Secret mint herb may stop breast cancer patients’ hot flushes and night sweats

Researchers at the University of Manchester are testing a secret herb in a bid to stop the severe hot flushes that besiege breast cancer patients on hormone treatment.Professor Alex Molassiotis, of the School of Nursing, Midwifery and Social Work, says the herb – one of the mint family, found in any kitchen – is thought to stop the hot flushes and night sweats which can be so bad that some women have to change their clothes three or four times a night.

It is traditionally used by Mediterranean women undergoing the menopause, but Professor Molassiotis cannot name it as he and his team are carrying out a double blind trial (neither the patient nor the doctor is allowed to know whether they are in the group taking the herb or a placebo).

The women are taking hormone treatment to lower oestrogen and progesterone levels as these affect the growth of some breast cancer cells. This can lead to early or revisiting menopause with symptoms such as anxiety, dry skin, bone thinning and hot flushes, with some women having up to 30 flushes a day. It is too risky for them to take Hormone Replacement Therapy (HRT) as this will increase the hormone levels again. Instead they are advised to cut out tea, coffee and nicotine, try alternative remedies or a certain type of anti-depressant.

Professor Molassiotis said: “It is hoped that the herbal remedy will be simpler and cheaper to take, as well as more effective, thus improving the lives of women who need all their energy to fight the disease.”

He and his team are now recruiting 170 volunteers for the randomized trial, half of whom will take the phytooestrogen herb in the form of a pill and half of whom will take a placebo, from Greater Manchester and Cheshire. Only breast cancer patients who have or are receiving hormone treatments for their cancer are allowed to take part, and only if they experience at least one hot flush a day of moderate and above severity for at least a month. The treatment will be for a total of three months, taking one pill a day. The team will assess the volunteers’ hot flushes four times over six months from starting the trial with questionnaires and a blood sample.

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Article adapted by MD Only Weblog from original press release.
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Contact: Mikaela Sitford
University of Manchester

Valuable Vitamin D report bridges gap in bone health benefits

A new evidence report on vitamin D and bone health reviews the current scientific evidence and identifies its strengths and weaknesses. This report is a valuable resource that examines a range of scientific perspectives related to vitamin D and bone health across the lifecycle.

“This independent, systematic review is timely because there are mixed messages and recommendations to consumers regarding the benefits and harms of vitamin D intake” said NIH Office of Dietary Supplements (ODS) Director, Paul M. Coates, Ph.D. He added, “The evidence report in combination with the conference presentations and discussions, newly available methodological tools, and newer information on the vitamin D status of the US population will provide an invaluable and very timely update for the research and public health communities of what we know and what we need to know for this key nutrient.”

Researchers have long known that vitamin D had an impact on bone health but there is uncertainty about how much vitamin D is needed to achieve optimal bone health and whether there are differences in the relationship of vitamin D status to bone health across age and life stage groups. This report highlights the fact that the largest amount of evidence for bone health benefits is in postmenopausal women and older men (the majority over 60 years of age) taking vitamin D supplements. This report also confirms that vitamin D from ultraviolet-B (sunlight) exposure, fortified foods, or dietary supplements are all effective in raising the level of circulating vitamin D. Of concern, there were only sparse data on other subgroups cited as being at high risk for the consequences of low vitamin D, such as dark-skinned individuals and pregnant and lactating women.

The report found it difficult to define specific blood levels of markers for vitamin D status that indicate optimal levels for bone health. One reason for this is that current methods, which measure serum-25-hydroxy vitamin D as the marker for vitamin D status, yield highly inconsistent results. As part of its broader vitamin D initiative, ODS is working with laboratory testing facilities to standardize the quantification of vitamin D status.

The report investigators were not able to separate the impact of vitamin D from that of calcium, as most trials studied the effect of vitamin D plus calcium. The combination of vitamin D3 (daily dose 700 to 800 IU) and calcium (daily dose 500 to1200 mg) decreased the risk of falls, fractures and bone loss in the elderly (ages ranged from 62 to 85 years). The current recommended intake is 400 IU/day for people 51-70 years of age, and 600 IU/day for people over 70 years of age. Based on the combined data of two trials, the decreased risk of fractures was seen primarily in the subgroup of elderly women (average age 85 years) living in nursing homes.

Vitamin D intake above current recommended levels was not reported to be associated with an increased risk of harms. However, most trials using higher doses of vitamin D were not adequately designed to assess potential harms.

