‘Healthier’ Fast Food Options for Kids May Not Be


Promises of healthier kids’ meals have drawn increasing numbers of families back to fast food restaurants, but most kids are still being served unhealthy options, a new survey finds.

Nine out of 10 parents had purchased lunch or dinner for their child in the past week at one of the big four fast food chains in 2016, up from 8 of 10 parents in 2010, the results showed.

This increase was driven in part by fast food claims that they’ve replaced sugary sodas and greasy french fries with healthier options in kids’ meals, said lead researcher Jennifer Harris, director of marketing initiatives for the University of Connecticut’s Rudd Center for Food Policy and Obesity.

But children are still dining on kids’ meals full of fat, sodium and calories, with no sign that the healthier options are making much of a difference, Harris added.

“It’s a marketing tactic on the part of these restaurants to make parents think their products are healthy,” Harris said. “If they can make parents think it’s actually a healthy choice to take their child there, then it’s good for their business. That’s what we found, even though what kids are getting really hasn’t changed.”

Since 2013, the four largest fast food restaurant chains — McDonald’s, Burger King, Wendy’s and Subway — have introduced policies to offer healthier drinks and sides with their kids’ meals, Harris said.

To see whether these policies have made a difference, the Rudd Center conducted an online survey with approximately 800 parents regarding lunch or dinner purchases at one of the big four chains.

Published Sept. 27, the Rudd survey found that 74 percent of kids still receive unhealthy drinks or side items with their kids’ meals when they eat fast food:

  • Only 6 out of 10 parents who purchased a kids’ meal received a healthier drink such as low-fat milk or fruit juice, indicating no change between 2010 and 2016.
  • Two-thirds of parents chose a healthier drink for a preschool-age child (2-5), on average, but only half chose a healthier drink for an older child (6-11).
  • Half of parents received a healthier side with a kids’ meal in 2016, such as yogurt or apple slices. However, 6 out of 10 received an unhealthy side like french fries or chips, since some restaurants now offer two sides with kids’ meals.
The healthy-option policies have made a difference in one critical way, however.

Nearly all of the parents said they plan to purchase fast food for their child more often because of restaurants’ healthier kids’ meal policies, researchers found.

“When you ask parents about that, they think it’s great that kids’ meals are healthier now,” Harris said. “But there really hasn’t been any change.”

About one-third of parents didn’t even bother with a kids’ meal for their children. They purchased regular menu items, which include adult-sized portions and tend to be less nutritious than kids’ meal items.

The Rudd Center argues that policymakers should follow the lead of communities in California, Colorado, Kentucky and Maryland, where laws or regulations have been adopted to require that all restaurants automatically provide healthy drinks and sides with kids’ meals.

Restaurants can help by promoting healthier choices and discontinuing the practice of offering unhealthy sides alongside healthier sides, the Rudd Center added.

But parents also need to step up, said registered dietitian nutritionist Malina Linkas Malkani, a spokeswoman for the Academy of Nutrition and Dietetics.

“Until there is more widely enacted legislation that requires the restaurants to automatically offer these healthy choices, the responsibility falls pretty squarely on parents and caregivers to make the healthier choices and to teach their children how to make those choices for themselves,” Malkani said.

Parents should teach kids to avoid foods heavy in added sugars, sodium and saturated fat, Malkani said. They also should promote foods rich in protein, calcium, vitamin D, iron, healthy fats and vitamin C.

Malkani said it was “disheartening to hear the high percentage of children who received the less healthy beverages and sides, but I did think it was good news that there are healthier beverages and sides available.

“I have to give so much credit to the chains that are offering the healthier choices automatically. I hope this is a trend that takes off,” she said.

Calcium And Vitamin D May Not Protect Against Bone Fractures After All


One of the most contentious questions in nutrition science over the past decade has been whether older adults should be taking supplemental vitamin D and calcium.

As the world’s population ages and broken bones and fractures become even more of a public health concern, with huge social and economic consequences, researchers have been trying to make sense of conflicting studies on the association between supplements and fracture risk.

 

A study published in the Journal of the American Medical Association on Tuesday took a fresh look at this issue by analysing 33 randomised clinical trials involving a total of more than 50,000 adults over the age of 50.

Each of these previous research papers involved comparing calcium, vitamin D, or both, with a placebo or no treatment.

The analysis, conducted by Jia-Guo Zhao of Tianjin Hospital in China, was focussed on older adults who live in the general community and did not include those in nursing homes, hospitals, and other facilities.

The conclusion was clear: vitamin D and calcium supplements do not seem to be warranted to prevent bone breaks or hip fractures in those adults. Such supplements had no clear benefit regardless of dose, the gender of the patient, history of fractures, or the amount of calcium in the diet.

The US Preventive Services Task Force, an influential federal advisory body, has raised questions about these supplements since 2013, when it issued recommendations saying evidence to support the benefit of the supplements in older adults without osteoporosis or vitamin D deficiency was “insufficient”.

Marion Nestle, a professor emerita of food sciences and nutrition at New York University, wrote in an opinion piece at that time that the UPSTF’s statement should caution clinicians “to think carefully before advising calcium and vitamin D supplementation for healthy individuals”.

She said this week bone health involves many different aspects of eating and activity.

“Bone preservation throughout life requires eating healthfully, engaging in weight-bearing activity, avoiding excessive alcohol, and not smoking – good advice for everyone,” Nestle said.

