Disease Proof

Here are two great tips for building strong healthy bones. From AOL’s Your Health:

Best Foods for Calcium: You're not limited to milk for calcium, as there are plenty of foods that are calcium-fortified naturally. Two ounces of swiss cheese provides 530 mg of calcium, more than twice the amount in 6 ounces of milk. You'll get 240mg of calcium from two ounces of sardines, two stalks of cooked broccoli gives you 250mg, six ounces of cooked collard greens provide 225mg and three ounces of almonds contains 210mg. Other sources: fermented soy products like natto, dried raw figs, rhubarb, pinto beans, turnip greens, and kale.

Exercise, Best Bone Builder: Adults who exercise regularly are able to maintain a good balance between bone-building and bone-dissolving processes in the body. Exercise also limits bone loss during old age. And it's never too late to start -- President Ronald Reagan began weight training at age 82. Most experts recommend a combination of weight-bearing exercise (walking, jogging) and muscle-building exercise (weight training). Remember to work all the major muscles -- that means chest, shoulders, arms, legs and back.

Strong bones are important, but swiss cheese isn't—yuck!. Anyway, check out this DiseaseProof mini-series on bone health:

• Can Your Bones Last a Lifetime: Osteoporosis is Not a Natural Consequence of Aging
  
• Can Your Bones Last a Lifetime: The Nutritional Causes of Bone Loss
• Can Your Bones Last a Lifetime: Benefits of Vitamin D
• Can Your Bones Last a Lifetime: Exercising Wisely to Strengthen Bones
• Can Your Bones Last a Lifetime: Weighted Vests for Women

Over the last few years, the health benefits of seeds also have become more apparent. A tablespoon of ground flaxseed, hempseeds, chia seeds, or other seeds can supply those hard-to find omega-3 fats that protect against diabetes, heart disease, and cancer.1 Seeds are also rich in lignans, a type of fiber associated with a reduced risk of both breast cancer and prostate cancer. In addition, seeds are a good source of iron, zinc, calcium, protein, potassium, magnesium, Vitamin E, and folate. The plant goes to great effort in producing and protecting its seed, filling each genetic package with high concentrations of vitamins, minerals, proteins, essential oils, and enzymes.

I’m no bird, but I eat a lot of seeds—sesame, flax, and sunflower—daily.

A new study claims folate may help prevent heart damage. Reuters reports:

Folate-treated rats experienced significantly less functional impairment of the heart than did the placebo-treated animals, senior author Dr. David A. Kass, from Johns Hopkins Medical Institutions in Baltimore, and colleagues found. On reperfusion, smaller areas of dead heart muscle were also noted in the animals pretreated with folate.

Further analysis suggested that folate may have achieved these beneficial effects, in part, by maintaining levels of the high-energy phosphates ATP and ADP in the heart.

"We want to emphasize that it is premature for people to begin taking high doses of (folate)," Kass said in a statement. "But if human studies prove equally effective, then high-dose folate could be given to high-risk groups to guard against possible heart attack or to people while they are having one."

Ladies are looking to keep your bones strong? Health offers up a Fuhrman-friendly tip:

Estrogen helps your bones absorb calcium and enables your body to use calcium more efficiently. A few weeks of dieting are thought to be harmless; any bone mass lost is likely reversible, says Robert Lindsay, M.D., Ph.D., a past president of the National Osteoporosis Foundation. But several months or longer could be harmful.

What should you eat? Foods that help you reach the daily recommendation of 1,000 milligrams of calcium-but you don't have to count on dairy if you're worried about fat. Collard greens (179 mg of calcium per serving), kale (90 mg), broccoli (90 mg), and almonds (71 mg) are great calcium sources. Supplements can be helpful, too, but don't ignore this: Diets loaded with fruit and veggies are linked to a lower incidence of osteoporosis.

I guess all we need is a great source of both folate and calcium. Dr. Fuhrman’s got one:

Asparagus is one of the most healthful foods on the planet. It leads nearly all fruits and vegetables in the wide array of nutrients it supplies. Ten ounces (one box of frozen spears) have only 68 calories and 9 grams of protein, yet it is like a vitamin pill, giving you a variety of minerals such as selenium, zinc, calcium, copper, and manganese. Plus, it is very rich in folate.

Sure, there are others, but come on—ASPARAGUS ROCKS!

Personally, I’m beyond nuts—probably certifiable at this point—anyway, MSN Health & Fitness tells us why nuts are great for our health. Take a look:

Almonds: A June 2006 study in the Journal of Agricultural and Food Chemistry showed an ounce of almonds provides as many flavonoids—compounds that fight free radicals and reduce inflammation—as a 1⁄2-cup serving of broccoli or a cup of green tea.

Walnuts: Walnuts contain alpha-linolenic acid (ALA), an omega-3 fat linked with reduced risk of heart disease, improved glucose control and, most recently, stronger bones. In a study of 23 overweight people published earlier this year in Nutrition Journal, increasing intake of ALA via walnuts and flaxseed oil decreased the rate of bone breakdown.

Pecans: Last year in Nutrition Research, researchers from Loma Linda University reported that pecans contribute significant amounts of gamma-tocopherol, the major form of vitamin E in U.S. diets. Pecans also provide notable amounts of zinc, a mineral most often found in animal-based foods.

Pistachios: Research presented earlier this year at an Experimental Biology conference suggests that lutein, an antioxidant in pistachios, helps protect "bad" LDL cholesterol from oxidization by free radicals. Oxidized LDL contributes to the development of plaque in arteries.

Fantastic! All four of these are delicious. Now, We Like it Raw passes along this awesome video. Here’s how to make your own nut milk. Enjoy:

I’m a big fan of nut milk. My favorite is almond milk. In fact, here’s the one that’s in my refrigerator right now. Check it out:

Almond Breeze is a non-dairy beverage made from real almonds, all natural, smooth and creamy with a hint of almonds. Almond Breeze is a great tasting non-dairy beverage without the thin, chalky after taste of rice and soy beverages.

Almond Breeze won the 2004 Best Taste Award from the prestigious American Culinary Institute (ACI). ACI is an independent, chef based judging organization.

Enjoy Almond Breeze chilled by the glass and on your cereal. You will love how it froths in coffee drinks, enhances fruit smoothies, and blends cup for cup in your favorite recipes.

• Gluten, cholesterol and lactose free
• Excellent source of calcium, vitamins D & E
• Good source of vitamin A
• A refreshing alternative to soy and rice non-dairy beverages

Do any of you drink almond milk? Ever try this one?

Do you get your Vitamin D? Hopefully you do because according to Dr. Fuhrman it’s a pretty important vitamin with a very vital function. He explains in the Importance of Vitamin D:

Vitamin D is a fat-soluble vitamin that your body makes after exposure to ultraviolet (UV) rays from the sun. Vitamin D functions as a hormone because it sends a message to the intestines to increase the absorption of calcium and phosphorus. By promoting calcium absorption, vitamin D helps to form and maintain strong bones.