“The vitamin D and bone health evidence report provides valuable insights because it is based on an independent and rigorous examination of the totality of evidence across all age groups and during pregnancy and lactation,” said Agency for Healthcare Research and Quality (AHRQ) Director Carolyn Clancy, M.D. “It Is important that health care decisions are made using a review of all available evidence and not solely on the results of individual study reports.”

This report served as the framework for a conference, Vitamin D and Health in the 21st Century: An Update. The ODS-sponsored report was produced by the University of Ottawa Evidence-based Practice Center, and is available at:
http://www.ahrq.gov/clinic/tp/vitadtp.htm.

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Article adapted by MD Only Weblog from original press release.
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Contact:
Lisa Ahramjian
National Institute of Health

The mission of ODS is to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, stimulating and supporting research, disseminating research results, and educating the public to foster an enhanced quality of life and health for the U.S. population.

Smart Bone Cells May Add or Remove 3% Bone Mass Per Month

Liyun Wang, UD assistant professor of mechanical engineering, views osteocytes (bone cells) in her lab, as graduate students Wen Li and Xiaozhou Zhou examine the magnified images in the background.  Click here for more information.

Ten million people in the United States are estimated to already have bone diseases, and almost 34 million more are estimated to have low bone mass, putting them at increased risk for osteoporosis, according to the National Osteoporosis Foundation.

Liyun Wang, assistant professor of mechanical engineering at the University of Delaware, knows the serious consequences of osteoporosis.

Two of Wang’s aunts have suffered from the insidious bone-thinning disease, and one aunt died within a year after falling and fracturing her hip.

Wang is now leading research that will shed light on how osteocytes–the cells encased inside your bones–sense external stimuli and communicate with cells on the surface, signaling them to either build more bone or remove existing bone.

The five-year, $1.6 million project, ranked in the top 5 percent of research proposals recommended for funding by the National Institutes of Health (NIH) this year, holds promise in unveiling the mysteries of bone and joint diseases afflicting people worldwide.

The results may not only help scientists home in on the cause of osteoporosis and arthritis, but also develop more effective drug therapies to treat the debilitating bone and joint diseases.

The project will involve an interdisciplinary team of investigators at UD, including Prof. Mary C. Farach-Carson and Associate Prof. Randall Duncan, who hold primary appointments in biological sciences with joint appointments in mechanical engineering, and John Novotny, assistant professor of mechanical engineering.

“Bone and joint disorders affect almost half of all people over 50 years old, at a cost of $250 billion annually in the United States,” Wang said. “A third of the people who suffer a fracture due to bone loss end up dying within a year.”

The embedded bone cells, or osteocytes, that Wang is studying, act like the bone’s “brain.”

“The osteocytes are very smart,” Wang says. “They can tell whether a person is using his or her bones or not. If the person is physically active, the osteocytes tell cells on the surface that it’s okay to put on more bone. Otherwise, they signal the surface cells to remove bone at a rate that can be as high as 3 percent bone mass per month, which is the case for patients confined to long-term bed rest and for astronauts,” she notes.

The osteocytes lie in tiny pits or holes, called lacunae, within the bone. These living cells have many long arms that connect them to surface bone cells and the bone’s vascular system. The narrow channels housing the osteocyte’s arms (canaliculi) and the lacunae form a network through which a mixture of water, nutrients and other bioactive molecules flows.

“Although it is hard as cement, bone is actually like a stiff sponge,” Wang says. “It’s porous and has water inside. When we have mechanical loading, when you run, for example, a part of the leg bone is compressed, and water is pushed through gaps, less than a micrometer in size, between the osteocytes and the bone cement that surrounds them.”

This powerful wave of fluid keeps the osteocytes happy and functioning well, Wang says, delivering nutrients to them from nearby blood vessels and quickly dispersing signaling molecules, such as calcium ions, from one cell to its neighbors.

Using a novel microscopic imaging method that Wang developed, which is based on fluorescence recovery after photobleaching (FRAP), the research team hopes to do what no one has done before: see inside living bone and determine how rapidly these signaling and nutrient molecules are transferred between the cells when a bone is at rest and when it is at work.

A high-powered laser-scanning microscope will be used to assess the movement of molecules in the tibia of an anesthetized mouse. A harmless green fluorescent dye, tagged to various-sized proteins, signaling molecules and cell nutrients, will be injected into the animal’s bloodstream.