Vitamin D is not a vitamin but a hormone that is produced in reaction to sunlight and seems to have many different roles in the body related to bones, cancer, heart disease, diabetes, immune function, and reproductive health.

Daniel Fabricant, president of the Natural Products Association, which represents manufacturers and retailers of dietary supplements, said the study draws its conclusions with “too broad of a brush”.

He said it focusses on the healthiest segment of the population by looking at people who are able to live at home.

“There is a lot missing,” Fabricant said. “People with prior breaks or family incidence of osteoporosis may still need vitamin D.”

Calcium and vitamin D have been known to be important to bone maintenance for a long time, and the best way to get the daily recommended doses are the natural way.

For calcium, that means eating dairy products like milk, cheese, yogurt or calcium-rich leafy greens. For vitamin D, that means getting some sun exposure. Only a few foods contain vitamin D, and they include fatty fish like salmon.

The issue is many Americans don’t get enough calcium or vitamin D – which is why the debate over supplements has become so important.

In 2010, the Institute of Medicine (IOM) released recommendations tripling the daily intake of vitamin D for most people to 600 IU per day and raising the calcium intake to 1,000 milligrams.

While that report has few explicit mentions of supplements, the use of supplements seems assumed, and it includes a lot of discussion about the importance of setting and following upper limits for intake of vitamin D and calcium.

“As North Americans take more supplements and eat more of foods that have been fortified with vitamin D and calcium, it becomes more likely that people consume high amounts of these nutrients,” the group wrote, warning of the possibility of kidney and tissue damage from overconsumption.

Fabricant also said the new study contained limited information on the dosages involved. “Maybe the average dose was on the lower end of dose response curve,” he said.

“While it’s a nice exercise of mathematics, it doesn’t get at the actual issue, which is what are optimal levels for people who need the supplements?”

The new study did not look at the benefits or risks of vitamin D supplements on other conditions, but previous studies have suggested they can lower risks for diabetes and certain cancers.

However, an April 2017 study in JAMA Cardiology found high monthly doses of vitamin D supplements did not seem to do much to help with cardiovascular disease.

One other limitation of the study is some of the trials included in the analysis did not test baseline vitamin D blood concentration for all participants.

Calcium and vitamin D supplements may not protect against bone fractures


(iStockphoto)

One of the most contentious questions in nutrition science over the past decade has been whether older adults should be taking supplemental vitamin D and calcium. As the world’s population ages and broken bones and fractures become even more of a public health concern, with huge social and economic consequences, researchers have been trying to make sense of conflicting studies on the association between supplements and fracture risk.

A study published in the Journal of the American Medical Association on Tuesday took a fresh look at this issue by analyzing 33 randomized clinical trials involving a total of more than 50,000 adults over the age of 50. Each of these previous research papers involved comparing calcium, vitamin D or both with a placebo or no treatment. The analysis, conducted by Jia-Guo Zhao of Tianjin Hospital in China, was focused on older adults who live in the general community and did not include those in nursing homes, hospitals and other facilities.

The conclusion was clear: vitamin D and calcium supplements do not seem to be warranted to prevent bone breaks or hip fractures in those adults. Such supplements had no clear benefit regardless of dose, the gender of the patient, history of fractures or the amount of calcium in the diet.

The U.S. Preventive Services Task Force, an influential federal advisory body, has raised questions about these supplements since 2013, when it issued recommendations saying evidence to support the benefit of the supplements in older adults without osteoporosis or vitamin D deficiency was “insufficient.”

Marion Nestle, a professor emerita of food sciences and nutrition at New York University, wrote in an opinion piece at that time that the UPSTF’s statement should caution clinicians “to think carefully before advising calcium and vitamin D supplementation for healthy individuals.”

She said this week bone health involves many different aspects of eating and activity. “Bone preservation throughout life requires eating healthfully, engaging in weight-bearing activity, avoiding excessive alcohol, and not smoking — good advice for everyone,” Nestle said.

Vitamin D is not a vitamin but a hormone that is produced in reaction to sunlight and seems to have many different roles in the body related to bones, cancer, heart disease, diabetes, immune function and reproductive health.

Daniel Fabricant, president of the Natural Products Association, which represents manufacturers and retailers of dietary supplements, said the study draws its conclusions with “too broad of a brush.” He said it focuses on the healthiest segment of the population by looking at people who are able to live at home.

“There is a lot missing,” Fabricant said. “People with prior breaks or family incidence of osteoporosis may still need vitamin D.”

Calcium and vitamin D have been known to be important to bone maintenance for a long time, and the best way to get the daily recommended doses are the natural way. For calcium, that means eating dairy products like milk, cheese, yogurt or calcium-rich leafy greens. For vitamin D, that means getting some sun exposure. Only a few foods contain vitamin D, and they include fatty fish like salmon.

The issue is many Americans don’t get enough calcium or vitamin D — which is why the debate over supplements has become so important. In 2010, the Institute of Medicine (IOM) released recommendations tripling the daily intake of vitamin D for most people to 600 IU per day and raising the calcium intake to 1,000 milligrams. While that report has few explicit mentions of supplements, the use of supplements seems assumed, and it includes a lot of discussion about the importance of setting and following upper limits for intake of vitamin D and calcium.

“As North Americans take more supplements and eat more of foods that have been fortified with vitamin D and calcium, it becomes more likely that people consume high amounts of these nutrients,” the group wrote, warning of the possibility of kidney and tissue damage from overconsumption.

