New England Health Advisory

By Inger Pols

On Friday, I looked at how to make healthier meat choices and today I’m going to look at how we can do the same with dairy. Humans are the only species that consumes milk past infancy. And we don’t just consume it: We inhale it! We drink milk and we eat butter, cream, cheese and ice cream more now than ever before. In 2001, Americans consumed 30 pounds of cheese per person. That is eight times more than we consumed in 1909 and more than double consumption in 1975!

While much of the cheese eaten in the early 1900s was made locally on a farm, today we are eating processed shredded cheeses out of plastic bags and we’re eating on the run: About 55% to 65% of the cheese we eat comes from commercially manufactured and prepared foods like packaged snack foods and fast food sandwiches.

Being Dutch, I consider cheese to be one of my four primary foods; I don’t think I could live without it. And because of my background and my blood type, I can handle dairy products without any digestive concerns. But over the past few years, I have reduced my dairy intake significantly and made several changes to the dairy products I do consume. Most of us are simply consuming too much dairy; making some changes can go a long way toward improving our health.

Not Your Parents’ Milk

Whenever I talk about reducing dairy consumption, I always run into someone who grew up on a farm who argues that their parents lived long healthy lives drinking milk every day. And I don’t doubt that, because when I ask about it further, they always say their diet included one glass of milk with a meal and some butter and cheese, all made locally on their farm—which means they consumed raw unpasteurized milk and milk products made freshly and untreated. In fact in 1909, 56% of all milk consumed was ingested on the farm where it was produced. By 2001, that number had dropped to 0.3%.

While pasteurization is hailed as a great invention because it kills bacteria and prevents milk from souring, the heat process also kills off many beneficial nutrients. Named after Louis Pasteur, pasteurization was developed as a means of preserving beer and wine. Pasteur never applied it to milk; that came later, in the late 1800s, when dirty urban dairies were trying to find a way to produce cleaner milk. They discovered that pasteurization allowed them to still use the dirty milk, which was easier and cheaper than finding ways to make the milk cleaner.

The idea quickly spread as profits grew. In order to market the new form of milk, producers had to convince consumers that unpasteurized milk was harmful. A smear campaign to link raw milk to diseases was undertaken and today, most people believe that raw milk is dangerous to consume. But the truth is that pasteurized milk poses far more health risks than raw milk.

Raw milk contains healthy bacteria that actually inhibit the growth of harmful organisms; once removed, the pasteurized milk is actually more prone to contamination. In addition, the pasteurization process destroys many vital nutrients in the milk. Studies show up to a 66% loss of vitamins A, E and D and a 50% loss of vitamin C. Vitmains B6 and B12 are totally destroyed by the pasteurization process, as are many beneficial hormones, antibodies and enzymes. One enzyme destroyed in the process is lipase, which impairs fat metabolism and the ability to absorb fat-soluble vitamins such as A and D.

Pasteurization also makes calcium and other minerals less available. One way they test to see if the milk is appropriately pasteurized is to look for the destruction of phosphatase. If it’s absent, the milk is considered fully pasteurized. But phosphatase is essential for the absorption of calcium. So pasteurization makes calcium insoluble. It also destroys iodine, the lack of which can cause constipation.

Pasteurization also turns the sugar of milk, lactose, into beta-lactose, which is more rapidly absorbed in the system and has been shown to make children hungrier sooner. But the dairy industry has formed a strong lobby to prevent the distribution and sale of raw milk in order to protect their profits.  They’d rather have you believe it is harmful because if you found out the truth, you probably wouldn’t want to drink pasteurized milk.

Hormones, Pesticides and Antibiotics

In addition to not being pasteurized, raw milk is produced on farms that also avoid some of the real dangers of milk and milk products today: hormones, pesticides and antibiotics.

In the newsletter on healthier meat choices, I discussed how hormones are used to help the animals to grow bigger. In addition to that injection process, some farms use an additional hormone called rBGH, which is a synthetic growth hormone. Back in the 1930s, a typical cow produced 12 pounds (or about a gallon and a half) of milk a day. By 1988, the average was 39 pounds a day. This was done primarily through selective breeding and using rBGH. Today a cow can now generate 50 pounds of milk a day.

Cows injected with rBGH are 79% more likely to contract mastitis (an infection of the udder). Those cows also suffer from reproductive difficulties, digestive problems, an increased need for antibiotics and other abnormalities. Consumer’s Union reports that milk from rBGH treated cows is more likely to be of lower quality and contain more pus and bacteria than milk from untreated cows.

But even if you find milk from farms that don’t use rBGH, other harmful hormones present in the cow remain. In addition to the ear pellet they receive as a calf containing synthetic hormones to help them grow, cows’ milk contains high amounts of estrogen because 75% to 90% of milk comes from pregnant cows. Milk from a late-stage pregnant cow can have up to 33 times as much estrone sulfate (a form of estrogen) and 10 times more progesterone. Much research ties excess estrogen to reproductive cancers such as prostate, testes, ovarian and breast cancer. Male breast enlargement has also been tied to high dairy and hormone-laden meat consumption.

Test analysis has revealed traces of 80 different types of antibiotics in milk. Animal products like milk can also contain up to 14 times more pesticides than plants If you worry about pesticides in produce, you should be even more concerned about pesticides in meat and milk.

Anyone who has been pregnant, or been around a pregnant woman, understands the effect high hormone levels can have on the body. They have likely also seen that what the mother eats is transferred to the child through the milk and has an immediate and noticeable effect on the child if there is an allergy or sensitivity issue. Consuming the milk of a perennially pregnant cow makes consuming estrogen unavoidable. As one physician/scientist from the Harvard School of Pubic Health put it, “The milk we drink today is quite unlike the milk our ancestors were drinking without apparent harm.”