The dyed molecules will be subjected to a flash of intense light, temporarily photobleaching them black, leaving a distinct black sector surrounded by green. Thus, if the molecules diffuse into one another’s territories, they can easily be tracked by color.

Using similar techniques, Wang is investigating the communication between bone and cartilage in the development and progression of osteoarthritis, one of five projects in an $11 million NIH grant led by Thomas Buchanan, professor and chairperson of the UD Department of Mechanical Engineering. The UD effort includes a unique mentoring program for women scientists.

Wang says she is grateful for the mentoring and support she has received from her colleagues at UD since she joined the faculty in 2005, as well as from her doctoral advisers at the City College of New York, including Profs. Susannah Fritton, Steve Cowin, and Sheldon Weinbaum; and Dr. Mitchell Schaffler, with whom she worked as a postdoctoral researcher at the Mt. Sinai School of Medicine.

Currently, Wang’s laboratory group includes Wen Li, a graduate student in biomechanics and movement science, Xiaozhou Zhou, a graduate student in mechanical engineering, and undergraduate students Ben Keller and Laura Schultz, who are both working on degrees in mechanical engineering, and Samantha Nigro, who is pursuing her degree in biological sciences. Research associate Jun Pan will join the group at the end of this year.

“My students have been excellent,” Wang says, smiling. “They are well-organized and eager to learn how to do research. They are very motivated, and that is important. We have exciting work ahead of us!”

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Article adapted by MD Only Weblog from original press release.
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Contact: Tracey Bryant
tbryant@udel.edu
302-831-8185
University of Delaware

Wang is seeking two additional doctoral students and one postdoctoral researcher in the areas of biomechanics, orthopedic biology or mechanical engineering to join her research team. For more information, contact Wang at [lywang@udel.edu].

Stanford/Packard scientists discovery way to speed bone healing

Blocking a naturally occurring inhibitor of bone formation accelerates healing of skull defects in mice, say researchers at the Stanford University School of Medicine and Lucile Packard Children’s Hospital. The finding advances the understanding of how the skeleton develops and opens new therapeutic avenues for many of the disorders that are expected to afflict aging baby boomers.

“This could potentially lead to much more effective therapies for how we replace bone or promote bone healing,” said Michael Longaker, MD, professor of plastic and reconstructive surgery. “Let’s say I’m an 80-year-old with a fractured hip. It would be invaluable to be able to heal more quickly and regain mobility and strength.”

The study will be published in the Sept. 7 issue of the Journal of Biological Chemistry.
Scientists have known for some time about a class of proteins called bone morphogenetic proteins, or BMPs, which stimulate bone formation. In fact, some current therapies for stimulating bone formation, such as spinal fusions, use recombinant BMPs to help healing. But Longaker’s new study of a protein called Noggin, which blocks bone growth, suggests there might be another, more efficient approach.

Noggin was first identified in 1992 by one of Longaker’s collaborators, Richard Harland, PhD, now a faculty member at the University of California-Berkeley, as a protein that guides tissue fate in developing frog embryos. In 2003, the researchers found that Noggin prevents the premature fusion of bones in the skull during infancy by blocking the actions of BMPs.

Longaker and the first author of the new study, Derrick Wan, MD, a postdoctoral scholar at Stanford, wondered whether interfering with Noggin expression could speed bone growth.In the new study, they initially found through work with tissue cultures that using small pieces of RNA to block Noggin expression in bone-forming cells increased the activity of the cells’ BMPs and nudged them further down the bone-producing path. Furthermore, bone-forming cells in which Noggin expression was suppressed were able to heal large skull defects in mice significantly more quickly than Noggin-expressing cells.

“Basically we just took away the natural brake and let the accelerator go to town,” said Longaker, who is also a pediatric craniofacial surgeon at Packard Children’s Hospital.

Despite the accelerated rate of healing seen in the mice treated with the Noggin-challenged cells, bone formation didn’t run rampant in these animals. After eight weeks, the healed skulls of the two groups of mice looked similar. This is important because over-enthusiastic bone formation could exacerbate rather than solve musculo-skeletal problems.

“The bone that was formed looked very normal,” said Longaker. “It’s not as if these mice grew horns or anything.”

In addition to the obvious therapeutic implications, the discovery of the interplay between Noggin and BMPs also sheds light on a perplexing developmental mystery: What guides skeletal formation during embryogenesis, when BMPs are expressed in many cells not destined to become bone? Now it appears that Noggin, along with other potent BMP inhibitors, keeps the BMPs in check throughout most of the body. This type of yin-yang relationship keeps the body primed to respond quickly to damage like fractures.