Fabricant also said the new study contained limited information on the dosages involved. “Maybe the average dose was on the lower end of dose response curve,” he said. “While it’s a nice exercise of mathematics, it doesn’t get at the actual issue which is what are optimal levels for people who need the supplements.”

The new study did not look at the benefits or risks of vitamin D supplements on other conditions, but previous studies have suggested they can lower risks for diabetes and certain cancers. However, an April 2017 study in JAMA Cardiology found high monthly doses of vitamin D supplements did not seem to do much to help with cardiovascular disease.

One other limitation of the study is some of the trials included in the analysis did not test baseline vitamin D blood concentration for all participants.

How to Tell If an Egg Has Gone Bad


Useful information from Bon Appétit tells you how to distinguish good eggs from bad. The method is simple: All you have to do is drop them in water. If they sink, they’re fresh; if they’re submerged with the wide end up they’re old but still useful. But if they float, they’re bad.

With that out of the way, all we have to do is talk about how good eggs are for your health and as a palate-pleasing entrée on your plate. The myth that eggs are bad for you has pretty much been proven for what it is: a myth. The truth is you can easily eat a dozen eggs a week with no adverse health events, as studies now show that eating that many eggs has no effect on cholesterol levels or triglyceride levels compared to eating less than two eggs per week — even for people with heart disease or type 2 diabetes.

One of the great things about eggs is that they’re abundant in antioxidants and vitamins such as choline, lutein, zeaxanthin, copper, calcium and folate — all things that many people are deficient in. When eating eggs, be sure to consume the yolks, which are full of these substances and more, including omega-3 fats. Egg yolks provide other valuable vitamins (A, D, E and K), too, most of which are not found in egg whites.

When choosing eggs, either get them from someone local who raises their own free-ranging, pastured chickens or always look for organic brands at the store, with labels that say the chickens were raised in free-range pastures.

Source:mercola.com

What You Need to Know About Vitamin K2, D and Calcium


Vitamin K is a fat-soluble vitamin most well known for the important role it plays in blood clotting. However, many do not realize that there are different kinds of vitamin K, and they are completely different.

Watch the video discussion. URL:https://youtu.be/ET_2w9OOdtY

Story at-a-glance

  • Vitamin K2 is an important fat-soluble vitamin that plays critical roles in protecting your heart and brain, and building strong bones. It also plays an important role in cancer protection
  • The biological role of vitamin K2 is to help move calcium into the proper areas in your body, such as your bones and teeth. It also helps remove calcium from areas where it shouldn’t be, such as in your arteries and soft tissues
  • The optimal amounts of vitamin K2 are still under investigation, but it seems likely that 180 to 200 micrograms of vitamin K2 might be enough to activate your body’s K2-dependent proteins to shuttle calcium to the proper areas
  • If you take oral vitamin D, you also need to take vitamin K2. Vitamin K2 deficiency is actually what produces the symptoms of vitamin D toxicity, which includes inappropriate calcification that can lead to hardening of your arteries
  • If you take a calcium supplement, it’s important to maintain the proper balance between calcium, vitamin K2, vitamin D, and magnesium. Lack of balance between these nutrients is why calcium supplements have become associated with increased risk of heart attack and stroke

The health benefits of vitamin K2 go far beyond blood clotting, which is done by vitamin K1, and vitamin K2 also works synergistically with a number of other nutrients, including calcium and vitamin D.

Dr. Kate Rheaume-Bleue, a naturopathic physician with a keen interest in nutrition, has authored what I believe is one of the most comprehensive books on this important topic, titled: Vitamin K2 and the Calcium Paradox: How a Little Known Vitamin Could Save Your Life

“I tuned in to the emerging research about K2 early in 2007,” she says. “Not long before, I had read Nutrition and Physical Degeneration by Weston A. Price. When I learned about vitamin K2, I thought:

“Hey, you know what? I’m sure Price talked all about this in his book.” I went to the book, looked through it, and didn’t find any reference to vitamin K2. I was really stumped.

A little bit later in 2007, I read a brilliant article by Chris Masterjohn that links vitamin K2 to Price’s work on Activator X.

Once I realized that link, the light bulb went on about how important this nutrient is, and how overlooked it’s been for so long. It really provides the missing piece to the puzzle of so many health conditions, and yet it was being completely overlooked, despite the overwhelming amounts of modern-day research.”

What’s So Special About Vitamin K2?

Vitamin K is actually a group of fat-soluble vitamins. Of the two main ones, K1 and K2, the one receiving the most attention is K1, which is found in green leafy vegetables and is very easy to get through your diet. This lack of distinction has created a lot of confusion, and it’s one of the reasons why vitamin K2 has been overlooked for so long.

The three types of vitamin K are:

  1. Vitamin K1, or phylloquinone, is found naturally in plants, especially green vegetables; K1 goes directly to your liver and helps you maintain healthy blood clotting
  2. Vitamin K2, also called menaquinone, is made by the bacteria that line your gastrointestinal tract; K2 goes straight to your blood vessel walls, bones, and tissues other than your liver
  3. Vitamin K3, or menadione, is a synthetic form I do not recommend; it’s important to note that toxicity has occurred in infants injected with this synthetic vitamin K3

It also plays a role in removing calcium from areas where it shouldn’t be, such as in your arteries and soft tissues.

“K2 is really critical for keeping your bones strong and your arteries clear,” Rheaume-Bleue says.

