Coral Calcium Mindful Weight Loss Social Eating Homocysteine and Heart Disease Micronutrient Deficiency What Is Complementary and Alternative Medicine Omega-3 And Diabetes Anaphylactic reaction to goat's milk Urinary Tract Health - CranberryThis article is printed with permission from the author.
J Nutr. 2003 Nov;133(11 Suppl 2):3927S-3931S.
Micronutrient deficiencies and cognitive functioning.Black MM.
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA. mblack@umaryland.edu
The relationship between four micronutrient deficiencies (iodine, iron, zinc and vitamin B-12) and children's cognitive functioning is reviewed. Iodine deficiency during pregnancy has negative and irreversible effects on the developing fetus. Although there is some evidence that postnatal iodine deficiency is associated with cognitive deficits, the findings are controversial. Iron deficiency is widespread and has been associated to cognitive deficits, but the results of prevention trials are inconsistent. Zinc deficiency has been linked with low activity and depressed motor development among the most vulnerable children. Associations with cognitive development are less clear and may be limited to specific neuropsychological processes. Vitamin B-12 deficiency has been associated with cognitive problems among
Omega-3 Fatty Acids:Focus on Diabetes
Kathy J. Shattler, M.S, RD
kshattler@charter.net
Omega-3 Fatty Acids (FA) is a class of polyunsaturated fatty acids (pufa). Important nutritionally essential omega-3 FA include ALA or ?-linolenic acid, EPA or eicosapentaenoic acid and DHA or docosahexaenoic acid. For our purposes, we will refer to these fatty acids as ALA, EPA and DHA. The human body cannot make EPA or DHA, but can competitively make EPA and DHA from ALA in the normal human body. The most widely available sources of EPA or DHA include wild salmon, herring, mackerel, anchovies and sardines. Farmed salmon, being grain fed, have a higher proportion of omega-6 fatty acids than wild salmon. Other oily fish include tuna. Consumers of fish should be aware of the potential presence of PCBs, dioxins. lead, cadmium, mercury nickel and arsenic - pollutants and heavy metals that are often removed in high quality supplements.
Why is the intake of EPA and DHA so important in diabetes? People with diabetes do not generally die of high blood sugars; they die of microvascular and macrovascular complications of which one of the most serious is heart disease. A recent study in Lancet (2007) involved over 18,000 patients with unhealthy cholesterol profiles. The patients in the study group received either 1,800 mg of EPA with a statin drug or a statin drug alone. Statin drugs include the following: Lipitor, Mevacor, Zocor, Crestor, Lescol, Prevachol and Baycol. The trial went on for five years. It was found at the end of the study that those in the EPA group had superior heart function. Non-fatal coronary events were also significantly reduced.
People with diabetes are 6 times more likely to suffer a first heart attack and 3-8 times more likely to die from heart disease than those without diabetes. The American Heart Association (AHA) recommends eating fish (particularly fatty fish) at least two times per week to prevent heart related complications and to treat already existing heart problems. They also recommend that patients with documented heart disease consume about 1 g of EPA + DHA per day in capsule form. Patients who need to lower triglycerides in particular are recommended 2-4 g of EPA + DHA UNDER A PHYSICIANS CARE. Supplementation at this level may lower triglycerides by 20-40%.
Why should the physician know if you are taking fish oil capsules? Several reasons exist of which one is bleeding complications. An increase in the risk of hemorrhagic stroke or drug interactions (i.e. Coumadin, aspirin) is more likely to occur with a supplementation of > 3 g per day. Some physicians also become concerned over the potential increase in LDLs and reduced glycemic control among diabetics with the high dosage of omega-3 fatty acids. It may be noted that to treat triglycerides over 500 mg/dl a new drug containing EPA and DHA called Lovaza is available that provides 465 mg EPA and 375 mg DHA in a one gram capsule. By contrast, over the counter preparations range from 30% (165mg EPA/110mg DHA) to 50% (300mg EPA/200 mg DHA). Supplements need to be pharmaceutical grade meaning that they need to be free of pesticides and contaminants associated with fish oils. Lovaza is free from contaminants.