A new process has been developed called ultra-pasteurization, which involves longer treatment times at higher temperatures, resulting in milk that is totally sterile. It’s not being advertised, but you can look for the word in small print on almost every national brand and even some organic brands (Horizon, the largest organic producer, now ultra-pasteurizes.)

Given all the challenges with modern milk production, it’s no surprise that many Americans are allergic or sensitive to it and that it can cause headaches, sinus and chest congestion, stomach pain, cramping, diarrhea, gas and sore, scratchy throats. Milk has also been linked to asthma, atherosclerosis, upper respiratory and ear infections, obesity and cancer. (Many doctors now think children with recurring ear infections may have dairy sensitivities.)

Many people have difficulties digesting milk even if they are not lactose intolerant. According to Dr. Walter Willett of Harvard University, “The majority of humans naturally stop producing significant amounts of lactase—the enzyme needed to properly metabolize lactose, the sugar in milk—sometime between the ages of two and five. In fact, for most mammals, the normal condition is to stop producing the enzymes needed to properly digest and metabolize milk after they have been weaned. Our bodies just weren’t made to digest milk on a regular basis. Instead, most scientists agree that it’s better for us to get calcium, potassium, protein, and fats from other food sources, like whole plant foods—vegetables, fruits, beans, whole grains, nuts, seeds, and seaweed.”

The Many Varieties of Milk

For my family and myself, traditional milk, even organic, is simply not a good health choice. Raw milk not only avoids the hormone, antibiotic and pesticide challenges of modern milk production, it also offers the nutrients and enzymes that the pasteurization process destroys. Raw milk is a complete source of protein full of beneficial bacteria and vitamins, minerals and enzymes. If you are going to consume cow’s milk, I suggest you do so sparingly and that you explore raw milk options.

In some states, you can buy raw milk in stores such as Whole Foods. In most states, however, you’ll have to buy directly from the farm. And that may not be a viable option for some. Another option to consider is goat’s milk. Much of the world consumes goat not cow’s milk, because it’s more widely available and also because many people can digest goat’s milk readily even if they cannot tolerate cow’s milk.

Goat’s milk is a great source of calcium and protein, phosphorus, riboflavin (vitamin B2), potassium and the amino acid tryptophan. It’s also been shown to enhance the metabolism of copper and iron. For those with milk allergy symptoms such as asthma, eczema, ear infections and rheumatoid arthritis, switching to goat milk may help alleviate symptoms.

The major problem with goat milk is the expense. For many people who consume moderate or large amounts of milk, it will not be financially viable. I personally consume very little milk. I put a small amount in my chai tea in the morning and I use a little when I make a risotto or a sauce that I want to have some depth or richness. I find that a small amount of goat’s milk does the trick and makes for a delicious and rich sauce. Because I use so little and a half gallon can last me more than two weeks, (and yes, it lasts that long without spoiling), I justify the expense. (I definitely noticed a reduction in bloating after switching from cow’s to goat’s milk.)

For those who can’t access or afford raw milk or goat milk, or who want a non-animal option, I recommend rice or almond milk. Almond milk can be made inexpensively at home so it’s a great option if you want a fresh milk alternative that doesn’t cost a lot.

I do not recommend soy milk because it contains a natural chemical that mimics estrogen, though it does contain nutrients and protein. As we discussed in the prostate article, these estrogens take up the hormone receptor sites intended for estrogen and leave the excess estrogen to wander around the body.

Studies show excess estrogen can alter sexual development and can lead to reproductive concerns and cancers. One study showed that two glasses of soy milk a day contained enough pseudo estrogen to alter the timing of a woman’s reproductive cycle. As a result, I suggest everyone avoid soy milk.

Choose Better Cheese

While I have focused predominantly on milk since it is the source for all dairy, cheese is a far bigger component of most people’s diets than milk. In general, we eat way too much cheese and cutting back on processed foods with cheese or hidden cheese in fast foods is a great step toward better health. When you do choose cheese, the same principles that we discussed above apply: Look for raw milk cheese (most markets carry some, especially raw milk bleu cheeses and they are delicious) and goat’s milk cheese, which are also prevalent and tasty. Experiment with these kinds of cheese and if you are a cheese lover like me, you’ll find some delicious new options in raw milk and goat’s milk cheeses.

Occasionally, I do eat traditional cheese, but I buy it from Europe because the European Union has banned all hormones. When you buy a cheese from the mountainous Alps region of France or Switzerland, you are typically getting cheese made the traditional old-fashioned way from cows or goats who have roamed free in the sunshine, eating grass and living without pesticides, chemicals or drugs.

How Much is Too Much?

So now that we have looked at milk and cheese options, how much, if any, dairy should you consume? Less is definitely more when it comes to dairy: For me, a little bit of raw milk or goat cheese makes my day and I try to eliminate eating cheese that is an afterthought rather than a primary focus in my meal. I believe in bioindividuality, which means I think that every body is different and your tolerance will depend on your own lifestyle factors and diet, as well as that of your ancestors. Some people can handle dairy without incident while others should cut it out completely. This may be due in part to the enzymes present in our blood.

Dr. Peter D’Adamo argues in his blood type diet book, Eat Right for Your Type that blood type Bs (as I am) can handle dairy. Because ABs have some B in them, they can handle a little dairy as well. But type A should significantly reduce if not eliminate dairy and blood type O should completely avoid all dairy. This may or may not ring true for you, but if you are at all curious, I suggest eliminating dairy completely for two weeks, especially if you have any symptoms like headaches, IBS, sinuses, asthma or bloating/gas, and see how you feel during that time. (That includes all milk, cheese, yogurt, butter and ice cream.) Then introduce it slowly and see how you feel as you begin to eat it again: you’ll know right away if you can handle dairy and what types affect you more than others.