Now, vitamin K2 can be broken into two additional categories, called:

  1. MK-4 (menaquinone-4), a short-chain form of vitamin K2 found in butter, egg yolks, and animal-based foods
  2. MK-7 (menaquinone-7), longer-chain forms found in fermented foods. There’s a variety of these long-chain forms but the most common one is MK-7. This is the one you’ll want to look for in supplements, because in a supplement form, the MK-4 products are actually synthetic. They are not derived from natural food products containing MK-4.

    The MK-7 – these long-chain, natural bacterial-derived vitamin K2 – is from a fermentation process, which offers a number of health advantages:

    1. It stays in your body longer, and
    2. It has a longer half-life, which means you can just take it once a day in very convenient dosing

How Much Vitamin K2 Do You Need?

The optimal amounts of vitamin K2 are still under investigation, but it seems likely that 180 to 200 micrograms of vitamin K2 should be enough to activate your body’s K2-dependent proteins to shuttle the calcium where it needs to be, and remove it from the places where it shouldn’t.

“The most recent clinical trials used around those amounts of K2,” Rheaume-Bleue says. “The average person is getting a lot less than that. That’s for sure. In the North American diet, you can see as little as maybe 10 percent of that or less. Certainly, not near enough to be able to optimize bone density and improve heart health.”

She estimates that about 80 percent of Americans do not get enough vitamin K2 in their diet to activate their K2 proteins, which is similar to the deficiency rate of vitamin D. Vitamin K2 deficiency leaves you vulnerable for a number of chronic diseases, including:

Osteoporosis Heart disease Heart attack and stroke
Inappropriate calcification, from heel spurs to kidney stones Brain disease Cancer

“I talked about vitamin K2 moving calcium around the body. Its other main role is to activate proteins that control cell growth. That means K2 has a very important role to play in cancer protection,” Rheaume-Bleue says.

“When we’re lacking K2, we’re at much greater risk for osteoporosis, heart disease, and cancer. And these are three concerns that used to be relatively rare. Over the last 100 years, as we’ve changed the way we produced our food and the way we eat, they have become very common.”

Researchers are also looking into other health benefits. For example, one recent study published in the journal Modern Rheumatology1 found that vitamin K2 has the potential to improve disease activity besides osteoporosis in those with rheumatoid arthritis (RA). Another, published in the journal Science2, found that vitamin K2 serves as a mitochondrial electron carrier, thereby helping maintain normal ATP production in mitochondrial dysfunction, such as that found in Parkinson’s Disease.

According to the authors:

“We identified Drosophila UBIAD1/Heix as a modifier of pink1, a gene mutated in Parkinson’s disease that affects mitochondrial function. We found that vitamin K(2) was necessary and sufficient to transfer electrons in Drosophila mitochondria. Heix mutants showed severe mitochondrial defects that were rescued by vitamin K(2), and, similar to ubiquinone, vitamin K(2) transferred electrons in Drosophila mitochondria, resulting in more efficient adenosine triphosphate (ATP) production. Thus, mitochondrial dysfunction was rescued by vitamin K(2) that serves as a mitochondrial electron carrier, helping to maintain normal ATP production.”

The Interplay Between Vitamin K2, Vitamin D, and Calcium

As I’ve discussed on numerous occasions, vitamin D is a critical nutrient for optimal health and is best obtained from sun exposure or a safe tanning bed. However, many are taking oral vitamin D, which may become problematic unless you’re also getting sufficient amounts of vitamin K2. Dr. Rheaume-Bleue explains:

“When you take vitamin D, your body creates more of these vitamin K2-dependent proteins, the proteins that will move the calcium around. They have a lot of potential health benefits. But until the K2 comes in to activate those proteins, those benefits aren’t realized. So, really, if you’re taking vitamin D, you’re creating an increased demand for K2. And vitamin D and K2 work together to strengthen your bones and improve your heart health.

… For so long, we’ve been told to take calcium for osteoporosis… and vitamin D, which we know is helpful. But then, more studies are coming out showing that increased calcium intake is causing more heart attacks and strokes. That created a lot of confusion around whether calcium is safe or not. But that’s the wrong question to be asking, because we’ll never properly understand the health benefits of calcium or vitamin D, unless we take into consideration K2. That’s what keeps the calcium in its right place.”

IMPORTANT: If You Take Vitamin D, You Need K2

This is a really crucial point: If you opt for oral vitamin D, you need to also consume in your food or take supplemental vitamin K2.

“There are so many people on the vitamin-D-mega-dose bandwagon, taking more and more of vitamin D. And it could absolutely be causing harm if you are lacking the K2 to complete the job to get the calcium where it’s supposed to be,” Rheaume-Bleue warns.

“We don’t see symptoms of vitamin D toxicity very often. But when we do, those symptoms are inappropriate calcification. That’s the symptom of vitamin D toxicity. And it is actually a lack of vitamin K2 that can cause that…”

While the ideal or optimal ratios between vitamin D and vitamin K2 have yet to be elucidated, Rheume-Bleue suggests about 150-200 micrograms of K2 will meet the need for the “average” healthy person.

“My earlier recommendation was not taking into account people who were doing high dose of vitamin D supplementation,” Rheaume-Bleue says. “That’s where it gets a little bit more technical. It seems that for the average person, around 200 to 280 micrograms will activate your K2 proteins and do a lot of good for your bones and your heart. If you’re taking high levels of vitamin D… then I would recommend taking more K2.”

The good news is that vitamin K2 has no toxicity. No toxic effects have ever been demonstrated in the medical literature.