AHA also recommends foods high in ALA. What is wrong with this recommendation? Conversion of ALA to EPA and DHA is limited in people with diabetes, the aging process and those with common nutrient deficiencies of B3, B6, C, Zinc and Magnesium. A diet high in linoleic acid (from corn, safflower oil, primrose, pumpkin, wheat germ etc) can inhibit conversion by as much as 40%.Saturated fats and trans fats inhibits ALA conversion. The American diet is high in saturated fats and trans fats found mainly in baked goods, fried foods, margarines, lard and fast foods to name a few. Ethanol inhibits conversion. A ratio high in omega-6 pufas to omega-3's inhibits conversion. Even without these variables, conversion of ALA to EPA and DHA range from 0% to 15% with some studies showing less than .5%. The only published significance of ALA in diabetes is the reduction of platelet build-up. So, the question is asked, is it better to increase your ALA in your diet to avoid diabetic complications or focus on increasing EPA and DHA? It is clear that while much more research is needed, some of these questions can already be answered.
Many people ask what the mechanism of action is of EPA and DHA in reducing the incidence of cardiovascular, or heart, related complications in diabetes. So far, we have identified that they lower triglycerides, decrease platelet clumping, inhibit plaque formation, reduce inflammation and stimulate the relaxation of cells in the walls of blood vessels. Despite these positive affects, it should be noted that omega-3 fatty acids have no effect on lowering total cholesterol. While they may increase HDLs (good cholesterol) by 1-3%, they may also increase LDLs (bad cholesterol) by 5-10%. Therefore, for individuals with high blood levels of total cholesterol or LDLs, significant improvements will likely not be seen and a different treatment or additional treatment may need to be selected.
This article wouldn't be complete without elaborating on the omega-6 to omega-3 ratio (especially Linoleic vs. Alpha Linolenic) of fatty acids. A good ratio is important for maintaining cardiovascular health. Both types of fats compete for the same enzymes and the same metabolic pathway. The American diet typically contains ratios of 10:1-15:1 omega-6 to omega-3 ratios. The recommendations are closer to a 4:1 to 1:1 ratio. The most effective way to alter the ratio to a favorable one is to increase EPA and DHA intakes.
There are no RDAs for omega-3 fatty acids. The acceptable intake (AI) is 1.6 g for men and 1.1 for women.
Conclusions:
There is little consensus on exactly how much omega-3 to take and what form it should be in. More research is needed on the mechanisms by which the different fats could affect diabetes complications and even glycemic control. It is clear from the AHA that some agreement has been reached on the usefulness of omega-3 fats in the positive effects on heart disease associated with diabetes and recommendations for supplementation have been made. Studies need to incorporate population, drug and genetic variables to further understand how omega-3 fats affect diabetes complications.References
American Heart Association Recommendations. (2007). Fish and Omega-3 Fatty Acids, AHA recommendations. http://www.americanheart.org/presenteer.jhtml?identifier=4632. Accessed November 20, 2007.
American Diabetes Association. Diabetes and Cardiovascular (Heart) Disease. http://www.diabetes.org/diabetes-statistics/heart-disease.jsp . Accessed November 20, 2007.
Barre, DE. (2007). The role of consumption of Alpha-Linolenic, Eicosapentaenoic and Docosahexaenoic Acids in human metabolic syndrome and type 2 diabetes - a mini review. J of Oleo Science. 56;(7):319-325.
Comparing omega-3s from fish and flax seed oil. http://www.omega3sealoil.com/Chapteer4_3c.html Accessed November 20, 2007
Feldman, Donna. (2007). Omega-3 Fats and Health-an Update. A CEU4U.COM continuing education module. http://www.ceu4u.com. Reviewed November, 2007.
Harris, WS. (2006). The Omega-6/Omega-3 Ratio and Cardiovascular Risk: Uses and abuses. Curr Atherosclerosis Reports. 8:453-459.