To your health!

Inger Pols
Editor of New England Health Advisory

By Inger Pols

This is part five of a series on the supplements I think every adult should take. Previous issues focused on whole-food based multivitamins, ubiquinol, fiber and omega 3. You can read them by clicking here.

The final supplement on the list is vitamin D, which is made in our bodies through sun exposure. But today, we simply don’t get enough direct exposure to sunshine, without sunscreen, to make the vitamin D we need.

Vitamin D helps with bone health by facilitating calcium absorption. It also plays an important role in many other healthy body functions. Vitamin D has been shown to improve immune health and heart health, protect against cancer, autoimmune diseases, depression and a host of other conditions.

Vitamin D deficiency is a major cause for concern as it affects multiple systems in our bodies. Vitamin D deficiency is far more pervasive than previously believed, with research now indicating virtually all adults and children have lower than optimal vitamin D levels.

The only way to know how much vitamin D you need on a daily basis is to get your levels tested a couple of months after you begin to supplement. You want to see levels of 125-200 nmol/L, or nanomoles per liter. (Sometimes test results are reported in nanograms per milliliter or ng/ml. It’s the same test, just a different measurement: Like miles per hour versus feet per second. If your test results are in ng/ml, you will want to see at least 50 ng/ml for optimal vitamin D function.)

Estimates now suggest that 5,000 International Units, or IU, of vitamin D a day or 35 IU per pound for kids or heavier people is appropriate. But some of us need more: I was recently listening to a renowned brain expert say that as a physician, he was shocked when he found out after vitamin D testing that his body required 10,000 IU a day to function at its optimal level since he lives in southern California and is exposed to sunshine all year.

My whole food multivitamin contains 5,000 IU of vitamin D3 and I get plenty of daily summer sunshine, so I don’t take a supplement in summer. But most multivitamins have shockingly low levels of vitamin D3. So even if you are taking a good whole-food multivitamin, you’ll most likely need to add some D3, unless you get time outside without sunscreen every day. And even though my multivitamin provides a good baseline, I still find that I need to supplement with an additional 1,000-2,000 IUs of vitamin D3 during the long New England winters. Unless you are in a warm weather climate, you probably will too.

If you haven’t read my full article on vitamin D, you should check it out. Before we leave the topic of supplements, I want briefly mention three other supplements that did not make my top five list that you may want to consider: collagen, probiotics and DIM.

Collagen

If you read my article on bone health, you know how important collagen is to avoiding bone fractures. You can and should get your collagen from eating good collagen-rich foods like dark green leafy vegetables. But if you find—like many—that you may not be eating enough collagen and you are not taking a good whole-food multivitamin, you may want to consider collagen supplementation.

As I shared in an earlier article, in order to maintain my weight and to prevent blood sugar issues, I try to eat small amounts of protein, healthy fats (omegas 3s) and fiber at every meal or snack. If I am ever in a situation where I am not consuming protein, I will take a collagen supplement (and a fiber or omega 3 supplement if needed) for balance. While not nearly as good as eating the right foods, in a pinch, it’s better than taking in carbohydrates (sugar) without any having protein to balance it out since carbs ingested without a protein counterbalance are stored as fat in the body.

Probiotics/Digestive Enzymes

We’ve all heard of antibiotics: They kill off or inhibit the growth of bacteria. But antibiotics also kill off the healthy bacteria in our digestive tract and inhibit our ability to digest food and to absorb nutrients. Probiotics contain the beneficial flora that your digestive system needs and digestive enzymes that work in your stomach to help break down foods. Both can be damaged by illness, poor diet and antibiotics, so if you have experienced any of those and have not taken a course of probiotics and enzymes afterward, your digestive system is likely not operating at top capacity.

Probiotics and digestive enzymes are also a must if you have digestive concerns such as cramps, constipation, diarrhea, gas or bloating or Irritable Bowel Syndrome. If you struggle with allergies or asthma, food sensitivities such as sugar or gluten, yeast infections or urinary tract infections, rosacea, acne or skin conditions, headaches or migraines, chronic bad breath (halitosis), PMS or hormonal imbalance, or achy joints, you should consider probiotic supplementation.

Depending on how long and how strong your course of antibiotics was, or how severe your digestive concerns are and what your diet is like (if it is very acidic), you may want to stay on probiotics for a while to ensure balance is restored and maintained. At a minimum, you’ll want to take probiotics and digestive enzymes while taking antibiotics and for several weeks afterward. A two to three month supplementation cycle is great for restoring balance and digestive health after any significant stress to your digestive system. Eating yogurt can help, but your body most likely needs more help than yogurt alone can provide.

Even if you haven’t had antibiotics lately or faced a digestive health concern, your system could still be imbalanced from a concern long ago. Probiotics can help restore balance if you have a heavily acidic diet that promotes yeast and causes other imbalances in your digestive pathway. I recommend a month (or two) of probiotic and digestive enzyme supplementation every year to help ensure your digestive system has everything it needs to maximize the nutrient absorption of the food you are eating.

There are many different probiotic strains and each works differently in the body, so you may need to experiment with more than one brand to find the right one. If you are facing a specific issue, research your condition to find the best strains. The right probiotic should make a difference within the first week or two. If you don’t see improvement after two weeks, try another brand with different strains of bacteria. If you are just looking to restore balance annually with no specific concerns, choose a highly rated probiotic that has bifidobacteria and lactobacillus acidophilus in the billions.

DIM or Diindolylmethane

Diindolylmethane, or DIM, promotes healthy hormonal balance through beneficial estrogen metabolism. DIM is a naturally occurring phytonutrient found in cruciferous vegetables (like broccoli, cabbage or collards), which we know are good for us, but do not eat nearly enough of. DIM can balance estrogen by blocking “bad” estrogen and promoting good or beneficial estrogen in our bodies.