Not to mention it’s instrumental in the maintaining of strong healthy bones. Dr. Fuhrman talks about this further in Can Your Bones Last a Lifetime: Benefits of Vitamin D:

Medical studies show taking vitamin D is more effective than taking extra calcium for osteoporosis. In a recent 3-year prospective multi-center study, 622 women with osteoporosis, 50 to 79 years of age, who had one or more compression fractures of their spine, were randomly assigned to receive 25 mcg of calcitriol (900 IU vitamin D) or 1000 mg calcium for three years. In the third year, the vitamin D-supplemented group had 9 fractures per 100 women, and the calcium-treated group had 31.5.The difference in effect also was evident after two years.

Apparently he must be on to something because new research links Vitamin D intake to physical performance levels in the elderly. Eric Nagourney of The New York Times reports:

The researchers, led by Denise K. Houston of Wake Forest University, drew on data from an Italian study in which more than 900 people 65 and older were tested for vitamin D levels and asked to perform several tasks. The researchers looked at how fast they walked, how quickly they could get out of a chair and how well they could balance.

By some estimates, about a quarter of elderly people do not get enough vitamin D. But it is not purely a matter of diet, the researchers said, because much of the body’s vitamin D comes from exposure to sunlight. Older people may be less likely to be in the sun, said the researchers, who also pointed out that skin produces vitamin D less well as it ages.

Now, it isn’t just older people who need to be mindful of how much Vitamin D they’re getting. Dr. Fuhrman insists everyone should make sure they’re getting enough. From Vitamin D and Cancer:

Laboratory, animal, and epidemiologic evidence suggests that vitamin D may be protective against cancer. Epidemiologic studies suggest that a higher dietary intake of calcium and vitamin D, and/or sunlight-induced vitamin D synthesis, correlates with lower incidence of cancer, including lymphoma, breast, prostate, and colon cancer.1 In fact, for over 60 years, researchers have observed an inverse association between sun exposure and cancer mortality,2 and those with more sun exposure had fewer cancers. The inverse relationship between higher vitamin D levels in blood and lower cancer risk in humans shows a significantly lower risk among those with the highest vitamin D intake.

From the March 2005 edition of Dr. Fuhrman's Healthy Times:

For years, I have been advising thin women to wear and exercise with a weighted vest. Weighted vests can be worn for hours each day and are the most effective prescription a doctor can order to prevent and even treat osteoporosis. The problem in the past has been finding the best vests that are designed for women and have the weights in the right place to strengthen the back bone and keep the spine erect. It is important that the weights are positioned predominantly in the back pack area so that the weight is felt on the shoulders in order to stimulate bone development in the spine.

Frustrated with the commercially-available vests—bulky, stiff, unattractive, and cumbersome, with the weights around the waist instead of around the upper chest—Pamela Free (a member of DrFuhrman.com) designed a new vest that meets my specifications and offers the cushioning and comfort that women require. (These new vests are available from our online store.)

Women can start with just a little weight of 6-8 pounds and gradually increase the weight (up to ten percent of your body weight) to strengthen their bones, not only during exercise, but as they work, shop, bend, stand up, and move all day. Wearing a weighted vest has other benefits as well, such as burning more calories all day, increasing core strength, and stabilizing muscles, thus improving balance and decreasing the risk of falls.

Here’s more on this topic:

• Can Your Bones Last a Lifetime: The Nutritional Causes of Bone Loss
• Can Your Bones Last a Lifetime: Osteoporosis is Not a Natural Consequence of Aging
• Can Your Bones Last a Lifetime: Benefits of Vitamin D
• Can Your Bones Last a Lifetime: Exercising Wisely to Strengthen Bones

From the March 2005 edition of Dr. Fuhrman's Healthy Times:

Rather than letting your bones weaken as you age, you can strengthen them and keep them strong.

Our bones are composed of a porous network of calcified bridges called a trabecula network, which under an electron microscope looks like the inside of a sponge. This network of connecting bridges continually breaks and rebuilds with normal wear and tear as a result of the activities of daily living.

When use and weight-bearing activities are increased, many of these bridges break, but then are rebuilt—thicker and stronger. In fact, they grow and thicken in response to the stresses placed on them. With little muscle stress on the joint, they lose density and become thin and fragile. The strength and density of bone over time is directly proportional to the muscle strength moving that fulcrum. Just as muscles build with regular exercise, the bone strengthens too, right along with the muscle. In fact, a good test for bone strength is muscle strength.

Unfortunately, most women in America and other modern countries have relatively sedentary lives. Even women who do regular exercise and walk are susceptible, since most popular exercises do not adequately stress the spine with enough stimuli for bone growth. Having a healthy, erect spine is extremely important for digestion and overall health. Activities that exercise and strengthen the spine include digging, shoveling, carrying toddlers, using rowing machines, and doing back extension exercises. Scientific studies also have demonstrated that wearing a weighted vest can have a powerful protective effect.1

Here’s more on this topic:

• Can Your Bones Last a Lifetime: The Nutritional Causes of Bone Loss
• Can Your Bones Last a Lifetime: Osteoporosis is Not a Natural Consequence of Aging
• Can Your Bones Last a Lifetime: Benefits of Vitamin D
• Can Your Bones Last a Lifetime: Weighted Vests for Women

From the March 2005 edition of Dr. Fuhrman's Healthy Times:

Because vitamin D increases the absorption of calcium in the gastrointestinal tract and stimulates osteoblastic (bone-building cells) activity, vitamin D has been generating lots of interest lately in the medical literature. Borderline low levels of vitamin D have been found to be very common in the United States and Canada.

Medical studies show taking vitamin D is more effective than taking extra calcium for osteoporosis. In a recent 3-year prospective multi-center study, 622 women with osteoporosis, 50 to 79 years of age, who had one or more compression fractures of their spine, were randomly assigned to receive 25 mcg of calcitriol (900 IU vitamin D) or 1000 mg calcium for three years. In the third year, the vitamin D-supplemented group had 9 fractures per 100 women, and the calcium-treated group had 31.5.The difference in effect also was evident after two years.

The take-home message here is that curtailing habits that cause calcium wasting in the urine and monitoring vitamin D for adequate intake are more important than taking extra calcium. Attention to vitamin D status is most critical in those not getting regular sunshine. The most effective prescription for preventing and reversing osteoporosis involves diet-style modifications, extra vitamin D intake, and an effective exercise program.

Here’s more on this topic:

• Can Your Bones Last a Lifetime: The Nutritional Causes of Bone Loss
• Can Your Bones Last a Lifetime: Osteoporosis is Not a Natural Consequence of Aging
• Can Your Bones Last a Lifetime: Exercising Wisely to Strengthen Bones
• Can Your Bones Last a Lifetime: Weighted Vests for Women

From the March 2005 edition of Dr. Fuhrman's Healthy Times:

Low intake of calcium is not the main factor resulting in osteoporosis. In spite of the world’s highest intake of calcium, American women have one of the highest hip fracture rates in the world. This is not merely due to inactivity and lack of hard physical labor. It is also due to factors that accelerate the loss of calcium in the urine. Controlling the factors that work together to leach calcium from the bones and increase calcium in the urine (by reducing and eliminating them) is much more important than taking extra calcium. Osteoporosis is so prevalent because the vast majority of Americans eat a diet that is low in vegetables and high in animal products, sugar, salt, and caffeine.