Mayo Clinic Omega-3 Fatty Acids. http://www.mayoclinic.com/health/fish-oil//NS_patient-fishoil. Accessed 10/27/07.
Yokoyama M,et al. (2007). Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomized open-label, blinded endpoint analysis. Lancet;369:1090-98.
USDA Office of Dietary Supplements. http://ods.od.nih.gov/Health_Information/omega_3_fatty_acids.aspx Accessed 10/28/07.the elderly, but little is known about its effect on children's cognitive functioning. Rates of vitamin B-12 deficiency are likely to be high because animal products are the only source of vitamin B-12. Although micronutrient deficiencies often co-occur in the context of poverty, little is known about the impact of multiple micronutrient deficiencies on cognitive development.
Please refer to complete article for details. This is another area where complementary medicine is so important. There were many times I recommended to my WIC moms to put their children on a zinc supplement. I think it makes a difference in their growth and development. Intelligence change was something I had not considered.
Coral Calcium
"Ask and it shall be answered"
Question: What is the difference between the coral calcium I see advertised and other forms of calcium? Is coral calcium better for me to take?
Basically, it is a hype. Marketers are always trying to make a buck on consumers' lack of knowledge about a product and a lot of deception is occurring. Thank goodness you have me. This is why I say it is a hype to promote coral calcium over other forms.
First of all, coral calcium contains only 24% - 38% of the least absorbable type of calcium, calcium carbonate. The marketers often call it "calcite" or, sometimes, "aragonite" to confuse people into thinking it is something other than the primary ingredient in Tums.
There are dangers in using "natural" sources of calcium with the greatest being lead contamination. In one study, the lead content of 136 brands of calcium supplements was determined and 2/3 of those calcium supplements failed to meet the acceptable lead levels. The most likely products to contain lead were the more natural forms while the product most unlikely to contain lead were products like calcium citrate or refined and purified calcium carbonate.
The bottom line is that the most suitable supplement for most people is calcium citrate. This is essentially because calcium is absorbed better through an acidic environment. Acid production decreases with age and certain medications. Microcrystalline calcium hydroxyapatite may exert additional benefits to bone health; however, it is poorly absorbed compared to the other forms and are more expensive.
Calcium phosphate is least likely to cause constipation, but is poorly absorbed and blocks the absorption of other minerals.
Reference: http://www.doctormurray.com/articles/CoralCalcium.htm
Food is more than a source of energy. It can also play a role in our struggle for identity. Some experts even claim that weight and body size represents a cultural problem with female power. Others claim that emotional problems explain the eating habits of the majority of overeaters. These factors have nothing to do with diet or calories. They have to do with the mind, the emotions and spirit.
Many of us overeat to fill a void. We just feel empty - emotionally, psychologically,spiritually- and we fill that emptiness with food. Some of us are angry, but turn it inward by obsessing with food.
Some therapists have contended that unresolved psycological issues may promote a fear of becoming thin because is associated with vulnerability. A large body can convey a sense of safety against the world, people and society in general. This tendency is observed most frequently in overweight people who have been physically, sexually or psychologically abused.
Struggling with weight issues means struggling with who you are and how you are meeting your needs. Following a good nutritional and fitness plan is definitely in the picture, but if you don't change your mind and emotions, you will never be permanently successful in maintaining your goal body weight.
The first step in any successful weight loss program should begin with the mind and a commitment to change.
"Choice, not chance, determines our destiny"
Social Eating
Social Eating Social eating involves much more than just sharing food with friends. It opens up a world of emotions, vulnerabilities, life-scripts that we may not even be aware of. The first step in learning how to eat in public with friends or business associates is to become aware, or conscious of what you are eating, feeling, experiencing so you can learn more about those things that you need to deal with. Remember, you are not just changing what you eat, but how you eat and your entire relationship with food.
Eating and emotions have been paired together and a pervasive part of our lives since we were born. The link between eating, emotions and security is almost inseparable. When these factors are not understood, or are linked together in an unhealthy manner we tend to have an unhealthy eating relationship with food that is only played out more vividly when eating with others in social situations.