For women, healthy estrogen metabolism prevents breast, cervical and uterine cancers; for men, it is required for prostate health. (Men, you have estrogen in your bodies and are exposed to it in foods and the environment as well, so it’s just as important for you!) We are going to be talking more about DIM and prostrate health in Friday’s issue.

Not everyone needs DIM, so it didn’t make my top five list. But if you’re concerned about hormonal balance, fibers, tumors or reproductive cancers or prostate health, DIM is a supplement you should consider taking daily. (I found it quiets my hot flashes.) Generally speaking, unless cancer runs in your family, you are perimenopausal and/or you are already struggling with reproductive issues like fibroids or hysterectomy, it’s something you can wait to take until you’re in your 50s.

Research has shown that most DIM supplements cannot be absorbed; they require microencapsulation. Only one company, BioResponse, has a patented microencapsulation with extended release naoparticles, ensuring predictable absorption. This company is the only brand being used in all the published clinical trials, including those sponsored by the National Cancer Institute, so it’s the one I take and recommend.

To your health!

Inger Pols
Editor of New England Health Advisory

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By Inger Pols

Today we’re starting a five-part series: The five supplements I think every adult should take. The first one is a whole-food based multivitamin.

A recent article in Reader’s Digest called vitamins a scam and said that taking them is a waste of money. It cited a study of 160,000 mid-life women that showed no difference in health with respect to the big diseases like cancer, heart disease and stroke, from taking a multivitamin. But as with all studies, you need to dig deeper—in this case because not all vitamins are created equal. (I am always suspect when a magazine whose advertising is largely from pharmaceutical companies says vitamins are worthless.)

The article challenges the benefits of certain individual supplements, such as vitamins A or E, which will likely have little, if any, effect when taken in isolation without proper co-factors. The article does recommend one standalone vitamin that should be taken by everyone: vitamin D. We’ve already discussed the importance of vitamin D and the rampant deficiency among children and adults today, so I couldn’t agree more. (Click here for more on vitamin D.) Vitamin D3 can stand on its own and I take it daily; most other vitamins need to be taken together as part of a complete nutritional package.

Eating a whole food and plant-based diet will go a long way toward staying healthy and I strongly recommend we do both. We cannot eat too many dark leafy green vegetables and we should be eating the rainbow (fruits and vegetables that cover every spectrum of color from white to orange, red, green and purple.) But I also take a whole food multivitamin and a whole food raw green superfood powder, because the truth is, it is very difficult to get the nutrients we need from our modern food supply.

These days, to offset the bad fats and processed food sugars we consume and to restore balance within our bodies, we need more vegetables than ever. We are not just eating to fuel our bodies, we are eating to heal our bodies from the inflammation and oxidation of our processed diets. It’s getting harder to get the nutrients we need because in addition to the packaged and prepared foods in our diets, our fresh food supply is not as vitamin rich as it used to be. Soil has been depleted of nutrients, food is sprayed with chemicals and pesticides or is genetically modified to grow bigger or to resist disease, and then it is transported hundreds or thousands of miles to get to our tables.

If you go to a farm or a market and buy fresh produce, you know that after a few days on your counter, it will begin to go bad. Now think about the grapes or tomatoes you are buying from the opposite coast or from South America. They were picked, packaged and then shipped (sometimes by barge) to the U.S., sent out by truck across the country to your local market, displayed on the shelf for several days and then finally taken home.

For the produce to survive that trip looking fresh and beautiful and without bruising, it is heavily sprayed with chemicals, and picked before it is ripe and allowed to mature along the way. Once the fruit leaves the vine, it doesn’t get the sun and the nutrients any longer, it doesn’t fully develop the enzymes and phytonutrients that are usually present in mature fresh picked local produce.

(I’m going to talk about organic versus local and making better food choices soon, but you should also know that many chemicals and pesticides banned in the U.S. are used freely in the foreign countries from which we buy produce.)

Studies estimate more than 50% of nutrient value is lost in the journey from farm to table. So even if you are doing your best to eat a lot of good fruits and veggies, unless you have access to a local farm, it is hard to get food with the nutritional profile you need for health. Then you’d have to eat a lot of it, and how many of us can sit down and eat a bunch of tomatoes or a basket full of kale. You’ll feel full long before you can finish, especially if you paired it with a big piece of meat protein or dairy.

While I fantasize about growing my own food, here in New England, with a long, cold winter and a busy life with two kids and work, it’s not possible at the moment. I do my best to shop at local farmers’ markets for fresh produce, and I buy flash frozen organic produce when I can’t. But despite my best efforts, I do not believe that I can get the nutrition I need without taking a multivitamin (my kids take one too).

But there is a big difference among multivitamins. There are natural organic whole food based products that when manufactured correctly leave the integrity of the whole food intact.

When looking for a good whole food supplement, keep in mind that whole foods are just that: whole foods. Look for ingredients such as carrots, spinach, wheat grass, spirulina, kale, celery etc. There will be vitamins listed as well but their sources will also be present: The original foods from which they were derived. When the ingredient list reads more like a science report than a grocery list, and there are no food sources included just isolated chemicals, it’s typically comprised of manmade synthetic compounds.

Because synthetic vitamins are created in a lab to simulate the real thing, they are often not identical in the way they interact with or are absorbed by the body. They are often missing minerals, nutrients and other requisite co-factors for assimilation. In addition, they often contain cheap fillers and binders from ingredients like sand and titanium dioxide, dibasic calcium phosphate and microcrystalline cellulose, they are ingredients that our bodies cannot absorb and that may even be harmful to us. Many common over-the-counter vitamins are passed through the stool whole and intact. (Centrum is famous for this).

