Posts made in June, 2010

Flashfree food for thought: lignans and breast cancer risk

Posted by on Jun 7, 2010 in breast cancer | 1 comment

I’ve written previ0usly about the potential benefits of flaxseed in boosting bone health and alleviating hot flashes.  Now, researchers are suggesting that flaxseed and other foods that contain high levels of lignans –  a type of phytoestrogen with both weak estrogen and antioxidant activities – may also help lower the risk of breast cancer in postmenopausal women.

In a large analysis of 21 studies examining possible links between lignan intake and breast cancer risk, the researchers found that including large amounts of lignan in the diet reduced the risk of developing breast cancer by as much as 14% in postmenopausal women. What’s more, risk was reduced by as much as 16% in studies that specifically examined levels of compounds called “enterolignans,” which are created with dietary lignan enters the stomach and interacts with bacteria residing in the intestines. The researchers say that lignan may offer moderate protection against breast cancer because it blocks estrogen activity that promotes tumour growth, perhaps mostly when natural estrogen is low (i.e. during menopause). However, the study did not provide details as to what constitutes “large” amounts of the compounds.

Flaxseed is one of the richest dietary sources of lignan, although it is also found in other foods including sesame seeds, sunflower seeds, whole grain breads, muesli, kale, broccoli, white cabbage and brussel sprouts, apricots and strawberries. You can find a full list of the lignan content in foods here.

Should you start eating more lignan? The good news is that the foods that are richest sources of the phytoestrogen are also quite healthy.  And, wth the potentially added benefits of preventing osteoporosis and lessening hot flashes, it seems that boosting lignan intake is a win-win all around!

Want to read more? Reuters Health has an excellent write up with additional information on the study.

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When it comes to calcium, think moderation

Posted by on Jun 4, 2010 in bone health | 3 comments

There’s a new condition emerging among postmenopausal women: calcium alkali syndrome (milk-alkali syndrome).

Milk calcium what?!

A wonderful commentary slated to appear online this month in the Journal of  the American Society of Nephrology highlights the dangers of consuming too much calcium . In it, the author  tells the tale of Chicago bartender Bertram Welton Sippy, who in 1915, introduced his bar patrons with ulcers to the Sippy diet, hourly intake of milk, cream eggs and farina cereal interspersed with Sippy powders on the half hour (i.e. dissolvable antacid like minerals that included calcinated magnesia, sodium bicarbonate and bismuth subcarbonate). A recipe for disaster? You bet, because the overkill of calcium and minerals led to symptoms that include headache, nausea, vomiting, mental clouding, a distaste for milk and eventually, kidney failure. Yikes!

While men were the primary victims of the condition in the last century, it appears that a new group of victims started to emerge in the 90s – postmenopausal women who have increased their intake of calcium and vitamin D to combat osteoporosis. And although calcium, not milk, is the primary driver, the condition is the third most common cause of hospital admission for significantly elevated blood calcium levels.

It appears that the necessity to preserve our bones has created a modern version of the Sippy diet.

The best strategy for reducing the risk of calcium-alkali syndrome is to moderate your intake of calcium supplements. In fact, the authors say that although an average of more than 4 g/day of supplemental calcium is most commonly linked to illness, small numbers of women have developed it on as little as 1 to 1.5 g calcium a day. Of note, while younger adults are able to store excess calcium in bone, aging seems to reduce this natural defense and instead, calcium tends to leave the bone (thereby leaving us more susceptible to fragile bones and osteoporosis) and in turn, a potential build up in the bloodstream. Still, the authors emphasize that calcium supplements in moderation are a necessary and beneficial option for women at risk for osteoporosis. The trick is to limit supplemental calcium intake to no more than 1.2  to 1.5 grams daily because our bones need protection. Read the label. And speak to your healthcare practitioner. When it comes to protecting our bones through supplementation, moderation appears to be the key.

p.s. Stay away from the Sippy diet. It’s a sippier slope (sorry, couldn’t resist!).

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Wednesday Bubble: bisphosphonates…enough to make your jaw drop

Posted by on Jun 2, 2010 in bone health, oral health | 0 comments


Are you being treated for osteoporosis? Has your doctor told you about a rare but extremely serious side effect of drugs known as bisphosphonates that causes the jaw bone to collapse?

Osteonecrosis is a disease that occurs when the blood supply to bone is cut off. This results can result in pain, limited range of motion and an eventual collapse of the bone in the affected area. According to the American Dental Association, reports of jaw osteonecrosis among very small numbers of patients taking Fosamax for osteoporosis started to emerge in 2003.  At higher risk were cancer patients who were receiving intravenous bisphosphonate therapy as part of their treatment. In the majority of patients, osteonecrosis developed after dental surgery.

As I’ve written previously, osteoporosis and low bone mineral density are well-known issues for menopausal women. Studies have shown that after age 35, women (and men) start to lose their bone density at a rate of 0.3% to 0.5% a year.  However, as estrogen levels decline through menopause, the rate of bone density loss accelerates. In fact, during the first five years after menopause, women can experience as much as a 30% loss of bone density. What’s more, experts estimate that by the time a woman reaches the age of 50, she has a 40% risk of suffering a fracture due to osteoporosis for the rest of her lifetime.

Bisphosphonates are frequently prescribed as an alternative to estrogen therapy for preserving bone mass during menopause. Although less than 1% of jaw osteonecrosis have been reported in patients taking oral bisphosphonates, recent research suggests that the majority don’t know about possible side effects. In fact, in this particular study of 71 women and 2 men, 82% said they couldn’t recall or were unsure if their physicians had told them about jaw osteonecrosis.

What you need to know

Taking care of your mouth is essential at any age but particularly during menopause. During the transition, women are especially at risk for altered taste and burning mouth syndrome. Additionally, we are learning that the drugs that we take to prevent loss may actually cause bone death in some women.

The American Dental Association recommends that patients inform their dentist and hygienist that they are taking bisphosphonates to prevent osteoporosis so that extra precaution can be taken before any routine or major dental procedures. if you start to experience the following signs and symptoms while taking bisphosphonates, call your doctor and dentist immediately:

  • pain, swelling
  • gum or jaw infection
  • gums that don’t heal
  • loose teeth
  • jaw heaviness or numbness
  • impaired range of motion
  • exposed bone

Undoubtedly, the benefits of bisphosphonate therapy definitely outweigh the risks. Still, it is unclear whether or not bisphosphonates will ultimately prove to be as risky as HRT, as there have also been reports of  hip fractures in a very small amount of women taking these drugs for five years or more.

Unfortunately, there are few medicinal alternatives available in the United States, although a new drug Prolia, was approved for treatment of osteoporosis just yesterday. I don’t know much about Prolia, other than it is an agent that has been widely used in treating cancer patients. However, there are some early indications that Prolia might also cause jaw osteonecrosis. Only time will tell.

Meanwhile, I can’t emphasize enough that physical activity and ample calcium and vitamin D intake are essential. The risk of doing nothing now? Enough to make your draw drop…literally.

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