If we hunger for meaningful and fulfilling relationships, we typically fill that void with food. What we really need to do is work on our relationship skills, if that is the case. It is not uncommon to seek professional help to be able to identify and develop skills for dealing with emotional an/or relationship-related eating habits.
When approaching social eating situations, it is good to have a strategy. Understanding emotional eating is the first step, but there are also some practical things you can do to remain in control when in public:
- Don't discuss anything emotionally exhausting at mealtime. Let your body work with food and not the psyche.
- Pay careful attention to your body's signal of "fullness". Restaurant portion sizes are not necessarily geared toward hunger or what is "nutritionally appropriate".
- If you have food left over, ask for a bag. Don't fall into the trap of thinking that you need to eat every bite or you are wasting your money.
- If you find yourself the brunt of unwanted comments like "oh, are you on a diet?", or "what's the matter with you, you're eating like a bird!" or any number of other comments geared at how you are eating, act as if nothing was wrong. You don't need to announce that you are trying to change your eating habits if you don't think people are going to be supportive. You can always excuse yourself and go to the bathroom if the going gets rough and you want to get away from conversation or food cues.
- Eating out is fun and that shouldn't have to change just because you need to change your eating habits. Have fun. Laugh. Talk. Dance.
- Avoid starving yourself all day so that you don't have to worry about that one social meal.
- Don't be afraid to specify how you want something cooked in a restaurant. There is nothing wrong with asking questions such as "does that come with a sauce", or "may I have that baked with no added butter?". Be assertive, yet polite.
- Order or choose vegetables or a salad so that you have something to munch on instead of the rolls and butter. Ask for salad dressing on the side and dip your fork into it for flavor rather than pouring it on your salad.
- The longer it takes you to eat, the longer you are occupied. It also gives the brain a chance to figure out that you are full after the stomach sends the message.
Homocysteine and Heart Disease
Homocysteine is a sulfur-containing amino acid normally found in the body. During the past few years, elevated levels of this amino acid have been linked to heart disease even in those individuals who had normal cholesterol levels. Apparently, homocysteine may cause atherosclerosis by any of 3 different mechanisms:
- A direct toxic effect that causes damage to the cells lining the arteries
- Oxidation of low-density lipoprotein (LDL)
- Interference with clotting factors.
Two recent studies have strengthened the relationship between elevated homocysteine and heart disease, stroke and peripheral vascular disease. The first study was published in June 1997 and consisted of a large multi-center trial in men and women younger than age 60. The researchers found that the risk of adverse cardiovascular events such as stroke increased 2.2 times in those individuals who had a total plasma homocysteine level in the top fifth of the normal range compared to others in the group. This risk was independent of other risk factors, however, it was notably higher in smokers.
The second study was conducted in Norway and also published in June of 1997. This study found that among 587 patients with coronary heart disease, the risk of death after 4-5 years was proportional to plasma total homocysteine levels. The risk rose from 3.8% in those with the lowest homocysteine levels to 24.7% in those with the highest levels.
It has been found that plasma levels of homocysteine are strongly influenced by diet, as well as genetic factors. The dietary components with the greatest effects on homocysteine levels are folic acid, B6 and B12. Folic acid and the other B vitamins help break down homocysteine into a harmless substance. Recent evidence has shown that low blood levels of folic acid are linked with a higher risk of fatal heart disease and stroke.
Americans who follow a well-balanced diet should get enough of these B vitamins (folic acid, B6 and B12). The best sources for folic acid include:
- Citrus fruits
- Fortified cereal
- Tomatoes
- Vegetables
- Grain products
- Beans and lentils
B12 is found in meats and milk products, but not fruits, vegetables, beans, grains, nuts or seeds. B6 is found in meat, fruit, vegetables and grain products. Lowering the serum concentration of homocysteine has been shown to reduce the risk of heart disease. Screening for elevated levels of homocysteine may be advisable for individuals who already have heart disease or are at high risk for heart disease due to genetics or other lifestyle habits.