Taking a multivitamin that includes a broad spectrum of vitamins, minerals and nutrients can make a difference, but only if it is bioavailable and bioabsorpable; in other words your body can actually break down and absorb the nutrients. That is not possible with synthetic vitamins. I prefer a whole food-based product that is as close to what I should be eating as possible, and made from the real thing, not created to imitate it.

Interestingly the Readers Digest article’s main argument against taking multivitamins said, “These days, you’re extremely unlikely to be deficient if you eat an average America diet, if only because many packaged foods are vitamin enriched.”

Think about that for a moment.

Food manufacturers strip out all the vitamins that exist in the food during the manufacturing process. Then they “enrich” them, by adding back cheap lab-created imitations. They want us to believe that these created versions are the same as the original, but research shows they are not: You cannot duplicate naturally occurring nutrients from synthetic ingredients. In addition, they will be missing enzymes and cofactors required for assimilation. When I see “enriched” on a food label, I know to stay away.

The truth is that enriched foods do not add vital nutrients to our bodies, nor will synthetic vitamin pills. The best way to get what we need is from the whole food source. Nature intended us to eat vitamins, minerals, trace minerals and phytonutrients together as they work synergistically. When whole food supplements are made the right way, they maintain a multitude of the plants original components and the integrity of the food source. So eat as much good stuff as you can. Buy local when you can, organic if possible. But know that even then, most of us will still need to supplement with a whole food-based supplement to bridge the gap for long term health and wellness.

To your health!

Inger Pols
Editor of New England Health Advisory

P.S. As I mentioned at the top of today’s issue, we are always eager to hear from readers. Besides commenting on our articles, you can also connect with New England Health Advisory on Twitter and Facebook. “See” you there!

There are 206 bones in the human skeleton that support and protect our internal organs and perform a number of important functions. But we rarely give them much thought unless we break one and we have to learn to function without it. When you’re a kid, it can be a cool badge of honor, but as an adult, it can wreak havoc with your life.

A few years ago, I broke my right wrist so severely that I now have a four-inch plate and two screws where my wrist bone once was. I was at the roller rink with my kids when a boy lost control and knocked me over. The accompanying nerve damage was excruciating and learning to bathe, dress, cook and take care of my little kids without the use of my wrist was quite a challenge.

It took me almost a year to fully recover, and as a result, I’m even more conscious of my bone health now.

If you’re struggling with wear and tear on hips or knees or perhaps you’re concerned about bone health and osteoporosis as you age (or you have a friend or family member who is), there is much you can do to prevent and even repair bone damage. Today I’m going to explore how you can avoid drugs, replacement surgeries and debilitating fractures as you age, and have strong healthy bones for life.

How our Bones Work

Our bones are meant to last: Exhumation at burial sites thousands of years old reveals intact skeletons. Ancient societies’ medical records reveal no issues or concerns with bone failure as people age. So what has changed?

Bones are continuously being built up and broken down. In fact, the entire human skeleton is replaced every 10 years. There are two types of cells in the bones needed to complete this task: Osteoblasts, which produce new bone, and osteoclasts, which are responsible for removing damaged or unnecessary cells from the bones. These cells work to structure your bones as you grow, to regulate calcium levels in the blood, and to repair stresses and damage from daily function.

In addition, almost all of our hormones, including testosterone, estrogen, progesterone, cortisol, thyroid hormones and growth hormones have an effect on bones. We hear a lot about women being at risk for osteoporosis post-menopause, when estrogen levels in the body fall; clearly the hormone connection is real.

Osteoporosis occurs when bone tissues thin as we age, resulting in a loss of bone density. But is osteoporosis a problem? Rather, it is the fractures that could potentially result that cause the most concern. Research indicates that there are people with thin bones who never experience fracture and people whose bones are dense who do. So is bone density really the issue, or is it really all about minimizing fractures?

Thanks to aggressive marketing campaigns, everyone knows of the connection between calcium and bone health. I cringe every time I go into my kids’ schools and see posters of athletes and pop stars with white mustaches. The U.S., Australia, New Zealand and most of Western Europe are the largest consumers of dairy in the world. Yet we have more fractures than people from Asia and Africa. In fact, the populations of Africa and Asia consume almost no dairy, but have fracture rates 50%-70 % lower than ours.

Calcium may be important, but clearly it is not enough on its own.

Let’s look at how bones are structured.  Bones are made of an interwoven lattice-like structure: a collagen matrix. This makes up about 35% of the bones and it is what gives bone its flexibility. This matrix forms the base that then traps calcium phosphate, a mineral salt, which is also known as hydroxyapetite. Hydroxyapetite forms about 65% of bone mass and it is what gives bones its strength. Bones are also the depositories of many minerals that the body needs such as sodium, potassium and magnesium.

Tests measure bone density. But if you fall, what determines whether your bones fracture? Is it the density of the bone? If so, why don’t we see that thin bones consistently fracture and that dense bones do not?

Perhaps it’s not how thick the bone is, but rather, how flexible the collagen matrix is and how able it is to support you when you fall or find yourself out of your natural alignment. Caring for bones means more than just calcium; it means ensuring the flexibility of the collagen web.

What About Bisphonates?

Bisphonates such as Fosomax, Actonel and Boniva work in two ways: By preventing bone perforations that can weaken structure and by inhibiting the osteoclasts, the cells that break down old bone. Normal bone processes includes resorption, in which old bone is cleared away. But osteoporosis drugs prevent that process, so the old bone stays around longer.

