bone health

Fish oil. One of these is not like the others…

Posted by Liz on Jan 23, 2012 in aging, bone health, diabetes, women's health | 2 comments

[Photo credit: Australian Government Department of Sustainability, Environment, Water, Population and Communities. Australian Antarctic Division. ™2004.

Fish oils. Love em or hate em, they're here to stay. And researchers will continue to research the hell out of these substances -- namely omega 3 fatty acids -- until they solve the question of 'do they or don't they?' Meanwhile, true confession: as much as I've attempted to take fish oil supplements or flaxseed oil per health practitioner recommendations, I've always failed horribly. It's the burp factor. They make me burp and I taste fish all day long. Can't stand it. Or Stomach it. Or something.

And then I was contacted by the folks over at Everest Nutrition Corporation about its krill oil supplement. And I've been reborn.

Let me give you a brief overview of omega-3s and then the lowdown on krill. And why I've been converted.

Early last year I wrote a post on research that examined if some of the most commonly used ingredients in supplements may or may boost certain components of mental energy. Here's an excerpt (although if you'd like to read the post in its entirety, you can find it here):

Omega-3 fatty acids I love fish oils. Researchers continue to study them because their utility is so broad, although the source of omega-3, dosage and ratio of EPA and DHA appear to be important factors in terms of mood (i.e. depression in particular) and mental energy. Overuse of fish oils can also impair the ability of blood to clot and depress overall immune functioning. Still, out of the dietary components that researchers studied, omega-3′s were by far the one most backed by clear data. Most recently, they’ve also been shown to help prevent stroke. In so far as mental energy goes, the researchers note that evidence suggests that fish oils may help delay or reduce cognitive decline in the elderly or improve verbal fluency. Less clear is whether this benefit is stronger if the they are taken earlier in life before cognitive decline. And of course, there is litte agreement on whether or not fish oils supplements convey the same benefits as obtaining the through dietary sources. And, if you choose to obtain your omega-3s through supplementation or pure oil, there is the issue of  overfishing of the world's oceans and how fish oil preparations may contribute to the problem.

So what about fish oil supplements derived from krill?

Krill are small, shrimp-like crustracean that feed on microscopic organisms in the ocean called phytoplankton. Compared to other sources of omega-3s, krill is in less danger of being overfished, one reason why it is so attractive. However, the omega 3s in krill oil attach themselves to fats the form cell membranes (phospholipids), rather than triglycerides, which theoretically makes krill derived omega-3 fatty acids more effective reducing fats in the heart and liver. Another benefit of krill oil is that it contains an antixidant called astaxanthin, which helps protect the body from damage by UV rays, and can help reduce LDL-cholesterol levels while raising HDL-cholesterol levels. Moreover, astaxanthin crosses the blood brain barrier, meaning that it might be of use in protecting eyes, the brain and the central nervous system from circulating free radicals.

However, buyer beware! Not all krill oils are created equal and you want to be certain that what you're buying meets the highest standards in terms of:

• Meeting content claims about levels of ecosapentaenoic acid (EPA), doxosahexaenoic acid (DHA) and phospholipids
• Meeting claims about how much astaxanthin is delivered per capsule
• If the formulation meets standards for purity, safety and cleanliness per International Krill Oil Standards (IKOS)
• If the product is stable
• If the product meets the standards for contents of heavy metals and mercury

You also need to know that krill oil should not be taken by people with shellfish allergies. Additionally, some people report having gastrointestinal issues, e.g. diarrhea, loose stools when taking krill oil; this is due to the fatty acid that is present in the oil, and may be alleviated by taking a lower dose. Like other forms of fish oil, krill oil may also thin the blood and impair its ability to clot, and in some cases, may interact with thyroid medication. Pregnant women should speak to their doctors before trying krill oil.

Like many other forms of omega-3 fatty acids, krill oil can be expensive. A 30-day supply of Everest Nutrition's Krill Oil costs roughly $30 a month, which comes out to $1 a day or $.50 a capsule.

So, what do I think? I'm a believer. I have had physicians and other healthcare practitioners recommend that I take fish oil for as long as I can remember. And I haven't because of the burp factor. I'm grateful to have discovered krill oil. And I highly recommend Everest Nutrition's formulation, primarily because the manufacturer adheres to the highest of standards.