Although the concept needs to be tested in humans, the researchers envision a day when many disorders could benefit by tweaking Noggin levels up or down.

“Think of the way we treat arthritis,” said Longaker. “Right now, we cut off the diseased part of the joint and glue in a metal implant. Imagine if we could instead use a biodegradable replacement seeded with a compound that could knock down Noggin expression in the area and slowly secrete BMPs. Over two or three years, the implant would dissolve, to be replaced by the individual’s own healthy bone. This is a first step toward the concept of personalized bone tissue engineering.”

In addition to Wan, Longaker’s Stanford collaborators include Jason Pomerantz, MD, postdoctoral scholar; Jae-Beom Kim, PhD, research associate; and Helen Blau, PhD, the Donald E. and Delia B. Baxter Professor of Pharmacology. Longaker also collaborated with researchers at UCLA.

The research was funded by the National Institutes of Health, the Oak Foundation, a Ruth L. Kirschstein National Research Service Award, and an Ethicon-Society of University Surgeons Research Fellowship.

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Article adapted by MD Only Weblog from original press release.
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Contact: Krista Conger
Stanford University School of Medicine

Nearly 50% of young women unaware Osteoporosis risk!

Many young women are unaware of the dangers of osteoporosis, leaving them vulnerable to crippling bone disease.

Mark J. Kasper, Ed.D., FACSM was the lead researcher for a survey of 302 college females enrolled in an elective physical activity course. While almost all (97.7 percent) had heard of osteoporosis, only 52.9 percent were able to correctly identify eight or more out of 14 risk factors listed and only 30.8 percent named all three major risk factors: low calcium intake, a sedentary lifestyle, and infrequent menstruation. The National Osteoporosis Foundation defines osteoporosis as “a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures, especially of the hip, spine and wrist.”

Kasper pointed out that 39.7 percent of respondents believed they were unlikely to develop osteoporosis. “Despite a similar lifetime risk of developing osteoporosis, heart disease or breast cancer, there is a lack of knowledge and a high degree of complacency concerning osteoporosis in young women,” said Kasper. “This data mirrors our previous research suggesting that educational interventions targeting young women either have not been implemented or have been ineffective.”

The coeds in Kasper’s study that osteoporosis is a serious illness, but less serious than heart disease or breast cancer. Blacks were less likely than whites to identify risk factors and to believe that they would develop osteoporosis. Respondents ranged from 18 to 21 years of age.

Exercise Aids Bone HealthPhysical activity is the only known intervention that can potentially increase bone mass and strength in the early years of life and reduce the risk of falling in older populations, according to a Position Stand from the American College of Sports Medicine (ACSM). The official ACSM pronouncement, published in the November 2004 issue of Medicine & Science in Sports & Exercise®, encourages the adoption of specific exercise prescriptions designed for various ages to best capitalize on the chances to accrue and preserve bone throughout the various stages of life.

The paper cites worldwide predictions that the number of hip fractures will double by the year 2025, with a mortality rate of 15 to 20 percent within the first year following such a fracture for elderly individuals, as reasons to encourage a better understanding of the types, durations and frequencies of physical activities that help build and maintain bone. These include high-intensity, high-impact activities for children to build bone and moderate-to-high intensity weight-bearing activities for adults to maintain bone mass.

For adults, experts have established these recommendations to help preserve bone:

Mode – weight-bearing endurance activities such as tennis and jogging, activities that involve jumping, and resistance exercise (weight lifting)
Intensity – moderate to high
Frequency – weight-bearing activities 3 to 5 times per week, resistance exercise 2 to 3 times per week
Duration – 30 to 60 minutes a day combined

For children, especially in the years surrounding the onset of puberty, experts recommend the following activities to help build bone:

Mode – impact activities such as gymnastics and jumping activities combined with moderate resistance training
Intensity – high, but with appropriate weights for resistance training (no more than 60 percent of the maximum amount a person can lift one time)
Frequency – at least three days per week
Duration – 10 to 20 minutes with multiple sessions within the same day potentially being more effective

The Position Stand also explicitly mentions the importance of bone health for men, noting that the predicted increase in osteoporotic falls and fractures in men in the coming decades is even greater than in women. The authors also encourage weight-bearing physical activities for even the most frail and elderly, provided they can still perform them safely.

The conclusions outlined in this news release are those of the researchers only, and should not be construed as an official statement of the American College of Sports Medicine.