In order to adequately protect your bone stores of calcium, animal protein consumption must be limited to 15 ounces per week or less, and salt consumption should be under 1200mg per day. Caffeine, refined sweets, and vitamin A supplements should be eliminated.

Here’s more on this topic:

• Can Your Bones Last a Lifetime: Osteoporosis is Not a Natural Consequence of Aging
• Can Your Bones Last a Lifetime: Benefits of Vitamin D
• Can Your Bones Last a Lifetime: Exercising Wisely to Strengthen Bones
• Can Your Bones Last a Lifetime: Weighted Vests for Women

From the March 2005 edition of Dr. Fuhrman's Healthy Times:

Just as with heart disease, a great many Americans expect osteoporosis to occur as a natural consequence of aging. There is nothing natural about having a heart attack. Neither is it natural to break a few bones from coughing, hugging, or bending over. It certainly is not natural for your spine to collapse, creating pain and loss of your health, and it is not natural for your back to become painful, rounded, and humped for the rest of your life. It is not natural to grow so weak and frail that you fall and suffer a hip fracture.

Unfortunately, natural or not, more than 300,000 hip fractures occur each year, and more than 10 million American women suffer from osteoporosis. The lifetime risk of a hip, spine, or forearm fracture is nearly 40 percent among 50-year-old Caucasian women and more than 13 percent among Caucasian men.

Osteoporosis happens because of a combination of nutritional factors that accelerate calcium loss in the urine, low stores of vitamin D, and lack of weight-bearing exercises and core body strength.

Here’s more on this topic:

• Can Your Bones Last a Lifetime: The Nutritional Causes of Bone Loss
• Can Your Bones Last a Lifetime: Benefits of Vitamin D
• Can Your Bones Last a Lifetime: Exercising Wisely to Strengthen Bones
• Can Your Bones Last a Lifetime: Weighted Vests for Women

Salt, when you hear the word, what thoughts come to mind? “Too much salt is bad for me.” Or, “That reminds me, I’ve got to check my bid on Ebay for that Elvis salt & pepper shaker set that I simply must have.” Heck, maybe you even have one of these lines, “My grand daddy lived to the ripe ole’ age of ninety-six and he put salt on everything from pasta to pickled pigs feet.”

That pretty much sums up salt’s MO. Lot’s of people who think it’s bad and limit their exposure to it, and then there are others who dump it on everything. As for Dr. Fuhrman, he’s no fan of salt. In fact, he considers it to be one of the seven worst foods for health and longevity. Here’s all seven:

• Butter
• Cheese
• Potato Chips and French Fries
• Doughnuts
• Salt
• Sausage, hot dogs
• Pickled, smoked or barbequed meat

Atkins rivals the creativity of the raw-food chefs of today in his uses for pork rinds. Pork rinds are chunks of pigs’ skin that are deep-fried, salted and artificially flavored. He recommends people use them to dip caviar. Or, perhaps for those who can't afford caviar, one can use fried pork rinds as a "substitute for toast, dinner rolls...You can use them as a pie crust... or even matzo ball soup (see our recipe on p. 190)."[144] Matzo balls made out of pork rinds?--now that is a diet revolution!

You’ve got to wonder about recommendations like this, especially since according to Dr. Fuhrman salt consumption has been linked to the development of stomach cancer and hypertension. Consider this excerpt from Eat to Live:

Any excess salt added to food, outside of what is contained in natural foods, is likely to increase your risk of developing disease. Salt consumption is linked to both stomach cancer and hypertension.1 For optimal health, I recommend that no salt at all be added to any food. The famous DASH study clearly indicates that Americans consume five to ten times as much as they need and that high sodium levels over the years has a predictable effect on raising blood pressure.2 Just because you don’t have high blood pressure now doesn’t mean that you won’t. In fact, you probably will have high blood pressure if you keep eating lots of salt over the years.

So, what happens when dangerous diet information is put out there? The masses eat it up. For example, from Livin’ La Vida Low-Carb here’s Jimmy Moore’s take on salt:

Unless you are salt-sensitive (and it just so happens that I am!), there is no reason why you should watch your salt intake. An overwhelming majority have no reason to cut down on their salt intake. NONE! The fact that a minority of the population has sensitivity to salt should not make this a universal recommendation.

Luckily for Jimmy, he’s “salt-sensitive.” So he is limiting his exposure to it, but saying that the majority of people have no reason to avoid salt, well, that seems a little misguided because in addition to the hypertension and stomach cancer risk, Dr. Fuhrman associates salt intake with osteoporosis and heart attacks. More from Eat to Live:

Salt also pulls out calcium and other trace minerals in the urine when the excess is excreted, which is a contributory cause of osteoporosis.3 If that is not enough, high sodium intake is predictive of increased death from heart attacks. In a large prospective trial, recently published in the respected medical journal The Lancet, there was a frighteningly high correlation between sodium intake and all cause mortality in overweight men.4 The researchers concluded, “High sodium intake predicted mortality and risk of coronary heart disease, independent of other cardiovascular risk factors, including high blood pressure. These results provide direct evidence of the harmful effects of high salt intake in the adult population.”

Now these dangers are clear, but arguably the biggest problem with salt is it shows up where you least expect it to. Sure, you can crack down on your habit of burying every meal in it, but, that’s only half the battle. Sally Kuzemchak of Prevention magazine explains that the main problem with salt is that it’s everywhere:

It's crammed into cheese slices and canned vegetables and sprinkled into cinnamon-raisin bagels and sandwich bread. You can consume a day's worth of the mineral with an order of mu shu pork with rice from your local Chinese restaurant, according to an analysis by the consumer group Center for Science in the Public Interest, in Washington, DC. As much as 80% of the sodium we get every day comes from these processed and prepared foods—not the salt shaker.

Sally also points to additional research highlighting the dangers of high-sodium diets:

There's also evidence to suggest that high-sodium diets may up the risk of gastric cancer. And in a small study from Colorado State University, a high-salt diet (more than 5,000 mg per day) worsened lung function in people with exercise-induced asthma, which occurs in as many as 90% of asthmatics. A low-salt diet improved it.

Information like this really makes you wonder how Dr. Atkins could endorse eating salty snacks like pork rinds. Now, the concern over people’s salt exposure is growing. Back in September Melanie Warner of The New York Times reported that the American Medical Association wants the government and the food industry to limit the amount of salt that can be used in food production. More from the report:

Specifically, the medical association, which had never before called for regulation of a food ingredient, asked the F.D.A. to revoke salt’s long-time status as a substance that is “generally recognized as safe,” a classification that warrants little oversight. Instead, the F.D.A. should regulate salt as a food additive, the medical group said.