“The reason why K2 doesn’t have potential toxic effect is that all vitamin K2 does is activate K2 proteins. It will activate all the K2 proteins it finds. And if they’re all activated and you take extra K2, it simply won’t do that. That’s why we don’t see a potential for toxicity the way we do with vitamin A or D,” she says.

If You Need Calcium, Aim for Calcium-Rich Foods First

For those who are calcium deficient, Rheaume-Bleue recommends looking to food sources high in calcium, before opting for a supplement. This is because many high calcium foods also contain naturally high amounts of, you guessed it, vitamin K2! Nature cleverly gives us these two nutrients in combination, so they work optimally. Good sources of calcium include dairy, especially cheeses, and vegetables, although veggies aren’t high in K2.

Additionally, magnesium is far more important than calcium if you are going to consider supplementing. Magnesium will also help keep calcium in the cell to do its job far better. In many ways it serves as nutritional version of the highly effective class of drugs called calcium channel blockers. If you do chose to supplement with calcium, for whatever reason, it’s important to maintain the proper balance between your intake of calcium and other nutrients such as:

  • Vitamin K2
  • Vitamin D
  • Magnesium

The Importance of Magnesium

As mentioned previously, magnesium is another important player to allow for proper function of calcium. As with vitamin D and K2, magnesium deficiency is also common, and when you are lacking in magnesium and take calcium, you may exacerbate the situation. Vitamin K2 and magnesium complement each other, as magnesium helps lower blood pressure, which is an important component of heart disease.

Dietary sources of magnesium include sea vegetables, such as kelp, dulse, and nori. Few people eat these on a regular basis however, if at all. Vegetables can also be a good source, along with whole grains. However, grains MUST be prepared properly to remove phytates and anti-nutrients that can otherwise block your absorption of magnesium. As for supplements, Rheaume-Bleue recommends using magnesium citrate. Another emerging one is magnesium threonate, which appears promising primarily due to its superior ability to penetrate the mitochondrial membrane.

How Can You Tell if You’re Lacking in Vitamin K2?

There’s no way to test for vitamin K2 deficiency. But by assessing your diet and lifestyle, you can get an idea of whether or not you may be lacking in this critical nutrient. If you have any of the following health conditions, you’re likely deficient in vitamin K2 as they are all connected to K2:

  • Do you have osteoporosis?
  • Do you have heart disease?
  • Do you have diabetes?

If you do not have any of those health conditions, but do NOT regularly eat high amounts of the following foods, then your likelihood of being vitamin K2 deficient is still very high:

    • Grass-fed organic animal products (i.e. eggs, butter, dairy)
    • Certain fermented foods such as natto, or vegetables fermented using a starter culture of vitamin K2-producing bacteria. Please note that most fermented vegetables are not really high in vitamin K2 and come in at about 50 mcg per serving. However, if specific starter cultures are used they can have ten times as much, or 500 mcg per serving.
    • Goose liver pâté
    • Certain cheeses such as Brie and Gouda (these two are particularly high in K2, containing about 75 mcg per ounce)

“An important thing to mention when it comes to cheese (because this becomes an area of confusion), [is that] because cheese is a bacterial derived form of vitamin K2, it actually doesn’t matter if the cheese came from grass-fed milk. That would be nice, but it’s not the milk that went into the cheese that makes the K2. It’s the bacteria making the cheese, which means it doesn’t matter if you’re importing your brie from France or getting it domestically. Brie cheese, the bacteria that makes brie cheese, will make vitamin K2,” she says.

Fermented vegetables, which are one of my new passions, primarily for supplying beneficial bacteria back into our gut, can be a great source of vitamin K if you ferment your own using the proper starter culture. We recently had samples of high-quality fermented organic vegetables made with our specific starter culture tested, and were shocked to discover that not only does a typical serving of about two to three ounces contain about 10 trillion beneficial bacteria, but it also contained 500 mcg of vitamin K2.

Note that not every strain of bacteria makes K2. For example, most yoghurts have almost no vitamin K2. Certain types of cheeses are very high in K2, and others are not. It really depends on the specific bacteria. You can’t assume that any fermented food will be high in K2, but some fermented foods are very high in K2, such as natto. Others, such as miso and tempeh, are not high n K2.

Pregnant? Make Sure You’re Getting Enough Vitamin K2

Last but not least, while vitamin K2 is critical for the prevention of a number of chronic diseases listed above, it’s also vital for women who are trying to conceive, who are pregnant, and for growing healthy children. “K2 plays a very important role throughout pregnancy (for the development of teeth for both primary and adult teeth, the development of proper facial form, healthy facial form, as well as strong bones), then again throughout childhood to prevent cavities, and through adolescence as the skeleton is growing,” Rheaume-Bleue says.

Vitamin K2 is needed throughout pregnancy, and later while breastfeeding. It may be particularly important during the third trimester, as most women’s levels tend to drop at that time, indicating there’s an additional drain on the system toward the end of the pregnancy. Since vitamin K2 has no toxicity issues, it may be prudent to double or even triple — which is what Rheaume-Bleue did during her own recent pregnancy — your intake while pregnant.

Greater intake of calcium doesn’t necessarily reduce osteoporosis risk .


Osteoporosis, health, lifestyle health, calcium, Osteoporosis calcium, vitamin D, indian express lifestyle, indian express health

Calcium sources vary widely in their bio-availability and several factors that affect absorption of calcium include vitamin D, vitamin A, vitamin K, protein, sodium, dietary acidosis, and dysbiosis.