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Article adapted by MD Only Weblog from original press release.
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Contact: Communications and Public Information
American College of Sports Medicine

Nutrition Standards For “Competitive” Foods and Drinks

Report Recommends Nutrition Standards For ‘Competitive’ Foods and Drinks Sold in Schools 

Spurred by the rising rate of obesity among American youth and the increasing availability of high-calorie, low-nutrient products on school grounds, a new report by the Institute of Medicine proposes a set of nutritional standards for “competitive” foods and drinks available in schools.  The standards promote consumption of fruits, vegetables, whole grains, and nonfat or low-fat dairy products and limit the amount of saturated fat, salt, added sugars, and total calories.  The standards also restrict the sale of caffeinated items. 

Developed by an IOM committee at the request of Congress, the standards apply to a la carte cafeteria items, products sold in vending machines and at school stores, and other foods and drinks that are available outside of — and therefore compete with — federally reimbursable school meals, which already must conform to some nutrition guidelines.  The proposed standards take into account the varying needs and responsibility levels of children and teens — for example, by limiting the sale of caffeine-free diet soda to high schools after school only, and by recommending smaller juice portions for younger children.   

“The alarming increase in childhood obesity rates has galvanized parents and schools across the nation to find ways to improve children’s diets and health, and we hope our report will assist that effort by setting standards for foods and beverages that have so far escaped any requirements,” said committee chair Virginia A. Stallings, Jean A. Cortner Endowed Chair in Pediatric Gastroenterology and director of the Nutrition Center, Children’s Hospital of Philadelphia; and professor of pediatrics, School of Medicine, University of Pennsylvania, Philadelphia.  “Making sure that all foods and drinks available in schools meet nutrition standards is one more way schools can help children establish lifelong healthy eating habits.” 

The committee proposed two tiers of competitive foods and beverages that could be available in schools based on grade level.  The standards apply only to competitive items sold or available on campuses, not to federal school meals or to bagged lunches or snacks that children bring to school.   

Tier 1 products should be allowed at all grade levels during the regular school day and during after-school activities involving students.  The foremost criterion of foods and drinks included in this category is that they provide at least one serving of fruits, vegetables, whole grains, or nonfat or low-fat dairy.  In addition, Tier 1 snacks contain no more than 200 calories per portion, and entrée items that could be sold a la carte do not exceed calorie limits on comparable school lunch program items.  Tier 1 items have no more than 200 milligrams of sodium per snack portion or 480 milligrams per a la carte entrée item.  They contain no more than 35 percent of total calories from fat; less than 10 percent of total calories from saturated fats; no trans fats; and no caffeine except in naturally occurring trace amounts.  They also contain no more than 35 percent of calories from total sugars; exceptions to this guideline are flavored milk, which may contain up to 22 grams of sugars per 8-ounce serving, and yogurt, which should not exceed 30 grams of sugars per 8-ounce portion.  

Examples of Tier 1 foods include whole fruit; raisins; carrot sticks; whole-grain, low-sugar cereals; some multigrain tortilla chips; some granola bars; and nonfat yogurt with no more than 30 grams of added sugars.  Examples of entrée items that meet the criteria are a fruit salad with yogurt or a turkey sandwich.  Tier 1 beverages are plain water, skim or 1 percent milk, soy beverages, and 100 percent fruit or vegetable juice.  Because of their calorie content, juices are capped at 4-ounce servings for elementary and middle-school students and 8-ounce portions for high school students.  

Unlike Tier 1 items, Tier 2 competitive foods and beverages do not necessarily provide a serving of vegetables, fruits, whole grains, or low-fat or nonfat dairy, but they otherwise conform to the U.S. Dietary Guidelines for Americans.  These items should be available to high school students only and after school only.  Like Tier 1 items, Tier 2 foods contain 200 calories or less per portion, 200 milligrams or less of sodium per portion, 35 percent or less of total calories from fat, less than 10 percent of total calories from saturated fats, no trans fats, no caffeine except in naturally occurring trace amounts, and no more than 35 percent of calories from total sugars.  Tier 2 drinks contain five or fewer calories per portion and no caffeine; they are not vitamin- or mineral-fortified, but may be carbonated and may contain flavoring or a sugar substitute.  