[Disclaimer: I was not paid to write this review of Everest Nutrition Krill Oil. However, company representatives did provide me with product to try.]

Can yerba mate protect your bones?

Posted by Liz on Dec 19, 2011 in bone health | 2 comments

Have you heard of yerba mate? Made from dried, ground leaves and twigs of a tree indigenous to South America (Ilex paraguariensis), yerba mate is a caffeinated beverage that is steeped in hot water and drunk through a metal straw inserted into a dried gourd. This method of consuming yerba mate is known as mate cebado.  Like coffee, tea and colas, yerba mate contains a stimulant (xanthine), and on average, contains about 330 mg of caffeine for every (1.5 quarts) consumed.

Why the interest? Well, coffee and consumption of caffeine have been linked to lower bone mineral density, accelerated bone loss and increased fracture risk, all major red flags for women as they age who become increasingly at higher risk for osteoporosis. Conversely, beverages like green and black tea, both of which have considerable caffeine content, are reportedly protective of bone. So, what about yerba mate and your bones?

In study upcoming in the January 2012 issues of Bone, researchers looked at the effect of yerba mate in postmenopausal women who drank at least a liter per day (prepared as mate cebado) for five years.  These women were sedentary, did not smoke or also drink more than three cups of coffee or tea daily, were not on HRT or bisphosphonate therapy and used alcohol moderately. Yet, when they were compared to women of similar age and menopausal status who did not drink yerba mate, they were found to have higher bone mineral density levels at both the spine and hip. And, when researchers delved deeper, they found that only one other factor —  body mass index — similarly and positively affected these BMD measures.

However, yerba mate contains high levels of xanthine, the same stimulant implicated in coffee’s detrimental effect on bone, implying that it wouldn’t be bone protective, right? A possible explanation for these positive bone effects is that yerba mate contains organic compounds, such as in particular, polpyphenols (antioxidant chemicals), flavonoids and alkaloids that may confer these positive benefits.

Before you start changing your caffeine habits, there are a few things that you need to know. Yerba mate has been linked to esophogeal and oral cancer and cancer of the larynx (although this may be associated with the temperature of the drink as well as the compound itself). Because it contains such a high level of stimulant, it may not be safe for people with high blood pressure  who are especially sensitive to caffeine or who are taking blood pressure medications. Finally, there is some indication that in high doses, yerba mate can negatively affect the liver.

Me? I’m going to stick with my coffee habit and counteract any negative bone impact through weight bearing exercise. Still, it’s good to know that yerba mate may be an alternative worth looking into.

Newsflash…Before you ‘D’ know the facts. New recommendations from EMAS.

Posted by Liz on Dec 16, 2011 in bone health, diet | 0 comments

Vitamin D. Lately it’s been touted as the cure-all for all that ails. From bone health and diabetes, to cancer and infections, vitamin D is the go-to supplement. But, do you really need it? And how much should you be taking on a daily basis?

Vitamin D levels are reportedly low in women undergoing menopause and because it is necessary to maintain bone health, there is no question that it’s in great demand by our bodies. This is especially true of fair skinned individuals, women, and people who live at higher altitudes. In fact, research shows that a number of factors can influence how the body synthesizes or produces Vitamin D, including altitude, time of year (e.g. winter) time of day, amount of exposed skin at any given time, skin pigmentation, extensive use of sun protection (i.e. sunscreen, protective clothing, shade) and air pollution). However, the more news that comes out about vitamin D, the more confusion abounds as to its true benefits and how much you should be taking.

Some of that much needed detail is provided in a recent statement issued by the European Menopause and Andropause Society. Rather that put you to sleep with all the details, here a few highlights that sets current knowledge about vitamin D on the correct path:

• Although there have been a ton of studies on vitamin D, linking it to outcomes and risks and benefits in a variety of conditions, evidence for its benefit is strongest in terms of bone/skeletal health.
• Osteoporosis is very common in postmenopausal women leading to increased fracture risk. It appears that adequate levels of vitamin D may help preserve bone structure and contribute to the function of muscles. In studies, women with the lowest vitamin D blood levels were shown to have the highest fracture risk.
• Healthy postmenopausal women can insure that their body’s levels of vitamin D are optimized by exposing skin to the sun, 15 minutes at a time at least three to four times a week during Spring, Summer and Fall. This does not include artificial UV exposure from tanning booths.
• Experts recommend that women supplement sun exposure with no more than 800 to 1,000 IU of vitamin D supplements a day.
• If you are someone at risk for low vitamin D levels, you should see your doctor or health care practitioner for screening to achieve optimal vitamin D levels.
• Women who are obese, have conditions that prevent proper absorption of nutrients (for example, HIV or chronic diarrhea) or have liver or kidney issues need to have tailored vitamin D recommendations.