While calcium is a critical nutrient for the body, particularly known to reduce the risk of osteoporosis, high intake of the mineral doesn’t necessarily lower a person’s risk for osteoporosis. In  fact, excessive calcium may make your bones weaker.

Large Harvard studies of male health professionals and female nurses reported that individuals who drank one glass of milk (or less) per week were at no greater risk of breaking a hip or forearm than those who drank two or more glasses per week. When researchers combined the data from the Harvard studies with other large prospective studies, they still found no association between calcium intake and fracture risk. Moreover, there was some suggestion that calcium supplements taken without vitamin D might even increase the risk of hip fractures.

In traditional Asian countries where both dairy consumption and overall calcium levels in the diet are the lowest, bone fracture rates were also the lowest. The incidence of hip fracture in mainland  China and  Japan  were among the lowest in the world in 80s and 90s, but has risen markedly with urbanisation. Conversely, in countries like the  United States  where calcium consumption is among the highest in the world, so are the fracture rates among the highest. Clearly, its not only calcium in the diet, other nutrients and lifestyle factors are involved.

Osteoporosis is a complex multi-factorial disease including several factors like inadequate exercise, chronic inflammation, multiple mineral and vitamin deficiencies, nutritional imbalances and not simply lack of calcium in the diet.

Calcium sources vary widely in their bio-availability and several factors that affect absorption of calcium include vitamin D, vitamin A, vitamin K, protein, sodium, dietary acidosis, and dysbiosis.

Dietary acidosis reduces calcium absorption. It is caused by excessive consumption of acid forming foods including animal protein, dairy and meat. Additionally, consumption of highly acidic substances like coffee, carbonated drinks, alcohol, sugar, over the counter and prescribed drugs, and even the metabolic byproducts of chronic stress can all put the acid-alkaline balance beyond the tipping point. On the flip-side, the under-consumption of alkalinizing fruits and vegetables can compromise bio-availability of calcium. For this reason, perhaps vegetarians who consume plenty of fruits and vegetables may need less calcium than meat eaters and many cultures manage on much lower intakes.

Other factors like dysbiosis, an over growth of unfriendly bacteria in the gut due to certain medications or faulty diets can compromise absorption of nutrients including calcum. Many common medicines including antacids, steroids, thyroxine, diuretics interfere with calcium metabolism.

Consumption of excessive calcium through diary products, supplements and imbalanced diets may be making our bones weaker. In addition excess calcium can deposit into soft tissues, leading to osteoarthritis, muscle cramping, insomnia, constipation or kidney stones. Calcium and vitamin D supplementation must be taken under medical supervision.

For optimal utilisation of calcium, it is important to take adequate levels of nutrients including vitamin D, phosphorus, zinc, manganese, magnesium, and boron, together with exercise. Vitamin D can be obtained either through exposure to sunlight, or as a supplement.  In other words there is no substitute to eating right and exercising. Calcium rich foods and supplements alone will not prevent osteoporosis.

Ways for preventing osteoporosis

* Adequate dairy and foods rich in bio-available calcium, particularly in adolescence (>3 glasses of low fat milk/dairy/day).

* Include soy and flaxseeds in your diet.

* Balanced diet rich in antioxidants, fruits and vegetables.

* Good intestinal health.

* Adequate exposure to sunlight.

* Avoid excess sodium, caffeine, phosphorus, protein, & alcohol.

* No more than three cups of coffee a day

 

Do You Really Need a Vitamin D Supplement?


A new study says that taking vitamin D supplements for bone-strengthening and protection against osteoporosis is not necessary for healthy middle-aged adults.

But a bone health expert at Cleveland Clinic urges people at risk for vitamin D deficiency to consult their doctors before discontinuing use.

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Studies showed no significant increase in BMD

Recent concerns about the safety risks of taking calcium supplements has led some adults to take vitamin D (without calcium) for bone protection.

The University of Auckland study — a meta-analysis of past studies — found that vitamin D supplements alone had little effect on bone-mineral density (BMD). Investigators combined data from 23 past trials, studying 4082 adults, 92 percent of whom were women. Studies showed no significant increase in BMD in most areas of the body.

In light of this researchers concluded that widespread use of vitamin D for osteoporosis prevention in adults without risk factors for vitamin D deficiency was unwarranted.

Importance of vitamin D shouldn’t be minimized

Chad Deal, MD, was not involved in the study but is Director of the Center of Osteoporosis and Metabolic Bone Disease at Cleveland Clinic.

Though not disagreeing with the study’s conclusions, he worries that the findings may cause some to minimize the positive impact of vitamin D on at-risk people.

“The study is on the effect of vitamin D on BMD, which is modest and not surprising,” says Dr. Deal. “Vitamin D would not be expected to have a large effect unless the patient had severe vitamin D deficiency, in which case the bone density effect could be significant.”

“Patients with vitamin D deficiency should not get the take-home message that vitamin D will not benefit them,” he says.

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Fracture protection and other safeguards

For older, at-risk patients, vitamin D deficiency can have a major impact on fracture, says Dr. Deal. Deficiency can cause osteomalacia, softening of the bone due to impaired mineralization, which makes fractures more likely.

Bone mineral density is not a perfect surrogate for fracture, especially in older patients,” Dr. Deal says.

Vitamin D can also have “huge benefits” on muscle function, cognition and falling, he adds.

Healthy middle-aged adults should talk to their doctor about both their vitamin D and calcium levels to see if they need to be taking vitamin D supplements, either alone or with calcium.

