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Americans like simple solutions to complicated problems. This is especially true in medicine.
Two fundamental "truths" of health advice are 1) calcium builds strong bones and 2) saturated fat clogs coronary arteries. Both may turn out to be wrong.
The calcium story has been building for decades. Because everyone knows that bones contain calcium, it seemed logical to assume that taking more of this mineral would make bones stronger. As a result, millions of women have been told to swallow a couple of calcium pills daily to ward off osteoporosis.
Had people bothered to look carefully at the research, however, their enthusiasm might have dimmed. More than 140 studies have been published on the role of dairy, milk and calcium supplements in reducing fractures. Two thirds of them show no benefit from calcium consumption.
Adding vitamin D to calcium has produced mixed results. Only about half these trials have shown some benefit.
Epidemiological studies from around the world also suggest that calcium might not be the key to preventing osteoporosis. People in places where milk and dairy products are very popular (Scandinavia, U.S., U.K., New Zealand and Germany) have markedly higher rates of hip fractures than places like Africa, China, New Guinea, Iran and Brazil where milk and dairy consumption is low.
A recent review in the British journal BMJ (August 7, 2010) has challenged the general assumption that calcium supplements are safe. The investigators analyzed 11 well-controlled studies involving more than 12,000 subjects. They found that people assigned to take calcium were nearly 30 percent more likely to have a heart attack than those taking placebo pills. Although the absolute increase is not great, so many people take calcium tablets that the overall number of excess heart attacks could be quite high.
Contradicting conventional wisdom creates confusion and conflict. This appears especially evident when it comes to dietary advice.
Another recent study casts doubt on the superiority of the "prudent diet" for preventing heart disease (Annals of Internal Medicine, Aug 3, 2010). For decades, Americans have been urged to eat less fat, especially saturated fat, in an effort to control weight and reduce the risk of heart disease. But a new study compared the effects of an Atkin's-style low-carb diet to a low-calorie, low-fat diet in 300 volunteers for two years.
Both groups lost about the same amount of weight, about 15 pounds at the end of the study. The real surprise was that the low-carb (higher fat) diet produced greater improvement in key cardiovascular risk factors, particularly good HDL cholesterol and blood pressure.
To better understand these complicated health issues readers of this column may wish to consult our Guides to Osteoporosis and Heart Health for more detail about other strategies.
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If the Atkins high carb, high fat diet is more healthy than a low fat, low calorie diet, why did Atkins and people who follow his diet look so puffy, old and out of shape, with fat, red faces. Atkins keeled over at a relatively early age. I don't see how chomping on bacon, steak, fried potatoes, cakes and pies can be anything but deadly. People who are vegetarians, and may even eat wild fish, are slim, muscular and very athletic. The are very healthy. Atkins looked like a puffy couch potato and unhealthy which he was.
It is annoying to read so many ridiculous conflicting statements about what is healthy. We are going to have to find out for ourselves. For me, it is don't eat red meat or shell fish, nothing fried, and eat mostly fresh fruit and veggies, whole grains, some nuts and seeds as much organic as possible.
I don't believe cheese burger, chili cheese dogs, pizza, bacon and eggs with gravy are the way to good health. Just look at the people who eat that way and then look at vegetarians and which one do you want to look like? Do you want to dig your grave with your teeth? A doctor I know developed diabetes in his early 60s. He immediately became a vegetarian. He told me "If it doesn't grow in the ground, I don't eat it now."
In about four and one half months he lost 40 pounds, now he is slim and looks about 20 years younger than he did. His diet change saved his life. Look around at fat people and slim healthy people, see what they eat, and decide for yourself which one you want to be.
PEOPLE'S PHARMACY RESPONSE: THE LAST WORD IS CERTAINLY NOT IN ON THE BEST DIET, AND IT IS LIKELY THAT THERE IS INDIVIDUAL VARIABILITY. ONE CORRECTION, THOUGH: DR. ATKINS DID NOT "KEEL OVER" AT AN EARLY AGE. HE SLIPPED ON THE ICE AND HIT HIS HEAD. COMPLICATIONS OF THAT INJURY CAUSED HIS DEATH.
The calcium study failed to report that there was NO additional heart risk where the subjects used a supplement of 500 mg per day.
It would have been more helpful had the authors noted that at least two studies found that dietary baseline calcium consumption was 650 mg or below (presuming baseline means dietary sources), and adding 500-650 mg by a calcium supplement was not problematic.
I personally think the claim for requiring milk for strong bones came from the milk producers. Many people and groups can't digest milk to include Asians, Africans and people with lactose intolerance and Celiac disease and they haven't turned into jelly fish. I personally think it is something in our western diets that is taking the calcium out of our bones.
Well I must say this is a very provocative editorial. I do have osteoporosis & take calcium & eat dairy trying to improve it - why pray tell would all the doctors recommend that if there really isn't any proven benefit ?
I also take red yeast rice for high cholesterol & eat a Mediterranean type diet in hopes of helping with that. SO again I must ask why is all the conventional wisdom prescribing & recommending these solutions if there isn't solid evidence to support them ?
As you say - this creates great confusion! Whats a person to do?
PEOPLE'S PHARMACY RESPONSE: SCIENCE KEEPS ACCUMULATING EVIDENCE, BUT IT DOESN'T ALWAYS CONFIRM WHAT WE THOUGHT WE KNEW. AS FOR WHAT TO DO, KEEP LOOKING FOR THE EVIDENCE AND ADJUST ACCORDINGLY WHEN YOU FEEL IT IS WARRANTED.
I would have appreciated a few words as to what DOES work, as opposed to only negative findings.
I have diabetes and urinary microalbumin. I'm not sure my kidneys would tolerate a high protein diet plus I'm afraid I'd lose weight.
I ditto the above comments. I want to know what DOES work. If I am not to take calcium twice a day, then I want to know what I can do on a daily basis to support my bones and prevent or lessen my chances of developing osteoporosis. Please write about this! Thank You.
The question that one should be asking is what are the carbs that you are eating and what is happening to your heart disease - not what your lab results show. If you are eating vegetables and whole grains (high carb diet) then it is unlikely that they would cause problems. In Esselstyns (Cleveland Clinic surgeon and researcher) book Prevent and Reverse Heart Disease he shows before and after pictures of coronary arteries clearing plaques (angiogram studies) after people have been on a low fat and high carb diet eating vegan (about 70% carbohydrates). Over 25 years of research confirm his work with none of his patients who follow his vegan diet getting more cardiovascular disease and those who had their angiograms repeated over time showing clearing of some coronary artery plaques.
Dean Ornish has produced the same results with a similar vegan diet over a long period of time as well. He thinks that exercise and meditation are also very important to improving one's heart disease. Losing weight alone is not a singular goal that we should be striving to achieve. Reversing and preventing progression of heart disease seems a better goal.
I take Calcium 600 mgs bid. It seems to help my bones. I also have osteoporosis and I am afraid not to take it.
How much vitamin D3 should I take a day? And which brand is best?
There seems to be more questions than answers and, as always, it is best to do your own research. Health solutions have never been "one size fits all". Just be smart about it.