Instead of a natural process that renews the bone skeleton every 10 years, the old bone is kept around and during the first year, new bone keeps getting built. That’s why many people see such great results short-term from bone building drugs. But after a while, that process peaks and just as the bone resorption stops, so does the bone creation. Somehow the osteoblasts that build bone are repressed by the bisphonates and the natural process is halted.

New research reveals that many people on these drugs have spontaneous fractures that are not trauma related but simply bones breaking while walking up stairs or performing normal daily routines. Ultimately, the old bone buildup and the lack of new bone growth may make the bones even more brittle than they were before!

When we looked at cholesterol, we talked about the “number needed to treat,” or NNT. (Some scientists say anything over 50 is like buying a lottery ticket.) A study of post-menopausal women showed that twice as many of the high-risk fracture group (history of a previous fracture and low bone density) on placebos had a fracture versus those on the drug Fosamax. This study result allowed Fosamax to claim a 50% reduction in fractures. But just as in the cholesterol fine print, we need to dig deeper to understand what that means.

The study shows that 2.2% of the placebo group had a fracture versus 1.1% of the Fosamax group. The net result of risk reduction was 1%. For every 100 women treated, 99 got no benefit. Those 99 would be much better served with diet and exercise changes given all the side effects of these drugs, including irregular heartbeats, increased fractures of the femur (isn’t that what we are trying to prevent?), ulcers and upper GI irritation, joint, bone and muscle pain, and rare but serious jaw bone decay.

So if drugs aren’t the answer, what can we do? The answer lies in exercise and diet.

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Exercise: Get Moving

Weight bearing exercise is critical to bone strength. As a cycling instructor, I paid attention when a cycling magazine reported that they looked at the bones of professional/serious cyclists and found men in their 50s with hip bone density similar to that of elderly women. There is something about the cycling movement that grinds the hipbone and if you ride to excess without weight bearing exercise, it takes its toll on your hips.

Cyclist or not, we all need to walk, run, hike, dance or climb stairs to get exercise. And we should also work on strength training. While lifting weights can be done in a gym, you can also use household or kitchen items and perform body weight exercises such as push-ups.

And since fractures have a lot to do with flexibility, stretching is key. The hip flexor muscle in particular needs to be flexible enough to respond should you fall out of normal alignment. Yoga and tai chi can be helpful, but you can just lie on the floor and stretch at home, too.

Balance training can also be helpful: The better your balance the less likely you are to tumble and encourage fractures. Try standing on one foot without holding onto anything. If that’s easy, close your eyes. Practice over time and your balance will improve: You’ll be able to hold that pose for longer periods of time with greater stability.

Bone-Building Diet Options

The complex interplay of minerals and nutrients for bone health means that dietary answers are not as simple as taking more calcium. Calcium needs approximately 16 other nutrients in order to be utilized by your body and dairy calcium does not deliver those nutrients. So taking dairy as a source of calcium is not helpful unless you also consume a wide variety of plant foods to access those other nutrients. But since calcium can also be delivered through those same plant foods, increasing dairy is ultimately unnecessary.

Calcium is not enough. Collagen and the vitamin C required to make it are critical. In fact, some researchers have suggested that vitamin C is as integral to bone health—or given our deficiencies, perhaps even more so—than calcium. Vitamin C stimulates the enzymes that create the connective tissue and the collagen. But collagen also requires adequate protein for formulation. A deficiency of either one, protein or vitamin C, may weaken the collagen matrix and prevent the calcium salts from being retained.

Man is one of the few mammals that cannot make vitamin C in its liver, so we must ingest all our daily vitamin C requirements. Vitamin C is not stored in the body, so it must be continually replenished.

The prior Recommended Daily Allowance of vitamin C—60 mg—was selected to avoid scurvy, a disease that occurs when we are extremely vitamin C deficient.

Researchers now recommend that we get a minimum of 200 mg of vitamin C a day, though a recent study on college age men showed they needed as much as 1,000 mg a day. 200 should be sufficient for most of us, but getting that amount means at least five servings of fruits and vegetables. We know about citrus fruits like oranges and grapefruits, as well as berries like strawberries and raspberries, but vegetables are good sources of vitamin C as well, without the blood sugar impact. Dark green leafy vegetables like kale, spinach, collard greens and asparagus are all good sources of vitamin C.

Vitamin D is also required for calcium absorption (so we need to get our daily dose of sunshine), as are a host of other minerals including phosphorus, magnesium, boron, copper, manganese, silica, zinc, folic acid and vitamins B12, A and K.

Its best to get these minerals through a whole plant food diet: dark green leafy vegetables, beans, nuts, seeds, seaweeds and some fish. But if you can’t do that, a whole food supplement can help bridge the gap. (Just note that with vitamin C, you will want to consume several smaller doses a day instead of one larger one.) We also need the presence of healthy fats (omega-3s) to perform necessary body functions around vitamin absorption.

Finally, it’s important to know that an overly acidic diet will weaken our bones. Acid creating foods such as alcohol, sugar, flour, grains, meat fish, poultry and eggs pull calcium and other minerals out of teeth and bones. The more minerals there are in a food, the more alkaline it is, so eating fruits, vegetables, seaweeds, salt and other alkalizing foods can help balance out too much acid and support our natural healing and bone repair process.

To your health!

Inger Pols
Editor of New England Health Advisory

P.S. As I mentioned above, humans cannot produce their own vitamin C, so it must come from our diet. It’s one of the most important, yet often overlooked vitamins. Most animals make 4,000 mg to 6,000 mg of vitamin C just to carry out regular functions. While most people are lucky to get 150 mg a day from their normal diet.

Aside from regular maintenance, vitamin C is needed for the production of collagen, which forms the walls of you blood vessels. This makes vitamin C a key player for heart and brain health. It’s also a powerful antioxidant, critical for good skin and vital for healthy bones.