Examples of Tier 2 items include single servings of baked potato chips, low-sodium whole wheat crackers, graham crackers, pretzels, caffeine-free diet soda, and seltzer water.  Tier 2 beverages should be available only after school because students may otherwise forgo healthier choices such as milk and juice.  In addition, sports drinks should be available only to students engaged in an hour or more of vigorous athletic activity, at the discretion of coaches, the report says.  The committee recommended against making fortified water available as either a Tier 1 or 2 option.   

The committee did not support the sale of caffeinated products to school-age children because of the potential for negative effects, including headaches, moodiness, and other results that could disrupt students’ abilities to concentrate and learn.  Although caffeine-free diet soda can be an after-school option for high school students, the committee did not recommend for or against foods containing sugar substitutes.  While several studies indicate the overall safeness of consuming sugar substitutes, studies have not explored the effects of long-term consumption of these products starting in childhood.   

Schools should allow only Tier 1 products to be sold as fundraiser items on elementary and middle school campuses; high schools could allow Tier 2 items to be used for on-campus fundraising.  Schools should encourage products used in celebrations such as holiday parties to meet the standards.  Likewise, schools also should encourage foods and beverages sold at after-school and community events that include adults — such as athletic events and PTA meetings — to conform to the standards. The committee was not asked to recommend a plan for implementing the proposed standards.  However, it noted that schools will need technical and financial support.  Federal agencies should work with the food and beverage industries to develop a system for identifying products that meet the Tier 1 and Tier 2 criteria to help food service personnel more readily evaluate items.     

The study was sponsored by the Centers for Disease Control and Prevention.  Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public.  The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.  A committee roster follows.   

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Article adapted by MD Only Weblog from original press release.
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Contact: Christine Stencel
National Academies Press

Copies of Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth are available from the National Academies Press;

Low Vitamin D Linked to Higher Risk of Hip Fracture

 Women with low levels of vitamin D have an increased risk of hip fracture, according to a study led by the University of Pittsburgh Graduate School of Public Health presented this week at the 29th annual meeting of the American Society for Bone and Mineral Research at the Hawaii Convention Center. Jane A. Cauley, Dr.P.H., professor of epidemiology, and colleagues evaluated patient data on 400 women enrolled in the Women’s Health Initiative Observational Study Cohort who had experienced hip fracture, confirmed by their medical record, over a median of 7.1 years. Levels of 25 hydroxyvitamin D, an indicator of vitamin D status, in the bloodstream were measured for these patients and compared with those of a control group matched for age, race, ethnicity and the date of relevant blood work. As vitamin D concentrations decreased, the risk of hip fractures climbed.“The risk of hip fractures was 77 percent higher among women whose 25 hydroxyvitamin D levels were at the lowest concentrations,” said Dr. Cauley, who has spent much of the past 15 years investigating the physical changes that take place in postmenopausal women. “This effect persisted even when we adjusted for other risk factors such as body mass index, family history of hip fracture, smoking, alcohol use and calcium and vitamin D intake.”Vitamin D deficiency early in life is associated with rickets – a disorder characterized by soft bones and thought to have been eradicated in the United States more than 50 years ago.

Though the exact daily requirement of vitamin D has not been determined, most experts think that people need at least 800 to 1,000 international units a day. Many experts believe the current recommended levels of 400 IUs daily should be increased.

The vitamin is manufactured in the skin after sun exposure, and is not available naturally in many foods other than fish liver oils. Some foods are fortified with the vitamin.

Dr. Cauley’s work also focuses on use of estrogen, risks of hip fractures, bone density and cholesterol levels of women who are going through menopause. As a co-principal investigator for the University of Pittsburgh’s site of the Women’s Health Initiative, a National Institutes of Health-sponsored study, Dr. Cauley and her colleagues continue to examine the effects calcium and vitamin D have on osteoporosis.

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Article adapted by MD Only Weblog from original press release.
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Contact: Michele Baum
University of Pittsburgh Graduate School of Public Health (GSPH)

Founded in 1948 and fully accredited by the Council on Education for Public Health, GSPH is world-renowned for contributions that have influenced public health practices and medical care for millions of people. One of the top-ranked schools of public health in the United States, GSPH was the first fully accredited school of public health in the Commonwealth of Pennsylvania, with alumni who are among the leaders in their fields of public health. A member of the Association of Schools of Public Health, GSPH currently ranks third among schools of public health in NIH funding received. The only school of public health in the nation with a chair in minority health, GSPH is a leader in research related to women’s health, HIV/AIDS and human genetics, among others.

For More Information About Supplementing Vitamin D Click Here

How Good Is Your Calcium Supplement?