And the news about over supplementation and toxicity? First of all, you can never get vitamin D toxicity through sunlight (although as we know, too much sun can lead to other problems, like skin cancer). And, toxicity issues have been linked to dosages above 50,000 IU over several months time. Last, women with cancer are likely to convert vitamin D in the body faster, so need lower levels. Again, this calls for monitoring by a health practitioner.

Overall, before you ‘D.’ know the facts. These recommendations are a great start.

Plums…delicious, sweet. And, good for bone health?

Posted by Liz on Aug 19, 2011 in bone health | 0 comments

[Image: all rights reserved 2012.  Used with permission by Tartella. Visit them online at http://www.tartella.com/ and if you love this print as much as I do, you can purchase it in their Etsy store.]

Yowza! I am excited about study findings published in the British Journal of Nutrition linking dried plums (better known as the lowly prune) to improved bone mineral density in menopausal women. If these findings ring true and can be duplicated in larger groups of women, they may have a tremendous impact on the steps we take to preserve our bones as we age — most notably, the ability to avoid bisphosphonates – which have been linked to collapse of jaw bones and even an increase in the fractures they are supposed to protect. Moreover, although calcium supplementation is broadly recommended, there is an indication that it may increase heart disease risk in some women.

However, as one of the investigators note in BJN, study findings consistently show that greater intakes of fruits and vegetables have positive effects on bone resorption (the breakdown of bone), adding prunes among fruits and onions among vegetables, to be the most effective functional foods in terms of their actions on modulating the process by which bones break down and build up again.

In animal studies, prunes were shown to prevent bone loss as well as restore bone mineral density in conditions created to mimic bone loss associated with osteoporosis. In addition to these studies, researchers had also a conducted a short, three-month study in menopausal women in whom bone mass was improved simply by eating around 10 prunes (100 g) daily.

In this latest iteration, the same researchers compared two groups of menopausal women assigned to eat around 100 gm of prunes (~10) or 75 gm dried apples (the equivalent of the prunes in terms of energy, carbohydrates, fats and fiber) daily for a year. All of the women had been in menopause for anywhere from one to 10 years, were not on hormone therapy and were also asked to take 500 mg calcium plus 400 IU vitamin D with their daily dried fruit.

The findings? By the end of one year, women eating prunes had significantly lower levels of several markers for bone turnover compared to their peers who ate dried apple. Conversely, the prune eaters had significantly higher levels of bone mineral density in their ulnas (one of two long bones in the forearm) and spine compared to the other group. The researchers say that this is partly due to the fact that prunes suppress the rate at which bone cells break down bone, which exceeds the rate at which they build it up as we age.

Women in particular lose up to 50% of their spongy, or trabecular bone (the network that makes up most of bone structure) and up to 30% of their cortical bone (the outer shell) within the first 10 years of the onset of menopause. Of the investigators, Professor and chair of Florida State University’s Department of Nutrition,  Bahram Arjmandi, suggests that women (and men) interested in maintaining or even improving bone health start eating two to three prunes a day and gradually build to six to 10. Arjmandi says to “do something meaningful and practical beforehand, ” and “don’t wait until you get a fracture or are diagnosed with osteoporosis” and need medication.

Sure, prunes get a bad rap. But aren’t ‘bad’ bones even worse? Truly, prunes can be ‘as delicious and sweet’ as plums. The writing on the wall suggests that you don’t wait until it’s too late.

Whole body vibration training: what’s the lowdown on bone health?

Posted by Liz on Aug 15, 2011 in bone health | 2 comments

Back in 2009, I wrote a post about the positive effect that whole body vibration training might have on body composition. Now, researchers are suggesting that it may actually affect bone health in a beneficial way.  Who would have thunk it?