In addition to fighting the action of free radicals, vitamin C reduces inflammation and boosts immune response. To get this vital nutrient, click here.

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The A, B, C’s of Vitamin D

Too Much of a Good Thing?

Not Your Grandmother’s Cod Liver Oil

Winter can be long. Thankfully, here in New England, we do get bright sunny days. (Unlike Detroit where I spent several gray winters craving sunshine due to “lake effect.”) But the days are short and it is hard to get out and experience sunlight if you work a traditional schedule.

I took my kids on vacation for school break this February and it was amazing how much better we all felt once we had some time in the sun. It was not just about being away and relaxing; I felt noticeably better–physically and emotionally -after experiencing the sunshine on my skin.

Vitamin D, the sunshine vitamin, has been getting a lot of press lately, and for good reason. While we have always known it helps with bone health as it facilitates calcium absorption, new research is proving that higher levels of the vitamin have an impact on immune health and protect against cancer, heart health, autoimmune diseases, depression, periodontal disease, diabetes and a host of other conditions.

While adequate levels are shown to be protectors against many conditions, low levels, or deficiencies, are now linked to concerns with these same systems and conditions. Studies now show that vitamin D deficiency is rampant and far more pervasive than previously believed.

Many experts say increasing your vitamin D levels may be the single most important thing you can do to improve your health.

What is Vitamin D?

Interestingly, vitamin D is not really a vitamin; it’s actually a group of prohormones. The two major forms are known as vitamin D2, known as ergocalciferol, and vitamin D3, known as cholecalciferol. Vitamin D is one of the four fat-soluble vitamins, which means it is absorbed with the help of lipids (fats) in the intestinal tract. This means that without adequate fat present, the body will not absorb vitamin D. It also means that unlike water-soluble vitamins, which are not readily stored, excess vitamin D can be stored in fat and muscle tissue for future use.

The vitamin D the body receives from food, supplementation or sun exposure is inert and undergoes two reactions in the body in order to become active. The metabolic product created from this process, calcitrol, is a hormone that is said to target over 2,000 genes. That is about 10% of all human genes; no wonder some call it the miracle cure!

A Return to Rickets

Vitamin D deficiency is so rampant now that a recent report in the British Medical Journal revealed the return of a condition common in Victorian times known as rickets. Rickets is a disease affecting growing children whose bones do not harden or set appropriately due to insufficient vitamin D. This once common condition disappeared in developed countries upon discovery that minimal levels of vitamin D would prevent it, but it has now returned.

A new study recently published in the journal Pediatrics here in America revealed that as many as two-thirds of all children are deficient in vitamin D. Among darker-skinned populations the deficiency is even more rampant, with as many as 92% of black children being deficient and as many as 80% of non-black Hispanic children being deficient.

These numbers are based on the new target minimum of 75 nanomoles per liter (nmol/L).
(Until recently, the standard minimum had been considered 50 nmol/L but many researchers have recently suggested that level be raised.)

According to the Vitamin D Council, however, the recommended minimum vitamin D dosage is actually much higher. They cite recent research that indicates that below 100 nmol/L, the body uses vitamin D up as quickly as it is created. At between 100 and 125 nmol/L, some people begin to store vitamin D, but others do not. At 125 nmol/L, virtually everyone begins to store excess vitamin D in fat and muscle tissue.

The Vitamin D Council considers numbers below 125 to indicate “chronic substrate starvation” and recommends a range of 125-200 nmol/L. (Using these numbers as a baseline, I would venture a guess that virtually everyone tested in that study would be deficient.)

Vitamin D is used to support the immune system and protect against so many conditions that the presence of any health concerns in the body may well warrant a need for an increase in availability. If your body is fighting cancer or heart disease, or looking to recover after a strenuous workout, how much more vitamin D might you need? We don’t yet know those answers, but we can certainly imagine that there might be cases where the body needs much more.

Whether you choose to follow the recommendations of the Vitamin D Council or to be more conservative and follow more traditional guidelines, it is likely that you need to raise your vitamin D levels.

How do I measure my Vitamin D levels?

The only way to reliably know how deficient in vitamin D you might be is to have a simple blood test performed called a 25 hydroxyvitamin D test or a 25 (OH)D. Your doctor can do this easily and most insurance plans should cover it. Many doctors will still consider significantly lower numbers to be acceptable (keeping up with the emerging research can be a full-time job and your doctor already has a full-time job); if so, it will be up to you to share information and partner with your physician to find the right level for you.

If your physician will not test you for vitamin D, you can order a test from the Vitamin D Council on its Web site. You complete the test and mail it back for accurate results (in all states but New York, which prohibits testing of specimens collected in or mailed from New York and prohibits data transmission from the lab to New York physicians or residents.) The test costs $65–or $220 for four if you want to test periodically or test more than one family member.

The tests will tell you your current levels, but from there you will need to figure out how much supplementation you require to get you to where you want to be.

How much vitamin D do I need?

Generally speaking, we know that the darker your skin, the bigger you are and the less daily sunshine you receive, the more you will need.

While current FDA guidelines suggest a vitamin D level of 400 International Units, or IUs, per day, many researchers and physicians have increased their suggested optimal adult vitamin D level to around 5,000 IUs per day. I have also seen a formula used that indicates a body needs 35 IUs per pound of body weight, which allows for variance for children and heavier people.

Supplementation at the 5,000 IU level has been shown to bring vitamin D into the desired nmol/L range for many people. But because vitamin D is used to fight cancer, regulate the immune system and myriad other functions, there can be a need for much more depending on what is going on in your body. Some studies have revealed that certain individuals need as much as 25,000 to 30,000 IUs just to reach a consistent rate of 125 nmol/L!