If the recommendation were adopted, packaged-food companies would have to adhere to limits on allowable sodium levels for various categories of food, and speed up the search for an alternative to salt as a preservative and flavor enhancer.

What I take away from all this is more evidence of people’s emotional attachment to food, in this case salt; when you talk with Dr. Fuhrman he often refers to this phenomenon. Sometimes people are so blinded by their emotional crush on certain foods that they can’t face facts. The evidence shows that salt is bad for us, but, I guess some people just can’t stand the thought of a lonely pepper shaker.

Written by Dr. Fuhrman’s colleague Anna Quisel, M.D. for the July 2003 edition of Healthy Times:

As a woman and a breast-feeding mother, I almost feel guilty when someone asks, “You don’t drink milk? How do you get your calcium?” As people learn more about the problems associated with osteoporosis, interest in calcium is skyrocketing. That’s the good news. The bad news is that the dairy industry has done a terrific job of promoting dairy products as the only adequate dietary source of calcium. Dairy products are far from the solution, and may very well be a cause of the problem.

Adequate amounts of calcium are necessary for high-level health. Calcium is necessary for heart muscle contraction, skeletal muscle contraction, the action of most hormones in the body, and bone strength. Because calcium is so crucial to survival, our bodies carefully regulate the amount of it in our blood. We even have a back-up reservoir of calcium available at all times—our bones.

Calcium reservoir
To keep a constant level of calcium in the blood, our bodies are continually adding and removing calcium to the bloodstream. When there is extra calcium in the bloodstream, the body removes some of it and stores it in the bones. When there is too little, the body takes calcium from the bones and adds it to the bloodstream.

It works like this: When serum calcium levels fall, a hormone called parathyroid hormone, produced in four small glands attached to the thyroid gland, stimulates osteoclasts. The osteoclasts break down bone and release calcium. When calcium is plentiful, a hormone called calcitonin, made in the thyroid, stimulates osteoblasts, cells that store calcium by building bones.

For a long time, scientists thought this was the whole story—if you don’t get enough calcium, your body will withdraw calcium from your bones, and eventually you will develop osteoporosis. But the story is turning out to be more complex.

High intake, weak bones
Much to the chagrin of the dairy industry, scientists have discovered that more calcium isn’t better. In fact, the countries around the world with the highest rates of calcium intake—including the U.S. and Canada—have the highest rates of hip fractures among the elderly. The largest source of calcium in these countries is dairy products. In one of the largest studies of diet and health ever undertaken in the U.S., the Nurse’s Health Study, researchers found that high total calcium intake and milk consumption did not protect against osteoporotic fractures.1 In a comprehensive review of all studies of dairy intake and bone strength in 2000, researchers concluded “that the body of scientific evidence appears inadequate to support a recommendation for daily intake of dairy foods to promote bone health in the general U.S. population.”2

Japanese women have lower total calcium intake than U.S. women at about 400-500 mg per day from soy products, vegetables, and small fish bones—yet they have lower rates of hip fracture despite having smaller bones.3 So high calcium intake alone, especially when the source of calcium is dairy products, does not ensure bone strength. Even bone mineral content (the amount of calcium- phosphate in bones) does not necessarily determine risk of fracture. This mineral-content finding is very important because physicians currently assess risk for bone fractures using x-ray measurement of bone mineral content.

Building strong bones
Adopting an Eat to Live-style diet is crucial for strong bones. Vegetables, beans, fruits, and nuts are the best sources of calcium, potassium, vitamin K, magnesium, and vegetable protein, as well as the phytochemicals (such as isoflavones) and micronutrients that are gaining recognition as important for bones. Keep in mind that the current U.S. daily calcium recommendation of 1200 to 1500 mg for postmenopausal women is an attempt to offset the ill effects of the typical vegetable-and nutrient deficient American diet, which is laden with salt, caffeine, and junk-food. Sadly, even this attempt to flood the body with extra calcium to compensate for poor nutrition has not been proven to prevent fractures.4 (Check out Get Some Veggie Calcium for good sources of calcium.)

Weight bearing and resistance exercise are extremely important to bone strength, and can reverse osteoporosis even in postmenopausal women.5 Walking is particularly important to hip bone strength.

Vitamin D might be more important to bone strength than calcium. Vitamin D promotes the uptake of calcium from the intestines and also increases bone building. The sun is probably our best source of vitamin D. Vitamin D needs are probably met with 15 minutes of exposure in the middle of the day three times per week. Many studies have shown that vitamin D supplements increase bone density in postmenopausal women; however, a recent comprehensive review of the subject determined that the efficacy of vitamin D supplements had not been proven.6 If you haven’t had your vitamin D blood levels checked, you might consider it so that you can increase your sun exposure or add a supplement if necessary.

Avoid toxins. The ingestion of animal protein—especially when combined with low vegetable intake, steroids, caffeine, cigarettes, vitamin A (retinol—found only in animal foods, fortified foods, and vitamin pills), and salt all have been associated with weak bones.

It’s always a bit unnerving when you read stuff like this, especially since so many people in this country take antidepressants. But according to a new study, many top-selling depression medications might increase the risk of bone breaks in older people. Lindsey Tanner of the Associated Press reports:

People aged 50 and older who took antidepressants, including Zoloft, Prozac and other top-sellers, faced double the risk of broken bones during five years of follow-up, compared with those who didn't use the drugs, the study found…

…Research in animals suggests that the pills might have a direct effect on bone cells, decreasing bone strength and size, said Dr. David Goltzman, an endocrinologist at McGill University in Montreal and colleagues said.

Goltzman stresses the serious implications of these findings because millions of people take antidepressants, and, older people are already at risk for osteoporosis, a bone-weakening disease—quite the dubious double-whammy.

Now, this reminds me of all the reports from back in December linking acid suppression medication to heightened risk of hip fractures. Here's one from ScienceDaily:

Potent acid suppressive medications such as PPIs have revolutionized the management of acid-related diseases. Millions of individuals have been using these medications on a continuous or long-term basis, according to background information in the article. Some research has shown that PPI therapy may decrease insoluble calcium absorption or bone density in certain patients. These factors could increase the risk for hip fracture, which has a death rate during the first year after the fracture of 20 percent. Among those who survive this period, 1 in 5 require nursing home care and often an emergency department visit, hospitalization, surgery, and rehabilitation, with huge health care costs.

So, in case you’re worried about the potential dangers of acid medication, consider Dr. Fuhrman’s thoughts on the matter. From September 2005 edition of Healthy Times:

Bone strength is directly proportional to muscle strength, and bone health requires a lifetime commitment to regular exercise and physical activity. Inactivity or bed rest can be disastrous to the bones. Go to the gym, walk, wear a weighted vest, do back exercises, work in the garden, and stay involved with sports or fitness pursuits appropriate to your ability and health. Nutritional excellence is vitally important, and cannot be replaced by supplements. Taking supplements is merely an adjunct to other critical lifestyle factors that reduce risk.