Calcium is essential for many functions in the body, including:

• regulating the heartbeat
• conducting nerve impulses
• stimulating hormone secretions
• clotting of blood
• building and maintaining healthy bones.

Calcium is a mineral found in many foods. Getting enough of this nutrient is important because the human body cannot make it. Even after you are fully grown, adequate calcium intake is important because the body loses calcium every day through the skin, nails, hair, and sweat, as well as through urine and feces. This lost calcium must be replaced daily through the diet. Otherwise, the body takes calcium out of the bones to perform other functions, which makes the bones weaker and more likely to break over time.

Experts recommend that adults get 1,000 to 1,200 mg (milligrams) of calcium each day. Although food is the best source of calcium, most Americans do not get enough of it from food sources. Calcium-fortified foods (like orange juice, bread, cereals, and many others on your grocer’s shelves) and calcium supplements can fill the gap by ensuring that you meet your daily calcium requirement.

What to Look for in a Calcium Supplement

Calcium exists in nature only in combination with other substances. These substances are called compounds. Several different calcium compounds are used in supplements, including:

• calcium carbonate
• calcium phosphate
• calcium citrate.

These compounds contain different amounts of elemental calcium, which is the actual amount of calcium in the supplement. It is important to read the label carefully to determine how much elemental calcium is in the supplement and how many doses or pills to take.

Calcium supplements are available without a prescription in a wide range of preparations and strengths, which can make selecting one a confusing experience. Many people ask which calcium supplement they should take. The “best” supplement is the one that meets your needs. Ask yourself these questions:

• How well does my body tolerate this kind of supplement? Does it cause any side effects (like gas or constipation)? If so, you may want to try another kind or a different brand.
• Is this kind of supplement convenient? Can I remember to take it as often as recommended each day?
• Is the cost of this supplement within my budget?
• Is it widely available? Can I buy it at a store near me?

Other Important Things to Consider

Purity: Choose calcium supplements with familiar brand names. Look for labels that state “purified” or have the USP (United States Pharmacopeia) symbol. Avoid calcium from unrefined oyster shell, bone meal, or dolomite without the USP symbol, because it may contain high levels of lead or other toxic metals.

Absorbability: Most brand-name calcium products are absorbed easily in the body. If you are not sure about your product, you can find out how well it dissolves by placing it in a small amount of warm water for 30 minutes and stirring it occasionally. If it hasn’t dissolved within this time, it probably will not dissolve in your stomach. Chewable and liquid calcium supplements dissolve well because they are broken down before they enter the stomach.

Calcium, whether from food or supplements, is absorbed best by the body when it is taken several times a day in amounts of 500 mg or less, but taking it all at once is better than not taking it at all. Calcium carbonate is absorbed best when taken with food. Calcium citrate can be taken anytime.

Tolerance: For certain people, some calcium supplements may cause side effects such as gas or constipation. If simple measures (such as increasing your intake of fluids and high-fiber foods) do not solve the problem, you should try another form of calcium. Also, it is important to increase the dose of your supplement gradually: take just 500 mg a day for a week, then slowly add more calcium. Do not take more than the recommended amount of calcium without your doctor’s approval.

Calcium Interactions: It is important to talk with a doctor or pharmacist about possible interactions between your over-the-counter and prescription medications, and calcium supplements. For example, calcium supplements may reduce the absorption of the antibiotic tetracycline. Calcium also interferes with iron absorption. So you should not take a calcium supplement at the same time as an iron supplement – unless the calcium supplement is calcium citrate, or unless the iron supplement is taken with vitamin C. Any medication that you need to take on an empty stomach should not be taken with calcium supplements.

Combination Products

Calcium supplements are available in a bewildering array of combinations with vitamins and other minerals. Calcium supplements often come in combination with vitamin D, which is necessary for the absorption of calcium. However, calcium and vitamin D do not need to be taken together and/or in the same preparation in order to be absorbed by the body. Minerals such as magnesium and phosphorus also are important but usually are obtained through food or multivitamins. Most experts recommend that nutrients come from a balanced diet, with multivitamins used to supplement dietary deficiencies.

Getting enough calcium – whether through your diet or with the help of supplements – will help to protect the health of your bones. However, this is only one of the steps you need to take for bone health. Exercise, a healthy lifestyle, and, for some people, medication, are also important.

