoflavones) showed reduced
bone loss. Soy isoflavones are
abundant in tofu, soymilk, and
tempeh (but I do not recommend
TVP, a highly processed texturized
vegetable protein).
Testosterone, estrogen, and progesterone
stimulate bone formation, as does
growth hormone. With the current
risks associated with Premarin
and Provera (Prem Pro), I only
recommend bio-identical hormone
treatment. If blood test markers
of growth hormone indicate a low
level, which is very common as
people age, it may well be worthwhile
to have injection treatment with
human growth hormone (oral supplements
are generally ineffective).
Magnesium, vitamin K, and omega-3
oils from fish are all of potential
benefit in preventing osteoporosis.
A comprehensive program of diet,
exercise, dietary supplements,
and appropriate hormonal therapies
is likely to provide the most
benefit in preventing and reversing
this disease.
Q. I have read
about the contamination of farm-raised
fish. Is there also a problem
with contamination of fish oil
supplements?
—RG, via email
A. A wide range of fish oil products
are available in the health market,
as a source of omega-3 oils. These
oils have many health benefits,
especially for people who have
limited conversion of alpha-linolenic
acid to the EPA and DHA that are
the most active components of
fish oil. The conversion is more
limited in the elderly and in
children, and these oils are important
for brain function, lipid control,
protection from heart and blood
vessel disorders, controlling
inflammation, and treating depression,
as well as many other health problems.
ConsumerLabs, an independent
testing company, found that of
the 20 commercial fish oil supplements
that they tested, none were contaminated
with mercury, probably due to
the species of fish that were
used as the oil source. Other
contaminants are unlikely to be
a problem because of the distillation
and purification processes used
to extract the oils.
However, ConsumerLabs tested
20 brands and found that six contained
only 50-80 percent of the amount
of omega-3 oil that was claimed
on the label. (More recent testing
indicates that manufacturers are
paying attention to these results
and improving their products.)
Be sure to buy your fish oil supplements
from reliable companies with about
30 percent omega-3 oil (combined
EPA and DHA).
Organic Consumers
Association, Action Alert, Bush
Administration moving to allow
corporate takeover of organics!
May 5, 2004; www.organicconsumers.org
Compliance
and enforcement directive NOP
C&E #04.01 www.ams.usda.gov/nop/Compliance/pesticidesCompliance.pdf
Kerr D, et
al., Resistance training over
2 years increases bone mass in
calcium-replete postmenopausal
women. J Bone Miner Res. 2001
Jan;16(1):175-81.
Wyshak G, Teenaged
girls, carbonated beverage consumption,
and bone fractures. Arch Pediatr
Adolesc Med 2000 Jun;154(6):610-3.
van Meurs JB,
et al., Homocysteine levels and
the risk of osteoporotic fracture.
N Engl J Med. 2004 May 13;350(20):2033-41.
McLean RR,
et al., Homocysteine as a predictive
factor for hip fracture in older
persons. N Engl J Med. 2004 May
13;350(20):2042-9.
Holick MF,
Vitamin D: importance in the prevention
of cancers, type 1 diabetes, heart
disease, and osteoporosis. Am
J Clin Nutr. 2004 Mar;79(3):362-71.
Kovacs AB,
Efficacy of ipriflavone in the
prevention and treatment of postmenopausal
osteoporosis. Agents Actions 1994
Mar;41(1-2):86-7.
Agnusdei D,
et al., Effects of ipriflavone
on bone mass and calcium metabolism
in postmenopausal osteoporosis.
Bone Miner 1992 Oct;19 Suppl 1:S43-8.
Scheiber MD,
et al., Dietary inclusion of whole
soy foods results in significant
reductions in clinical risk factors
for osteoporosis and cardiovascular
disease.... Menopause 2001 Sep-Oct;8(5):384-92.
Science Daily,
2004-03-17 Fish Oil Supplements
May Contain Flame Retardants.
Product Review:
Omega-3 Fatty Acids (EPA and DHA)
from Fish/Marine Oils, www.consumerlab.com/results/omega3.asp
Tod Cooperman
(ConsumerLabs.com representative),
Lecture presentation at the American
College for Advancement in Medicine
Scientific Meeting, May 22, 2004
Dietary selenium appears to protect
against the development of advanced
prostate cancer. Results from
the Physicians Health Study at
Harvard shows that men with the
highest blood levels of selenium
had a 50 to 60 percent reduction
in advanced prostate cancer. They
compared 586 men with prostate
cancer to 577 control subjects.
((Li H, et al., A prospective
study of plasma selenium levels
and prostate cancer risk. J Natl
Cancer Inst. 2004 May 5;96(9):696-703.)
This confirms earlier studies.
Selenium is found in nuts, whole
grains, brewers yeast, and seafood,
and it is common in high quality
multivitamins.
After a heart attack, depression
and loneliness often trigger a
recurrence, but this risk is greatly
reduced in people who exercise.
Researchers studied over 2000
subjects, and among those who
were socially isolated or depressed,
heart attack recurrence was double
the rate in those who were sedentary
compared to those who exercised.
In addition, their depression
was relieved by exercise. (Blumenthal
JA, et al., Exercise, depression,
and mortality after myocardial
infarction in the ENRICHD trial.
Med Sci Sports Exerc. 2004 May;36(5):746-55.)
A typical fast-food breakfast
at McDonalds (and probably similar
chains) induces an inflammatory
response that could explain why
such foods are associated with
an increased risk of heart disease.
Researchers measured oxygen free
radicals and inflammatory markers
such as CRP, after a 900 calorie
meal of egg and sausage McMuffins,
and hash browns. The CRP and free
radical markers all increased.
Aljada A, et al., Increase in
intranuclear nuclear factor kappaB
and decrease in inhibitor kappaB
in mononuclear cells after a mixed
meal... Am J Clin Nutr. 2004 Apr;79(4):682-90.
Cookouts do not have to include
meat or be rich in saturated fat
to be delicious. On a skewer,
alternate chunks of red and green
peppers, cherry tomatoes, onion
quarters, tofu cubes, eggplant
(small cubes cook faster), zucchini
and summer squash chunks, and
crimini or other mushrooms. Marinate
these (the longer the better),
before skewering, in a mixture
of water, soy sauce, balsamic
vinegar or lemon juice, olive
oil, crushed garlic, dried or
crushed fresh ginger, fresh basil,
thyme, and ground pepper. Put
them on the grill until slightly
soft (10-20 minutes), turning
several times. You can cover this
with a variety of sauces for serving.
Make a tangy, thick and creamy
Thai-type sauce with peanut or
almond butter, coconut milk, crushed
garlic, ground cumin and coriander,
chili pepper, and lemon juice.
Pour the sauce over the veggies
and serve on brown rice.