New Data Dispute Calcium Cardiovascular Risk in Both Sexes.


Two new studies contribute further to the debate over the cardiovascular risk associated with supplementary or dietary calcium, each decidedly coming down on the side of no significant risk — to men or women.

“[Based on these findings], clinicians should continue to evaluate calcium intake, encourage adequate dietary intake, and if necessary, use supplements to reach but not exceed recommended intakes,” Douglas C. Bauer, MD, from the University of California, San Francisco, the lead author of the first study, toldMedscape Medical News.

Results of both studies were reported at the recent American Society for Bone and Mineral Research (ASBMR) 2013 Annual Meeting.

Dr. Bauer’s observational trial is one of few contemporary studies to evaluate the level of risk among men, who are often poorly represented in calcium studies, he noted. The results showed no association between calcium dietary intake or supplementation and total or cardiovascular mortality. The second study was an updated meta-analysis of calcium supplementation among women and similarly demonstrated no increased risk for ischemic heart disease (with adjudicated outcomes) or total mortality in elderly women. It did draw some criticism for potential bias and contamination, however.

Nevertheless, says Robert Marcus, MD, a retired Stanford University bone specialist, the 2 studies are “powerful. The one involving men had very elegant, accurate reports of death and validated diagnosis of myocardial infarction, and the [study involving women] was also excellent work,” he commented.

“This field has been the subject of an enormous amount of controversy, ambiguity, and confusion for the past several years, and I think the most important thing is to help us come up with what is true,” he said. The quality of data to suggest an adverse effect of calcium is “very poor,” and there is now compelling evidence that there is little to substantiate this, he noted. But despite these reassuring new findings, public anxiety over a potential risk with calcium is unlikely to go away, he believes.

In recommendations issued in 2010, the ASBMR said that most adults 19 years of age and older require about 600 to 800 IUs of vitamin D daily and 1000 to 1200 mg of calcium daily through food and with supplements, if needed.

Contemporary Data on Calcium Intake in Men

The use of calcium supplements, predominantly with vitamin D, is an important therapy for the prevention of osteoporosis and its clinical consequences. But concerns about the cardiovascular safety of calcium have emerged periodically; in 2 alarming meta-analyses published in 2010 and 2011 by Dr. Mark Bolland and colleagues, for example, there was a 27% increase in MI among individuals allocated to calcium supplements in the first study and a 24% increased risk in the second.

More recently, a 40% increase in total mortality and up to a 50% increase in cardiovascular mortality was seenamong women from a Swedish mammography cohort with a calcium intake exceeding 1400 mg per day. In that study, the effect on mortality appeared to be especially strong if a high dietary intake of calcium was combined with calcium supplements.

In their new study, Dr. Bauer and his colleagues set out to assess rates of dietary calcium intake, use of supplements, and mortality in a prospective cohort of 5967 men over the age of 65 years in the Osteoporotic Fractures in Men (MrOS) study.

The participants completed extensive surveys at baseline on their dietary calcium intake, and supplementation was verified by a review of pill bottles by trained staff.

Mean dietary calcium intake was 1142 ± 590 mg/day, with more than half — 65% — of participants reporting use of calcium supplements.

Over the 10-year follow-up, among 2022 men who died, 687 deaths were caused by cardiovascular disease. The highest mortality for CVD was seen in the quartile with the lowest intake from calcium supplementation.

And in models that adjusted for age, energy intake, and calcium use, men in the lowest quartile of total calcium intake (less than 621 mg per day) had higher total mortality compared with those in the highest quartile (more than 1565 mg of calcium per day).

Adjustment for additional confounding factors showed no association between calcium dietary intake and total or cardiovascular mortality (P for trend .51 and .79, respectfully). Likewise, there was no association between calcium supplementation and total or cardiovascular mortality.

The authors also conducted an additional analysis of calcium intake and adjudicated cardiovascular disease events in a subcohort of the study, MrOS Sleep, involving 3120 patients who took part in a 7-year follow-up, and again there was no higher risk for cardiovascular events associated with calcium intake.

The study did have is limitations, Dr. Bauer acknowledged, including the observational design, calcium intake being assessed with a food frequency questionnaire, and cause of death not being formally adjudicated. Nevertheless, the findings are important in demonstrating the level of risk among men in a contemporary setting, he pointed out.

“Contrary to the Swedish study of women, we found no evidence that calcium supplementation is harmful to men, even among those with the highest dietary calcium intake,” he concluded, recommending that future studies should include adjudicated outcomes.

Study in Men as Expected, but Female Research Questioned

In the second study reported at the ASBMR meeting, Joshua Lewis, MD, PhD, from the University of Western Australia, Perth, and colleagues reported a meta-analysis of 19 randomized controlled trials involving women over the age of 50 years who had received calcium supplementation for more than a year.

Importantly, the analysis included reports of adjudicated cardiovascular outcomes, which the researchers note is important because gastrointestinal events can be misreported as cardiac ones. They also assessed all-cause mortality.

Among 59,844 participants in the studies, there were 4646 deaths, and the relative risk for death among those randomized to calcium supplements was 0.96 (P = .18).

The relative risk for 3334 ischemic heart disease events among 46,843 participants was 1.02 (P = .053), and the risk for 1097 MI events among 49,048 participants was 1.09 (P =.21).

“The data from this meta-analysis does not support the concept that calcium supplementation with or without vitamin D increases the risk of ischemic heart disease or total mortality in elderly women,” concluded Dr. Lewis.