Vitamin D needs are individual and must be customized. That’s why it is recommended that you test in order to be sure your supplementation is adequate for your own body’s needs.  It is recommended that you begin supplementation first and consume vitamin D regularly for two to three months before you have your levels tested in order to see how effective your dosing is for you. (If you feel more comfortable testing first, that’s fine. Just know that you may need to test several times in the process.)

Unless your climate remains constant year round, you will probably want to test in summer and in winter to get a sense of the shifts in your body and how the season changes affect your dosage levels. People who avoid the sun as well as those with darker skin pigmentation will likely need to increase their dosage, especially in winter.

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Too Much of a Good Thing?

According to the Vitamin D Council, even at the new recommendation of 125-200 nmol/L (much higher than most doctors will be familiar with), those ranges are still very conservative. But because excess Vitamin D is stored in fat and muscle tissue, there have been concerns about toxicity from over consumption.

While we should always be aware of such possibilities–and that is yet another reason to work with your doctor and get tested regularly–the risk of toxicity is much less than previously believed. Because the body is geared to produce very high levels of vitamin D from our daily sun exposure, we have the capacity to absorb very high levels.

Typical summer sun exposure of 20 minutes (without sunscreen and with face, arms and legs uncovered) yields 20,000 IU of vitamin D. We didn’t have sunscreen until recently; our bodies were built to be in sunlight for much of the day (building up our sun exposure to prevent burning of course.) So we are engineered to produce and absorb very high levels of vitamin D. And we also have a built-in safety mechanism: After the body produces about 20,000 IUs of vitamin D, the sunlight, begins to break it down, preventing the body from excess. And once we are tan, the body naturally adjusts and makes less, producing only about 10,000 IUs.

But oral consumption is different: Can we overdose on vitamin D? While pharmacological overdoses of vitamin D2 have been documented, the same is not true for vitamin D3. Research conducted to determine toxic excess in animals revealed that the dose of vitamin D3 it takes to kill half the animals when tested in dogs was about 3,520,000 IU/kg. (Yes, sorry, they did in fact test this on animals.) That is estimated to be about 176,000,000 IUs taken by a 110-pound human.

Leading researcher Dr. Reinhold Vieth suggests that toxicity may possibly begin to occur after chronic daily consumption of 40,000 IUs a day. Clearly there is a great deal of room between the minimum guideline of 5,000 IUs and long-term daily consumption of 40,000 IUs.

Vitamin D Co-Factors

The body needs several substances to utilize vitamin D appropriately.  These co-factors include magnesium, zinc, boron, vitamin K2, genestein and a small amount of vitamin A.

I believe many people are magnesium deficient (because calcium and magnesium partner together and so many people supplement calcium but neglect magnesium–I’ll discuss magnesium more in a future newsletter) and because of that, magnesium is an important consideration in vitamin D supplementation.

If you struggle with reaching optimal vitamin D levels after supplementation, a magnesium deficiency could be the reason why. At the same time, as you supplement with vitamin D, any existing magnesium deficiency could be exacerbated.

So paying attention to the co-factors, especially magnesium, is an important component of successful vitamin D absorption.

Walking on Sunshine

The best way to increase vitamin D in your body is through sunshine. Exposed skin in summer sun for 20 minutes will give your body its daily dose. But unless you live in southern Florida, you won’t be able to get what you need year-round from sunlight alone and you’ll need to supplement, at least during winter months.

Tanning Beds

Tanning beds emit both UVA and UVB rays. However, the body is only interested in the UVB rays for vitamin D synthesis. UVB rays are shorter and affect the surface layers of the skin and as a result, can cause sunburns. The dark tans that come from tanning beds result mostly from UVA rays. Therefore, most tanning salons calibrate their beds to produce mostly UVA rays (often as high as 95% UVA) and minimal UVB.

Not Your Grandmother’s Cod Liver Oil

It is possible to get vitamin D from foods such as salmon (wild sockeye is best; not farm raised), mackerel, herring, sardines and catfish. But a standard portion of these foods will only yield about 250-350 IUs, so you’ll have to eat a lot!

Grandmother’s remedy of a tablespoon of cod liver oil is a highly effective form as well; it yields 1,360 IUs.  (Many companies now flavor the oil with lemon or orange so that the taste is not like what you might remember; my kids will even eat it and they can choose between oil and pill form.)

Choose a brand that has been tested and found to remove contaminants such as mercury and PCBs, which can be present in fish.

Cod liver oil, however, also contains vitamin A, another fat-soluble vitamin that some suggest has toxicity concerns at high doses.  I believe that in time research will show that–similar to vitamin D–high doses of vitamin A from natural sources are safe. For now, if you have concerns about excessive vitamin A, rather than quadrupling the dosage of cod liver oil to get to 5,000 IUs, you’ll want to consider D3 supplementation through pills, sprays or oils.

Studies show that vitamin D2 is only about 20%-40% as effective in supplementation as vitamin D3. Many over-the-counter vitamin D supplements–and virtually all prescription forms–contain vitamin D2. But D3 (cholecalciferol) is widely considered to be a more effective source, so read the label carefully.

And don’t be afraid of 15-20 minute breaks in the sun without sunscreen (we’ll talk about the myth that it will cause skin cancer in another newsletter). You will feel energized and renewed and many systems in your body will be thankful.

To your health!

Inger Pols
Editor of New England Health Advisory

P.S. As Inger mentioned above, cod liver oil is an excellent source of one of nature’s most important nutrients: Vitamin D. Things have changed a lot since your grandmother used to give you a tablespoon full–there’s no fishy after taste and most capsules have a pleasant lemon/lime flavor. You owe it to yourself to try this time-tested vitamin today–it can help you fight diseases and live a healthier life! Click below to find out more!

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