Okay back to the issue involving antidepressants. Is there a safer way to help treat depression, one that doesn’t emphasize the popping of pills? More from Dr. Fuhrman’s Healthy Times, this time the March 2006 edition:

Nutrition and Mood Disorders
With over a million prescriptions for antidepressants being filled each week and annual sales of 11 billion dollars at stake, it is unlikely that a new protocol for depressed people will emerge in America. Money usually dictates direction in the medical/drug/insurance industry. However, the conflict and controversy over the dangers of psychotropic medications used for depression, and the recent cardiac-related deaths from Ritalin prescribed for ADHD, are calling attention to the all-too-cozy relationship between government agencies and the drug industry. The public no longer can trust the validity of drug-related information that comes from even such formerly respected sources as medical journals and universities. These institutions depend increasingly on pharmaceutical dollars (advertising and grant monies), and this has led to numerous instances of inaccurate reports that conceal evidence and promote drug use.

Treating Depression Naturally
It is clear that people are more prone to depression and other diseases when their intake of high nutrient-containing plant food is low. It also has been shown that the response to medication and other therapeutic intervention can be suboptimal when antioxidant nutritional status is inadequate.1 Whenever we measure low levels of vegetable-derived nutrients, we find depression more prevalent. For example, low folate intake and low folate blood levels have been shown to correlate with depression.2 Low folate in the bloodstream is a marker for low fruit and vegetable intake. Deficiencies of folate, vitamin B12, iron, zinc, and selenium tend to be more common among depressed than non-depressed persons.3

Natural therapies are surprisingly effective. Recent advances in non-pharmacologic treatments for depression can help people feel better—and even assist them in making total recovery—without dependence on medications. Researchers doing the studies in this field have been surprised to find that natural therapies can have very high success rates, rivaling those of drugs. Of particular interest is the fact that these non-pharmacologic treatments get results faster than drug treatments. Now is the time for all people with depression to give these safe, natural treatments a try. By combining the most promising facets of these approaches, the likelihood of improvement and recovery is greatly enhanced.

• Shankar Vedantam of The Washington Post takes a look at the idea of preventing mental decline:

The idea of preventing Alzheimer's and other forms of mental decline is immensely attractive -- and there is some early evidence that this may be possible. Recent research, including an article published two weeks ago in the Journal of the American Medical Association, shows that boosting mental skills with simple exercises can help slow the rate of decline as people age.

• Can your level of education determine how long you live? Gina Kolata of The New York Times reports:

Dr. Lleras-Muney and others point to one plausible explanation — as a group, less educated people are less able to plan for the future and to delay gratification. If true, that may, for example, explain the differences in smoking rates between more educated people and less educated ones.

Smokers are at least twice as likely to die at any age as people who never smoked, says Samuel Preston, a demographer at the University of Pennsylvania. And not only are poorly educated people more likely to smoke but, he says, “everybody knows that smoking can be deadly,” and that includes the poorly educated.

• According to Penelope McClenny of The Seattle Times a tiny town in Alabama lost 10,000 pounds:

In January 2006, a group of residents concerned about the town's health started a free program called "Get Lost in Jackson." Over the next year, participants checked in at monthly weigh-ins; attended classes on fitness, nutrition and health; and began exercising.

• Nara Schoenberg of The Chicago Tribune examines how overweight people are viewed in China:

“In 19th Century China, being heavy was a sign of great wealth and success, both for men and for women. So this is really a change in the sense that . . . China has been a very poor country, and people are just very, very thin. Now, of course, China is doing very well, and many people have a very reasonable lifestyle and are not suffering at all, but it's not just something the eye is accustomed to seeing and the cultural norm is just that smaller is better.”

• Senator Edward M. Kennedy plans to stiffen measures on tobacco. Diedtra Henderson of The Boston Globe has more:

The legislation is part of a handful of sweeping bills that Kennedy and others will seek to pass as Democrats begin running Congress. Republicans like Tom DeLay , the former House majority leader who helped to thwart tobacco regulation, are no longer in office.

• The Detroit Free Press provides some warning signs for low bone mass:

Low dietary calcium and vitamin D: Milk and other dairy products can provide a major source of bone-building calcium to most diets. Leafy green vegetables and soybeans are also high in calcium.

• Faye Flam of The Philadelphia Inquirer presents one man’s crusade against soy:

While some pundits rank radical feminism among the top threats to American manhood, James Rutz says we should shift some blame to tofu.

That's because tofu is made of soy. And soy consumption, writes the Megashift Ministries founder and religion columnist for conservative news site WorldNetDaily.com, "commonly leads to decrease in the size of the penis, sexual confusion and homosexuality."

• Vegetables, a colorful rainbow of nutrients, this according to Kate Santich of The Orlando Sentinel:

Red tomatoes contain lycopene, which not only is good for your heart but also fights cancer and could boost prostate-gland health too.

Blue and purple fruits such as blackberries, black currants and plums promote urinary-tract health and memory function and could thwart the development of cancer. Cranberries have been shown to increase HDL, or good cholesterol, and they act as powerful antioxidants

• Meg Nugent of The Star-Ledger takes a look a dieting, both the mental and the emotional commitment:

Losing weight because you want to look good is an extrinsic motivation and one that usually won't take you very far. "Aesthetics can't drive it hard enough, like wanting to fit into your skinny jeans," Dixie Douville, a certified fitness trainer and co-founder of Active Weigh Health and Weight Loss Coaching in Flanders said. "The biggest reason it doesn't work is, a lot of people are unreasonable with the goals they set."

From the July 2003 edition of Dr. Fuhrman’s Healthy Times:

The first three back exercises involve use of gym equipment. Never attempt to lift heavy weights with your back. Perform smooth movements with an amount of weight light enough for you to be comfortable doing at least twenty repetitions.

1. Seated cable row: With knees slightly bent, lean forward, then pull the handles back to your chest with elbows wide as your back comes to vertical.

2. Wide cable pull downs: Pull down the cable to your chest with elbows wide as you lean back to a sixty-degree angle.

3. Back extensions: Lean over exercise ball, and arch your back up like a reverse sit up, or use a back extension chair made for this exercise.

4. Superman: While lying on your stomach, lift trunk and legs up off the ground like a bow.

5. Alternate Superman: Use alternate arm and leg to perform the superman.

6. Weighted backpack: Wear a weighted backpack for a few hours per week. Normal activities of moving around and getting up and down with a weighted backpack on strengthens the back.

From the September 2005 edition of Dr. Fuhrman's Healthy Times:

A good example of doctor-induced (iatrogenic) hip fracture results from the use of medications to suppress stomach acid production in the treatment of indigestion, esophagitis, and gastritis. The typical doctor is unaware that these diseases are caused by poor nutrition. Likewise, these doctors also are blind to the positive health effects of nutritional excellence and unaware that high cruciferous vegetable consumption prevents Helicobacter zylori (bacteria that causes gastritis and pyloric ulcers) from setting up housekeeping in the stomach. Most doctors only know one option— acid-suppression drugs.