But bone specialist Ian Reid, MD, from the University of Auckland, New Zealand, who was a coauthor on some of the Bolland studies, said this analysis essentially repeats previous ones, but with the inclusion of 20,000 patients from the Women’s Health Initiative (WHI), many of whom continued to take their own calcium tablets, regardless of whether they were randomized to calcium or placebo.

These “contaminated” WHI data have the potential to mask the effect of calcium, he told Medscape Medical News. In addition, in a study from Denmark also included in the meta-analysis, subjects were not properly blinded to treatment assignment and the calcium and control groups were not comparable at baseline for cardiovascular risk, which introduced “major potential bias,” he added.

Regarding the results from the study in men by Dr. Bauer and colleagues, Dr. Reid said they were not surprising to him. “Generally, people who take calcium supplements have more health-conscious behaviors than those who do not and so have a lower baseline risk of heart disease” that can “obscure small adverse effects of drugs such as calcium,” he observed.

An effect has to be “very substantial” before it can be picked up in an observational study, because of the many confounders that can obscure such an effect, he concluded.

Source: Medscape.com

Calcium, vitamin D failed to halt BMD loss in breast cancer.


Calcium plus vitamin D supplements are often suggested for patients at risk for osteoporosis and in women undergoing breast cancer treatment, but a recent analysis published in Critical Reviews in Oncology/Hematologyhighlights the insignificant data behind this methodology.

“We evaluated clinical trial evidence for calcium and vitamin D supplementation in maintaining skeletal health of women with breast cancer,” Gary G. Schwartz, PhD, a cancer epidemiologist at Wake Forest Baptist Medical Center in Winston-Salem, N.C., said in a press release. “At the doses recommended, the data show that these supplements are inadequate to prevent loss of [bone mineral density].”

Of 16 trials, researchers found that none of them evaluated calcium plus vitamin D supplements vs. no supplements in preventing BMD loss in women with breast cancer. Additionally, researchers reported inadequacies in the prevention of BMD loss when doses of 500 mg to 1,500 mg calcium and 200 IU to 1,000 IU vitamin D per day were administered among pre- and postmenopausal women with breast cancer.

However, exercise or pharmacologic interventions could prevent BMD loss in this patient population when such supplementation is not effective, researchers wrote. The researchers added that controversial literature exists regarding the risk for cardiovascular disease with the use ofcalcium supplements.

“The take-home message is that this very common practice of supplementation doesn’t really seem to be working,” Schwartz said. “Future trials are needed to evaluate the safety and efficacy of calcium and vitamin D supplementation in women undergoing breast cancer therapy.”

Source: Endocrine Today.

 

Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis.


 

Phosphate binders (calcium-based and calcium-free) are recommended to lower serum phosphate and prevent hyperphosphataemia in patients with chronic kidney disease, but their effects on mortality and cardiovascular outcomes are unknown. We aimed to update our meta-analysis on the effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease.
METHODS: We did a systematic review of articles published in any language after Aug 1, 2008, up until Oct 22, 2012, by searching Medline, Embase, International Pharmaceutical Abstracts, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature. We included all randomised and non-randomised trials that compared outcomes between patients with chronic kidney disease taking calcium-based phosphate binders with those taking non-calcium-based binders. Eligible studies, determined by consensus with predefined criteria, were reviewed, and data were extracted onto a standard form. We combined data from randomised trials to assess the primary outcome of all-cause mortality using the DerSimonian and Laird random effects model.
FINDINGS: Our search identified 847 reports, of which eight new studies (five randomised trials) met our inclusion criteria and were added to the ten (nine randomised trials) included in our previous meta-analysis. Analysis of the 11 randomised trials (4622 patients) that reported an outcome of mortality showed that patients assigned to non-calcium-based binders had a 22% reduction in all-cause mortality compared with those assigned to calcium-based phosphate binders (risk ratio 0.78, 95% CI 0.61-0.98).
INTERPRETATION: Non-calcium-based phosphate binders are associated with a decreased risk of all-cause mortality compared with calcium-based phosphate binders in patients with chronic kidney disease. Further studies are needed to identify causes of mortality and to assess whether mortality differs by type of non-calcium-based phosphate binder.

 

Comments from Clinical Raters

Nephrology

Novel and potentially practice-changing. We currently use calcium-based phosphate binders to control lab abnormalities, usually switching to sevalamer when hypercalcaemia becomes an issue. This review shows that the mortality in RCTs is higher in people treated with calcium binders rather than sevalamer. Whether sevalamer is protective or calcium binders harmful is not addressed by this work, and there are no data to answer this important question. The cost of sevalamer compared with calcium is another important issue. We also do not know whether the harms associated with calcium could be mitigated by a different strategy with the calcium concentration in the dialysate. Finally, this meta-analysis has substantial heterogeneity, only 70 events separating the groups, and borderline statistical significance. Is this good enough evidence on which to change practice?

Nephrology

Although previous meta-analyses suggested similar results favouring non-calcium-containing phosphate binders on patient survival, this update appears to confirm it. It, therefore, has a stronger message about the need for changing clinical practice about first-choice phosphate binders. I do not necessarily agree with the phrasing in the conclusion about harm of calcium-containing phosphate binders per se, since many patients do not always like or tolerate the first-choice binder and could end up requiring a calcium-containing binder that nevertheless is probably better than not taking any binding at all. A good quality meta-analysis.

Source: Lancet