If you don’t know what I’m referring to, whole body vibration training utilizes a vibration platform  for a number of theoretical benefits ranging from weight loss and rehabilitation for muscles to improved balance However, it is also promoted a low-impact alternative to drugs and other therapies to counteract bone loss associated with aging. The concept itself is a bit strange; a person stands, feet shoulder length apart , knees locked and hands to their sides on a vibrating platform producing between.3g’s and 1.1g’s (28Hz-60Hz) of vibration for up to 30 minutes a day (the maximum recommended vibration exposure without adverse effects). That’s it. No cardio, no weight training, no nothing. Just a whole lotta vibration.

So, does it or doesn’t it?

According to a study in the Journal of Osteoporosis, just 20 minutes of intermittent vibration (one minute on, one minuter rest) at low frequency, low magnitude strength (i.e. 12 Hz) resulted in significant and clinically meaningful declines in a primary marker for bone resorption (when bone cells break down bone). In this study, 46 postmenopausal women received vibration once or three times weekly over eight weeks compared to sham vibration (minimal, continuous vibration) once weekly. Of note, a third had already been diagnosed with osteoporosis, osteoporotic fractures or osteopenia, and 41%, with osteoarthritis. In other words, two thirds of these women already had issues with bone health.

The findings?

For the first time, whole body vibration training was shown to benefit bone health. In fact, the primary marker for bone resorption was reduced by 34.6% in women who had vibration therapy three times a week compared to women who had the sham vibration, which researchers say is clinically meaningful. The key was training at least three times week with high frequency, low magnitude vibration whereas training only one day a week only had minimal benefit.

Importantly, this decline is also significant when compared to a 25% reduction in markers of bone resorption in women with osteoporosis/oteopenia who take medication and regularly walk.

Information is still needed on factors like the duration of vibration training, if more or less would suffice and if benefits can actually be maintained over time. It’s also unclear if gender, nutritional or hormone status or use of medications affects the value of vibration training. Still, the results are pretty encouraging.

Positive vibrations? Yeah, you bet!

Wednesday Bubble: Soy takes another hit

Posted by Liz on Aug 10, 2011 in bone health, herbal medicine, hot flash | 4 comments

We’re live!

Welcome to the new home of Flashfree! Our URL has changed but the same content that you’ve grown to know and ‘love’ is the same.

Let’s kick off http://flashfree.me with the latest and ‘greatest’ report on soy: it does not help menopausal symptoms or prevent bone loss.

Isn’t this contrary to what’s been reported previously, at least with regards to women with the ability to produce  S-equol?

In this latest nail to the soy coffin, research appearing in the Archives of Internal Medicine suggests that part of the issue in proving or disproving the utility of soy for menopause is the lack of trials of long duration, consistent use of low doses of soy isoflavones, small number of participants and too much breadth and depth of age and menopausal status. However, the SPARE trial (Soy Phytoestrogens as Replacement Estrogen), aimed to change this paradigm by examining the effect of daily 200 mg soy isoflavones in tablet form in 248 women between the age of 45 and 60. All participants had been in menopause for one to five years or for six to 12 months. These women were studied for two years, were instructed to take the active pill or placebo tablet before breakfast, and stop taking any hormones for at least six months before the study started. Calcium was supplemented in women who were taking less than 500 to 1000 mg daily. Importantly, women taking the isoflavone tablets were actually receiving a dose equal to approximately twice that normally obtained through food in Asian diets.

At the study’s end, the researchers found that women taking soy or placebo were on equal footing and that soy did not appear to prevent bone loss or reduce bone turnover. Moreover, soy did not appear to have any significant effect on hot flashes, night sweats, libido or vaginal dryness. They also say that even though women who are able to produce S-equol in their guts were likely to benefit from soy compared to women who are not, they did not see any specific benefit when these women were studied separately. Although not considered a dangerous side effect, constipation was experienced by more than a third of women taking soy.

So, what are we to think? Some studies say soy is effective, particularly among S-equol producers while others, like this well designed trial, show that it is now. However, there has been some data suggesting that the ratio of specific isoflavones may play an important role, and there is no information in the published study about this ratio other than to say that the soy supplement used is similar to those obtained in health food stores.

When it comes to soy, the verdict isn’t quite out yet, although the studies that have been conducted to date can’t seem to tease out what’s what. As always, use caution and lower your expectations. There are other non-hormonal approaches that may provide greater benefit when it comes to bone loss and menopausal hot flashes and other symptoms.

Want to read more on soy isoflavones? Check out the Flashfree archives.