According to a recent study, long-term use of acid suppression therapy with medications (H2 blockers or proton-pump inhibitors) increases the risk of hip fractures. These medications interfere with calcium absorption, leading to osteoporosis and increased fracture risk. The study followed over 500,000 adults over the age of 40 for 15 years and found, in general, those on chronic therapy with these medications had about double the risk of hip fractures. Interestingly, the risk of hip fractures associated with these medications was even higher for men than for women.1

Remember, bone strength is directly proportional to muscle strength, and bone health requires a lifetime commitment to regular exercise and physical activity. Inactivity or bed rest can be disastrous to the bones. Go to the gym, walk, wear a weighted vest, do back exercises, work in the garden, and stay involved with sports or fitness pursuits appropriate to your ability and health. Nutritional excellence is vitally important, and cannot be replaced by supplements. Taking supplements is merely an adjunct to other critical lifestyle factors that reduce risk.

Experts are encouraging the lactose intolerant to experiment with more dairy. Ed Edelson of HealthDay News reports:

The American Academy of Pediatrics has a new attitude about consumption of milk and milk products by children with lactose intolerance: Hey, give it a try.

New guidelines say the academy "supports use of dairy foods as an important source of calcium for bone mineral health and of other nutrients that facilitate growth in children and adolescents." Specifically, it does not recommend eliminating dairy products to treat lactose intolerance.

In practical terms, said Dr. Melvin B. Heyman, a member of the committee that wrote the guidelines, the new advice is for parents of children with lactose intolerance, in collaboration with pediatricians, to "test the system and see how much milk, cheese and ice cream they can tolerate."

According to Dr. Fuhrman dairy products, including milk, are linked to Parkinson’s disease, cardiovascular disease, and ovarian cancer. Also, in his book Disease-Proof Your Child he explains that milk is especially dangerous for young children:

Milk, which is designed by nature for the rapidly growing cow, has about half its calories supplied from fat. The fatty component is concentrated more to make cheese and butter. Milk and cheese are the foods Americans encourage their children to eat, believing them to be healthy foods. Fifty years of heavy advertising by an economically powerful industry has shaped the public's perception, illustrating the power of one-sided advertising, but the reality and true health effects on our children is a different story. Besides the link between high-saturated-fat foods (dairy fat) and cancer, there is a body of scientific literature linking the consumption of cow's milk to many other diseases. If we expect our children to resist many common illnesses, they simply must consume less milk, cheese, and butter. Dairy foods should be consumed in limited quantity or not at all.

Looking for a good source of calcium? Many people are surprised to find out that green vegetables like kale, broccoli, and Romaine lettuce are hearty sources of calcium:

Calcium Content Per 100 Calories of Plant Matter

• Kale, 470 mg
• Romaine Lettuce, 374 mg
• Broccoli, 322 mg

• The Best Foods For Bones: Fruits and Vegetables
• Choose Vegetable Calcium Over Animal Calcium
• Dairy, Fast-Growing Kids, and Cancer

• According to an ABC News report distracting kids with cartoons while giving them injections is more effective than the comfort of a parent.

• Some thoughts on Osteopenia from a Retired Doc’s Thoughts:

The Osteoporosis Foundation (NOF) and the American Association of Clinical Endocrinology (AACE) have different recommendations regarding the use of medications. NOF seems to recommend medications for those patients with osteopenia with no risk factors if the T score is below -2 and for those patients with T scores of less than -1.5 if they have one or more risk factors which include low body weight ( less than 127),history or family history of fragility fractures,smoking, estrogen lack or excessive alcohol use ,use of certain medications including steroids. AACE would recommends medication if the T score is less than 1.5 IF the patient has had fracture(s) or if the T score is less than -2.5.( This is the WHO definition of osteoporosis so-strictly speaking- AACE is recommending treatment for osteoporosis not osteopenia and recommends treatment for osteopenia only if there is a history of fractures.)

• Nancy Zuckerbrod of the Associated Press explains that even though a federal judge believes cigarette companies have conspired to mislead people, they will not be fined:

U.S. District Judge Gladys Kessler rejected a government proposal to impose fines on the industry if youth smoking rates fail to drop in the coming years, despite finding that the companies marketed to teens and lied about it.

The judge did order the companies to stop labeling cigarettes as "low tar," "light," "ultra light" or "mild," saying they have used those terms to mislead consumers.

"They distorted the truth about low tar and light cigarettes so as to discourage smokers from quitting," Kessler said.

• Julie’s Health Club talks about the recent ban on the highly toxic pesticide lindane, which by the way is still used in prescription shampoos and lotions:

The Environmental Protection Agency this month banned the highly toxic pesticide lindane, which has been used for 50 years to treat crop seeds.

But incredibly, lindane can still be used in prescription shampoos and lotion treatment for head lice and scabies, because these products are regulated by the Food and Drug Administration, not the EPA, according to news reports.

Moreover, "regulated" does not mean the products have necessarily been safety tested. Cosmetic products and ingredients are not subject to FDA pre-market approval.

• Angela Pirisi of HealthDay News helps explain exactly what the heck SPF really means:

The Sun Protection Factor (SPF) is a laboratory measure scientists developed to measure the time it takes skin to burn under UV exposure, but you have to do some of your own math, since it's an individual thing. If you know how long it takes you to start burning without protection in the midday sun, say 10 minutes, multiply that by the SPF number. In theory, for someone who burns in 10 minutes without protection, a sunscreen with an SPF 30 would deliver 300 minutes of protection against burning -- that's five hours. But experts note that's not the reality.

In a comment to last week's post Choose Vegetable Calcium Over Animal Calcium Helena sought Dr. Fuhrman's thoughts about Gabe Mirkin's opinion on animal protein and calcium absorption. Here's what Dr. Fuhrman had to say:

Gabe Mirkin, M.D.: Studies done many years ago suggested that eating a lot of protein increases calcium loss in the urine and therefore it was thought that eating protein weakens bones by taking calcium out of them. However, recent studies show that eating protein increases calcium absorption so the extra calcium in the urine comes from increased absorption, not from being take out of bones. Reports in the American Journal of Clinical Nutrition (Volume 78, Issue 3, 2003) show that eating plenty of protein and lots of foods from plants helps to keep bones strong. Most scientists now feel that a very low-protein diet can cause osteoporosis, while a moderately high-protein diet may help to prevent it.