Source: NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases

Exercise Reduces Muscle and Joint Pain 25%

People who exercise regularly experience 25% less muscle and joint pain in their old age than people who are less active. Research published in Arthritis Research & Therapy reveals that people who regularly participate in brisk aerobic exercise, such as running, experience less pain than non-runners even though they are more likely to suffer from pain from injuries.

Bonnie Bruce and colleagues from Stanford University, USA, compared the level of pain in a group of runners and a group of community-based individuals who acted as controls. Participants were followed for 14 years, and were on average in their mid-sixties when the study started. Each year, they completed a questionnaire about their health status, exercise habits and history of injuries. In total, the study included 866 subjects: 492 Runners’ Association members and 374 controls.

Bruce et al.’s results show that the greater majority of physically active participants did, on average, between 355 and 2,119 minutes of exercise per week over the course of the study, while controls exercised significantly less. After adjusting for confounding factors such as gender, age, weight and health status the results show that pain increased in both groups over time. But members of the Runners’ Association experienced 25% less musculoskeletal pain than controls. This reduction persisted throughout the study period, until the subjects reached an age of 62 to 76 years.

“Exercise was associated with a substantial and significant reduction in pain even [...] despite the fact that fractures, a significant predictor of pain, were slightly more common among runners,” conclude the authors.

More research is needed to investigate the mechanisms that might underlie the effect of exercise on musculoskeletal pain in old age.

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Article adapted by MD Only Weblog from original press release.
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Aerobic Exercise And Its Impact On Musculoskeletal Pain In Older Adults: A 14-Year Prospective, Longitudinal Study
Bonnie Bruce, James F. Fries, Deborah P. Lubeck
Arthritis Research & Therapy 2005, 7:R1263-R1270 (19 September 2005)

Juliette Savin
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BioMed Central
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Little Children Not Getting Enough Fiber

A Penn State analysis of the diets of a nationally representative sample of U.S. preschoolers, ages 2 to 5, shows that more than three-quarters of the children are not getting enough fiber.

Children who consumed the most fiber also had the most nutrient-rich diets. However, all children in the study ate fewer dairy servings than recommended by the Food Guide Pyramid.

Dr. Sibylle Kranz, assistant professor of nutritional sciences who led the study, says, “There is clinical evidence that children with low fiber intakes are at risk of chronic constipation. However, there are also other reasons to encourage fiber consumption in children. For example, fiber has been shown to lower cardiovascular risk in adults. Children who eat high-fiber foods are more likely to grow up into adults who consume adequate fiber.”

The study detailed in the Journal of the American Dietetic Association in a paper, Dietary Fiber Intake by American Preschoolers is Associated with More Nutrient-Dense Diets. (view abstract) The authors are Kranz; Diane C. Mitchell, Penn State Diet Assessment Center coordinator; Anna Maria Siega-Riz, associate professor of maternal and child health, University of North Carolina, Chapel Hill; and Dr. Helen Smiciklas-Wright, Penn State professor of nutritional sciences.

In the study, dietary consumption estimates were based on 2-day averages of 5,437 children whose parents provided information in the 1994-1996 and 1998 Continuing Survey of Food Intake by Individuals conducted by the U.S. Department of Agriculture. The researchers conducted separate analyses on the 2 and 3 year olds and the 4 and 5 year olds and compared them.

The younger children had, on average, a higher fiber intake than the older children. The two and three year olds, whose fiber intake placed them in the top quarter of the sample, met the new National Academy of Sciences Dietary Reference Intake level. These guidelines propose that Americans of all ages consume 14 g total fiber per every 1,000 calories based on evidence for reduced cardiovascular disease risk at that level.

The main fiber sources consumed by the children were, in order: low-fiber fruits, such as applesauce; legumes; and high-fiber cereal. Other low-fiber, low-nutrient foods that contributed very small amounts of fiber to the children’s diets included pizza and other high-fat, grain-based mixed dishes and high-fat salty snacks such as chips. High-fiber vegetables and fruit, which should be a major source of fiber, were consumed in too small quantities to contribute to the total average fiber intake.

“If parents feed their preschoolers fiber-rich foods, they are most likely providing important nutrients for the children as well,” Kranz says. “An easy substitution to get more fiber into their diets is to change to whole-grain products and high-fiber cereals. Also, children usually like sweet potato, baked beans, grapes and oranges and they’re all high-fiber, high-nutrient foods.”

The study was supported by a seed grant from the Penn State College of Health and Human Development.

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Article adapted by MD Only Weblog from original press release.
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Source: Andrea Elyse Messer
Penn State