Dr. Mirkin is not giving enough information to understand the entire story. Let's review some of the evidence from the studies in question and come to some recommendations that are more specific. Even though excessive consumption of animal protein over many years does encourage bone disease and bone loss and a higher consumption of vegetable protein over animal protein is conducive to less osteoporosis it is also true that too little protein in later life (after age 70) when digestive efficiency declines could lead to less calcium absorption, muscle wasting and bone thinning. Studies suggest that both too much protein (animal protein) and too little protein are unfavorable to bone mass. Therefore, it may be advisable as we age to assure adequate protein intake and pay more attention to it especially if we find a decrease in weight and muscle mass with later life aging. Let's review the following relevant studies:

Rapuri PB ; Gallagher JC ; Haynatzka V. Protein intake: effects on bone mineral density and the rate of bone loss in elderly women. Am J Clin Nutr. 2003; 77(6):1517-25.
This study investigates the associations of dietary protein intake with baseline bone mineral density (BMD) and the rate of bone loss over 3 y in postmenopausal elderly women. It finds " no association seen between protein intake and the rate of bone loss (in a three-year period). The study did note that all these elderly women did not eat much protein in general and the highest range of protein consumption was only about 70 grams a day. Elderly women with low protein intake at baseline (before the study began were noted to have lower bone mineral density, likely because of a little less muscle mass), because muscle mass and strength is linked to bone mass. This study does not tell us much more than logic and common sense would. Protein digestive efficiency declines in the elderly and getting adequate protein is necessary for adequate muscle and bone mass in later life.

Sellmeyer DE ; Stone KL ; Sebastian A ; Cummings SR. A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. Study of Osteoporotic Fractures Research Group. Am J Clin Nutr. 2001; 73(1):118-22.
This study followed over 1000 elderly women over a 7 - 10 year period. The study scientists concluded that animal foods provide predominantly acid precursors, whereas protein in vegetable foods is accompanied by base precursors not found in animal foods. Imbalance between dietary acid and base precursors leads to a chronic net dietary acid load that may have adverse consequences on bone. The study found increase bone loss and risk of hip fracture in those with a higher ratio of animal protein to vegetable protein. The study scientists concluded that an increase in vegetable protein and a decrease in animal protein may decrease the risk of hip fracture in the elderly. This study illustrates the importance of getting the majority of calories (and protein) from plant sources and cautions that protein from animal food sources should be a minor contributor to total protein requirements for maximizing bone health. Even if some animal protein is added to a diet, it should not be the major source of protein, green vegetables, beans, nuts and seeds, should be the major source of protein and animal source a minor source.

Devine A ; Dick IM ; Islam AF ; Dhaliwal SS ; Prince RL Protein consumption is an important predictor of lower limb bone mass in elderly women. Am J Clin Nutr. 2005; 81(6):1423-8.
This study compared protein intake with bone mineral density in the heel in 75 year old women and illustrated at this later age the higher range of protein intake (above 80 grams a day) had better bone mineral density. They did not follow hip fracture rates. This study shows that as we get older it is important to assure adequate intake of protein (as well as other nutrients).

Kerstetter JE ; O'Brien KO ; Insogna KL. Dietary protein, calcium metabolism, and skeletal homeostasis revisited. Am J Clin Nutr. 2003; 78(3 Suppl):584S-592S.
This study showed reduction in calcium absorption and very low protein intakes below .8 mg per kg, and support the other evidence that elderly women should strive to maintain their total protein intake above a gram per kilogram of body weight.

Conclusion

• It is important to keep exercising to maintain muscularity in our later years.
• To maximize mineral absorption and bone health, supplements of D and many other nutrients are advisable and become increasingly important as we age as digestive efficiency may decrease.
• Vegetable protein sources, beans, edamame, nuts, seeds, and green vegetables are the most favorable sources of protein for long life and bone health. Adequate protein intake is important and vegetarian diets should be designed so that adequate protein intake is consumed. Vegetarian diets where the vast majority of calories come from grains and roots such as rice and potato are not ideal for long-term health.
• Attention to protein intake with supplements or some animal products may be a useful to maintain peek muscle and bone mass to prevent the occurrence of increasing frailty, common in the elderly, but for reasons of cardiovascular health, diets should be designed so that animal products are used sparingly and not the major source of protein in the diet.

A lot of people believe a vegetable-based diet, which excludes milk and cheese, doesn't provide enough calcium. According to Eat to Live fruits and vegetables contain ample amounts of calcium and this veggie-calcium is actually retained more efficiently in our bodies. Dr. Fuhrman explains:

Green vegetables, beans, tofu, sesame seeds, and even oranges contain lots of usable calcium, without problems associated with diary. Keep in mind that you retain the calcium better and just do not need as much when you don't consume a diet heavy in animal products and sodium, sugar, and caffeine.

Dr. Fuhrman points out that despite its reputation, milk's calcium-absorption rate is lower than what you might think:

Many green vegetables have calcium-absorption rates of over 50 percent, compared with about 32 percent for milk.1 Additionally since animal protein induces calcium excretion in the urine, the calcium retention from vegetables is higher. All green vegetables are high in calcium.

Given the concentrated calcium dose in green vegetables and the health risks associated with of diary products, veggies are a great tool for protecting yourself against bone debilitating diseases like osteoporosis. The Chicago Tribune agrees…kind of.

In an article entitled Shoring Up Your Bones reporter JoAnn Milivojevic re-hashes a lot of the same recommendations for keeping bones strong and dense that you heard as a kid:

An easy way to combine calcium and vitamin D, according to Blatner, is to have an 8-ounce serving of milk and/or fortified soymilk three times a day. She recommends pouring the fortified beverage of your choice on cereal in the morning, blending it with frozen fruit for a smoothie, drinking a glass with lunch or having a glass of hot chocolate for dessert. Cosman cautioned that the milk be low-fat or non-fat: "There's no way taking in all that saturated fat is good for you," she said.

The daily recommended value for vitamin D is 400 international units (IU). You may need more or less depending on your age or food habits. For example, the NOF suggests that postmenopausal women need more because a decline in estrogen means a decline in calcium absorption. Vegans (vegetarians who don't eat eggs or dairy) may also need to take extra steps to ensure they're getting enough calcium through the plant-based foods they eat.

Good sources of calcium include fortified breakfast cereals, milk, yogurt, cheese, tofu and greens such as collards and kale. To get the most nutritional bang for your bite, create such tasty combinations as broccoli and cheese. A half cup of steamed broccoli with an ounce of cheese gets you 20 percent of your daily recommended value of both calcium and vitamin D.

It's encouraging to see mass-media even suggesting vegetables as a sufficient source of calcium, but Milivojevic, like some many others, is clearly reluctant to wipe away her milk mustache permanently. For those loyal to bovine juice Dr. Fuhrman recommends restricting milk consumption to only fat-free skim and taking supplements as needed.

From his book Eat to Live Dr. Fuhrman provides additional insight on role of animal calcium in the standard American diet (SAD):

The American "chicken and pasta" diet style is significantly low in calcium, so adding dairy as a calcium source to this mineral-poor diet makes superficial sense—it is certainly better than no calcium in the diet. However, much more than just calcium is missing. The only reasons cow's milk is considered such an important source of calcium, is that the American diet is centered on animal foods, refined grains, and sugar, all of which are devoid of calcium. Any healthy diet containing a reasonable amount of unrefined plant foods will have sufficient calcium without milk. Fruits and vegetables strengthen bones. Researchers have found that those who eat the most fruits and vegetables have denser bones.2 These researchers concluded that not only are fruits and vegetables rich in potassium, magnesium, calcium, and other nutrients essential for bone health, but, because they are alkaline, not acid-producing, they don induce urinary calcium loss. Green vegetables in particular have a powerful effect on reducing hip fractures, for they are rich not only in calcium but in other nutrients, such as vitamin K, which is crucial for bone health.3

Vitally important steps you can take to avoid the debilitating problems of bone loss and osteoporosis:

Osteoporosis affects 8 million American women and 2 million men, causing 1.5 million fractures each year. As many as 18 million additional Americans may have low bone density (osteopenia), a precursor to osteoporosis. As women age, many suffer from a collapse of their lumbar vertebrae, resulting in pain and disability. Even after screening and diagnosis, most women are offered only drugs and calcium. Physicians rarely address the additional causes of osteoporosis.

1. Check your Vitamin D level

Over the years, I have checked my patients' vitamin D levels (25 hydroxy) regularly. Surprisingly, a high percentage of people are vitamin D deficient. Vitamin D deficiency is a leading cause of osteoporosis, but I routinely encounter women who, although taking calcium and drugs such as Fosomax, remain vitamin D deficient.The high prevalence of vitamin D deficiency I have seen in patients (primarily new patients) is in spite of the fact that most of them were taking a multivitamin with the standard 400 IU of vitamin D. My medical practice is in New Jersey, which offers fewer year-round opportunities for sun exposure than more southerly areas, but people everywhere are trying to avoid the sun because of the skin cancer risks and aging of the skin. Therefore, I recommend that your vitamin D level be checked occasionally at a routine physician visit to assure an adequate level.

2. Do not take vitamin A in a supplement or multivitamin

It has been known for some time that vitamin A in high doses can be associated with birth defects--such as cleft palate and heart abnormalities--but current research suggests the dose at which you become at risk is lower than previously thought. After studying the dietary habits of almost 23,000 pregnant women, researchers were surprised to find that even the doses found in standard vitamin pills resulted in a quadrupling of birth defects. Do you think vitamin A is only toxic to pregnant women and perfectly safe for everyone else? Of course, you don't. Researchers have found that even relatively low doses of vitamin A also are linked to calcium loss in the urine and to osteoporosis. Taking any vitamin A is unnatural and unwise. We make all the vitamin A we need from the carotenoids in fresh produce.

3. Do not consume more than 1500 mg of sodium daily

All the excess salt Americans consume, leading to high blood pressure and other medical problems, also contributes to calcium loss in the urine and osteoporosis. The excess sodium you consume each day must be excreted, and this process also washes away and wastes your calcium stores.

4. Do back exercises at least twice weekly

Bones are living,dynamic organs. Your bones continually are dissolving old bone tissue and rebuilding new bone tissue. Bone strength is directly proportional to muscle strength. Bones, like muscles, respond to stress by becoming bigger and stronger, and, like muscles, bones weaken and literally shrink if not used. Most women have been told by their physicians to do weight-bearing exercises such as walking and stair climbing to avoid bone loss. While these exercises may be helpful for developing hip muscles and bones, they do not protect the spine from bone loss. It is essential to exercise your back.

Studies have found that a back strengthening exercise program can provide significant, long-lasting protection against spinal fractures in women at risk for osteoporosis. One such study involved postmenopausal women, ages 58-75. Half performed back-strengthening exercises for two years, while the other half served as the control group. Almost all of the vertebral compression fractures that occurred during the ten years the women were studied occurred in the control group. The exercise group retained a significant advantage in back strength, even eight years after the exercise program ended, and its members had significantly higher bone density than those in the control group.1

The New England Journal of Medicine recently published a study claiming that two popular arthritis supplements don't work. Gina Kolata of The New York Times reports that despite the $734 million Americans spent on glucosamine and chondroitin in 2004, trials revealed few results.

In the member section of his website, Dr. Fuhrman has said "I think glucosamine and chondroitin are safe and have some clinical evidence to show they are mildly helpful. So if they are helping you, great."

He is more interested in looking at the bigger picture. He says that poor diets can cause rheumatoid arthritis and similar conditions. Adopting a nutrient rich vegetable based diet offers you the chance to eradicate it. This is from Dr. Fuhrman's book Eat to Live:

Some people, especially other physicians, may be skeptical. There are so many exaggerated and false claims made in health field, especially by those selling so-called natural remedies. Nevertheless, it is wrong to underestimate the results obtainable through appropriate nutritional intervention. Even many of my patients with autoimmune illnesses (such as lupus, rheumatoid arthritis, asthma, and hyperthyrodism) are able to recover and throw away their medications.

When one of my patients who had a severe case of rheumatoid arthritis went back to her previous physician, a rheumatologist, and told him she was now well and did not require any medication, he replied, "It must just be that you are resting more." She said, "I'm not resting more. In fact, I am more active than ever because my pain is gone, and I stopped the drugs." He replied, "It's just a temporary remission; you'll be back soon with another crisis." She never went back.

The mounting skepticism about milk consumption and its effects on human health is going mainstream. A recent article in the Chicago Tribune is all over the topic:

Milk, the sacred cow of the American diet, is under attack and not just by animal-rights activists. Though federal dietary guidelines and most mainstream nutrition experts recommend that people age 9 or older drink three glasses of milk a day, researchers are examining the role of dairy in everything from rising osteoporosis rates, Type 1 diabetes and heart disease to breast, prostate and ovarian cancer.

Last March, the journal Pediatrics published a review article concluding that there is "scant evidence" that consuming more milk and dairy products will promote child and adolescent bone health. Some leading practitioners of integrative medicine, including best-selling author Dr. Andrew Weil, suggest eliminating dairy products from the diet to help treat irritable bowel syndrome, asthma, eczema and ear infections. The late Dr. Benjamin Spock reversed his support of cow's milk for children in 1998 in his last edition of his world-famous book "Baby and Child Care."

The Tribune article encourages people not to see milk as the only viable source of calcium, and it's no secret that green vegetables are loaded with calcium (even the National Dairy Council will tell you so).

The calcium from some vegetables such as broccoli, bok choy and kale is absorbed as well as or better than calcium from milk and milk products, according to the National Dairy Council's Calcium Counseling Resource. But the report also says that to get the same amount of calcium absorbed from 1 cup of milk, one would have to eat nearly 2 1/2 cups of broccoli or 8 cups of spinach.

But consider the total nutritional picture. Green vegetables are dense with so many kinds of nutrition beyond just calcium.

Also, if you want some pointers about how to get your kids to eat calcium-rich fruits and vegetables, you really should listen to Dr. Fuhrman's free podcast on the topic.

Finally, in his book Disease Proof Your Child, Dr. Fuhrman explains that if you insist on cow's milk nonetheless, do yourself a favor and choose skim.

Osteoporosis affects 8 million American women, and 2 million men, causing 1 1/2 million fractures each year. As many as 18 million more Americans may have low bone density (osteopenia), a precursor to osteoporosis. As women age, many develop collapse of their lumbar vertebrae resulting in pain and disability. Even after screening and diagnosis most women are offered drugs and calcium, without addressing all the additional causes of osteoporosis, which are discussed below.